Federal health officials have announced a major revision to the U.S. childhood immunization schedule, reducing the number of vaccines recommended for all children from 17 to 11 and shifting several shots into a category that emphasizes individualized decision-making between families and health care providers.
Under the updated guidance issued by the Centers for Disease Control and Prevention, vaccines for illnesses such as rotavirus, hepatitis A and B, meningococcal disease, respiratory syncytial virus (RSV), and seasonal influenza are no longer advised as routine for every child. Instead, they are recommended primarily for children at higher risk or after discussion with a clinician through what officials call “shared clinical decision-making.” Vaccines moved into this category remain available and covered by insurance, according to the Department of Health and Human Services.
The changes follow a presidential memorandum issued in early December directing federal health agencies to compare U.S. vaccine recommendations with those used in other developed countries. Administration officials said the review examined policies in 20 peer nations and concluded that the United States recommends protection against more diseases, and more total doses, than any of its counterparts, without achieving higher overall vaccination rates.
Health Secretary Robert F. Kennedy Jr. said the revised schedule is intended to bring U.S. policy closer to international practice while placing greater emphasis on transparency and parental choice. He argued that allowing families and physicians to weigh individual risk could help address declining confidence in public health institutions and improve adherence to vaccination guidance.
Acting CDC Director Jim O’Neill formally accepted the recommendations after reviewing a scientific assessment prepared by senior officials within HHS and the Food and Drug Administration. That assessment found that several countries with narrower routine schedules maintain strong child health outcomes and higher public trust through education rather than broad mandates.
The CDC will continue to classify vaccines into three groups: those recommended for all children, those advised for certain high-risk populations, and those based on shared clinical decision-making. Vaccines that remain in the universal category include those for measles, mumps, rubella, polio, tetanus, diphtheria, pertussis, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and chickenpox.
Federal officials stressed that no vaccines have been removed from coverage. All shots on the schedule will still be provided without cost-sharing under insurance plans, regardless of category. They also said the agencies plan to launch new placebo-controlled trials and long-term studies examining vaccine timing and outcomes, though details on cost and duration were not provided.
The move has drawn sharp criticism from public health experts and medical organizations. Epidemiologist Michael Osterholm warned that changing long-standing recommendations without public input or detailed data disclosure could confuse parents and place children at risk. The American Academy of Pediatrics said it would continue to recommend broader vaccination, including for hepatitis, influenza, RSV, and meningococcal disease, and urged families to consult their pediatricians.
Supporters within the administration counter that vaccination rates for some routine shots have fallen in recent years, including for measles, and that rebuilding confidence requires a different approach. They said the updated framework is designed to encourage informed conversations rather than reduce access.
Whether the revised federal guidance will influence school vaccination requirements remains unclear, as those rules are set by states. Health officials said they plan to work with state agencies and physician groups to explain the changes and provide updated educational materials.
As the new schedule takes effect, the debate reflects broader disagreements over how best to balance disease prevention, public trust, and individual choice in U.S. health policy.
Image is in the public domain and was created by James Gathany, Centers for Disease Control and Prevention.
