CDC Changes Recommendations for Six Childhood Vaccines

The U.S. Department of Health and Human Services (DHHS) announced updates to the national childhood vaccine schedule involving six vaccines (rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B) following a presidential memorandum directing the U.S. Centers for Disease Control and Prevention (CDC) to review and revise its recommendations. The changes clarify which vaccines are routinely recommended for all children and which should involve “shared decision-making” between families and their doctors.¹

Secretary of Health and Human Services Robert F. Kennedy, Jr. said:

President Trump directed us to examine how other developed nations protect their children and to take action if they are doing better. After an exhaustive review of the evidence, we are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent. This decision protects children, respects families, and rebuilds trust in public health.²

US Alignment With Vaccine Schedules of Other Developed Countries

DHHS conducted an assessment that compared childhood vaccination schedules across 20 developed countries to better understand how the United States approaches routine vaccination. The review found that the U.S. differs from its peers by recommending vaccines against a larger number of diseases and a higher total number of vaccine doses in the childhood years.

Despite this broader schedule, the U.S. does not record higher overall vaccination rates than many other developed nations. Several countries that recommend fewer routine childhood vaccines continue to achieve strong child health outcomes and high vaccination coverage by focusing on public trust, education, and voluntary participation rather than vaccine mandates. In 2024, the United States recommended more childhood vaccines than any other peer country and more than twice as many doses as some European nations. At the lower end of the spectrum, Denmark vaccinated children against 10 diseases, compared with 18 diseases covered in the U.S. during the same year.³

The CDC has organized the U.S. childhood vaccine schedule into three distinct categories to clarify how vaccines are recommended. By organizing the vaccine schedule into these categories, the CDC said it aims to allow flexibility and more and informed decision-making for families.

Vaccines CDC Still Recommends for All Children

The CDC continues to recommend a core group of vaccines for all children. These include vaccines for diphtheria, tetanus and acellular pertussis (whooping cough) in the combined DTaP or Tdap shots; Haemophilus influenzae type b (Hib); pneumococcal disease; polio, measles, mumps and rubella in the combined MMR shot;  varicella zoster (chickenpox); and human papillomavirus (HPV). According to CDC officials, recent studies indicate that one dose of the HPV vaccine delivers protection comparable to two doses. Based on this evidence, the agency updated its guidance to reflect practices already adopted by several peer nations.⁴

Vaccines Recommended for Certain High-Risk Groups or Populations

According to the CDC, the benefits and risks of vaccination can vary based on personal circumstances. These include higher risk of exposure to infectious disease and pre-existing adverse health conditions, including immune compromising conditions that can increase the likelihood of infection and transmission of infectious diseases to others or increase the risk of an adverse vaccine reaction in the recipient.

To respond to these different individual circumstances, CDC officials places several vaccines in a category that targets specific populations thought to be at “high risk.” These vaccines include respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B. Healthcare providers are required to use clinical judgment to determine when these vaccines are appropriate based on a child’s individual risk factors.⁵

CDC Vaccine Recommendations Based on “Shared Clinical Decision-Making”

In some cases, public health officials say they are unable to clearly define which children will benefit most from a vaccine or who face a meaningful disease exposure or vaccine reaction risk. In these situations, the CDC recommends what is being termed as “shared clinical decision-making.”

With this approach, physicians and parents work together to decide whether vaccination makes sense for a particular child, taking into account the child’s personal health history, lifestyle, and potential exposure to a particular infectious disease. Vaccines in this category include those for rotavirus, COVID, influenza, meningococcal disease, hepatitis A, and hepatitis B.⁶

Some States Reject the Updated CDC Vaccine Schedule

Several states have declined to adopt the CDC’s revised childhood vaccine schedule, raising concerns about inconsistency in public health guidance across the country. State health officials in parts of the West Coast said they do not plan to implement the updated recommendations, arguing that the changes could weaken established vaccination practices and create uncertainty for families, doctors and other medical workers administering vaccines.⁷

In California, state public health leaders and medical trade organizations like the American Academy of Pediatrics (AAP) announced they would continue following existing vaccine guidance rather than the CDC’s new updated framework. Public health and medical trade group officials said they remain concerned that the revised schedule departs from long-standing recommendations without sufficient scientific justification and could undermine confidence in childhood mandatory vaccination programs.⁸

Wisconsin also rejected the CDC’s changes, with state officials choosing to recommend vaccine guidance developed by professional medical trade organizations like the AAP. Wisconsin health officials said they did not see new scientific evidence supporting the CDC’s revisions and expressed concern that altering recommendations could confuse doctors and parents.⁹

In Rhode Island, state officials are opting to follow the vaccine schedule recommended by the AAP rather than the updated CDC guidance. Public health officials there emphasized continuity of vaccine recommendations, signaling skepticism toward the federal changes.¹⁰

In December 2025, DHHS cancelled millions of dollars in federal grants previously awarded to the AAP. Federal health officials at DHHS said the organization receives funding from pharmaceutical and vaccine manufacturers, raising concerns about potential conflicts of interest.¹¹

New York state leaders announced they would maintain their existing childhood vaccination requirements for schools and childcare settings. Officials said the CDC’s updated schedule would not change state-level vaccination rules, reinforcing resistance to adopting the revised federal schedule.¹²

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