- The childhood immunization schedule was reduced to 11 mandated vaccines.
- The CDC recommends HPV vaccine as a single dose instead of two.
- Families can still access non-mandated vaccines through health care consultations.
Acting Centers for Disease Control and Prevention director Jim O’Neill has updated the childhood immunization schedule for the U.S. The list is now 11 diseases long, rather than the earlier 17, although federal health officials say families will still be able to access the other vaccines if desired and in consultation with a health care provider.
According to a U.S. Department of Health and Human Services fact sheet released Monday, a review of the immunization schedule was undertaken at the direction of President Donald Trump. Health officials checked with 20 peer countries to see what their childhood immunization schedules look like and mandated those for which there is consensus.
Three categories of vaccines
The immunization recommendation is broken into three categories:
Vaccines mandated for all children, including diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b (Hib), pneumococcal conjugate, polio, measles, mumps, rubella, and human papillomavirus (HPV). For those, there is international consensus. The varicella (chickenpox) vaccine was also added to that list. And the HPV recommendation is now one dose, not two of the vaccine.
Those recommended for certain high risk groups include respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY and meningococcal B. The risk factors that could lead to needing the vaccines include underlying comorbidities, risk of disease transmission to others and unusual exposure to the disease.
A number of immunizations can be obtained as part of shared clinical decision-making with a health care provider. Those include vaccines against rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A and hepatitis B.
Per the notice, “All immunizations recommended by the CDC as of Dec. 31, 2025, will continue to be fully covered by Affordable Care Act insurance plans and federal insurance programs, including Medicaid, the Children’s Health Insurance Program and the Vaccines for Children program. Families will not have to purchase them out of pocket.”
The announcement notes that the U.S. has more vaccines for children covered by insurance than in any peer country.
The notice ends with the statement that the “CDC will continue to closely monitor vaccine uptake, infectious disease rates and vaccine safety.”
Response from pediatrician group
The American Academy of Pediatrics (AAP) on its website Monday said that the vaccine recommendations prior to the revamp are appropriate. In a post called “Fact Checked,” the academy cited “robust evidence to support the safety, effectiveness and necessity of U.S. vaccine recommendations and noted that ”some public figures have falsely implied" the vaccines could be linked to chronic health conditions or autism.
The previous vaccine schedule has also been criticized because it lists more routine vaccines than some other countries require, the pediatrician group said. “The truth is that while vaccine guidance is largely similar across developed countries, it may differ by country due to different disease threats, population demographics, health systems, costs, government structures, vaccine availability and programs for vaccine delivery,” per the AAP.
The group also noted that recommendations from the federal government that vaccines be tested against placebo could pose ethical problems, because “standards ensure researchers do not purposely withhold beneficial treatments or preventive therapies from trial participants. No child in a vaccine trial goes unprotected without a very clear scientific and ethical reason.”