— “It won’t work and can’t end well,” one vaccine expert said
The CDC on Monday cut the number of universally recommended childhood vaccines from 17 to 11, contrary to the advice of public health experts. The new guidance will leave several immunizations, such as flu shots, open to families to choose but without clear guidance.
Officials said the overhaul to the federal vaccine schedule won’t result in any families losing access or insurance coverage for vaccines, but medical experts slammed the move, saying it could lead to reduced uptake of important vaccinations and increase disease.
The recommendations, outlined in a fact sheet, organize the childhood immunization schedule into three distinct categories:
- Immunizations recommended for all children: This will include vaccines for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox). The agency also reduced the recommended dosage for the HPV vaccine from two doses to one.
- Immunizations recommended for certain high-risk groups or populations: This will include immunizations for respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B.
- Immunizations based on shared clinical decision-making: This will include vaccines for rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B.
“President Trump directed us to examine how other developed nations protect their children and to take action if they are doing better,” Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said in a press release. “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.”
HHS said it reviewed 20 peer nations and “found that the U.S. is a global outlier among developed nations in both the number of diseases addressed in its routine childhood vaccination schedule and the total number of recommended doses but does not have higher vaccination rates than such countries. In fact, many peer nations that recommend fewer routine vaccines achieve strong child health outcomes and maintain high vaccination rates through public trust and education rather than mandates.”
The agency noted that Denmark, whose vaccine policy has previously been suggested by the Trump administration as a good model for the U.S., is at the lower end of vaccine mandates; that country “immunizes children against 10 diseases compared to a total number of 18 diseases for which protection was provided in 2024 in the U.S.”
CDC data show that routine childhood immunization in the U.S. from 1994 to 2023 with vaccines not recommended by Denmark prevented 6 million hepatitis B cases (and 940,000 hospitalizations), 4 million hepatitis A cases (and 78,000 hospitalizations), and 30 million rotavirus cases (and over 800,000 hospitalizations).
“After reviewing the evidence, I signed a decision memorandum accepting the assessment’s recommendations,” Acting CDC Director Jim O’Neill said in the release. “The data support a more focused schedule that protects children from the most serious infectious diseases while improving clarity, adherence, and public confidence.”
Medical Groups Sound the Alarm
“Today’s announcement by federal health officials to arbitrarily stop recommending numerous routine childhood immunizations is dangerous and unnecessary,” said Andrew D. Racine, MD, the president of the American Academy of Pediatrics, in a statement. “The longstanding, evidence-based approach that has guided the U.S. immunization review and recommendation process remains the best way to keep children healthy and protect against health complications and hospitalizations.”
“For decades, leading health experts, immunologists, and pediatricians have carefully reviewed new data and evidence as part of the immunization recommendation process, helping to keep newborns, infants, and children protected from diseases they could be exposed to in the United States as they develop and grow. Today’s decision, which was based on a brief review of other countries’ practices, upends this deliberate scientific process,” said Racine.
The American College of Physicians (ACP) issued what it called a “dire warning.”
“The ACP is vehemently opposed to the administration’s attempt to throw out the U.S. vaccine schedule and unilaterally substitute guidance from other countries,: ACP President Jason Goldman, MD, said in a statement. “The evidence is clear that vaccines prevent deaths, hospitalizations, and spread of disease…. Abandoning the U.S. evidence-based process is a dangerous and potentially deadly decision for Americans. ACP demands an immediate stop to this policy change. ACP warns that furthering Secretary Kennedy’s anti-vaccine agenda is dangerous and calls for his immediate removal.”
The American Medical Association (AMA) said it was “deeply concerned” by the decision. “Changes of this magnitude require careful review, expert and public input, and clear scientific justification,” AMA Trustee Sandra Adamson Fryhofer, MD, said in a statement. “That level of rigor and transparency was not part of this decision…. The scientific evidence remains unchanged, and the AMA supports continued access to childhood immunizations recommended by national medical specialty societies. We urge federal health leaders to recommit to a transparent, evidence-based process that puts children’s health and safety first.”
‘It Won’t Work’
Vaccine experts also panned the decision.
“Abandoning recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” said Michael Osterholm, PhD, MPH, of the Vaccine Integrity Project, based at the University of Minnesota.
“Kennedy’s decision will harm and kill children, like all of his anti-vaccination decisions will,” virologist James Alwine, PhD, a member of the coordinating committee of Defend Public Health, said in a statement. “Viruses and bacteria that were under control are being set free on our most vulnerable. It may take 1 or 2 years for the tragic consequences to become clear, but this is like asking farmers in North Dakota to grow pineapples. It won’t work and can’t end well.”