On January 5, in a press release and numerous other documents, Deputy Secretary of Health and Human Services Jim O’Neill, in his role as Acting Director of the Centers for Disease Control and Prevention, announced these changes in the U.S. childhood immunization practices.
They reduce the number of recommended vaccines from 18 to 10. The vaccines have been assigned to one of three categories: recommended for all children, recommended for certain high-risk groups, and only based on shared clinical decision-making.
“After reviewing the evidence, I signed a decision memorandum accepting the assessment’s recommendations,” O’Neill said in the press release. “The data support a more focused schedule that protects children from the most serious infectious diseases while improving clarity, adherence, and public confidence.”
The report, which was the basis for the recommendations, was prepared after President Donald Trump issued a memorandum in December to Secretary of Health and Human Services, Robert F. Kennedy, Jr., and the CDC director to “. . . review best practices from peer, developed countries for core childhood vaccination recommendations — vaccines recommended for all children — and the scientific evidence that informs those best practices, and, if they determine that those best practices are superior to current domestic recommendations, update the United States core childhood vaccine schedule to align with such scientific evidence and best practices from peer, developed countries while preserving access to vaccines currently available to Americans. “
“President Trump directed us to examine how other developed nations protect their children and to take action if they are doing better,” Kennedy said in the press release announcing the decision. “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.”
Unanimous support for the decision did not spill out. Even Sen. Bill Cassidy (R LA) and chair of the Senate Committee on Health, Education, Labor and Pensions posted on X, “The vaccine schedule IS NOT A MANDATE. It’s a recommendation giving parents the power. Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors, and will make America sicker.”
Speaking for the American Medical Association, Trustee Sandra Adamson Fryhofer, MD, said the AMA “. . . is deeply concerned by recent changes to the childhood immunization schedule that affects the health and safety of millions of children. . . Changes of this magnitude require careful review, expert and public input, and clear scientific justification. 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,” Fryhofer stressed in her statement.
Immunizations recommended for all children
The CDC will continue to recommend that all children are vaccinated against diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b (Hib), Pneumococcal conjugate, polio, measles, mumps, rubella, and human papillomavirus (HPV), for which there is international consensus, as well as varicella (chickenpox).
However, the CDC is following the lead of several peer nations by recommending the HPV vaccine be reduced to two doses from one. Recent scientific studies have shown that one dose of the HPV vaccine is as effective as two doses.
Recommended for Certain High-Risk Groups
Immunizations recommended for certain high-risk groups or populations are for respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B.
Immunizations Based on Shared Clinical Decision-Making
For some immunizations, which may rely more on the individual’s characteristics or situation, the CDC is recommending that physicians and parents, who know the child, should decide whether to administer the vaccine.
These immunizations include the rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B.
Insurance Coverage
“All vaccines currently recommended by CDC will remain covered by insurance without cost sharing,” said Dr. Mehmet Oz, Administrator for the Centers for Medicare & Medicaid Services, in the press release.“No family will lose access. . .”
All immunizations recommended by the CDC as of December 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, according to the CDC press release.
While Secretary Kennedy did not make the decision, it is consistent with his long-term concern about vaccinations and his September 2025 “Make Our Children Healthy Again” Report’s recommendations.
“This reckless move by the Trump administration has nothing to do with science or informed choice – it’s about appeasing a debunked anti-vaccine agenda being pushed by RFK Jr. and his allies,” said Gov. Gavin Newsom in a press release the same day. “Undermining the prior CDC’s childhood vaccine schedule flies in the face of decades of medical expertise and puts ideology over evidence. I strongly condemn this decision that puts infants and children at real risk.”
Between 2020 and 2024, trust in health care declined steeply from 71.5 percent to 40.1 percent, coinciding with school closures, other lockdowns, mandatory face masks, COVID-19 vaccination mandates with their de facto denial of infection acquired immunity, and other public health recommendations that lacked scientific rationale and went against basic principles of public health, according to the decision memorandum.
“The distrust of public health agencies during the pandemic has spilled over to other recommendations made by these agencies, including those with respect to vaccines. Over the same period, there was a decline in childhood vaccination rates across the country, with, for example, a reduction in measles, mumps, and rubella (MMR) vaccination from 95.2 percent to 92.7 percent. This has increased the potential risk for measles cases,” the memorandum stated.
However, health officials said that the panel — the Advisory Committee on Immunization Practices — which recommends vaccines will not vote on these new recommendations, and they said the decision does not sideline the panel.
On behalf of the California Medical Association, René Bravo, M.D., President and pediatrician, issued the following statement, “The decision to weaken the childhood immunization schedule is misguided and dangerous. As a pediatrician, I have seen firsthand how routine vaccinations save lives, prevent suffering, and protect entire communities. Compounding these concerns is a process that has lacked transparency, making it difficult for physicians and the public to understand the evidence and reasoning behind such a consequential change. Today’s decision undermines decades of evidence-based public health policy and sends a deeply confusing message to families at a time when vaccine confidence is already under strain. The California Medical Association strongly opposes this rollback and urges families to follow recommendations from trusted national and specialty physician groups.”
