Key takeaways:
- On January 5, 2026, the CDC updated the childhood vaccine schedule to recommend fewer routine vaccines for all children and introduced a 3-tiered framework: routine, high-risk–based, and shared clinical decision-making.
- The number of diseases recommended for universal childhood vaccination was reduced from 18 to 11, with several vaccines (including RSV, hepatitis A and B, influenza, and COVID-19) shifted to risk-based or shared decision-making categories.
- Pediatric organizations, including the American Academy of Pediatrics, strongly criticized the changes, warning they could increase confusion, erode trust, and lower vaccination rates despite continued insurance coverage.
On Monday, January 5, 2026, the Centers for Disease Control and Prevention (CDC) updated the nation's childhood vaccine schedule to recommend fewer vaccines to all children, according to a press release from the CDC.1
The updated recommendations feature a 3-tiered approach and will include immunization recommendations for all children, those recommended for particular high-risk groups or populations, and those based on what the organization is calling "shared clinical decision-making."
According to a press release from the CDC, all recommendations from 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."
The overhaul comes after recent changes to specific vaccine recommendations, including hepatitis B vaccination timing among infants, among others, throughout 2025.2
Updated CDC vaccine recommendations for all children
Per the new CDC fact sheet, all children are recommended to receive the following vaccines for the following 11 diseases (down from 18 diseases prior to the update):
- Diphtheria
- Tetanus
- Acellular pertussis (whooping cough)
- Haemophilus influenzae type b (Hib)
- Pneumococcal conjugate
- Polio
- Measles
- Mumps
- Rubella
- HPV
- Varicella
Related to the HPV vaccine, the CDC stated, "Recent scientific studies have shown that one dose of the HPV vaccine is as effective as two doses. The CDC is following the lead of several peer nations by recommending one instead of two doses of this vaccine."1
According to NBC News, the changes align the United States' vaccine schedule closer to that of Denmark, which has been a country often referenced in recent Advisory Committee on Immunization Practices (ACIP) meetings. Further, the CDC stated the United States recommended more childhood vaccines compared to any other "peer nation," and more than twice as many as "some European nations."3
This approach has been widely discredited by multiple US-based health care societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America, who have previously stated that past vaccine schedules have been developed specifically for the US, given this country's population and size.
Updated CDC vaccine recommendations for certain high-risk groups
The updated schedule removed certain vaccine recommendations for all children. Now, respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B vaccine recommendations are based on "risk-benefit profiles for different groups of people," according to the CDC. The agency says risk factors can include "unusual exposure to the disease, underlying comorbidities, or the risk of disease transmission to others."1
Updated CDC vaccine recommendations via shared clinical decision-making
Citing it is "not always possible for public health authorities to clearly define who will benefit from an immunization, who has the relevant risk factors, or who is at risk for exposure," some vaccines are now recommended by the CDC via shared clinical decision-making between physicians and parents.
Vaccines based on this approach now include:
- Rotavirus
- COVID-19
- Influenza
- Meningococcal disease
- Hepatitis A
- Hepatitis B
“Today’s announcement by federal health officials to arbitrarily stop recommending numerous routine childhood immunizations is dangerous and unnecessary," said AAP President Andrew Racine, MD, PhD, FAAP, in a statement sent to media organizations. "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."4
"Said to be modeled in part after Denmark’s approach, the new recommendations issued today by the U.S. Centers for Disease Control and Prevention no longer recommend routine immunization for many diseases with known impacts on America’s children, such as hepatitis A and B, rotavirus, respiratory syncytial virus (RSV), flu, and meningococcal disease," added Racine. "AAP continues to recommend that children be immunized against these diseases, and for good reason; thanks to widespread childhood immunizations, the United States has fewer pediatric hospitalizations and fewer children facing serious health challenges than we would without this community protection."
According to NBC News, though the vaccine schedule is not a mandate, it has long been used to guide what vaccines are covered by insurance as well as what vaccines are needed for school attendance.3
"The best case scenario is that nothing will change,” David Margolius, MD, director of public health, city of Cleveland, told NBC News. "The worst case scenario is that this causes more confusion, more distrust, lower vaccination rates, and then just this trend of political parties and ideologies determining which vaccines people should get.”
Editor's note: This is breaking news from the CDC. Updates to this article could follow.
References:
- Fact sheet: CDC childhood immunization recommendations. CDC. Press release. Published January 5, 2026. Accessed January 5, 2026. https://www.hhs.gov/press-room/fact-sheet-cdc-childhood-immunization-recommendations.html
- Fitch J, Ebert M. ACIP votes to update hepatitis B vaccine recommendation for infants. Contemporary Pediatrics. Published December 5, 2025. Accessed January 6, 2026. https://www.contemporarypediatrics.com/view/acip-votes-to-update-hepatitis-b-vaccine-recommendation-for-infants
- Lovelace Jr. B, Edwards E, Fattah Mustafa. CDC overhauls childhood vaccine schedule to resemble Denmark in unprecedented move. NBC News. Published January 5, 2026. Accessed January 5, 2026. https://www.nbcnews.com/health/health-news/rfk-jr-vaccines-overhaul-kids-denmark-fewer-childhood-shots-rcna250055
- Racine A. AAP Opposes Federal Health Officials’ Unprecedented Move to Remove Universal Childhood Immunization Recommendations. American Academy of Pediatrics. https://www.aap.org/en/news-room/news-releases/aap/2025/aap-opposes-federal-health-officials-unprecedented-move-to-remove-universal-childhood-immunization-recommendations/
