CDC Reduces US Childhood Immunization Schedule From 17 to 11 Diseases

Major revisions to the US childhood immunization schedule were announced Monday by federal health officials, reducing the number of diseases covered by routine vaccines from 17 to 11, according to reporting by The New York Times.¹ Public health experts said the changes represent a significant departure from the evidence-based process that has guided federal vaccine policy for decades.

Although states retain authority over school vaccination requirements, CDC recommendations strongly influence state policies, clinical practice, and insurance coverage. Experts noted that while prior changes under the current administration affected individual vaccines, the latest revisions reshape the overall framework of childhood immunization guidance.

The updated schedule, which takes effect immediately, was issued by Jim O’Neill, acting director of the CDC. It marks one of the most consequential public health policy shifts under HHS Secretary Robert F. Kennedy Jr, who has repeatedly questioned the scope of childhood vaccination in the United States. Just a few months ago, 6 leading medical organizations filed a lawsuit against Kennedy, arguing that his removal of COVID-19 vaccine recommendations for children and pregnant people was unlawful and dangerous.²

Under the revised schedule, routine vaccination against measles, polio, and pertussis remains recommended for all children. Immunization against other diseases, including respiratory syncytial virus, a leading cause of hospitalization among infants, will be recommended only for specific high-risk populations.¹ Vaccines for rotavirus, influenza, and hepatitis A may now be administered only after consultation with a health care provider.

“As we are already seeing signs of a severe respiratory season, this is not the right time to make changes that are not supported by clear evidence,” Robert Hopkins, MD, medical director of the National Foundation for Infectious Diseases, said in a statement. “Last flu season, 280 U.S. children died from influenza—the highest toll in more than a decade. RSV remains the most common cause of hospitalization among U.S. infants.”

Federal officials did not publicly detail the evidence supporting these changes. Demetre Daskalakis, MD, MPH, who led the CDC center overseeing vaccine policy before resigning in August, told The New York Times that the approach lacked appropriate expert involvement.

“Stealth announcements of seismic changes in vaccine policy should include experts in pediatrics, infectious diseases and immunology,” Daskalakis said. “These are lacking as is scientific process and a review of the data.”

Historically, CDC vaccine recommendations are developed through a formal, transparent process involving the Advisory Committee on Immunization Practices (ACIP), an independent panel that reviews clinical trial data, safety evidence, population-level benefits, and implementation considerations. Public health leaders said that the process was not clearly followed in this instance.

In June 2025, Kennedy removed all members of ACIP, claiming “persistent conflicts of interest” among the committee,³ though recent research showed that conflicts of interest were at a historic low in 2024.⁴

Sen Bill Cassidy, MD (R, Louisiana), chair of the Senate Health Committee, spoke out online against the immunization schedule overhaul, stating safe and effective vaccines prevent deaths among children.⁵

“The vaccine schedule IS NOT A MANDATE. It’s a recommendation giving parents the power,” Cassidy wrote on X. “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.”

The revisions follow a December 5 directive from President Trump instructing Kennedy to align the US vaccination schedule with those of other high-income countries, including Denmark, Germany, and Japan.¹ In a statement, Kennedy said the administration conducted an “exhaustive review of the evidence” and sought to align the US with international consensus while strengthening transparency and informed consent.

“The abrupt change to the entire U.S. childhood vaccine schedule is alarming, unnecessary and will endanger the health of children in the United States,” Helen Chu, MD, MPH, a physician and immunologist at the University of Washington and a former ACIP member, told The New York Times. “Already, parents are worried about what they are hearing in the news about vaccine safety,” she said. “This will increase confusion and decrease vaccine uptake.”

Public health experts have noted that the US schedule is already largely aligned with those of peer nations such as Canada, the United Kingdom, Australia, and Germany. Japan omits some vaccines recommended in the US but includes others not routinely administered domestically, such as vaccination against Japanese encephalitis.

“Comparing the U.S. childhood immunization schedule to that of Denmark or other countries ignores fundamental differences in population size, diversity, healthcare access, and infectious disease risk,” said Hopkins. “These differences matter. U.S. immunization policies must be guided by a transparent, evidence-based process and grounded in U.S. epidemiology and real-world risk.”

Legal experts have also questioned whether the administration has the authority to implement such changes without formal rulemaking. Richard H. Hughes IV, JD, a vaccine law expert at George Washington University, told The New York Times that the Administrative Procedure Act requires federal agencies to ground major policy decisions in evidence and prohibits actions that are “arbitrary and capricious.”

Federal officials emphasized that access to vaccines will not change. “All vaccines currently recommended by CDC will remain covered by insurance without cost sharing,” Mehmet Oz, MD, administrator of the Centers for Medicare & Medicaid Services, said in a statement.

References

1. Mandavilli A. Kennedy scales back the number of vaccines recommended for children. The New York Times. January 5, 2026. Accessed January 5, 2026. https://www.nytimes.com/2026/01/05/health/children-vaccines-cdc-kennedy.html
2. Klein H. RFK Jr sued by medical societies over unlawful COVID-19 vaccine rollbacks. AJMC^®. July 8, 2025. Accessed January 5, 2025. https://www.ajmc.com/view/rfk-jr-sued-by-medical-societies-over-unlawful-covid-19-vaccine-rollbacks
3. Grossi G. RFK Jr sweeps clean CDC vaccine advisory panel, aiming to bolster public confidence. AJMC. June 9, 2025. Accessed January 5, 2026. https://www.ajmc.com/view/rfk-jr-sweeps-clean-cdc-vaccine-advisory-panel-aiming-to-bolster-public-confidence
4. McCormick B. Conflicts of interest in federal vaccine advisory committees at historic lows despite RFK Jr claims. AJMC. August 19, 2025. Accessed January 5, 2026. https://www.ajmc.com/view/conflicts-of-interest-in-federal-vaccine-advisory-committees-at-historic-lows-despite-rfk-jr-claims
5. @SenBillCassidy. As a doctor who treated patients for decades, my top priority is protecting children and families. Multiple children have died or were hospitalized from measles, and South Carolina continues to face a growing outbreak. Two children have died in my state from whooping cough. All of this was preventable with safe and effective vaccines. 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. January 5, 2026. Accessed January 5, 2026. https://x.com/SenBillCassidy/status/2008278922350256150