Experts Warn CDC Childhood Immunization Schedule Revisions Could Reduce Uptake, Erode Public Trust

With recent CDC changes to the childhood immunization schedule, experts warn the revisions could confuse parents, reduce vaccine uptake, and threaten decades of public health progress.

CDC Revises Childhood Immunization Schedule as Experts Push Back

On January 5, the CDC announced major revisions to the US childhood immunization schedule, reducing the number of diseases covered by routine vaccines from 17 to 11.¹ The agency continues to recommend routine vaccination against diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, pneumococcal disease, polio, measles, mumps, rubella, human papillomavirus (HPV), and varicella (chickenpox).²

However, vaccines for rotavirus, COVID-19, influenza, hepatitis A, hepatitis B, and meningococcal disease are no longer universally recommended. Instead, hepatitis A and B, meningococcal ACWY and B, respiratory syncytial virus, and dengue vaccines are advised only for certain high-risk groups. In addition, vaccination against meningococcal disease, rotavirus, COVID-19, influenza, and hepatitis A and B is now guided by shared clinical decision-making.

These changes follow a presidential memorandum issued December 5, 2025, directing HHS Secretary Robert F. Kennedy Jr. and Acting CDC Director Jim O’Neill to examine how peer nations structure their childhood vaccination schedules and update the US schedule if “superior approaches” were identified abroad.¹

Federal health leaders reviewed the vaccination schedules of 20 peer nations and found the US to be a global outlier in both the number of diseases routinely addressed and the number of recommended doses. They noted that many peer nations with fewer routine vaccine recommendations report strong child health outcomes and high vaccination uptake, driven by public trust and education rather than mandates.

The revisions also come after Kennedy ended the terms of all 17 existing members of the Advisory Committee on Immunization Practices (ACIP) in June 2025, replacing them days later with new appointees, some of whom previously expressed antivaccine views.³ He claimed the move was intended to restore public trust in vaccines.

Leading up to the schedule changes, the new committee voted in September to separate the measles, mumps, rubella, and varicella vaccine, recommending the chickenpox vaccine be given as a standalone shot. They also voted last month to end the universal hepatitis B birth dose for infants.

Because the CDC’s revised childhood immunization schedule is advisory rather than mandatory, the American Academy of Pediatrics (AAP) released its own schedule on January 26 that maintains routine vaccination recommendations for vaccines removed by the CDC.⁴ The AAP said that the CDC’s recent changes depart from longstanding medical evidence, whereas its own schedule continues to base recommendations on disease risk and US-specific health care delivery considerations.

“For more than 60 years, millions of children and countless American communities have experienced the benefits of routine childhood vaccinations,” AAP President Andrew Racine, MD, PhD, said in a news release. “The AAP is working with our partners across medicine and public health to ensure that parents have credible, science-backed vaccine recommendations they can trust.”

Experts Criticize CDC Process, Evidence Behind Schedule Changes

Echoing the AAP, experts interviewed by The American Journal of Managed Care^®(AJMC) said the CDC revisions undermine decades of public health progress, complicate clinical care, and risk a resurgence of preventable diseases.

They include Amy Crawford-Faucher, MD, vice chair of the primary care institute and department of family medicine at Allegheny Health Network; Ramin Herati, MD, assistant professor at NYU Langone Health and director of the NYU Langone Vaccine Center; Sahal Thahir, MD, research instructor in pediatric infectious diseases at the University of North Carolina (UNC) School of Medicine; and Noel Brewer, PhD, distinguished professor at UNC Gillings School of Public Health and former ACIP member.

Brewer, one of the terminated ACIP members, said the CDC’s changes bypassed the ACIP’s usual evidence-to-recommendation framework. Previously, major changes were developed through internal government review with CDC and other agency experts, alongside consideration and public debate at ACIP meetings.⁵ Under Kennedy, changes have been announced with minimal consultation and no prior public notice. In this case, the new vaccine schedule was neither reviewed by CDC experts nor given a public hearing through ACIP, as reported by The Washington Post.⁶

“This work was [previously] done in a deliberative, evidence-informed, transparent way that is no longer present on ACIP and is especially no longer present with CDC,” Brewer told AJMC. “That leaves health care providers and families not knowing what they should do with vaccines. I believe this is perhaps deliberate, as a way to make it harder for people to get vaccines and to scramble people’s motivations and ability to pursue vaccination.”

He also criticized using countries like Denmark as a model for US vaccine policy, noting that the US is a large, heterogeneous nation with diverse cultures. Thahir added that Denmark is “the size of Wisconsin,” with different geography and population, making comparisons misleading. He also noted this comparison could discourage families from receiving necessary vaccines and disincentivize manufacturers from producing urgently needed vaccines.

Crawford-Faucher and Herati similarly emphasized that many peer nations, including Denmark, have more centralized or universal health care systems, as well as stronger public health infrastructures, making comparisons unreliable.

“[Health care] is not fragmented the way we sometimes deal with it here in the US, where there are different medical systems with medical records that just don’t talk to each other effectively,” Herati said in an interview with AJMC.

CDC Terminology Risks Confusing Parents and Lowering Uptake, Experts Say

When considering the revised recommendations, experts warned that placing more vaccines under “shared clinical decision-making” could reduce uptake. Thahir said that vaccinations have always involved shared decision-making and argued that the new terminology is “gaslighting” families and undermining trust in both vaccine manufacturers and pediatricians.

Crawford-Faucher agreed, underscoring that this change introduces doubt among parents. Similarly, Herati shared that it is likely to result in fewer vaccines administered over time, as pediatricians have limited time per visit to address questions, increasing the likelihood that vaccines categorized under shared decision-making may be deferred or overlooked.

“I think parents might decide to postpone or think about [vaccines], and that’s the window when you get below herd immunity, especially for things like measles, where it’s going to lead to outbreaks,” Crawford-Faucher told AJMC. “I think folks don’t fully understand every person’s role in maintaining a safe environment in public health.”

Experts Warn Reduced Vaccination Uptake Threatens Children’s Health

The experts highlighted several diseases of concern, including hepatitis B, measles, HPV, influenza, and meningococcemia. Crawford-Faucher described the ACIP vote to roll back the hepatitis B birth dose last month as a “big step backward.” Herati noted that 90% of infected infants develop chronic infections that can lead to liver cancer and cirrhosis, costing between $100,000 and $300,000 annually to manage.

Additionally, Brewer highlighted that many regions are already below herd immunity thresholds for measles, a trend Crawford-Faucher said has caused clinicians to treat nearly every childhood rash as a potential measles case; this situation is likely to worsen if vaccination rates continue to fall.

Brewer also emphasized the benefits of the HPV vaccine, which prevents about 40,000 cancers annually. He told AJMC that he fears that any loss in uptake could have “devastating” long-term consequences.

In addition, Thahir underscored the threat posed by influenza, noting that 89% of children who became severely ill last year were unvaccinated or not fully vaccinated. He also highlighted the impact of meningococcemia, a highly deadly pathogen with a 10% to 15% mortality rate that can result in limb loss, organ damage, and prolonged intensive care unit stays.

“The vaccine has been proven effective, and to reduce families’ decision-making power to get the vaccine, to reduce access to the vaccine, will lead to unnecessary illness and death in children that should be protected,” Thahir said.

Politicization of Vaccine Policy Threatens Public Trust, Experts Claim

Experts concluded that the credibility of the CDC and ACIP has been fundamentally undermined, even if the recommendations are reversed in the future. Brewer said the politicization of public health has caused lasting damage to public trust. Thahir added that restoring confidence would take years and require coordinated efforts from stakeholders beyond the CDC.

“Even if [ACIP] were to reverse course in a few years’ time…it’s going to take years and a wide variety of platforms and power structures to help give families the information they need to make the best choices for their children with regard to vaccines,” Thahir said. “That’s what the population of researchers, scientists, and public health officials needs to focus on; it can’t just be through the CDC anymore.”

References

1. Grossi G. CDC reduces US childhood immunization schedule from 17 to 11 diseases. AJMC. January 5, 2026. Accessed January 27, 2026. https://www.ajmc.com/view/cdc-reduces-us-childhood-immunization-schedule-from-17-to-11-diseases
2. Fact sheet: CDC childhood immunization recommendations. News release. HHS. January 5, 2026. Accessed January 27, 2026. https://www.hhs.gov/press-room/fact-sheet-cdc-childhood-immunization-recommendations.html
3. Joszt L. 5 key health care changes during Trump’s first year back in office. AJMC. January 9, 2026. Accessed January 27, 2026. https://www.ajmc.com/view/5-key-health-care-changes-during-trump-s-first-year-back-in-office
4. American Academy of Pediatrics issues recommended childhood and adolescent immunization schedule for 2026. News release. American Academy of Pediatrics. January 26, 2026. Accessed January 27, 2026. https://www.aap.org/en/news-room/news-releases/aap/2025/american-academy-of-pediatric-issues-recommended-childhood-and-adolescent-immunization-schedule-for-2026/
5. Kates J, Michaud J. The new federal vaccine schedule for children: what changed and what are the implications? KFF. January 9, 2026. Accessed January 27, 2026. https://www.kff.org/other-health/the-new-federal-vaccine-schedule-what-changed/
6. Sun LH. CDC staff ‘blindsided’ as child vaccine schedule unilaterally overhauled. The Washington Post. January 7, 2026. Accessed January 27, 2026. https://www.washingtonpost.com/health/2026/01/07/cdc-vaccine-recommendations-schedule-revisions/