Webinar Highlights Shifting Sentiment Toward Vaccines in the US

On January 5, the CDC made the announcement that it would only be recommending 11 vaccines for the childhood immunization schedule, down from the 17 that had previously been recommended.¹ Since then, a flurry of decisions has been made public, including several states stating that they would no longer follow the CDC or Advisory Committee on Immunization Practices (ACIP) when recommending vaccines for the start of schooling and other organizations, including the American Academy of Pediatrics, putting out their own vaccine recommendations that differ from the CDC recommendations.

In a webinar held by KFF, experts on the KFF staff discussed what those changes in the recommendations are, the response from states and other organizations, and public reaction.

Changes in CDC Vaccine Recommendations

Josh Michaud, PhD, MHS, associate director for Global and Public Health Policy at KFF, reviewed the key actions that were made by the Trump administration in the past year regarding vaccines.

Despite the federal changes in vaccine recommendations, Michaud emphasized that there were different roles in determining the vaccine policy between the federal and state governments. The federal government, he said, “has the authority and responsibility to approve or authorize vaccines in the US” and require insurance coverage of the vaccines recommended through the national guidelines developed by the federal government.

The state, meanwhile, can set vaccine mandates for schools, determine which guidelines or recommendations they follow, and require state-regulated insurers to cover vaccines.

Michaud noted that the Trump administration has focused its efforts on certain areas within vaccine recommendations and schedules, including vaccine approvals, developing national guidelines, requiring insurance coverage, and funding the Vaccines for Children program. “In each of these areas we just outlined, we’ve seen the Trump administration make policy changes, or at least make notable changes in their public stance about these roles,” he explained.

Michaud also detailed the changes in the pediatric vaccine recommendations that were made in January: “There are now 6 vaccines no longer recommended for routine use by all children in the US compared to a year ago, and these include rotavirus, COVID-19, influenza, hepatitis A, hepatitis B, and meningococcal vaccine. These vaccines are now recommended for a narrow group of children, instead of universally recommended…”

Michaud emphasized that insurance coverage of these vaccines is unlikely to change except for the HPV vaccine, where the second or third dose could change in terms of whether it is covered by private insurance.

State Reactions to Changes in Vaccine Recommendations

Jennifer Kates, PhD, senior vice president and director of Global and Public Health Policy at KFF, outlined how states have responded to the updated CDC vaccine recommendations. From September 2025 to February 2026, the number of states departing from the federal vaccine recommendations for all childhood vaccines increased from 9 states to 25 states, with most being Democratic-led.

“I will say that…states have choices as to how they’re going to make determinations for the policies in their state. But I’ve not really seen a situation where states have come out and delinked from CDC guidelines,” said Kates.

In response to the CDC guidelines, and as a precursor, several states have joined together to form new health alliances, specifically the West Coast Health Alliance that includes Oregon, Washington, and California,² and the Northeast Public Health Collaborative that includes New York, New Jersey, Pennsylvania, and Connecticut, among others.³ On the flip side, Idaho and Florida are 2 states that are looking to reduce or eliminate school mandates for vaccination.

Kates reiterated that these recommendations will not have any implications for insurance coverage through 2026, but manufacturers have signaled that they will not be investing in some research on vaccines because of the uncertainty surrounding government support.

Increases to exemptions to vaccines have also been seen, said Kates, with overall exemptions rising from 2.5% of all kindergarten-age children getting exempt in the 2019-2020 academic year to 3.6% in the 2024-2025 academic year, primarily fueled by non-medical exemptions.

Lastly, Kates noted that the federal recommendations could be seeing further changes. “Both Secretary [of HHS, Robert F.] Kennedy and ACIP members have signaled this in their statements. More divergence could be appearing across the country the next school season. So what happens in the fall with requirements is something to watch because states will probably have to make some decisions about what they’re going to mandate…” she said.

With the decline in vaccine uptake, more outbreaks could be possible, which could be a problem should vaccine research subside in the US.

Public Opinion on Vaccines Is Shifting Along Party Lines

Liz Hamel, senior vice president and director of Public Opinion and Survey Research, discussed the recent polling that KFF has done in regard to their thoughts on vaccines, both before and after the changes to the CDC recommendations. Trust in the CDC, she said, has declined over time. With only 43% of Republicans and 55% of Democrats trusting the CDC as of January 2026. Providers still remain the most trusted source of health information, with 90% of Democrats, 85% of Independents, and 86% of Republicans trusting their own doctor for health information.

“Beyond individual providers, none of the government agencies or individuals that we asked about are trusted by more than half of the public,” explained Hamel. “…And perhaps not surprisingly, we see deep partisan divides when we ask about [Secretary Robert F. Kennedy Jr or President Donald Trump].”

Confidence in the federal government to make recommendations for childhood vaccine schedules was low among all adults, with more than half saying they had little or no confidence in the federal government. On top of this, although 90% of parents believe it is very or somewhat important to get their child vaccinated for measles, mumps, and rubella (MMR), and 88% believe it is very or somewhat important to vaccinate their child for polio, these numbers dip dramatically for the flu and COVID-19, with only 56% saying it is at least somewhat important to get the flu vaccine for their child and only 43% saying it is important for their child to get the COVID-19 vaccine.

When polled specifically about the changes in the childhood immunization schedule, about 51% had read some or a lot about the changes, with more negative than positive reactions, primarily split along party lines.

“Overall, 54% of those who’ve heard about these changes expect that they’ll have a negative impact on children’s health, and that’s about twice the share who say they’ll have a positive impact, which is 26%,” said Hamel. “83% of Democrats who’ve heard of the changes expect them to have a negative impact, while about half of Republicans and [Make America Healthy Again] supporters expect them to have a positive impact on children’s health.”

Overall, all experts noted a partisan divide that is persisting through vaccine uptake starting with the COVID-19 pandemic in 2020.

“We have to remember that, at the same time, I think the open question [and] maybe this feeds into elections, is, is it going too far, and will the public push back? And will that be something that does a course correction, or will we see outbreaks?” questioned Kates. “Anytime there’s confusion or calling into question, it’s just going to make it more challenging to promote a message around this, the importance of [the MMR] vaccine.”

References

1. Grossi G. CDC reduces US childhood immunization schedule from 17 to 11 diseases. AJMC^®. January 5, 2026. Accessed February 19, 2026. https://www.ajmc.com/view/cdc-reduces-us-childhood-immunization-schedule-from-17-to-11-diseases
2. California, Oregon, and Washington to launch new West Coast Health Alliance to uphold scientific integrity in public health as Trump destroys CDC’s credibility. News release. Governor Gavin Newsom. September 3, 2025. Accessed February 19, 2026. https://www.gov.ca.gov/2025/09/03/california-oregon-and-washington-to-launch-new-west-coast-health-alliance-to-uphold-scientific-integrity-in-public-health-as-trump-destroys-cdcs-credibility/
3. Several northeastern states and America’s largest city announce the Northeast Public Health Collaborative. News release. NYC Health. September 18, 2025. Accessed February 19, 2026. https://www.nyc.gov/site/doh/about/press/pr2025/announce-northeast-public-health-collaborative.page