The Trump administration has rewritten federal childhood vaccine guidance in a sweeping move that reduces the number of immunizations routinely recommended for all children in the United States. Announced Monday by the Department of Health and Human Services, the changes drew immediate condemnation from major medical groups and public health experts, who warned that the overhaul bypassed established scientific review processes and could expose children to preventable diseases.
Under the revised guidance issued by the Centers for Disease Control and Prevention, the number of vaccines routinely recommended for all children has been reduced from 17 to 11. Several immunizations that were previously recommended universally are now limited to children considered at high risk or are subject to what the administration calls shared decision making between families and health care providers. Vaccines affected include those for hepatitis A and B, rotavirus, respiratory syncytial virus, seasonal flu, and meningococcal disease.
The changes follow months of concern among physicians and public health advocates after President Donald Trump selected Robert F. Kennedy Jr. to lead HHS. Kennedy, who has long questioned the safety and effectiveness of childhood vaccines, was confirmed by the Senate nearly a year ago. Last month, Trump issued a presidential memorandum directing Kennedy and Deputy Secretary Jim O’Neill, who is also serving as acting CDC director, “to review best practices from peer, developed countries for core childhood vaccination recommendations.”
In a statement released Monday, HHS said that “after consulting with health ministries of peer nations, considering the assessment’s findings, and reviewing the decision memo” prepared by National Institutes of Health Director Dr. Jay Bhattacharya, Food and Drug Commissioner Dr. Marty Makary, and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, O’Neill “formally accepted the recommendations and directed the CDC to move forward with implementation.”
Administration officials said the changes were intended to address declining public trust in vaccines. O’Neill claimed that “the data support a more focused schedule,” while Kennedy said, “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.”
A senior administration health official who briefed reporters on condition of anonymity said the changes followed a “comprehensive scientific assessment” comparing U.S. vaccine policy with that of 20 other countries. The assessment was authored by Martin Kulldorff, chief science officer at a unit of HHS who briefly served as chair of the CDC’s vaccine advisory committee last year, and Tracy Beth Høeg, acting director of the FDA’s Center for Drug Evaluation and Research. Officials confirmed the changes were made without formal public comment or input from vaccine manufacturers, bypassing the typical process in which the CDC’s Advisory Committee on Immunization Practices weighs in on schedule changes.
Medical organizations said that departure from established procedure was itself a serious public health concern. Dr. Sandra Adamson Fryhofer, an American Medical Association trustee, 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,” Fryhofer said. “When long-standing recommendations are altered without a robust, evidence-based process, it undermines public trust and puts children at unnecessary risk of preventable disease.”
“The scientific evidence remains unchanged, and the AMA supports continued access to childhood immunizations recommended by national medical specialty societies,” she added. “We urge federal health leaders to recommit to a transparent, evidence-based process that puts children’s health and safety first and reflects the realities of our nation’s disease burden.”
The American Academy of Pediatrics issued a similarly forceful response. AAP President Dr. Andrew D. Racine described the revised guidance as “dangerous and unnecessary” and said “the long-standing, evidence-based approach that has guided the US immunization review and recommendation process remains the best way to keep children healthy and protect against health complications and hospitalizations.”
Racine warned that the new guidance removes routine protections against diseases that continue to pose serious risks to children. “Said to be modeled in part after Denmark’s approach, the new recommendations issued today by the US 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,” he said. “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.”
“The United States is not Denmark, and there is no reason to impose the Danish immunization schedule on America’s families,” Racine continued. “At a time when parents, pediatricians, and the public are looking for clear guidance and accurate information, this ill-considered decision will sow further chaos and confusion and erode confidence in immunizations.”
Consumer advocacy groups also condemned the move. Dr. Robert Steinbrook, Health Research Group director at Public Citizen, said Kennedy and his deputies began “2026 by escalating and accelerating their mindless assault on the childhood and adolescent immunization schedule.”
“Extreme and arbitrary changes to the childhood vaccination schedule without full public discussion and scientific and evidence-based vetting put children and families at risk and undermine public health,” Steinbrook said. “The uncalled-for changes are likely to further erode trust in vaccines and decrease immunization rates, rather than increase confidence or boost vaccine uptake, as federal health officials assert.”
Epidemiologist Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy and head of the Vaccine Integrity Project, also criticized the decision. “Eliminating vital U.S. childhood vaccine recommendations without public discussion of the potential impacts on children in this country, or a transparent review of the data on which the changes were based, is a radical and dangerous decision,” Osterholm said. “This wildly irresponsible decision will sow further doubt and confusion among parents and put children’s lives at risk.”
The policy shift also raises questions about how vaccination rules will be applied across the country. As the Associated Press reported, states, not the federal government, have authority to require vaccinations for schoolchildren. While CDC guidance typically influences those policies, some states have begun forming alliances to counter the Trump administration’s new recommendations.
Lawrence Gostin, founding chair of the O’Neill Institute for National and Global Health Law at Georgetown University, predicted growing fragmentation. “Red states will mostly follow HHS guidance. Blue states will certainly keep the current schedule. We’ll see a checkerboard of different rules across America. Infectious diseases will surge as pathogens don’t respect state borders,” Gostin said.
Describing the CDC’s move as “reckless and lawless,” Gostin warned that “RFK Jr. is plunging the nation into uncertainty and confusion.” He added, “Will pharmacies and pediatricians offer vaccines without clear recommendations? Will insurers cover vaccines? Will school boards worry about liability? Needless hospitalizations and deaths are all but certain to occur.”
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