The Centers for Disease Control and Prevention has cut the number of vaccines it recommends for all children, following a review of vaccination practices in other countries, and evidence on the benefits and risks of the shots on the CDC’s schedule.

Here’s what to know.

Schedule Aligned With Other Countries

A review, prompted by a 2025 directive from President Donald Trump, showed that the United States was “a global outlier among peer nations in the number of target diseases included in its childhood vaccination schedule and in the total number of recommended vaccine doses,” health officials wrote in an assessment that underpinned the changes.

Dr. Tracy Beth Hoeg, a top Food and Drug Administration official, and Martin Kulldorff, chief science officer at the Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation, authored the assessment.

They advised officials to keep in place recommendations for certain vaccines, including the measles shot, in part because there is a consensus for the vaccines across peer nations, including Denmark. They also said the CDC should stop broadly recommending six other shots, including the hepatitis A vaccine, pointing to how some other similar countries do not recommend them for all, or any, children.

“Childhood vaccination recommendations must ... be based on the best available evidence and the best practices of peer, developed nations,” they wrote. “If there is a clear benefit of the vaccine, as for measles vaccines, the risks will need to be more substantial to outweigh the benefit. On the other hand, if the benefits are limited, as for the hepatitis A vaccine, even a small risk will tip the balance, where harms outweigh the benefits. For such vaccines, it is prudent to adopt a more conservative approach.”

Acting CDC Director Jim O'Neill approved the changes.

“The data support a more focused schedule that protects children from the most serious infectious diseases while improving clarity, adherence, and public confidence,” O'Neill said in a Jan. 5 statement.

“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,” Health Secretary Robert F. Kennedy Jr. added.

Trump said in a Jan. 5 post on Truth Social that the updated schedule “finally aligns the United States with other Developed Nations around the World.”

Sen. Bill Cassidy (R-La.), a doctor who voted to confirm Kennedy but has since clashed with him regarding vaccines, wrote in a post on X that he disagreed with the update.

“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,” he wrote.

Dr. Renata Moon, a pediatrician and senior fellow with the Independent Medical Alliance, said that the overhaul of the schedule “is a courageous step in the direction of common sense!”

“Thank you to HHS Secretary Kennedy and team for recognizing that we must make bold data-driven changes when possible, and for revealing that much of the alleged ‘scientific evidence’ of vaccine safety ... has simply never existed,” she told The Epoch Times in an email.

Key Changes

The new schedule takes the number of vaccines broadly recommended for children from 14 to eight. It also lowers the number of doses routinely recommended across childhood from about 50 to 22 or 23.

Previously, hepatitis A, influenza, meningococcal, and rotavirus vaccines were advised for all children. They are now recommended for certain high-risk groups. For other children, parents are advised to consult with their health care professional on the suitability of these vaccines for their children, according to the CDC.

The RSV monoclonal antibody injection, which works through passive immunization, was recommended for all children whose mothers did not receive a maternal RSV vaccine before birth and for some infants whose mothers received a vaccine before giving birth. It is now only recommended for children whose mothers did not get the vaccine before delivery.

The hepatitis B vaccine was, until recently, recommended for all children shortly after being born. It is now recommended for children whose mothers have positive or unknown hepatitis B status. For other kids, parents are advised to speak with doctors about the benefits and risks of vaccination. Only one similar country, Greece, recommends universal vaccination against hepatitis A, Hoeg and Kulldorff said in their assessment.

Only eight of the 20 peer countries whose guidance was reviewed recommend universal vaccination against influenza, 15 broadly recommend meningococcal vaccination, and 17 broadly recommend rotavirus vaccination.

The new schedule retains recommendations that all children receive vaccines against diphtheria; tetanus; acellular pertussis, or whooping cough; Haemophilus influenzae type B; pneumococcal disease; polio; measles; mumps; rubella; varicella, also known as chickenpox; and human papillomavirus.

All 20 of the peer countries broadly recommended these vaccines, with the exception of mumps in Japan and chickenpox in some countries, Hoeg and Kulldorff said.

U.S. officials will keep broadly recommending the chickenpox vaccine over concerns that deemphasizing the shot “could increase the average age at which the population naturally gets chickenpox when this disease could cause more complications,” O'Neill of the CDC said.

While human papillomavirus vaccination is still universally recommended, the number of recommended doses has been lowered from two or three to one. That’s in line with recent research showing comparable protection with a single dose, officials said.

What Experts Say

Some experts support the update, while others do not.

“This is a long-overdue recalibration of the number of vaccines administered to newborns and young children at the very outset of life,” Dr. Joseph Varon, president and chief medical officer of the Independent Medical Alliance, told The Epoch Times in an email.

Varon noted that the childhood vaccination schedule has expanded by 10 vaccines over the years, from four vaccines in 1983. He said the expansion often took place “with insufficient consideration for cumulative exposure and long-term health outcomes.”

Dr. Joseph Ladapo, Florida’s surgeon general, said in a post on X that the “breadth of the U.S. vaccine schedule far outpaced the evidence supporting it, and this change is a nice reminder that good health starts with food, exercise, and connectedness—not pharma.”

Dr. Ronald Nahass, president of the Infectious Diseases Society of America, said in a statement that “disease prevalence differs country to country, and there has been demonstrated and ongoing need in the U.S. for the vaccines included in the childhood vaccine schedule.”

Nahass said that many other peer countries have universal health care and parental leave, which can help prevent diseases, boost early care for children, and contribute to lower disease prevalence.

“It is irresponsible to haphazardly change vaccine recommendations without a solid scientific basis and transparent process. The commitment the U.S. has made to protecting children from vaccine-preventable illness and death must remain a top priority,” Nahass added.

Dr. Mike Ybarra, chief medical officer of the Pharmaceutical Research and Manufacturers of America, which represents vaccine makers, said in a statement that the organization opposes the changes.

What Drove the Update?

The schedule was updated in part because of a lack of information about the risks of vaccines and a decline in trust in public health, officials said.

Trials of the shots before approval are typically relatively limited in volume and short-term, while post-approval surveillance is challenging in that one of the main systems is voluntary, a Trump administration official told reporters on a call Monday.

“The United States administers significantly more doses of childhood immunizations than its peer nations, yet there is a significant knowledge gap due to a dearth of randomized vaccine trials and limited post-licensure infrastructure for monitoring potential adverse reactions and long-term chronic events,” O'Neill said in a memorandum outlining the changes.

The CDC states on its website that agencies “closely monitor the safety of vaccines in the United States through ongoing analysis of data, early detection of potential safety concerns and prompt public health action if needed.”

Randomized, controlled trials can help fill the gap that exists, in addition to observational studies, officials said on the call. The CDC has already begun some trials, and others are starting at the FDA and the National Institutes of Health. Certain trials will follow participants for years, one of the officials said.

Surveys show declines in trust in public health since the COVID-19 pandemic hit. One found a decrease from 71.5 percent in April 2020 to 40 percent in January 2024. People in that survey were less likely to have received a COVID-19 vaccine if they expressed lower levels of trust in doctors and hospitals.

Officials have noticed the declining vaccination rates. According to CDC data, rates have been decreasing in recent years, dropping among kindergartners in the most recent full school year to about 92 percent for most shots.

“We hope that this change will help address decreased uptake of vaccines, especially of the most important diseases, and increase trust in public health,” a health official told reporters on the call.

Dr. Robert Malone, an adviser to the government on vaccines, wrote on his blog that the update “addresses the erosion of public trust that followed overreach and coercive mandates during the pandemic years and acknowledges that vaccination, like any medical intervention, carries individualized benefit‑risk trade‑offs.”

Jen Kates, senior vice president of global and public health policy at Kaiser Family Foundation (KFF), said it is unclear what will happen after the policy updates.

“HHS says the changes will reduce distrust and increase vax rates. But they could do the opposite,” Kates said in a post on X. “We may not know until disease data are out.”

What About Insurance, Liability Protection?

Insurance companies are required, with limited exceptions, to cover vaccines recommended by the CDC under federal laws such as the Affordable Care Act.

The coverage requirements include vaccines for which the CDC advises shared clinical decision-making, or that parents consult with doctors before vaccination, according to KFF.

Officials this week said the changes to the childhood schedule will not result in any changes to insurance coverage.

“All vaccines currently recommended by CDC will remain covered by insurance without cost sharing,” Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said in a statement. “No family will lose access.”

That may not be true, according to some experts.

“They’re saying they’re not taking away access but the reality is, once these recommendations come down and filter through our health care system, there’s going to be a lot of confusion and there are going to be a lot of people who can’t get the vaccines that they want,” Dr. Sean O'Leary, a member of the AAP, told PBS.

“Despite federal health officials’ insistence that access to vaccines will not be reduced, and insurance will still cover the cost, history has shown us that that is not how the system in the U.S. works,” Dr. Georges Benjamin, executive director of the American Public Health Association and a former consultant to vaccine manufacturer GlaxoSmithKline, said in a statement.

AHIP, a group of insurers, said in 2025 that it would keep covering recommended vaccines as of Sept. 1, 2025, including shots against COVID-19 and influenza, with no cost-sharing for patients until 2027.

In 2025, the CDC changed COVID-19 vaccine recommendations from broadly recommended to only advised after consultation with a health care professional, prompting a lawsuit from the American Academy of Pediatrics (AAP). A federal judge ruled on Jan. 6 that the lawsuit can proceed.

The AAP, which receives money from vaccine companies, said this week that it is not updating its separate vaccination schedule. The academy broadly recommends 15 vaccines, including annual shots against COVID-19 and influenza vaccination.

Kennedy had previously criticized the AAP for recommending COVID-19 vaccines beyond the CDC’s childhood schedule, warning that it could lead to doctors being sued.

“Recommendations that diverge from the CDC’s official list are not shielded from liability under the 1986 Vaccine Injury Act,” Kennedy wrote in a 2025 post on X.

The National Childhood Vaccine Injury Act of 1986 introduced liability protection for vaccine companies and administrators while creating a program that compensates people for vaccine injuries.

On the call with reporters, an HHS official said that “HHS lawyers have assured us there will be no changes in liability protection for those vaccines.”

Sylvia Xu contributed to this report.