WASHINGTON — US. Health officials on Monday made significant changes to childhood vaccination recommendations, alarming pediatricians and other medical experts who say they are sowing confusion and undermining children's health.
The overhaul takes effect immediately, meaning that US Centers for Disease Control and Prevention will now recommend that all children be vaccinated against 11 diseases, up from 18 a year ago.
The changes come as vaccination rates in the U.S. slipped and the share of children exempt has reached an all-time high, according to federal data. At the same time the pace illnesses which can be protected against with vaccines such as measles and whooping cough are growing.
Here's what you need to know about the changes:
The federal government once recommended protection against these diseases only for certain high-risk children or based on individual doctor recommendations in what was known as “shared decision making.”
— Flu
— Hepatitis A
— Hepatitis B
— Meningococcal infection
— Rotavirus
— RSV
— COVID-19, change made in 2025.
The following vaccines remain on the list of recommended vaccines for everyone:
— Measles, mumps and rubella (MMR)
– Diphtheria, tetanus and whooping cough or whooping cough (DTP)
— Poliomyelitis
– Chicken pox
— Human papillomavirusor HPV. But, surprisingly, the guidelines are reducing the number of recommended doses of the HPV vaccine from two or three shots to one.
– Hib, or Haemophilus influenzae type B, is a bacteria that, despite its name, is not associated with influenza.
— PCV or pneumococcal conjugate vaccine
The U.S. Department of Health and Human Services said the overhaul was in response to a request from President Donald Trump in December. Trump has asked the agency to review how similar countries approach vaccine recommendations and consider revising U.S. guidance accordingly.
HHS said its comparison with 20 comparable countries showed the U.S. was “outstanding” in both the number of vaccinations it gave and the number of doses it recommended for all children. Agency officials pitched the change as a way to boost public confidence by recommending that children receive only the most important vaccinations.
However, many European countries recommend some vaccines that the US has removed from its list.
The country's major physician groups, including the American Medical Association and the American Academy of Pediatrics, say they will continue to recommend vaccines, which the Trump administration has now downgraded. They said there was no new scientific evidence to justify the changes, including no indication that the previous U.S. vaccination schedule was harming children.
Dr Sean O'Leary of the AAP said the changes could increase childhood morbidity and mortality from preventable diseases. He expressed particular concern that the U.S. would no longer recommend flu vaccinations for children as the flu season becomes severe and following a particularly severe season last winter.
A group of pediatricians has issued its own recommendations for childhood vaccinations. Additionally, states, not the federal government, have the authority to require schoolchildren to be vaccinated. Although CDC requirements often influence these state regulations, some states have begun creating your own alliances to counter the Trump administration's vaccine recommendations.
It's not clear yet. Due to contrary recommendations from pediatricians, visits to the doctor may not change. But medical experts say that when the U.S. government doesn't explicitly recommend the vaccine, it raises questions among parents, leading to more difficult conversations in the doctor's office.
If these changes mean that fewer children are vaccinated, outbreaks that have historically been prevented by high vaccination rates could spread more widely, leading to more illness and missed more school and work.
The Trump administration has said coverage will continue for families who still want to get vaccinated. Health insurers generally view vaccinations as a good deal because the shots cost less than hospitalization, and many have previously said they plan to cover what was recommended last year through 2026.
___
AP writers Ali Swanson and Mike Stobbe contributed to this report from New York.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. AP is solely responsible for all content.
