For parents of young children, visits to the pediatrician may pose new challenges and confusion now that the Centers for Disease Control and Prevention radically revised recommended childhood vaccinations.
On Monday, the agency shortened the list of vaccines recommended for all children, reducing the number of diseases targeted from 18 to 11 — an unprecedented change that flies in the face of recommendations from medical groups such as the American Academy of Pediatrics.
The new schedule divides vaccines into three categories: generally recommended vaccines, vaccines for high-risk groups, and vaccines recommended based on shared clinical decision making between patients and physicians. For example, Covid and flu vaccinations now fall into this third category, while RSV vaccinations for children are only recommended for high-risk groups.
Many families likely have questions about which vaccines their children are eligible for, and the answers aren't always clear-cut. The changes may require parents to monitor their children's vaccination schedules more closely, rather than relying on pediatrician reminders. However, major repairs are unlikely to affect your insurance coverage.
Here's what parents should know, according to interviews with doctors, infectious disease experts, insurance companies and health policy experts.
How to Find Out If Your Child Meets CDC Criteria
New guidance from the Centers for Disease Control and Prevention (CDC) continues to universally recommend vaccines for 11 diseases: measles, mumps and rubella; whooping cough, tetanus and diphtheria; chicken pox; polio; pneumococcal infection; HPV; and Haemophilus influenzae type B (Hib).
However, recommendations have changed for vaccines against seven other diseases. RSV vaccinations are now only recommended for high-risk groups. The Centers for Disease Control and Prevention (CDC) says parents should talk to their doctor about whether to give their child the rotavirus, Covid and flu vaccines. Vaccines for hepatitis A and B and two types of bacterial meningitis are classified as both high-risk and shared decision-making.
For many parents, these changes raise new questions: How can I tell if my child is at high risk? And can I still guarantee that my child will receive vaccinations that will be decided jointly?
The answer to the second question is quite simple: any parent who wants their child to receive a particular vaccine should be able to get it if their doctor or pharmacist agrees to give it. But regarding the first question, experts said it is often difficult to determine a child's level of risk of infection or disease, especially when it comes to RSV. Approximately 75% to 80% infants hospitalized with RSV are otherwise healthywithout any basic conditions.
“It is impossible to determine who is at risk for RSV in this country,” said Dr. Yvonne Maldonado, a professor of global health and infectious diseases at Stanford University.
In its revised guidelines, the fine print of the Centers for Disease Control and Prevention (CDC) suggests an initial dose of RSV for infants under 8 months of age if their mothers did not receive an RSV vaccine during pregnancy, and a second dose for children with underlying medical conditions such as chronic lung disease. This matches recommendations from the American Academy of Pediatrics.
Some doctors may not remind you about your child's next vaccinations.
Many pediatricians still follow the American Academy of Pediatrics' recommendations; if so, they'll likely notice when your child is eligible for vaccines that are no longer universally recommended by the CDC, such as flu shots. Pharmacies will also continue to post reminders online and in stores, said Dr. Brigid Groves, vice president of professional affairs for the American Pharmacists Association.
But Dr. Jake Scott, an infectious disease specialist at Stanford University School of Medicine, says many doctors rely on automated system this indicates that it is time for the patient to receive the vaccine according to CDC guidelines. The system does not flag vaccines that fall under the shared decision-making category, Scott said.
“It’s designed to make binary decisions – does this patient need this vaccine or not,” he said. “He doesn’t have the ability to say, ‘Maybe. Discuss this.”
This may place greater responsibility on parents to ensure their child's vaccinations.
Vaccine supply and availability may change
Changed vaccine recommendations could reduce demand for certain vaccines, which in turn could prompt some doctors to order fewer doses.
“I wouldn't be surprised if many physicians stop stocking vaccines that are now the basis for general clinical decisions,” Dr. Sean O'Leary, chairman of the American Academy of Pediatrics' committee on infectious diseases, said on a call with reporters Monday.
Lower vaccination coverage increases the risk of viral circulation
Pediatricians are concerned that the new vaccine schedule may lead parents to assume that some life-saving vaccines are useless and refuse to vaccinate their children.
“The move to shared decision making in clinics will lead to dramatic declines in vaccination coverage, and lower vaccination coverage will lead to preventable illness and death,” Scott said.
The US could see a larger rise in Covid or flu cases, as well as a resurgence of meningitis, experts said.
Immunocompromised children are sometimes less protected or ineligible for some vaccines. If some school districts decide to follow the CDC's new schedule, it could mean greater exposure of these vulnerable children to illness, said Dr. Kelly Gebo, dean of the Milken Institute School of Public Health at George Washington University.
“My concern now is that we are entering a phase where different states will have different recommendations, and that will create chaos for children, schools and their parents,” she said.
Insurance should still cover vaccinations
The Department of Health and Human Services said private and federal insurance programs will continue to cover all vaccines recommended under the previous CDC childhood immunization schedule. The three largest insurers confirmed to NBC News that such coverage will continue until the end of 2026.
Aetna said it will cover all shots recommended by the CDC's vaccine advisory panel as of Sept. 1, 2025, and Blue Cross and Blue Shield said it will continue to cover shots recommended by the panel as of Jan. 1. (The panel's recommendations on Covid vaccinations changed between those two dates.)
UnitedHealthcare said it will continue to cover children's vaccines. Its coverage policies are based on guidelines from the American Academy of Family Physicians and the American Academy of Pediatrics.
What to consider when making decisions with your healthcare provider
Experts say there is no reason for children to get fewer vaccinations than previously recommended by the Centers for Disease Control and Prevention (CDC), other than to avoid a few tears at the doctor's office.
Secretary of Health Robert F. Kennedy Jr. and other Trump administration officials have argued that children are receiving too many doses too early in life and have concluded that false link between early childhood vaccinations and allergies or autism. However, experts say the previous number of vaccinations does not pose any safety concerns.
“The amount of antigens—immune-stimulating proteins that children are exposed to through vaccines—is a very small fraction of what their immune system is exposed to on a regular basis,” Scott said.
“The science hasn’t changed,” Groves said. “These vaccines are safe, effective and prevent disease and death.”
Another new decision for parents: How many doses of the HPV vaccine should teenagers get?
As part of its revision of vaccination recommendations, the CDC recommended that children ages 11 to 12 years old receive one dose of the HPV vaccine instead of two or three.
Recent clinical trials suggested that one dose may be as effective as two in preventing human papillomavirus, which causes cervical cancer. However, the AAP continues to recommend two doses for children ages 9 to 12, or three doses for teens who have not yet started by age 15.
O'Leary said the American Academy of Pediatrics has considered recommending a single dose “for quite some time,” but there should be a transparent process for changing any such guidance.
