The CDC recently updated its childhood vaccine schedule to reduce the number of vaccines recommended for all children. But a federal judge blocked the new guidelines, citing in part the CDC advisory committee members’ lack of vaccine or scientific expertise. The ruling prevents the CDC from making the changes for now.
What Are the CDC’s Recommendations?
Until recently, the CDC and most medical societies recommended 17 universal immunizations for babies and children. But the CDC proposed limiting six vaccines only to certain high-risk groups or leaving the decision up to caregivers and doctors.
The CDC kept the same recommendation in place for 10 of these (plus chickenpox), like some peer nations, including:
- Diphtheria
- Tetanus
- Whooping cough (acellular pertussis)
- HPV (human papillomavirus)
- Hib (Haemophilus influenzae type B)
- Pneumococcal conjugate (PCV15, PCV20)
- Polio
- Measles, mumps, and rubella (MMR)
A single-dose immunization for HPV is also recommended for all children — a change from the multi-dose series that was recommended before. A recent National institutes of Health-funded clinical trial found that one dose of HPV vaccine worked as well as two doses. The CDC is following this guidance, as well as the lead of other peer nations, according to a news release.
No vaccines were entirely removed. But six were moved to other categories of the schedule. For example, some vaccines the CDC recommends only for certain high-risk groups. Other vaccines are recommended only based on a shared decision-making process with your child’s doctor, including:
- COVID-19
- Flu
- Rotavirus
- Hepatitis A
- Hepatitis B
- Meningococcal
Why did the CDC make these changes?
The CDC’s overhaul was based in part on the Trump administration’s move toward “shared decision making” between patients and doctors about vaccinations. The federal government sets the vaccine recommendations, but states set the law on which vaccines are required. The CDC said it revised its vaccine guidance partly because children in the U.S. get more shots and at higher doses than children in certain European nations.
How Does the CDC’s Schedule Differ From Those of Other Organizations?
Leading medical organizations — including the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) — warned that the CDC’s proposal was unnecessary and not based on evidence. These other organizations continue to recommend that all children get the six vaccines no longer universally recommended by the CDC.
Immunization timetable
| Vaccine | CDC Recommendation | AAP Recommendation | AAFP Recommendation |
| Human papillomavirus (HPV) | Recommended for all children (one dose) | Recommended for all children (two doses) | Recommended for all children (two to three doses) |
| RSV | Recommended for children whose mother didn’t have the vaccine or high-risk children, such as those with chronic lung disease | Recommended for all children (depending on maternal RSV vaccination status) | Recommended for all children (depending on maternal RSV vaccination status) |
| Hepatitis A | Recommended for traveling to high-risk areas or based on shared clinical decision-making | Recommended for all children | Recommended for all children |
| Hepatitis B | Recommended for children born to mothers whose hepatitis B status is positive or unknown or based on shared clinical decision-making | Recommended for all children | Recommended for all children |
| Meningococcal ACWY | Recommended for high-risk groups (such as those with anatomic or functional asplenia or HIV infection), those traveling to high-risk areas, first-year college students living in residential housing, or based on shared clinical decision-making | Recommended for all children | Recommended for all children |
| Meningococcal B | Recommended for high-risk groups, during outbreaks, or based on shared clinical decision-making | Recommended for high-risk groups or based on shared clinical decision-making | Recommended for high-risk groups or based on shared clinical decision-making |
| COVID-19 | Recommended based on shared clinical decision-making | Recommended for all children | Recommended for all children |
| Flu | Recommended based on shared clinical decision-making | Recommended for all children | Recommended for all children |
| Rotavirus | Recommended based on shared clinical decision-making | Recommended for all children | Recommended for all children |
Why Do Other Organizations Recommend Childhood Vaccines?
Rather than basing vaccine schedules on comparisons to other countries, organizations like the AAP and AAFP use scientific data about vaccine safety and efficacy to decide who needs which vaccines.
“[The CDC’s] schedule came from an entirely different process than what we’ve relied upon for decades,” says Kristin Moffitt, MD, a physician scientist and infectious disease expert at Boston Children’s Hospital. “Those changes really weren’t based in any new data or new science.”
Charlotte Moser, MS, co-director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, said that this data is still collected even after a vaccine has been prescribed for decades.
“We’ve been using virtually all of the vaccines that are routinely recommended for children for years, in most cases, for decades,” she says. “So, we have a ton of information about how well they work and their safety.”
Why are childhood vaccines important?
Routine childhood vaccines are essential for protecting children from preventable infections and making infections less severe when they do happen.
“Children are uniquely susceptible to many of the pathogens that are covered by the current recommended vaccines,” Moffitt says.
This is because children have been exposed to fewer germs than adults.
“Their immune systems don’t have the experience that adult immune systems have,” Moser says.
It can be hard to predict which children will end up having a more serious illness after an infection. That’s why vaccines are such an important protective measure.
What to Do if You’re Undecided
The changes to the CDC’s schedule can be confusing to navigate, but you don’t have to decide which vaccines to give your child on your own.
“[Parents] should first know that they can always talk to their pediatrician,” Moffitt says.
Before your child gets a vaccination, their pediatrician should review the shot with you first and provide an information sheet. You can use this as a chance to bring up any questions and concerns you have to be sure that you’re making an informed decision.
Your child’s pediatrician can also connect you with trustworthy resources to help you learn more about the immunizations available for your child.
“There’s a lot of helpful information out there if parents continue to have questions,” Moffitt says.
She suggests the AAP and the American Medical Association (AMA) as sources of credible information online.
Takeaways
Recent updates to the CDC’s childhood vaccine schedule moved some immunizations that were previously recommended for all children to categories recommending them only for high-risk groups or based on shared decision-making with a health care provider.
Other organizations, including the American Academy of Pediatrics and American Academy of Family Physicians, still recommend all of these immunizations for all children.
If you’re unsure about whether to give your child a vaccine, you can talk to your child’s pediatrician or use online resources from trusted organizations to make a decision you feel comfortable with.
CDC Childhood Vaccine Schedule FAQs
Here are the most commonly asked questions about the CDC childhood vaccine schedule.
Does this mean some vaccines are gone or harder to get?
As of now, no changes have been made to the availability of those vaccines moved to new categories on the CDC's schedule.
Will my insurance still cover the vaccines?
Yes, your insurance should still cover the same vaccines as before, since all three categories of the CDC's schedule require insurance companies to cover the cost of vaccinations.
Does my child still need these vaccines for school?
School vaccine mandates are decided by states, rather than the federal government and CDC, meaning that mandates have always varied between states. To learn more about the vaccine requirements within your region, speak to your child’s pediatrician or your local school system.
