The U.S. Department of Health and Human Services has announced major changes to the national pediatric vaccine schedule, reducing the number of diseases for which routine childhood immunization is recommended.
Under the new guidelines, children in the United States will continue to receive vaccines against measles, mumps, rubella, polio, pertussis (whooping cough), tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox).
Vaccines for other diseases—including hepatitis A and B, rotavirus, respiratory syncytial virus (RSV), bacterial meningitis, influenza, and COVID-19—will now be recommended only for certain high-risk groups or offered as “optional” through what officials describe as “shared clinical decision-making.”
Insurance companies are still required to fully cover all vaccines listed on the Centers for Disease Control and Prevention’s schedule, including those now classified as optional.
This policy change follows a presidential memorandum signed by President Donald Trump in December. The memorandum directed health agencies to update vaccination recommendations “to align with such scientific evidence and best practices from peer, developed countries.”
The revised U.S. vaccine guidelines now more closely resemble those of Denmark. In Denmark, children are routinely vaccinated against 10 diseases rather than a broader range. However, experts note that Denmark’s healthcare system differs significantly from that of the United States due to its universal coverage and smaller population.
Dr. Kelly Gebo of George Washington University commented on these differences: “The vaccines that are recommended in any particular country reflect the diseases that are prevalent in that country,” she said. “Just because one country has a vaccine schedule that is perfectly reasonable for that country, it may not be at all reasonable” elsewhere.
She pointed out disparities in maternal screening for hepatitis B between Denmark and the U.S., noting that less than 85% of pregnant women in America are screened compared to almost universal screening in Denmark. The United States has relied on widespread childhood vaccination since 1991 to protect against hepatitis B among children whose mothers may not have received adequate prenatal care.
Dr. James Alwine of Defend Public Health expressed concern about potential risks: “Viruses and bacteria that were under control are being set free on our most vulnerable,” he said. “It may take one or two years for the tragic consequences to become clear, but this is like asking farmers in North Dakota to grow pineapples. It won’t work and can’t end well.”
