On January 5, 2026 the US Dept. of Health and Human Services (HHS) and the acting director of the CDC jointly announced a major revision in the childhood immunization schedule. This is the first such change in the federal protocol, other than to add new vaccines or add additional doses of others, in decades. The trend has been to add to the schedule rather than to subtract.
This revision was met with wholesale rejection by the American Academy of Pediatrics (AAP), the Advisory Committee on Immunization Practices (ACIP), and many other medical and public health organizations. The American Academy of Family Physicians (AAFP) followed the lead of the AAP rejecting the revisions as well.
To me, the recommended changes were not much to be concerned about and didn’t represent a serious intent to gut the integrity of the entire schedule. Most of it remained the same. The changes in protocol involve seven vaccines that are not at the core of the schedule. These 7 vaccines were Rotavirus, COVID-19, influenza, meningococcal ACWY, hepatitis A and B, and HPV (Human Papilloma Virus). The new recommendation for 6 of the 7 was to make them optional, and to give them only after a discussion of the pros and cons of these vaccines.
With HPV (Gardasil) vaccine, a change in dosing occurred. Instead of the usual 2-dose regimen, only one dose was recommended. The age for administration was not specified, nor was a reason for this change stated. In fact, no scientific rationale was given for any of these changes.
Federal recommendations differ significantly from the AAFP recommendations and the recommendations of other major medical organizations. Several very important facts still remain:
No vaccine was removed from the recommendation schedule
All vaccines on the ACIP schedule have been thoroughly reviewed for safety and efficacy
and are still recommended.
Insurance coverage has not changed
State and school requirements are not affected by the revisions.
Most patients still look to their personal physician when it comes to vaccine
recommendations and are encouraged to discuss their options with their doctor.
Like I stated earlier, these changes aren’t a big deal. Rotavirus is a significant concern worldwide, but deaths from it are rare in the U.S. It does make kids fairly sick, however. The vaccine has reduced the number of cases significantly, and parents can still opt for the vaccine.
COVID-19 virus appears now not to be the concern it was 4 to 5 years ago so the fear of death from it has been lessened significantly. The latest vaccine is still available for administration.
Influenza vaccine has been strongly recommended for decades, but has never been a mandatory vaccination. It probably should be, but it remains a choice.
Meningococcal ACWY is a niche vaccine intended only for certain populations, but given to all. Those groups should be targeted for discussion and encouraged to be vaccinated.
Hepatitis A is a sporadic disease that is transmitted from the sick to the well, and is not common among the healthy members of society. In fact, it’s not terribly common among the unhealthy members of society. For it to be mandatory for everyone is overkill.
Hepatitis B is more common among certain segments of the population, ie. IV drug abusers, me who have sex with men, the sexually promiscuous, health care workers who are at risk for needle sticks, etc. Those folks are the focus of education and immunization efforts.
HPV vaccine falls into a similar category as Hepatitis B. Human Papilloma Virus is the cause of cancer of the uterine cervix in women and causes penile and anal warts and penile cancer in men. These are sexually transmitted diseases that occur in a more promiscuous population. It is still available for every adolescent if desired.
The majority of the schedule is unchanged. No vaccine has been deleted from the recommended list, and the timing of administration remains the same. No one is saying these vaccines should not be given, but they are saying they should be given to people who are high risk individuals. The message to doctors and the public is, select out the patients at risk for each vaccine on the “list of Seven,” discuss the benefits with them and administer the vaccine if they agree to take it. “Shared decision making” is just that—disclose, discuss, decide.
Disclose important information, discuss the pros and cons with the patient, decide to be given the shot if there is good reason.
Reference: Campos-Outcalt D. Practice Alert: Proposed Revision of the Federal Child and Adolescent Immunization Schedule bypasses Established Processes. Am Fam Phys 2026 August; 114(2):118-120.
News Release: CDC Newsroom. “CDC Acts on Presidential Memorandum to Update Immunization Schedule” www.cdc.gov/media/releases
