But many pediatricians and other healthcare providers, led by the American Academy of Pediatrics (AAP), are urging parents to ignore the changes and continue to immunize their children as before to protect against potentially serious illness.
Here’s how this all might play out if you’re a parent who wants your child to be vaccinated, and what you need to know to navigate this complicated situation.
How Have the Vaccine Recommendations Changed, and Why?
The CDC’s updated childhood immunization schedule has new recommendations for six vaccines that were once routinely advised for all children:
For children who are not considered at high risk, the CDC has moved these six vaccines from the “routine” category to “shared clinical decision-making.” This refers to a process that’s “individually based and informed by a decision process between the health care provider and the patient or parent/guardian,” according to the CDC.
Previously, these six vaccines were a default opt-in for parents, meaning that, unless otherwise directed, the action was to vaccinate. Now, for immunizations in the shared decision-making category, the action is not to vaccinate.
The CDC said it made the change in part out of a need for more “gold standard” science on vaccine benefits, risks, and outcomes. The agency also said the new vaccine schedule follows recommendations from a “comprehensive scientific assessment of U.S. childhood immunization practices, following a directive from President Trump to review international best practices from peer, developed countries.”
According to the CDC, the United States was an “outlier” among developed nations in recommending so many vaccines for children. The immunization changes now closely align with Denmark’s vaccine schedule, which it cited as a model to follow.
Major Medical Groups and Children’s Hospitals Are Pushing Back
“The AAP is unequivocally recommending that we continue to follow the AAP guidelines, which are aligned with the previous CDC guidelines before the new administration made the changes,” says Wendy Hasson, MD, an AAP spokesperson and a pediatrician in Portland, Oregon.
“Our stance is that the science has not changed,” Dr. Hasson says. “We continue to stand by the proven vaccine schedule that has kept [children] safe for many, many years.”
The AAP has argued against basing U.S. childhood vaccine recommendations on Denmark’s — a country far smaller than the United States, where the population is relatively homogeneous and healthcare is tax-funded and mostly free and accessible for everyone.
“America is a unique country, and Denmark’s population, public health infrastructure, and disease risk differ greatly from our own,” said Andrew Racine, MD, PhD, the president of the American Academy of Pediatrics (AAP), in a statement.
The American Academy of Family Physicians also declined to endorse the new CDC vaccine guidelines because “the science and evidence have not changed,” according to a statement from its president, Sarah Nosal, MD.
“Before vaccines, diseases like rotavirus caused thousands of hospitalizations and deaths each year in infants and toddlers,” Dr. Nosal said, and rates of these illnesses dropped once vaccines became routine.
Rates of illnesses like measles, whooping cough, and the flu have been rising recently, and health officials say declining vaccination rates are one reason why.
Major pediatric hospitals are also pushing back against the CDC changes. “We decided internally and communicated with all of our patients that we’re going to continue to follow the AAP guidance. It’s the schedule that we have confidence in because it reflects the decades of scientific data that’s been collected that demonstrates vaccines are safe, effective, and really lifesaving,” says Lori Handy, MD, an associate director of the Vaccine Education Center at the Children’s Hospital of Philadelphia (CHOP).
The data behind the new federal schedule changes are “not available or not transparent, and without that data, it’s really hard to understand why some of those changes would be made,” Dr. Handy says.
As for the Children’s Hospital Los Angeles, “We will continue to follow evidence-based immunization recommendations from the California Department of Public Health, the West Coast Health Alliance, and the American Academy of Pediatrics, and strongly encourage families to stay up-to-date on all recommended vaccines,” said a spokesperson.
“Vaccines prevent serious illness, hospitalization, and death,” they added, “especially for infants and medically vulnerable children.”
What Could Change About Your Family’s Vaccine Access?
If you are looking to protect a healthy child against the flu, for instance, you may have in the past had easy access to the vaccine just by walking into a pharmacy. Now, you will need to first make an appointment with a healthcare provider to get approval.
“Not every family has the time off work for that,” Hasson said. “Not everybody can take their kids out of school for that. Not everybody has transportation or the means to be able to do that.”
A further obstacle may be an individual pediatrician’s unwillingness or inability to contradict CDC directives. “The challenge is that an individual pediatrician may decide not to recommend that vaccine in the same way, or to stock that vaccine as they used to,” Handy says. “So, it will be important for parents to really have that conversation to understand what their individual provider is doing and what will be available to their children.”
For now, at least, cost shouldn’t be a barrier. The Trump administration announced that insurance companies will still be required to cover routine vaccines and those now under the shared decision-making umbrella. Health insurers have pledged to continue covering vaccines through the end of 2026.
Confusion Is Understandable
It’s understandable to be uncertain about vaccines given all the noise on social media, Handy says. If you are a parent you should expect to have more vaccination-related conversations with your child’s healthcare provider, Hasson adds.
In her practice, Nosal said she counsels parents about the diseases that vaccines prevent and why it matters, how well the vaccine works, and the known risks or side effects. She said she answers their questions, listens to their concerns, and guides them “using the best science and evidence-based information while respecting that this is your child and your family.”
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