The Centers for Disease Control and Prevention announced on Monday that it has updated its recommended vaccine schedule for children, reducing the number of immunizations all kids should receive from 17 to 11.
Effective immediately, the new guidelines recommend that six shots, which had previously been given to all children, only be given to those who are high risk, or given after consultation between parents and a doctor.
In a statement released Monday, the Health and Human Services Department said the changes came after a “scientific review of the underlying science, comparing the US child and adolescent immunization schedule with those of peer, developed nations.”
Proponents of the change, including HHS Secretary Robert F. Kennedy Jr., say the move follows policies in countries like Denmark and Germany.
These new guidelines come after a federal vaccine advisory committee voted to no longer recommend the hepatitis B vaccine last month.
The six vaccines that are no longer recommended for all children are hepatitis A, hepatitis B, influenza, meningococcal disease, rotavirus and respiratory syncytial virus.
Which shots are still recommended for all children?
There are still 11 diseases that the CDC advises all children get vaccinated against because they cause serious morbidity or mortality to children. These recommendations are in line with international consensus.
The diseases include whooping cough, diphtheria, tetanus, HPV, Haemophilus influenzae type B, pneumococcal disease, polio, chickenpox, measles, mumps and rubella.
Immunizations only recommended for high-risk children
The agency says certain shots should now only be given to high-risk groups, arguing that vaccines have “different risk-benefit profiles for different … people.”
High-risk groups can include those with underlying medical conditions, but HHS also says that “unusual exposure to the disease” or passing the disease to others are factors.
The vaccines in this category are hepatitis A, hepatitis B, meningococcal ACWY, meningococcal B, respiratory syncytial virus and dengue.
Vaccines recommended ‘based on shared clinical decision-making’
The third group of vaccinations is based on a framework called shared clinical decision-making, which means parents should consult with a healthcare provider about whether their child should get a particular shot.
The HHS has stated that physicians and parents are “best equipped to decide based on individual characteristics” if children should receive vaccinations for hepatitis A, hepatitis B, meningococcal disease, rotavirus, influenza and COVID-19, which was updated last May.
Why these guidelines are changing
In December, President Donald Trump advised the HHS to revamp the US vaccination schedule to follow those of other wealthy nations. He pointed out that Denmark’s schedule vaccinates against 10 diseases, Japan 14 and Germany 15.
In Denmark, vaccines for the flu, COVID, RSV, chickenpox, hepatitis A, rotavirus and meningococcal disease aren’t included in the recommendations for children.
Germany doesn’t recommend the hep A vaccine except for high-risk groups, or travel. COVID-19 shots are also only recommended for children with health risks. While the US previously gave the hep B vaccine at birth, Germany gives it at two months, unless the mother is a known carrier.
However, Germany recommends one vaccine for every child that the US doesn’t: meningitis B.
A longtime vaccine skeptic, Kennedy has argued the US schedule had not been rigorously tested and was a likely cause of rising autism rates — a claim that’s been repeatedly debunked — and offered a slimmer schedule, closer to the Danish model.
The HHS also argued that a “loss of trust” during the COVID-19 pandemic “contributed to less adherence to the full CDC childhood immunization schedule, with lower rates of consensus vaccines such as measles, rubella, pertussis and polio.”
Why has the US’s schedule been different from some other countries?
Since Trump’s memorandum in December, several experts, and The Post’s editorial board, have criticized the move, taking particular issue with modeling US policy on other countries like Denmark.
For one thing, the US has more than 343 million people. Denmark has just 6 million — about 1.7% of the US’s population. American demographics are different, as is the American healthcare system.
“It’s like comparing a cruise ship to a kayak,” Dr. Sean O’Leary, chair of the Committee on Infectious Diseases for the American Academy of Pediatrics, told NPR.
Denmark also has a national health registry.
“And so if there are outbreaks or if there are cases of these diseases, they can easily identify them,” Josh Michaud, associate director for global and public health policy at KFF, told the outlet. “They can treat them, get them into care, and also track down contacts, if that’s needed for the particular disease we’re talking about.”
There are other policy differences between the US and Denmark, including that Danish families get a year of paid parental leave, meaning parents can stay home with sick kids.
“It’s not at all fair to say look at Denmark unless you can match the other characteristics of Denmark,” Anders Hviid, who leads Denmark’s equivalent of the US’s CDC, told the New York Times.
He noted that the reason Denmark excludes certain vaccines is that those diseases don’t pose a big enough problem in the country. Denmark also buys all of its vaccines for its citizens — and has free universal healthcare, which likely induces more people to seek medical care when sick.
“[In Denmark,] everyone has access to excellent prenatal and childhood care,” Hviid told CNN. “As I understand it, that is not the case for everyone in the US. Vaccines prevent infections that may have poor outcomes for children who do not have access to good healthcare.”
What do the experts say?
The change has been largely criticized, with medical professionals expressing fear for what this could mean for future infections.
“They’re going to bring back suffering and death,” O’Leary told the Times. “I don’t say that with any hyperbole, that’s exactly what’s going to happen.”
Dr. Nada Mallick, dual board-certified in general pediatrics and pediatric critical care at Children’s National Hospital, has similar concerns.
“This raises public health concerns — particularly for influenza and RSV — as we enter peak winter season, when respiratory infections are already on the rise,” she told The Post.
Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Children’s Hospital, said she sees the change as a “disservice to American children.”
“Each of these vaccines was compared to placebo and showed how effective they were at preventing disease. By taking them away from being recommended, we are now offering American children placebo,” she said.
