Executive Summary 

• The Department of Health and Human Services (HHS), through the Centers for Disease Control and Prevention (CDC), recently updated the childhood vaccination schedule. 
• The change was taken pursuant to a presidential memorandum directing HHS and CDC to review “best practices” among peer countries for “core” childhood vaccine recommendations and to update the U.S. schedule if those practices were determined to be “superior,” while “preserving access” to vaccines currently available. 
• The revised schedule distinguishes: (1) immunizations recommended for all children, (2) immunizations recommended for certain high-risk groups or populations, and (3) immunizations based on shared clinical decision-making. 

Introduction 

On January 5, 2026, the Department of Health and Human Services (HHS) announced that Centers for Disease Control and Prevention (CDC) leadership had updated the U.S. childhood immunization schedule after a review comparing U.S. recommendations with those of “peer, developed” countries. The change was taken pursuant to a December 5, 2025, presidential memorandum directing HHS and CDC to review “best practices” among peer countries for “core” childhood vaccine recommendations and to update the U.S. schedule if those practices were determined to be “superior,” while “preserving access” to vaccines currently available. 

Operationally, HHS describes the revised schedule as a three-part structure that distinguishes: (1) immunizations recommended for all children, (2) immunizations recommended for certain high-risk groups or populations, and (3) immunizations based on shared clinical decision-making (SCDM), which is a decision process between the health care provider and the patient or parent/guardian. HHS also states that vaccines listed across these categories will be covered by insurance without cost-sharing, positioning the change as a reclassification of “default” recommendations rather than a restriction on availability. 

2026 Vaccine Schedule Update 

HHS’ press release identifies the “recommended for all children” category to include immunization against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, haemophilus influenzae type b (Hib) , pneumococcal disease, human papillomavirus (HPV), and varicella. 

The policy change is clearest in what is not in the universal category. The HHS fact sheet specifies that the high-risk category vaccines include respiratory syncytial virus monoclonal antibody (RSV-mAb), hepatitis A, hepatitis B, dengue, meningococcal vaccine for serotypes A, C, W, and Y, and meningococcal B (with further footnotes defining the triggering risk criteria). Finally, the shared clinical decision-making category includes rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B. As noted in the listings above, meningococcal disease, hepatitis A, and hepatitis B are dually categorized on the new schedule. 

HHS also highlights a change to HPV dosing, stating the CDC is now recommending one dose (rather than two) based on “recent scientific studies” and alignment with “several peer nation[s].” 

Below is a table summarizing the recategorization of the childhood vaccination schedule.

Source: HHS/CDC 

Purported Rationale 

The administration’s published rationale for updating the children’s vaccination schedule is framed as (1) international benchmarking and (2) trust and adherence considerations. 

First, the presidential memorandum asserts that the United States has been an “outlier” in the number of diseases for which it recommended vaccination for all children (including COVID-19 as of January 2025), and it cites Denmark, Japan, and Germany as comparators with fewer universally recommended diseases. HHS’s press release adopts a similar framing, stating that in 2024 the United States recommended more childhood vaccines than any peer nation and “more than twice as many doses” as some European nations, again referencing Denmark at the low end. The fact sheet states the revised U.S. schedule is intended to recommend “all vaccines for which there is consensus among peer nations,” with non-consensus vaccines reallocated to high-risk or SCDM categories.  

Second, HHS explicitly links the revision to public trust and uptake. The press release states that its assessment documented a “significant decline in public trust” from 2020–2024, coinciding with falling childhood vaccination rates and increased risk of vaccine-preventable disease. The fact sheet offers a quantified trust claim (trust declining from 72 percent to 40 percent between 2020 and 2024) and argues that a more “focused” core schedule could improve “clarity,” adherence, and public confidence.