Washington: The United States has overhauled its childhood immunisation guidelines, reducing the number of diseases for which vaccines are routinely recommended from 17 to 11, a move that has drawn sharp criticism from leading medical organisations.
The revised recommendations, issued by the Centres for Disease Control and Prevention (CDC), retain vaccines for diseases such as measles, polio and diphtheria as standard for all children. However, several others, including hepatitis A, hepatitis B and Covid-19, are now advised based on individual risk and shared clinical decision-making between doctors and parents.
US President Donald Trump welcomed the changes, describing them as rooted in the gold standard of science. The overhaul forms part of a broader set of health policy shifts under his administration, led by Health Secretary Robert F Kennedy Jr, a long-time critic of existing vaccine policies.
Trump stated that, “Many Americans, especially the ‘MAHA Moms,’ have been praying for these common-sense reforms for many years.” Kennedy said the updated schedule followed an ‘exhaustive review’ and was designed to protect children, respect families, and rebuild trust in public health.
Kennedy added that the US was aligning its approach with international norms while increasing transparency and informed consent. Under the new CDC guidance, vaccines recommended for all children protect against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella, or chickenpox.
A second category includes vaccines recommended depending on risk factors, such as those for respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, and meningococcal ACWY and B, which protect against forms of meningitis. A third group, covering Covid-19, influenza and rotavirus, has been left to parental choice in consultation with healthcare providers.
The CDC said insurance coverage would continue for all vaccines still recommended through the end of 2025. The changes follow an executive order signed by Trump in December directing health officials to compare the US vaccine schedule with those of peer developed countries.
According to the Department of Health and Human Services, comparisons with 20 countries, including the UK, Canada, Denmark and Australia, showed the US to be a global outlier in both the number of diseases covered and the number of doses administered. Denmark’s schedule, which targets around 10 diseases, was cited as a reference point.
That comparison has been strongly contested by paediatric experts. Dr Andrew D Racine, president of the American Academy of Pediatrics (AAP), said the decision was dangerous and unnecessary. Denmark has a population of about six million, compared with roughly 340 million in the US.
Racine added that, “At a time when parents, paediatricians and the public are looking for clear guidance and accurate information, this ill-considered decision will sow confusion and erode confidence in immunisations.”
Republican Senator Bill Cassidy of Louisiana, a physician, also criticised the move, warning it could increase vaccine hesitancy. The controversy follows a recent CDC decision to revise guidance on the timing of the first hepatitis B vaccine dose.
Previously recommended within 24 hours of birth, the first dose was shifted last December to two months after birth for infants born to hepatitis B–negative mothers, a change that the AAP also described as harmful.
Public health experts warn that the cumulative effect of these policy shifts could weaken long-standing immunisation programmes and reverse gains made against preventable childhood diseases.
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