The US Centers for Disease Control (CDC) has shifted its stance on childhood vaccination, having minimised its routine recommendation list to 11 vaccines.
This is down significantly from the regulator’s previous routine childhood vaccine schedule, which stood at 17 at the end of 2024.
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Through this policy change, vaccines for respiratory syncytial virus (RSV), hepatitis A and B, dengue and meningococcal ACWY & B jabs are no longer a part of routine childhood administration. Instead, the agency only encourages the use of these vaccines in certain “high-risk” groups – including those with underlying comorbidities or unusual exposure.
In line with “peer nations”, the agency will continue to recommend the routine immunisation of children against polio, tetanus, diphtheria, measles, mumps, rubella, pertussis, Haemophilus influenzae type B, human papillomavirus (HPV), varicella and pneumococcal disease.
According to US Health Secretary Robert F Kennedy (RFK) Jr, the US childhood vaccine recommendation list was shortened to better align with the international consensus, while promoting transparency and supporting informed consent amongst the public.
The CDC added that routine childhood jabs will still be covered by both the Affordable Care Act (ACA) and federal insurance programmes.
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By GlobalDataUS vaccine policy shifts
This significant policy shift follows the CDC’s prior call to revoke a three decade-long recommendation of routine hepatitis B vaccination in infants, which was met with heavy backlash from several medical bodies.
The CDC is not the only US health agency pushing for vaccine policy change, however, as the US Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research (CBER) lead, Vinay Prasad, is currently looking to alter the regulatory paradigm by diminishing reliance on “immunobridging” studies.
This proposal was also met with backlash – this time from a group of 12 former FDA commissioners, who noted that the plans would “undermine” regulations that currently ensure the availability of safe and effective vaccines in a comment piece published in the New England Journal of Medicine.
The FDA’s new drug evaluation head, Tracy Beth Høeg, who replaced Richard Padzur after his sudden retirement just one month after accepting the role, has also voiced her scepticism towards the value of certain vaccines.
Medical bodies react to the changes
In a 5 January statement, the Infectious Diseases Society of America’s (IDSA) president, Ronald Nahass, described the CDC’s decision as “irresponsible,” noting that the upending of long-standing vaccine recommendations without public transparency and engagement with external experts will “undermine confidence in vaccines”.
He also theorised that the move will lead to decreased vaccination and increased disease rates.
American Medical Association’s (AMA) trustee Sandra Adamson Fryhofer echoed Nahass’ sentiment, adding that the schedule change will “impact the health and safety of millions of children”, while undermining public trust.
Fryhofer also urged federal health leaders to “recommit” to transparency and evidence-based processes that take into account the “realities of disease burden in the US”.
Another organisation to speak out on the topic is the Pediatric Infectious Diseases Society (PIDS), which said that such a change to policy will cause confusion for both practitioners and parents.
PIDS also critiqued the CDC’s approach to align with peer nations, as the society believes that comparing the US to other countries based on the number of recommended vaccines leads to the oversimplification of complex differences in disease, burden, surveillance capacity, health systems and population risk.
“The prior US immunisation schedule was specifically designed to address the epidemiology of infectious diseases affecting children in this country and has a long-standing record of safety and effectiveness,” a PIDS spokesperson concluded.
