The Centers for Disease Control and Prevention will update the U.S. childhood immunization schedule following a federal review comparing U.S. vaccination practices with those of other developed countries, according to a decision memorandum signed earlier this month.
The memorandum was signed by Jim O’Neill, deputy secretary of Health and Human Services and acting CDC director, accepting recommendations from a scientific assessment ordered under a December 2025 presidential directive.
The review was initiated after President Donald Trump directed federal health agencies to examine how peer nations structure childhood vaccination schedules and whether alternative approaches could improve outcomes in the United States. The directive instructed agencies to preserve access to vaccines currently available to U.S. families.
According to the CDC, the assessment compared U.S. immunization recommendations with those of 20 peer, developed countries. The review evaluated clinical and epidemiological evidence, vaccine uptake, public trust, vaccine mandates, and areas where additional research may be needed.
The assessment found that the United States recommends vaccination against more diseases and includes more total doses in its routine childhood schedule than any peer nation, while not achieving higher vaccination rates. In 2024, the U.S. recommended protection against 18 diseases, compared with 10 diseases in countries such as Denmark.
Following review of the assessment and a joint decision memorandum presented by Jay Bhattacharya, Marty Makary, and Mehmet Oz, O’Neill directed the CDC to proceed with implementation of the recommendations.
Under the updated framework, the CDC will continue to organize childhood vaccines into three categories:
Vaccines recommended for all children;
Vaccines recommended for specific high-risk groups or populations;
Vaccines offered through shared clinical decision-making between families and clinicians.
All vaccines currently recommended by the CDC will remain covered by insurance without cost-sharing, according to federal health officials.
Vaccines listed in the “recommended for all children” category will include measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella.
The assessment also documented a decline in public trust in health care institutions between 2020 and 2024, alongside decreases in childhood vaccination rates and increased risk of vaccine-preventable diseases.
Federal health agencies said the recommendations also call for expanded research, including long-term observational studies and randomized clinical trials, to further evaluate vaccine safety, effectiveness, and outcomes. The Department of Health and Human Services will coordinate funding for this research through its agencies.
The CDC and HHS said they will work with state health departments, medical organizations, and other partners to implement the updated schedule and provide guidance to clinicians and families.
A fact sheet outlining the changes is available through the CDC.
