The Centers for Disease Control and Prevention (CDC) on Monday said it will follow the lead of Denmark and recommend that the number of routine vaccinations given to American children drop from 17 to 11. Public health advocates, including Senator Bill Cassidy, M.D., derided the decision, which they said will endanger the health of children.
The news of the updated immunization schedule was announced by the Department of Health and Human Services (HHS), which oversees the CDC.
Unlike prior updates to the childhood vaccine schedule, this overhaul did not undergo the CDC’s customary review by the Advisory Committee on Immunization Practices (ACIP). The committee, which is responsible for evaluating safety and efficacy evidence, met last month to discuss childhood vaccines but only voted to remove the universal recommendation that the hepatitis B vaccine be given at birth.
On Monday, HHS Deputy Secretary Jim O’Neill, who also serves as acting director of the CDC, signed a decision memorandum, which accepted recommendations from an assessment that reviewed international best practices from peer, developed countries per a directive from President Donald Trump.
The new recommendations are effective immediately. They still call for all children to receive vaccines for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox).
However, only certain high-risk groups or populations are recommended to receive respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B.
The CDC now advises that parents consult with physicians regarding whether their children should receive vaccines for rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B.
Insurers will still cover the cost of the vaccines without cost-sharing, according to Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services (CMS). “No family will lose access,” he said in the announcement. “This framework empowers parents and physicians to make individualized decisions based on risk, while maintaining strong protection against serious disease.”
But Cassidy, an advocate of vaccines who was a critical vote to confirm Robert F. Kennedy Jr. as HHS secretary despite concerns over his anti-vaccination views, criticized the change in the immunization schedule.
“As a doctor who treated patients for decades, my top priority is protecting children and families,” he wrote in a post on X Monday. “Multiple children have died or were hospitalized from measles, and South Carolina continues to face a growing outbreak. Two children have died in my state from whooping cough. All of this was preventable with safe and effective vaccines. The vaccine schedule IS NOT A MANDATE. It’s a recommendation giving parents the power. Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors and will make America sicker.”
Indeed, states have the authority to mandate vaccines, but the CDC does influence the regulations.
Public health advocates worry that the recommendations will further confuse parents who are influenced by vaccine misinformation online. Distrust in vaccinations has escalated in the wake of COVID-19 and statements by Kennedy that the United States recommends too many vaccines and has promoted a discredited theory that vaccines cause autism. Vaccine hesitancy within the United States has led to a significant increase in cases of measles, whooping cough, and the flu.
HHS and the CDC said that many peer nations recommend fewer routine vaccines than the United States. In 2024, the federal agencies said, the U.S. recommended more childhood vaccines than any peer nation, and more than twice as many doses as some European nations. But a 2024 CDC report found that routine childhood vaccinations have prevented approximately 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.
The U.S. will now more closely align with the recommendations of Denmark, which immunizes children against 10 diseases. But Jose Romero, M.D., FAAP, member of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases, said the United States doesn’t follow Denmark’s vaccine recommendations because children in America are at risk of different diseases. “The bottom line is vaccine recommendations in the United States are designed to help children resist serious illnesses so they can stay healthy, and our communities can stay healthy,” he said.
Robert Hopkins, medical director of the National Foundation for Infectious Diseases, told Nurses.org that the United States’ newest recommendations ignore fundamental differences in Denmark’s population size, diversity, health care access, and infectious disease risk. “These differences matter,” he said. “U.S. immunization policies must be guided by a transparent, evidence-based process and grounded in U.S. epidemiology and real-world risk.”