The Department of Health and Human Services (HHS) has accepted recommendations to update the nation’s childhood immunization schedule aligning its schedule similar to Denmark. Deputy Secretary of HHS Jim O’Neill, who is serving as acting director of the Centers for Disease Control and Prevention (CDC), signed a decision memorandum formally adopting the recommendations, which stem from a presidential directive. The directive instructed federal health leaders to assess how peer nations structure childhood vaccination schedules and to determine whether superior approaches exist abroad, while preserving Americans’ access to currently available vaccines.1
“After reviewing the evidence, I signed a decision memorandum accepting the assessment’s recommendations,” O’Neill said in a statement.1
The assessment examined immunization policies across 20 peer, developed nations, analyzing clinical and epidemiological evidence, vaccine uptake, public trust, mandates, and knowledge gaps.1
Up until this change, the US recommended childhood vaccines for 18 diseases. The statement released this afternoon noted that Denmark vaccinates against 10 diseases.1
“We don’t follow Denmark’s vaccine recommendations because we don’t live in Denmark. Children in the United States are at risk of different diseases than children in other countries,” Jose Romero, MD, FAAP, member, American Academy of Pediatrics (AAP) Committee on Infectious Diseases, said in a statement. “We also have a completely different health system. 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.” 2
On its website, the AAP has disputed the federal guidance and fact checked claims made by HHS and CDC.
Under the updated framework, CDC will continue organizing vaccines into 3 categories, all of which must be covered by insurance without cost-sharing:
Vaccines recommended for all children. Vaccines in this category will include those protecting against measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella.3
Vaccines for specific high-risk groups. The immunizations recommended for this group are for respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B.3
Vaccines offered through shared clinical decision-making. The immunizations in this category are for rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B.3
What You Need to Know
The US federal recommendation is to change from the previous 18 diseases to 11 diseases.
In doing so, the federal government aligns its childhood vaccine schedule more closely with Denmark.
No vaccines will lose insurance coverage, and the updated framework emphasizes shared clinical decision-making alongside universal protection against the most serious infectious diseases.
“All vaccines currently recommended by CDC will remain covered by insurance without cost sharing,” CMS Administrator Mehmet Oz, MD, said in a statement.1
HHS and CDC will work with state health agencies, physician organizations, and other partners to implement the updated schedule and educate clinicians and families nationwide.
Additionally, AAP added information from a previous CDC report. “Among children born [in the United States] during 1994–2023, routine childhood vaccinations will have prevented approximately 508 million lifetime 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.” 2
Our Editor-in-Chief Jason Gallagher, PharmD, FCCP, FIDP, FIDSA, BCPS, wrote about the massive changes going on within public health policy in our current issue. Read his article