What parents should know about the new childhood immunization schedule

The U.S. Centers for Disease Control and Prevention's new childhood immunization schedule represents one of the most dramatic changes in childhood disease prevention policy in decades.

Yale School of Public Health vaccine expert Dr. Jason L. Schwartz, PhD, an associate professor of public health (health policy), has been following the national vaccine debate closely. Dr. Schwartz explains the new vaccine schedule — and what it means for parents and families — below.

“When it comes to explaining these changes in recommendations, the short answer is that the CDC demoted several vaccines that used to be in the plain-and-simple, ‘you should get this vaccine’ category, to specialized sub-categories that have their own criteria and implications,” Dr. Schwartz said. “The concern is this is going to create widespread confusion about when those ‘special-category’ vaccines should be used, which will doubtlessly mean fewer kids will get those vaccines and more kids will get those diseases.”

Here’s more on the new vaccine schedule.

The new vaccine schedule reduces the number of diseases covered by recommended childhood vaccines from 17 to 11. It also divides vaccines into several categories:

• Vaccines recommended for all kids: chickenpox, diphtheria, Haemophilus influenzae type B (Hib), HPV (although the number of doses was reduced from two to one), measles, mumps, pneumococcal, polio, rubella, tetanus, and whooping cough.

• Vaccines that may be administered after shared clinical decision-making: COVID-19, flu, and rotavirus.

• Vaccines recommended for those at high-risk: RSV (recommended for all babies whose mothers did not receive the RSV vaccine) and dengue. Risk factors include other underlying illnesses, unusual exposure to the disease, or risk of transmission to others.

• Vaccines that are recommended for those at high-risk or may be administered after shared clinical decision-making for others: hepatitis A, hepatitis B, meningococcal ACWY, and meningococcal B.

“Despite concerns that the recommended vaccine list might be even more extensively revamped, or perhaps eliminated entirely, it is good to see that important vaccines such as MMR and HPV remain on the updated list,” Dr. Schwartz said.

For this category, the CDC is advising parents to speak with a health care provider or pharmacist about the risks and benefits of a vaccine based on their child’s medical history. Parents and providers have long had these types of conversations routinely, even before their explicit inclusion in the CDC recommendations.

Parents can still have their children receive vaccines for the 17 diseases that were indicated in the CDC’s 2025 vaccination schedule if they wish (and the American Academy of Pediatrics advises them to), but it may take a bit more effort and additional consultation with a health care provider.

Yes. All of the vaccines included in the new CDC schedule — including those no longer on the main ‘recommended list’ — are available at no cost to families. They remain covered by private insurance and government insurance programs such as Medicaid, Children’s Health Insurance Program (CHIP), and the Vaccines for Children Program.

A vast body of scientific and medical evidence has shown that childhood immunizations are one of the best tools we have for preventing serious diseases in children and keeping them healthy.

According to a 2024 CDC report, among children born in the United States between 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. During that same period, according to this report, vaccines no longer recommended by the CDC for all children under its new schedule prevented 6 million cases of hepatitis B (and 940,000 hospitalizations), 4 million cases of hepatitis A (and 78,000 hospitalizations), and 30 million cases of rotavirus (and over 800,000 hospitalizations).

“What we need to remember is that all of those vaccines that have been removed from the CDC’s recommended list and placed in the ‘choose-your-own adventure’ category prevent serious diseases that can make kids very, very sick,” Dr. Schwartz said. “Hep B, for instance, can lead to cirrhosis, liver failure, cancer, and death. Many of these symptoms can take decades to develop, and there is no cure.”

Dr. Schwartz discusses the new childhood vaccine schedule in greater detail in this Ask An Expert segment on KCBS radio.

The American Academy of Pediatrics (AAP), which represents more than 70,000 pediatricians nationwide, offers a downloadable pdf of its recommended childhood vaccination schedule, which is different from the CDC’s new schedule. You can find the AAP schedule here.