The United States has ended its longstanding guidance that all children receive vaccines against influenza and three other diseases, shifting to “shared clinical decision-making” between families and providers. The sweeping change — approved by Centers for Disease Control and Prevention Acting Director Jim O’Neill without the agency’s usual outside expert review — applies to rotavirus, meningococcal disease and hepatitis A, in addition to flu.
Public health experts warned the rollback could lead to preventable hospitalizations and deaths, arguing the process short-circuited the transparent, evidence-driven debate that typically accompanies changes to the childhood vaccine schedule.
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The move advances Health Secretary Robert F. Kennedy Jr.’s long-stated goal of paring back childhood vaccinations. Kennedy, a prominent vaccine critic, previously led efforts to drop universal recommendations for COVID-19 and hepatitis B shots for children, citing links to autism that scientists have repeatedly debunked.
A post on Truth Social praised the new schedule as “rooted in the Gold Standard of Science,” saying it aligns the United States with other developed nations and congratulating Kennedy and other health officials. “Many Americans, especially the ‘MAHA Moms,’ have been praying for these COMMON SENSE reforms for many years,” the post said, referring to Kennedy’s Make America Healthy Again movement.
For the policy change, two Health and Human Services officials, Martin Kulldorff and Tracy Beth Hoeg, reviewed vaccine protocols in 20 other developed countries — all of which have universal healthcare — and recommended shifting the U.S. schedule, the agency said. In a report, HHS wrote that the level of risk varies by disease and by child.
Across the 20 countries reviewed, the flu shot is universally recommended in four, while a shot against hepatitis A is universal only in Greece. The rotavirus vaccine is recommended for all children in 17 of the 20 countries, and shots against meningococcal disease are universal in 16.
Experts said those comparisons miss critical differences in disease burden and how healthcare is delivered in the United States. “Any decision about the U.S. childhood vaccination schedule should be grounded in evidence, transparency and established scientific processes, not comparisons that overlook critical differences between countries or health systems,” said Dr. Sean O’Leary, chair of the American Academy of Pediatrics.
Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said the CDC should have held public discussions on risks and benefits before dropping longstanding recommendations.
Each of the four vaccines prevents diseases that once caused unnecessary hospitalizations and death in children, said Dr. Jesse Goodman, a Georgetown University professor and former FDA chief scientist. Flu shots can prevent pediatric deaths; influenza killed 288 children in the 2024–25 season, according to the CDC. Hepatitis A infects the liver and usually resolves on its own but can lead to hospitalization and lifelong liver damage. Rotavirus, a cause of severe diarrhea and dehydration, used to send tens of thousands of children to the hospital each year, but vaccines have made such cases extremely rare, Goodman said. While bacterial meningitis in children is uncommon, about 15% of infected patients do not respond to antibiotics and die. “If you can safely prevent it, it makes total sense,” he said.
HHS said the updated recommendations maintain immunizations for 11 diseases, including measles, mumps and varicella, while classifying other shots as targeted to high-risk groups or under shared decision-making. The department said insurers will continue covering immunizations regardless of category.
The schedule also shifts the human papillomavirus (HPV) vaccine to a single-dose regimen for children, rather than two doses. Recent studies have found one dose is not inferior to the longer course, and the World Health Organization backs a single-dose schedule.
The CDC typically relies on advice from outside experts before changing vaccine recommendations. O’Neill’s sign-off without that review — and the administration’s emphasis on cross-country comparisons — left many pediatricians and infectious disease specialists concerned that political priorities, not scientific process, drove a decision with far-reaching consequences for child health.
By Abdiwahab Ahmed
Axadle Times international–Monitoring.
