2026 CDC Childhood Vaccine Schedule Updates: Key Changes

In January 2026, the Department of Health and Human Services (HHS) released a memo announcing significant changes to the recommended vaccine schedule for children.

These changes are a departure from the previous federal framework for pediatric health in the US and have drawn criticism from some medical groups.

Let’s explore the specific changes, the stated reasons, and the viewpoints of opposing groups.

Who sets the U.S. federal vaccine schedule for children?

Traditionally, the vaccine schedule for children has been set by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) through a formal review process.

This involved medical and public health experts on the ACIP thoroughly reviewing disease patterns and vaccine performance. The CDC would then set the vaccine schedule based on ACIP recommendations.

States have then used the CDC vaccine schedule to develop their own requirements for children and for school entry. Although each state ultimately decides on child immunization, the federal schedule has considerable influence.

What's new in the updated schedule?

The HHS has reduced the number of diseases targeted for childhood vaccination from 17 to 11.

It no longer recommends rotavirus, COVID-19, influenza, hepatitis A, hepatitis B, and meningococcal vaccines for all children in the US. The recommended vaccine dose for human papillomavirus (HPV) has been reduced to 1, down from 2 or 3.

At-risk children

These 6 vaccines will now be recommended only for at-risk children. The HHS memo defined risk factors as “unusual exposure to the disease, underlying comorbidities, or the risk of disease transmission to others.”

The CDC website has provided guidance on the risk factors for each vaccine, which healthcare providers and parents can refer to if in doubt. For example, they recommend hepatitis A vaccination if children are traveling internationally to areas with high or intermediate cases of hepatitis A.

Shared clinical decision-making

These vaccines were previously unilaterally recommended for children and have now been moved to shared clinical decision-making.

Essentially, parents and doctors together, rather than public health officials, will make these vaccine decisions. After a consultation with a healthcare provider and with parents' approval, these vaccines can still be administered.

Moving forward, there is potential for delays, as medical personnel must personally approve these specific vaccinations. Parents may also find the different advice at the federal and state levels confusing.

Why the updates now?

One of the main reasons for the change, according to the HHS decision memo, was that the US was recommending more childhood vaccines than other countries.

Reportedly, the schedule changes aim to bring the US closer in line with other nations, such as Denmark, which recommends 10 vaccines for children.

Health Secretary Robert F. Kennedy Jr. stated that the changes are intended to restore public faith in healthcare, protect children, and respect families.

Vaccine schedule by age

The schedule still groups recommendations by age and specific medical needs. Doctors should check the CDC official vaccine schedule chart for exact vaccine details and timing.

Infancy and early years

Visits in the first year include the earliest routine shots for babies. Doctors match the vaccination schedule for babies with specific minimum ages and required wait times.

Vaccines for toddlers include boosters that build on the protection established during infancy. From ages 2 to 4, children finish the remaining routine series before they start school.

School-age and teenagers

School entry triggers immunization record checks per state-specific vaccine rules. Healthcare providers can also refer to the adolescent immunization schedule to ensure teenagers stay up to date.

Catch-up vaccine schedule

The CDC offers a catch-up vaccination schedule for children and teenagers whose vaccinations have been delayed.

The healthcare professional should first check previous doses using records and immunization registries. Then they can refer to the catch-up schedule for the minimal intervals between doses.

The healthcare provider can then assess the need for additional vaccines due to medical conditions.

Seasonal and risk-based vaccines

Advice for some vaccines now relies on yearly monitoring and personal risk profiles. Healthcare professionals can review the CDC notes on this year's DTaP vaccine schedule and gaps between doses.

The CDC now advises parents and healthcare professionals to decide together whether children should get flu shots.

The debate: Support and criticism

The US President Donald Trump stated that the new recommendations are "rooted in the gold standard of science."

His online statement was "Many Americans, especially the 'MAHA Moms,' have been praying for these COMMON SENSE reforms for many years." (MAHA Moms refers to the political slogan Make America Healthy Again.)

Medical groups, including the American Public Health Association, the American Academy of Pediatrics, and the Infectious Diseases Society of America, have challenged the recommendations, saying the changes lack scientific support and could harm the public.

These groups have filed a lawsuit to block the implementation of the new recommendations.

Hands-on workflow advice

In practical terms, here are some action points to help your team prepare for the changes in immunization recommendations:

EHR and registry: Revise order sets and alerts to align with CDC pediatric immunization updates for 2026.
Documentation: Note lot numbers and expiration dates to meet immunization registry reporting needs.
Communication: Create balanced explanations of changes to tackle common parental vaccine concerns.