A new federal assessment argues that the US childhood vaccine schedule should be narrowed to a “core” set of consensus vaccines while keeping all current vaccines available, covered, and optional.
Commissioned after a December 2025 presidential memorandum, the report compares US recommendations with those of 20 peer nations, reviews uptake and trust, and highlights evidence gaps in long-term vaccine safety.
The authors note that by 2024, the US recommended routine vaccination against 17–18 diseases with 84–88 total doses, far more than many European schedules.
They propose retaining universal recommendations for 11 consensus vaccines—measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Hib, pneumococcal disease, HPV, and varicella—while shifting others (such as hepatitis A, rotavirus, meningococcal, influenza, and pediatric COVID-19) to high-risk or shared-decision-making categories.
A major theme is rebuilding trust after COVID-era mandates and communication missteps, which coincided with declining confidence in health agencies and a drop in MMR coverage from 95.2% to 92.7% in US kindergarteners.
The authors argue that respect for informed consent, less coercion, and more personalized recommendations can help stabilize uptake of core vaccines while easing concerns about non-consensus shots.
The report also calls current safety evidence incomplete, especially for cumulative schedule effects and chronic outcomes such as asthma, autoimmunity, and neurodevelopmental disorders.
It urges HHS to fund “gold standard” science, including placebo-controlled trials that randomize vaccine timing and large observational cohorts comparing different schedules, as well as more systematic use of VAERS, VSD, and the FDA’s BEST system for long-term signal detection.
In practical terms, the proposed update keeps every existing childhood vaccine available without out-of-pocket cost through insurance, Medicaid, CHIP, and the Vaccines for Children program.
What changes is how strongly each product is recommended: core vaccines for all children, targeted use for clearly high-risk groups, and shared clinical decision-making for families who, together with their clinicians, decide whether the expected benefit outweighs still-uncertain risks.
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Adapted from: Høeg TB, Kulldorff M. “Assessment of the US childhood and adolescent immunization schedule compared to other countries.” US Department of Health and Human Services; January 2, 2026. Available at: https://www.hhs.gov/sites/default/files/ assessment-of-the-us-childhood-andadolescent-immunization-schedulecompared-to-other-countries.pdf
