CDC overhauls childhood vaccine schedule to resemble Denmark in unprecedented move
The Centers for Disease Control and Prevention announced Monday an unprecedented overhaul of the childhood vaccine schedule that recommends fewer shots to all children.
Under the change — effective immediately — the vaccine schedule will more closely resemble Denmark’s, recommending all children get vaccines for 11 diseases, compared with the 18 previously on the schedule.
Senior Health and Human Services officials said the changes are meant to restore trust in public health that spilled over from the Covid pandemic.
“The loss of trust during the pandemic not only affected the COVID-19 vaccine uptake. It also contributed to less adherence to the full CDC childhood immunization schedule, with lower rates of consensus vaccines such as measles, rubella, pertussis, and polio,” reads the scientific assessment the agency based its decision on.
The assessment said “there is a need for more and better science” on vaccines — though the new schedule does not say there are specific vaccines children should not get.
In practice, not much will change for parents who want their children to continue to get all of the vaccines previously recommended. Insurance will continue to cover the shots.
“The best case scenario is that nothing will change,” said Dr. David Margolius, the director of public health for the city of Cleveland. “The worst case scenario is that this causes more confusion, more distrust, lower vaccination rates, and then just this trend of political parties and ideologies determining which vaccines people should get.”
There’s no “rigor or reason” to reduce the number of shots just because another country did it, Margolius said. “It just doesn’t make sense.”
In Denmark, vaccines for the flu, Covid, RSV, chickenpox, hepatitis A, rotavirus and meningitis are not included in the childhood schedule. Denmark also recommends some shots — including polio, diphtheria, tetanus and whooping cough — on a slightly different timeline than the U.S.
The CDC said it will continue to recommend that all children get vaccines for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, HPV and chickenpox.
Other vaccines, however, will be recommended for “high-risk groups” or recommended based on so-called shared clinical decision-making. Vaccines recommended for high-risk groups are shots for RSV, hepatitis A, hepatitis B, dengue and two types of bacterial meningitis.
The vaccines recommended based on shared clinical decision-making are for rotavirus, Covid, the flu, hepatitis A, hepatitis B and bacterial meningitis.
A senior HHS official said that all vaccines recommended as of the end of 2025 — before this schedule change went into place — will remain available and covered by Affordable Care Act plans and federal insurance plans, including Medicaid, the Children’s Health Insurance Program and the Vaccines for Children program.
The childhood vaccine schedule is a set of recommendations on the timing of vaccinations. It’s not a mandate, but is used to guide what vaccines are covered by insurance and are needed to attend daycare and public schools. States determine which vaccines are required for school attendance and have historically relied on the CDC schedule. It’s usually reviewed annually by the CDC’s vaccine advisory panel and updated based on the latest scientific evidence.
Public health experts and major medical organizations warn against the change.
Some public figures “have claimed that the U.S. childhood vaccine schedule is unsafe or unnecessary because the United States recommends more routine vaccines than some countries, like Denmark,” the American Academy of Pediatrics says on its website. “The truth is that while vaccine guidance is largely similar across developed countries, it may differ by country due to different disease threats, population demographics, health systems, costs, government structures, vaccine availability, and programs for vaccine delivery.”
Why Denmark?
Health Secretary Robert F. Kennedy Jr., an anti-vaccine activist, has said he believes children in the U.S. receive too many vaccines, falsely saying on multiple occasions that kids get as many as 90 doses before age 18. As health secretary, he has moved to limit vaccines for kids, including removing a recommendation for the Covid shot. Last month, the CDC rolled back a decades-long recommendation that all newborns get their first dose of the hepatitis B vaccine within 24 hours — a move experts said could lead to a resurgence of infections.
In December, Dr. Tracy Beth Hoeg, the acting director of the Food and Drug Administration’s Center for Drug Evaluation and Research who has been critical of the Covid shot, gave a presentation on the Danish vaccine schedule during a CDC vaccine advisory committee meeting.
The presentation by Hoeg — who holds dual citizenship in the U.S. and Denmark — suggested fewer vaccines may reduce children’s exposure to aluminum, an ingredient used in shots to boost the immune response and a target of anti-vaccine groups. A major study from Denmark, published in July, found that aluminum exposure from vaccines is not harmful. Kennedy demanded the journal retract the study, calling it “a deceitful propaganda stunt by the pharmaceutical industry;” the journal did not issue a retraction.
Shortly after the meeting ended, President Donald Trump directed health officials to review U.S. childhood vaccination recommendations and align them with the “best practices” from other developed countries — including Denmark.
Anders Peter Hviid, the senior author of the Danish study on aluminum in vaccines and a professor in the department of epidemiology research at Statens Serum Institut in Denmark — that country’s equivalent of the CDC — wrote in an email in December that Denmark has a more homogeneous population than the U.S., with greater trust in public health institutions, universal and free health care and lower rates of serious outcomes from infectious diseases that it doesn’t vaccinate against but the U.S. does.
Denmark’s robust public health system, for example, makes it much easier for the country to test pregnant women for hepatitis B and ensure that babies born to women test positive are vaccinated against the disease. A similar approach, now endorsed by the CDC, had not been successful in the U.S. at cutting infection rates in children.
Denmark’s vaccination schedule is not set in stone, however. Meeting summaries from the Danish Vaccine Council — an expert panel that advises Denmark on vaccine recommendations — from November of last year suggest growing interest in reassessing rotavirus, chickenpox and hepatitis B vaccinations.
In October, the Danish government began recommending RSV vaccination for pregnant women. The vaccine council is also considering the RSV antibody shot for infants. The shot was approved in the European Union in 2022.
Hviid said under the proposed changes, outbreaks for disease currently rare in the U.S. “will only get worse.”
“Derecommending will likely lead to lower uptake,” he said, “leaving more children exposed to infectious disease, both among those that choose not to get vaccinated and those too young or in vulnerable populations that depend on indirect protection through herd immunity.”
