Understanding the New Childhood Vaccine Guidelines

By Nissa Shaffi, Head of Policy & Advocacy

In January 2026, the U.S. Department of Health and Human Services (HHS) and the U.S. Centers for Disease Control and Prevention (CDC) announced major changes to the childhood immunization schedule, reducing the number of recommended vaccines from 17 to 11.

The childhood immunization schedule is facing another round of changes following a new Executive Order signed by President Trump on August 10, 2026.

The Executive Order (EO), “Delivering Gold Standard Childhood Vaccine Recommendations for Americans,” builds on major changes announced earlier this year by the U.S. Department of Health and Human Services (HHS) and the CDC.

In January 2026, HHS and CDC announced the major changes to the childhood immunization schedule, reducing the number of recommended vaccines from 17 to 11. The Executive Order maintains those changes. It also introduces new directives regarding administering vaccines, dosing schedules and federal policies around parental choice.

Despite changes in federal guidance for vaccines, the American Academy of Pediatrics (AAP) has NOT changed its vaccine recommendations. Many U.S. state departments of health have also not changed their guidance for vaccines.

Current vaccine recommendations  

The Executive Order formalizes CDC’s Three-Tier Vaccine Schedule:

1. All children

CDC continues to recommend childhood vaccines against 11 diseases. These are measles, mumps, rubella, polio, pneumonia, pertussis (whooping cough), chickenpox, diphtheria, Hib, HPV and tetanus. 

2. High-risk children

These vaccines are for children with health problems or special risks. They are: respiratory syncytial virus (RSV) for babies whose mothers did not receive the maternal RSV vaccine; and dengue.

Vaccines recommended for children with health problems or special risks also include Hepatitis A, Hepatitis B and meningitis. However, for children with no health problems or special risks, parents should discuss these vaccines with their child’s doctor as part of shared clinical decision-making.

3. Shared Clinical Decision-Making

Shared clinical decision-making is an approach in which doctors and parents work together to make healthcare decisions. It applies to vaccines for influenza (the flu), COVID-19 and rotavirus. It also applies to Hepatitis A, Hepatitis B and meningitis vaccines for children who have no health problems or special risks.

Key Changes to 2026 Vaccine Recommendations   

The Aug. 10 Executive Order establishes the unbundling of combination shots. It is designed to respect parental options.

1. Transitioning to single-disease shots (unbundling MMR)

The Executive Order directs federal agencies to work toward offering core vaccines as single-disease products rather than combination formulations taken in one doctor’s visit. This starts specifically with the MMR (Measles, Mumps, Rubella) vaccine.

Once single-disease shots are available, the policy advises administering them as three separate immunizations.

The Executive Order guarantees the bundled vaccines will still be available for parents who prefer them. In addition, families should be aware that MMR vaccines do not currently exist as singular shots — and likely will not be available for some time. FDA must first conduct clinical trials to approve unbundled MMR vaccines.

2. Spacing out pediatric visits

Federal guidelines now recommend giving childhood immunizations across separate medical visits rather than multiple shots in a single appointment. This directly relates to the unbundling of the MMR vaccine, to allow for spaced out visits to accommodate the new schedule.

3. Research into adjuvants and schedule sequencing

The Executive Order mandates the HHS Task Force on Safer Childhood Vaccines to deliver a 90-day plan to:

• Develop alternative adjuvants to aluminum and conduct comparative safety studies. An adjuvant is an ingredient added to some vaccines to help create a stronger and longer-lasting immune response.
• Evaluate the ideal timing and sequencing of all core childhood immunizations.
• Continuously monitor international and domestic vaccine safety data.

4. Federal actions on state mandates and exemptions

The Department of Justice (DOJ), Department of Education, and HHS are directed to ensure that federal grantees, contractors, and state and local entities respect parental authority and statutory obligations regarding religious and medical vaccine exemptions.

What the New Vaccine Schedule Means for Families

The new order does not alter health insurance coverage for childhood vaccines. Targeted childhood vaccines remain listed on the CDC’s official schedule. Major insurance providers affirmed they will continue covering them without co-pays.

• Insurance coverage. Parents will not have to pay out of pocket for many vaccines. Access remains strong. But now, families may need to talk more with their child’s doctor and make more choices themselves.
• Plan for multiple doctor visits. If you choose to follow separate-visit scheduling or single-dose administration, plan for additional pediatric appointments throughout the year. Check with your insurer regarding copays for individual office visits.
• Shared clinical decision-making. Parents have increased flexibility to tailor immunizations around their child’s health status. They are advised to work together with the child’s pediatrician or allergist to determine the optimal timing for seasonal and core vaccines to keep asthma well-controlled.

For people with asthma, allergies and certain high-risk groups, the following vaccines can help protect against illness or severe illness:

• Flu vaccine
• COVID-19
• RSV
• Pneumonia
• Pertussis (whooping cough) 

Vaccines work by helping to build a strong immune system. Vaccine schedules are carefully timed by healthcare providers to protect kids while their bodies are still growing and are most vulnerable to infection.

The schedules are based on decades of evidence-based research. They have helped keep children healthy against some of the deadliest diseases and saved lives. The practice has also helped save families – and the healthcare system – money by preventing illness.

Why did the vaccine schedule change? 

The new vaccine policy is based on immunization guidelines of some other countries. The United States now follows a vaccine schedule modeled after Denmark and 20 other “peer-developed” countries (e.g., UK, Canada, Australia, Japan and Germany). As a result, the schedule now recommends fewer vaccines.

This decision has caused concern among doctors, public health professionals and vaccine experts in the U.S. Modeling a schedule for American children based on what has worked in other countries is not an apt comparison.

Vaccine Guidelines Should be Rooted in Confidence, Effectiveness and Affordability

The new vaccine schedule does not reflect the diverse population and health status of U.S. children. This is why Allergy & Asthma Network advocates for greater diversity in research studies and clinical trials. Vaccine guidelines and health advice should be rooted in scientific evidence and benefit all children.

Further, introducing multiple doctor visits into the vaccine schedule could result in financial strain for families regarding copays.

The abrupt changes from different federal entities may be confusing and stressful for parents. When families receive less clear or consistent guidance about vaccines, they may feel pressure to decide which vaccines their children need and when they should receive them.

Unclear or conflicting messages can also make it harder for families to feel confident in their vaccine decisions. This may lead some families to delay or skip recommended vaccines, leaving more children unprotected and at greater risk for serious illness.

The changes come at a time when the United States is experiencing one of the worst outbreaks in childhood infectious diseases in more than three decades.

Allergy & Asthma Network urges CDC to install a robust, medically informed, expert vaccine panel. Americans deserve to receive scientifically validated public health information from a centralized federal resource that disseminates consistent and uniform messaging. This will help increase vaccine confidence and adequate uptake of immunizations to foster a healthy and safe society.  

What the AAP advises for childhood immunization schedule

The American Academy of Pediatrics (AAP) advised parents to work closely with their child’s pediatrician and follow trusted advice. Parents who wish to vaccinate their children for the previously recommended 17 vaccines may still do so.

Parents should also use reliable sources on the latest vaccine updates, such as from the AAP. If your child has asthma, allergies or another immune-related condition, be sure to discuss vaccines with the pediatrician so you can make the best decision for your child’s health.

If you want to find a vaccination site for flu, COVID-19, RSV, whooping cough and pneumonia, this Vaccine Locator can help.