ASTONISHING: Changes to U.S. vaccinations

What happens when a country rewrites the rules on vaccines for children?

That’s the question many Americans are asking after a dramatic policy shift was introduced in early January, the US Department of Health & Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) announced significant changes to the US childhood immunisation schedule, reducing the number of vaccines broadly recommended for all children from 17 to 11 .

It’s a move being described both as historic and controversial, with ripple effects across the globe.

What’s changed?

Under the new guidelines, a number of vaccines are no longer part of the routine schedule for all children. This includes respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B which are now only recommended for “high-risk” groups.

Furthermore, jabs for rotavirus, COVID-19, flu, meningococcal disease, hepatitis A, and hepatitis B will be based on “shared clinical decision-making” which is a process that leaves it up to families and clinicians to decide what’s appropriate based on individual circumstances. The new schedule also recommends US children receive a single dose of human papillomavirus (HPV) vaccine, rather than a two-dose course.

What’s the timing for it all?

HHS and CDC are now working with state health agencies to implement the recommendations including educating parents and clinicians on the updated immunisation schedule.

Importantly, while these vaccines are no longer universally recommended, they remain fully covered by insurance, so families won’t be out of pocket if they choose to proceed with them.

Why the shift?

US officials have presented the changes as part of a push to bring US vaccine policy more in line with other developed countries, following a directive from President Trump to review international best practices.

In an official statement, Health Secretary Robert F. Kennedy Jr, and long-time vaccine critic, said the decision “respects families, and rebuilds trust in public health.” 

The timing is no coincidence. The changes come as US vaccination rates have slipped, according to federal data, and the rates of vaccine preventable diseases, such as measles and whooping cough, are rising across the country.

What’s the response?

Medical experts and professional groups in the US and abroad have voiced concerns about both the process used to reach the decision to change the vaccine schedule and the potential consequences.

For one, the changes were made without consultation from the CDC’s longstanding immunisation advisory committee which is a step many believe undermines scientific integrity. A former director of the National Center for Emerging Zoonotic Infectious Diseases described it as an “astounding” decision made without scientific evidence or public input that will worsen vaccine access and increase disease outbreaks.

Others have criticised the decision to compare the US’s vaccine schedule with 20 other developed countries, arguing that this overlooks the fact these counties have universal healthcare, different health systems and they face different risks to the US, making these countries poor benchmarks for decisions which should be science-led.

While vaccine requirements for schoolchildren are ultimately set at the state level in the US, CDC guidance carries enormous influence. Some states have begun forming alliances to push back on the federal position, alongside leading medical organisations, including the American Medical Association and American Academy of Pediatrics, who have said they will continue to recommend all 17 vaccines as no new science has warranted the updated schedule and there is no data showing the previous schedule harmed children.

What does this mean for Australia?

While US officials claim to be following the lead of other developed nations, it’s worth noting that many developing countries are moving forward with more protection not less, expanding their vaccine schedules. For example, Australia and the UK both recently recommended the RSV vaccine for all pregnant people.

So, while it’s unlikely Australia or others will adopt a similar rollback, the US shift may prompt renewed scrutiny of existing schedules, especially in nations balancing rising health costs with expanding immunisation programs.

The primary concern, however, is that Australia may see increased vaccine hesitancy, particularly if confusion and uncertainty about the US decision spreads without context.

“While Australia’s National Immunisation Program remains a global gold standard, we cannot ignore the ripple effects of the US policy shift. Seeing the US roll back routine protection against diseases like influenza and RSV – leading causes of childhood hospitalisations – is deeply unsettling,” Catherine Hughes AM, Executive Director & Co-Founder of the Immunisation Foundation of Australia told Cube.

 “This shift replaces clear, universal guidance with a lack of clarity that risks confusing families and will likely lead to an increase in vaccine hesitancy here in Australia as global headlines cross our borders. When clear recommendations are replaced by confusion, it is our children who pay the price.”  

Where to next?

“In 2026, our priority must be supporting Australian healthcare providers – nurses, pharmacists and GPs – for a rise in questioning. We must also ensure our government remains proactive in defending our evidence-based schedule,” Catherine Hughes warns.

Jenny Herz, Cofounder & Director of Biointelect agrees: “It’s vital that we unite to champion the proven value of vaccination and strong infectious disease control. With the establishment of the Australian Centre for Disease Control, bringing national surveillance and strategic vaccine oversight under one roof, we have a pivotal opportunity. Now is the time for government, industry, academia and healthcare professionals to work in lockstep and shape a resilient, future ready public health system for all Australians.” 

As this new chapter in the US vaccine policy unfolds, communicators in Australia must ensure we are utilising every avenue possible to reinforce the importance of our evidence-based, publicly funded NIP and healthcare professionals are equipped with factual information which they can use to empower and inform communities.

Maintaining high levels of vaccine confidence and coverage in Australia will require clear messaging, continued transparency, expert guidance and strong community engagement, particularly to support parents navigating important health decisions for their families.