Understanding the New Childhood Vaccine Recommendations

Heather K. Wingo
January 13, 2025

Earlier this month, federal health officials announced changes to the U.S. childhood immunization schedule. These updates have raised questions for many parents. Here is what changed, why it matters, and what families can do to keep kids protected.

What Changed? 

Several vaccines that were previously recommended for all children are now listed as either:

  • High-risk only – Recommend for children with certain health conditions or circumstances, or
  • Shared Clinical Decision-Making (SCDM) - meaning families and health care providers decide together whether the child should receive the vaccine.

Changes to the Schedule:

Before: Universal1 birth dose (less than 24 hrs old)  and series2

Now: Recommended for high risk groups and SCDM

1. Universal - recommended for every child, regardless of health status or risk factors

2. Series - multiple doses over time to provide full protection

Before: Routine infant series1

Now: SCDM only

1. Series - multiple doses over time to provide full protection

Before: Routine for adolescents

Now: High risk & SCDM

Before: Two doses, recommended for 9 year olds

Now: Reduced to one dose, recommended for 11 year olds

Before: Recommended annually for all children older than 6 months.

Now: SCDM

Before: Recommended if the mother was not vaccinated in pregnancy or baby is high risk

Now: "High-risk," which is defined as the mother not being vaccinated during pregnancy

The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) still recommend the full schedule for all children based on strong scientific evidence. See the AAP Immunization Schedule here. See A Guide for Parents from Immunize.org. 

What Does Shared Clinical Decision-Making Mean?

Shared Clinical Decision Making does not mean a vaccine is unsafe or unnecessary. It means the provider will discuss your child’s health, risks, and benefits with you before making a decision. Some families may notice that these vaccines are no longer offered automatically during visits, so parents may need to ask about them. Reach out to me by email if you need help talking to your doctor. 

Why Do These Vaccines Still Matter?

Even though some vaccines are no longer routine, the diseases they prevent are still serious.

  • Hep B causes liver cancer, cirrhosis, and other chronic conditions. 
  • Infants can be infected if the mother has Hep B. But infections can also occur later from other household members.
  • More than 90% of babies infected develop chronic infection, and about 1 in 4 of them will face life-threatening liver disease. 
  • The vaccine is 90-95% effective. Benefits greatly outweigh risks.

Read more about Hepatitis B: 

  • Rotavirus is one of the most common causes of severe dehydration in infants. Before the vaccine, Rotavirus cause more than 50,000 hospitalizations in young children each year in the US.
  • The vaccine is 85-90% effective against severe diarrhea, dehydration, and hospitalization. And 70-75% effective against infection. 

Read more about Rotavirus here. 

  • Disease is rare but devastating. Even with treatment, 10-15% of cases are fatal. 20-60% of cases experience permanent disability. 
  • There's some evidence that the meningococcal B vaccines also protect against gonorrhea. 
  • The vaccine is 70-90% effective. 

Read more about Meningococcal here. 

  • One of the most effective cancer-prevention tools in medicine. 
  • After the world began vaccinating against HPV, cervical cancer rates dropped because the vaccine is highly protective against the main cancer-causing strains: HPV 16 and 18.
  • HPV can also cause head and neck cancer and genital warts.
  • The vaccine is 90+% effective. 

Read more about HPV here. 

  • Every year, hundreds of kids in the US die of the flu - in the 2024-2025 flu season, there were 280 pediatric deaths, 89% whom were unvaccinated. 
  • Vaccinating children also helps prevent missed school and protect other vulnerable members of the community, like grandparents. 
  • The vaccine is 30-60% effective. 

Read more about Flu here. 

  • RSV is the number one reason infants are hospitalized. Every year, 58,000-80,000 children under five are hospitalized. 
  • After recommending RSV antibodies for all kids, data showed that RSV hospitalizations substantially declined.
  • Antibodies are 80-90% effective. Benefits greatly outweigh risks. 

Read more about RSV here. 

Vaccines remain one of the most effective ways to protect children from these illnesses.

What Can Families Do?

  • Ask your provider about vaccines that now require discussion.
  • Follow trusted sources like AAP and AAFP for guidance.
  • Remember! These federal changes do not prevent families from vaccinating. Vaccines are still available and covered by insurance and programs like Vaccines for Children. If you need help finding vaccines near you, visit VaccineFinder.org 

Evidence Behind Vaccination

Vaccines are among the most studied and monitored medical interventions in the world. Before approval, every vaccine undergoes multiple phases of clinical trials involving thousand of participants to ensure safety and effectiveness. After approval, vaccines continue to be monitored through national safety systems like VAERS (Vaccine Adverse Event Reporting System) and V-Safe. Read more:

The bottom line…

The updated schedule simplifies recommendations but does not change the importance of protecting children from serious diseases. Talk to your child’s healthcare provider and make informed decisions together.