On Monday, the federal government issued new vaccine recommendations that cut the number of shots recommended for all children from 17 to 11. Pediatric infectious disease experts warn the changes could put infants and toddlers at greater risk and may affect future students.
“I’m frankly quite worried about American children,” said Dr. Sharon Nachman, chief of the pediatric infectious disease division at Stony Brook Children’s Hospital on Long Island. “By cutting back on the recommendations for vaccines for children born or living here, we are actually now endangering them.”
The changes in vaccine recommendations
Under the new schedule:
- Shots for hepatitis A and B, dengue, meningitis and RSV are recommended only for high-risk groups.
- Other shots — including those for flu, COVID-19, rotavirus and meningococcal disease — are now listed under “shared clinical decision-making,” a phrase that has produced widespread confusion.
Who’s behind it
The changes were authorized Jan. 5 by the acting director of the federal Centers for Disease Control and Prevention, Jim O’Neill. In December, President Trump had directed the agency to examine vaccine recommendations in “peer nations.”
The move comes after months of pressure from Health and Human Services Secretary Robert F. Kennedy Jr., who has sought to overhaul how vaccines are reviewed and recommended. Medical experts warn the push — stemming at least in part from debunked claims linking vaccines and autism — led to the sidestepping of long-standing scientific review protocols and may weaken public trust.
Why Denmark keeps coming up
Kennedy and other federal officials have pointed to Denmark as a model for the new approach. But pediatric experts say the comparison is deeply flawed. Dr. Nachman notes that Denmark’s vaccine policy, which recommends 10 vaccines, directly contradicts Kennedy’s longtime skepticism of the measles, mumps and rubella (MMR) vaccine.
“Now were pivoting and saying we’re going to do what Denmark does,” Dr. Nachman said. “In Denmark they trust how their vaccines are working. Which vaccine are they giving? Two doses of MMR.
“That change in public trust that you have now forced on the American people has no basis in reality,” she said.
Many experts say that Denmark is more of an outlier among “peer” nations, STAT reports. Most of them recommend between 13 to 16 vaccines for all children. Canada recommends 16, including rotavirus and meningococcal — both dropped from universal U.S. recommendations.
Critics also stress that Denmark’s population is relatively small and homogenous, with far fewer people moving in and out of the country than the U.S. It’s in especially stark contrast with New York City, which not only by itself has two million more people than Denmark but is a hub for immigrants and travelers from all over the world.
Denmark also has free medical care — which means parents enjoy benefits of paid sick leave and that the costs of pediatrician and ER visits and hospitalizations are covered.
“My worry is that families whose kids are sick aren’t going to go for medical care because it costs too much,” Dr. Nachman said. “They aren’t going to get the right medications, and we won’t identify their children’s illnesses until those kids are quite sick.”
What NYC health officials say
City health officials moved quickly to distance local policy from the federal guidance.
“By significantly shrinking the list of recommended vaccines proven to save lives, the CDC is putting the health and well-being of children and their families at risk,” said Dr. Michelle Morse, acting commissioner and chief medical officer at the New York City Department of Health and Mental Hygiene, during a press briefing Thursday. “We reject that guidance.”
Morse stressed that vaccination requirements for school and child care are determined by state and local law, not federal recommendations. City and state health departments issued a joint advisory to medical providers reminding them that existing childhood vaccination policies remain in effect.
“In New York City,” Morse said, “nothing has changed.”
Health insurance coverage
Administration officials say pediatric vaccines dropped from the universal recommendation list will still be covered by Affordable Care Act insurance plans and federal health insurance programs such as Medicaid, the Children’s Health Insurance Program (CHIP) and the Vaccines for Children program — at least through the end of this year.
“I don’t know and you don’t know what they’ll do in 2027 or 2028,” Dr. Nachman said.
Experts’ biggest concerns
- Confusion and loss of trust
Administration officials say the changes are meant to address public mistrust and lagging vaccine uptake. But pediatricians say it’s doing the opposite.
“What’s already happened is complete confusion and panic,” said Dr. Sara Lederman, a pediatrician at the Children’s Hospital at Montefiore Einstein in the Bronx. “I was just speaking the other day with a mom of a 2-month-old who said, ‘I’m so confused. I’m hearing one thing from one source of authority. I’m hearing another thing from another — and how do I make sense of this?’”
- Growing pushback towards routine vaccines
Doctors say this confusion is fueling vaccine hesitancy among parents, even for routine shots like the flu vaccine.
“There’s a lot of misconceptions that it makes you sick,” Dr. Lederman said, “when in fact it actually is just teaching your body how to respond to the real thing.”
- A possible uptick in diseases such as rotavirus in daycare and school settings:
Rotavirus spreads easily in daycare and school settings through shared surfaces and hand-to-mouth contact. The vaccine prevents severe illness when children are exposed. Since its introduction, cases, ER visits and hospitalizations have dropped dramatically.
“It is a horribly wicked virus,” Dr. Nachman said. By removing the vaccine from the universal recommendations, she warned, once kids enter group settings, “they’re all going to get sick.”
- Confusion around the transmission of serious viruses such as hepatitis B:
Other diseases may take far longer to show the effects of reduced vaccination. For instance, with hepatitis B, “the kids will be fine when they’re under 10 years of age, but from 10 to 20, they will start getting sick — and by 20 years of age, we will see cirrhosis,” Dr. Nachman said.
“So we’re not going to see the problems from cutting back on these recommendations for a decade or two,” she said. “By then, who’s going to remember who made these decisions?”
In December, even before the broader schedule change, a CDC panel whose members were appointed by Kennedy voted to drop the long-standing recommendation that all newborns receive the hepatitis B vaccine at birth.The panel said parents should consult with doctors, a stance pediatricians and major medical groups find dangerous.
Newborns exposed to the virus at birth have a high likelihood of lifelong infection. The vaccine is about 90% effective in preventing infection if given within 24 hours of birth.
But Dr. Lederman says misinformation about hepatitis B is already spreading: “A huge misconception is that it is only sexually transmitted,” she said. In fact, the virus can survive on surfaces for up to seven days, making contact from daily activities far more likely.
“As someone who has seen patients die very horrible deaths from liver disease,” she said, “it’s something that I’ve dedicated my life to helping to prevent.”
How to protect your family
The pediatricians we spoke with urge families to stay proactive. Their advice:
- Follow the previous vaccination recommendations for your child.
- Use trusted medical sources like the American Academy of Pediatrics (AAP) rather than what’s coming out of the White House or CDC.
- Consult your family pediatrician about specific concerns.
- Be a critical consumer: When you see conflicting information, ask who it’s from and why they’re saying it.
- Vet your child’s surroundings: Choose spaces that require vaccination. It’s also reasonable to ask others to be vaccinated before interacting with your young child.
- Advocate: Talk to your representatives about keeping your community healthy.
This story has been updated to include recent statements from city health officials.
