In a seismic shift for American public health, the Trump administration has dramatically scaled back official recommendations for childhood vaccinations, a move experts warn leaves the United States lagging behind peer nations like the United Kingdom and increases the risk of preventable disease outbreaks.
A Historic and 'Astounding' Rollback
The Department of Health and Human Services (HHS), led by Secretary Robert F Kennedy Jr, a long-time vaccine sceptic, announced it will no longer fully recommend roughly a third of vaccines previously on the childhood immunisation schedule. Jake Scott, an infectious diseases specialist at Stanford University, called it "the largest change in our vaccination schedule in modern American history."
Former public health official Daniel Jernigan labelled the decision "astounding," criticising it for lacking scientific evidence or public consultation. He accused officials of inflating vaccine risks, burying their benefits, and "sowing confusion" for parents and healthcare providers.
How the US Schedule Now Compares to the UK and Others
US officials claimed the change, ordered by Donald Trump in December, aligns America with "peer, developed countries." However, analysis shows the opposite is true. The new US policy now designates shots for hepatitis A, RSV, hepatitis B, and certain meningitis vaccines only for "high-risk" groups. Others, like influenza and rotavirus, now require a specific doctor's recommendation.
This places the US out of step with most other high-income nations. The UK, Canada, Australia, Japan, and most European countries have universal childhood recommendations for influenza, rotavirus, and hepatitis B. The UK recently moved to recommend the chickenpox vaccine for all children, a decision often informed by US safety data.
"The US policies used to be considered leadership in the public health policy space," Jernigan said. Jake Scott noted that many countries are "expanding their vaccine schedule, and a lot of them have looked to the US over the years."
Fragmented System Faces Greater Risk
Experts warn the new minimalist schedule is particularly dangerous for the US context. With 330 million people, a fragmented healthcare system, no universal healthcare, and profound health disparities, diseases can spread more easily before Americans seek care.
"Disease moves differently in the US," Scott explained, citing dense urban centres, remote rural areas, and high levels of travel. Jernigan highlighted the risk for young people moving from small towns to large universities, potentially exposing them to new threats like meningitis: "It's like traveling from your own country to a new country."
The decision process itself has drawn fierce criticism. The changes were made without public comment, input from the established Advisory Committee on Immunization Practices (ACIP), or feedback from bodies like the American Academy of Pediatrics. Instead, they rely on a report from two authors, including a frequent vaccine sceptic.
"The science hasn't changed," Scott stated. "The only thing that's changed is who's making the decisions and what conclusions they want to reach." Jernigan fears the move will erode public trust, urging parents and doctors to continue seeking and recommending vaccines to avoid tragic outcomes during future outbreaks.
