Here’s what to know about unprecedented changes to childhood vaccine recommendations

us. Health officials on Monday made sweeping changes to childhood vaccine recommendations, alarming pediatricians and other medical experts who say it will create confusion and harm children’s health.

The changes, effective immediately, mean the Centers for Disease Control and Prevention will now recommend that all children be vaccinated against 11 diseases, up from 18 a year ago.

The changes come as U.S. vaccination rates have been declining and the share of children exempted is at an all-time high, according to federal data. At the same time, rates of vaccine-preventable diseases, such as measles and whooping cough, are rising.

Here’s information about the changes:

Here are the changes to federal vaccine recommendations

Where the federal government once recommended broadly, it now recommends protection against these diseases only for certain at-risk children, or based on the advice of individual doctors, what’s known as “shared decision-making.”

— Flu

— Hepatitis A

— Hepatitis B

— Meningococcal disease

— rotavirus

—RSV

— COVID-19, what’s changing in 2025

Here’s what federal vaccine recommendations remain unchanged

The following vaccines remain on the list recommended for everyone:

— Measles, mumps and rubella (MMR)

— Diphtheria, tetanus and whooping cough or pertussis (DTaP)

— Polio

– chicken pox

— human papillomavirus, or HPV virus. But surprisingly, the guidelines reduce the recommended dose of HPV vaccine from two or three shots to just one.

— Hib, or Haemophilus influenzae type B, although the name has nothing to do with influenza, this bacterium

— PCV or pneumococcal conjugate vaccine

Why are vaccine recommendations changing?

The U.S. Department of Health and Human Services said the changes were made at the request of the president Donald Trump December. Trump asked the agency to review how peer countries are handling vaccine recommendations and consider revising U.S. guidance accordingly.

The U.S. Department of Health and Human Services (HHS) said the U.S. is an “outlier” compared with 20 peer countries in terms of the number of vaccines administered and the doses recommended for all children. Agency officials saw the change as a way to increase public trust by recommending only the most important vaccines for children.

However, many European countries recommend some of the vaccines that the United States removed from the list.

What do doctors and pediatricians say?

Large U.S. doctor groups, including the American Medical Association and the American Academy of Pediatrics, say they will continue to recommend the vaccine that the Trump administration has now downgraded. They said there was no new scientific evidence to support the changes, including no indication that previous U.S. vaccine programs harmed children.

Dr. Sean O’Leary of the American Academy of Pediatrics (AAP) said the changes could increase children’s likelihood of getting sick and dying from preventable diseases. He’s particularly concerned that the U.S. will no longer recommend flu shots for children as the flu season becomes increasingly severe after last winter’s particularly harsh season.

A group of pediatricians has issued its own recommendations for childhood vaccines. Additionally, states, not the federal government, have the authority to require schoolchildren to be vaccinated. While CDC requirements often influence those state regulations, some states have begun forming their own coalitions to fight the Trump administration’s guidance on vaccines.

What will happen to the family?

It’s not clear yet. Doctor visits may not change due to counter-advice from pediatricians. However, medical experts say that when the U.S. government doesn’t clearly recommend the vaccine, it raises questions among parents, making conversations at doctors’ offices more difficult.

If these changes mean fewer children are vaccinated, outbreaks historically prevented by high vaccination rates could spread more widely, leading to more illness and more school and school absences.

Will insurance continue to cover the vaccine?

The Trump administration said it will continue to provide coverage to families who still want the shot. Health insurers generally view the vaccinations as cost-effective because the shots are cheaper than hospitalization, and many have previously said they planned to cover coverage through 2026 as recommended last year.

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Associated Press writers Ali Swenson and Mike Stobbe contributed to this report in New York.

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The Associated Press is solely responsible for all content.