In a significant move to enhance the U.S. childhood immunization framework, Deputy Secretary of Health and Human Services Jim O’Neill, acting as the Director of the Centers for Disease Control and Prevention (CDC), has signed a decision memorandum endorsing recommendations based on an extensive scientific evaluation of childhood immunization practices. This decision follows a directive from President Trump, who called for a thorough review of international best practices from other developed nations.
The directive, issued via a Presidential Memorandum on December 5, 2025, tasked the Secretary of HHS and the Acting Director of CDC with examining vaccination schedules of peer countries, assessing the scientific evidence behind these practices, and potentially updating the U.S. schedule if more effective strategies are found, all while ensuring continued access to existing vaccines for American children.
In consultation with global health ministries and after reviewing a comprehensive assessment, O’Neill accepted the recommendations and directed the CDC to implement changes. Secretary Robert F. Kennedy Jr. emphasized the need for alignment with international norms to protect children, support families, and restore public trust in health initiatives.
The recent assessment found that the U.S. vaccination schedule is extensive, addressing more diseases and recommending more doses than peer nations, yet it does not boast higher vaccination rates. For instance, in 2024, the U.S. recommended vaccinations against 18 diseases, while countries like Denmark recommended only 10. Despite the broader vaccine offerings, those countries achieved strong health outcomes, primarily through public education and trust rather than stringent mandates.
Under the newly accepted recommendations, the CDC will categorize the immunization schedule into three groups: vaccines for all children, vaccines recommended for high-risk groups, and vaccines based on shared clinical decisions. This structure aims to empower parents and healthcare providers to make informed choices tailored to individual health risks while preserving comprehensive coverage of vaccines without any out-of-pocket costs.
The change comes in the context of a documented decline in public trust in healthcare institutions and falling vaccination rates between 2020 and 2024. Dr. Marty Makary pointed out the critical role of trust in public health, emphasizing that transparency, rigorous scientific standards, and respect for families are essential for rebuilding this trust.
The recommendations also call for an investment in high-quality, gold-standard scientific research to better understand the benefits and risks associated with vaccines. HHS agencies are committed to funding these initiatives, thereby enhancing the scientific basis for vaccine recommendations and ongoing evaluations as new information becomes available.
As the CDC collaborates with state health agencies and physician groups for the implementation of updated immunization schedules, efforts will also focus on educating parents and healthcare professionals about these changes, aiming to bolster public confidence in vaccination as a vital component of child health in the U.S.