The changes, directed by a presidential memorandum, updated the childhood immunization schedule to better align with other developed nations, a statement by the Department of Health and Human Services said.

Declining public trust in health care institutions and a desire to restore informed consent also prompted the move, according to the statement.

“President Trump directed us to examine how other developed nations protect their children and to take action if they are doing better,” said HHS Secretary Robert F. Kennedy Jr. “After an exhaustive review of the evidence, we are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent. This decision protects children, respects families, and rebuilds trust in public health.”

The review Kennedy referred to found several peer countries recommend fewer routine childhood vaccines at earlier ages or space doses differently, while maintaining comparable or better public health outcomes.

The U.S. childhood schedule includes vaccines for roughly 16 diseases before adulthood, including hepatitis A, rotavirus and varicella as universal recommendations.

The United States recommends more total doses, especially in the first two years of life, than other countries.

A fully vaccinated child in the U.S. receives about 50-60 vaccine doses. In most peer countries, the total number of doses is typically 30-40, with fewer injections in infancy and more spacing between doses.

A Pew survey released in November showed Americans are less certain about safety testing when it comes to vaccines and worry about the numbers of doses children are required to get.

The White House and HHS have emphasized the changes do not eliminate childhood vaccinations but adjust timing and recommendations to reflect global practices.

Officials argue the updated schedule gives parents more information and flexibility while maintaining protection against serious diseases.

“Among the fundamental principles of public health are respect for personal autonomy and self-determination, and informed consent is a cornerstone of medical care,” said the review of practices among developed nations.

Trust in health care institutions fell sharply from 71.5% to 40.1% between 2020 and 2024, as pandemic-era policies such as school closures, lockdowns, masking and vaccine mandates eroded confidence in public health leadership, the review said.

That loss of trust spilled over into routine immunization, contributing to declining childhood vaccination rates, including a drop in measles, mumps and rubella coverage from 95.2% to 92.7%, increasing the risk of measles outbreaks.

The Associated Press (AP) reported critics inside the medical community worry the revisions could undermine decades of public health.

“Abandoning recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” Michael Osterholm of the Vaccine Integrity Project, based at the University of Minnesota, told the AP.

Several experts told the wire service the existing schedule is already based on extensive safety and efficacy data and that the decision was rushed.

“Changes of this magnitude require careful review, expert and public input, and clear scientific justification. That level of rigor and transparency was not part of this decision,” said Dr. Sandra Fryhofer, of the American Medical Association.

HHS emphasized all vaccines included on the childhood immunization schedule will remain covered and families may still choose for their children to receive any of the recommended vaccines.

The updated schedule is intended to guide care, not restrict access, while preserving parental choice, officials said.

“Public health works only when people trust it,” said Food and Drug Commissioner Dr. Marty Makary. “That trust depends on transparency, rigorous science, and respect for families. This decision recommits HHS to all three.”

The CDC will continue monitoring disease trends and vaccination coverage as the updated schedule rolls out, HHS officials said.

While opposition from parts of the medical community remains strong, the administration said restoring confidence in public health requires reform, not retrenchment.

The goal is not fewer vaccines, but a system families trust again because it relies on informed consent.