HHS and CDC release 2026 childhood immunization schedule; what it means today for frontline providers
On January 5, HHS and CDC announced changes to the childhood immunization schedule, following a Presidential directive to align U.S. recommendations with those of “peer, developed countries.” This resulted in the acting CDC director’s decision to retain, as routinely recommended, the vaccines routinely recommended by other countries selected by HHS for evaluation. Other vaccines on the previous CDC schedule were shifted to categories of recommendation called “high-risk” or “shared clinical decision-making” (SCDM). No vaccines were removed from the schedule. Scientific evidence affirming the effectiveness, safety, and value of childhood immunizations remains unchanged.
The updated Childhood Immunization Schedule by Recommendation Group lays out these new categories.
Important information for nurses, pharmacists, and physicians who vaccinate:
- Science Remains Unchanged: The balance of risks and benefits are unchanged for vaccines shifted from routine to SCDM. If you recommended these vaccines strongly to your patients before, the classification of SCDM does not require changing your strong recommendation. The routine practice of informing parents of risks and benefits before their decision to vaccinate should continue.
- Out-of-Pocket Costs Remain Unchanged: HHS affirmed in its announcement that all childhood vaccines, including those moved to SCDM, remain covered with no out-of-pocket cost by private insurance plans regulated by the Affordable Care Act (ACA) or federal insurance programs such as Medicaid. Clinicians, hospitals, and states may continue to offer and be paid for administering these vaccines with no out-of-pocket cost to beneficiaries.
- Vaccines for Children (VFC) Program Remains Unchanged: There has been no change to vaccines approved for use through the VFC Program, which covers all vaccines on the schedule, including SCDM.
- HepB Vaccination of Newborns Is Permitted: Providing HepB vaccination at birth for optimal protection from hepatitis B remains a choice for mothers who are test-negative for hepatitis B. The schedule change does not require mothers to delay vaccination.
- SCDM Does NOT Require a Medical Appointment or a Doctor: SCDM simply involves a conversation with a healthcare provider (defined by CDC as a nurse, pharmacist, or physician) about the risks and benefits of receiving a vaccine, which is routine in any vaccination conversation. In the absence of a state regulation specifically limiting the scope of practice of a nurse or pharmacist to provide vaccines classified as SCDM, a child whose parent desires an SCDM vaccine may still be vaccinated by a nurse or in a pharmacy; they do not need to be referred to a medical clinic.
- SCDM Does NOT Require a Parent to Ask for Vaccination: You may recommend vaccines as usual. The decision to vaccinate has always been made by an informed parent and shifting from “routine” to “SCDM” does not change that.
- Healthcare Professional Organization Recommended Childhood Schedules Are Unchanged: The American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) have not changed their childhood vaccine recommendations.
- Vaccine Injury Compensation Program (VICP) Unchanged: There have been no changes to the existing liability protection and patient compensation for vaccine injuries through the VICP, including vaccines shifted to SCDM. Changes to VICP would require a substantial period of time and would require public notice and the opportunity for public comment.
What we don’t know:
- CDC Schedule Details: For example, we await more information about the HPV schedule change to one dose and whether two doses or three doses remain recommended for certain subsets of children, including those with immunocompromise or those who initiate vaccination at older ages. Detailed schedule footnotes for all vaccines previously provided in CDC schedules to cover special cases and the definition of high-risk groups for specific vaccines are unavailable at this time.
- Future Changes: Immunize.org will keep our readers alerted to any changes in our understanding of vaccine injury compensation, insurance coverage, VFC program coverage, state, school, or childcare requirements, and announcements from HHS or CDC.
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“Use of the GSK MenACWY-CRM/MenB-4C Pentavalent Meningococcal Vaccine Among Persons Aged ≥10 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, 2025” published in MMWR
CDC published Use of the GSK MenACWY-CRM/MenB-4C Pentavalent Meningococcal Vaccine Among Persons Aged ≥10 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, 2025 on January 8 in MMWR. This publication describes the MenABCWY vaccine by GSK (Penmenvy) as an option for use in children and adults age 10 years or older when both MenACWY and MenB (Bexsero) are indicated at the same visit. The recommendation mirrors the earlier recommendation for use of Pfizer’s MenABCWY (Penbraya) when the Trumenba brand of MenB is indicated. The minimum interval between doses of Penmenvy is at least 6 months. A portion of the summary appears below.
Meningococcal disease is a serious bacterial infection caused by Neisseria meningitidis. A new pentavalent meningococcal vaccine (MenACWY-CRM/MenB-4C [Penmenvy, GSK]) protects against N. meningitidis serogroups A, B, C, W, and Y and is licensed for use in persons aged 10–25 years. MenACWY-CRM/MenB-4C is the second pentavalent meningococcal vaccine approved in the United States. . . .
On April 16, 2025, the Advisory Committee on Immunization Practices recommended that, when both quadrivalent (serogroups A, C, W, and Y) and serogroup B meningococcal (MenB) vaccine are indicated concurrently for persons aged ≥10 years, MenACWY-CRM/MenB-4C may be administered instead. . . .
Because different manufacturers’ serogroup B–targeting vaccines are not interchangeable, this recommendation provides a pentavalent vaccine option for persons receiving the GSK MenB vaccine (MenB-4C) for other doses.
Access the MMWR article in HTML or PDF.
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Respiratory viral activity rises sharply across the country; vaccination reduces risk of severe illness
Acute respiratory illness activity causing people to seek health care is high, led by very high levels of influenza activity. Getting vaccinated or administering RSV preventive antibodies to unprotected babies now can help reduce the risk of severe illness, complications, and hospitalization.
Nationally, for the week ending January 3:
This season’s dominant influenza strain, a subtype A/H3N2 virus referred to as subclade K, is antigenically drifted from the A/H3N2 virus selected for the vaccine. Early reports from England indicate that vaccine effectiveness against influenza-related emergency department (ED) visits and hospital admissions remained within typical ranges (72%–75% reduced risk in children and adolescents, 32%–39% reduced risk in adults). Continue to strongly encourage vaccination.
Level of Respiratory Illness Activity
CDC monitors respiratory illness activity using an acute respiratory illness (ARI) metric. The ARI metric measures ED visits for a wide range of causes of acute respiratory illness, with or without fever, including the common cold, as well as influenza, RSV, and COVID-19. It offers a more complete picture than the influenza-like illness (ILI) metric used in past seasons. Because influenza is leading the respiratory illness wave, the ILI map is shown below:
Emergency Department (ED) Visits for Viral Respiratory Illness
The illustration below shows the proportion of ED visits (ranging from 0 to 10 percent) associated with COVID-19, influenza, and RSV. The horizontal axis shows trends from October 2024 into January 2026 for the three diseases, including the sharp increase in influenza-related visits.
Vaccination against COVID-19, influenza, and RSV reduces the risk of severe illness. Administration of RSV monoclonal antibodies for all infants younger than 8 months who are unprotected is critical now to provide them immediate protection as RSV activity rises in many communities.
Other CDC Respiratory Illness Resources
- CDC's Respiratory Illness Data Channel shows state and county level data on respiratory viral activity, associated ED visits, and presence in wastewater.
- CDC's Weekly Flu Vaccination Dashboard shows vaccination rates by age group. Examples include the Child Flu Vaccination Coverage and Intent (NIS-Flu) data, which show that:
- As of December 27, 2025, 42.5% of children ages 6 months through 17 years received a flu vaccination, similar to last season at this same time point (43.5%)
- Parents of 6% of children reported they definitely planned to get their child vaccinated
- The percentage of children who received a flu vaccination varies by child's age, mother's education, poverty status, urbanicity, and jurisdiction
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Measles: 2025 ends with 2,144 confirmed cases; 2026 begins with three cases in two states As of January 6, CDC reported the first three confirmed measles cases in two states: North Carolina and South Carolina. During 2025, a total of 2,144 confirmed measles cases were reported in 44 states. There were 49 outbreaks, and of reported confirmed cases, 88% were outbreak-associated.
CDC only requires reporting of laboratory-confirmed measles cases. Cases without laboratory testing for confirmation are not included in these numbers. Actual numbers of cases are, therefore, higher than confirmed case counts.
A map of 2025 measles cases in the United States, as of January 9, from the Johns Hopkins International Vaccine Access Center, appears below. Their U.S. Measles Tracker website includes state and county-level data.
Immunize.org offers measles-related resources for the public on several of our affiliated websites:
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“Can We Give Influenza Vaccine with Other Vaccines?” See the rationale for simultaneous vaccination in this 3-minute video, part of the Ask the Experts Video Series on YouTube.
This week, our featured episode from the Ask the Experts Video Series is titled Can We Give Influenza Vaccine with Other Vaccines? The video briefly describes CDC’s clinical guidance for the use of influenza vaccines with other vaccines. Any vaccine may be given on the same day or any day before or after influenza vaccination, at a different anatomic site.
The 3-minute video is available on our YouTube channel, along with our full collection of quick video answers to popular Ask the Experts questions.
Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise.
Journalists interview Immunize.org experts
Journalists seek out Immunize.org experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a recent citation.
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
Immunize.org Website and Clinical Resources
Spotlight on the website: Publication archives
Our readers will find immunization history preserved in Immunize.org’s archive of our periodical publications, dating back to 1994.
After clicking “News & Updates,” the Publication Archives icon provides access to Immunize.org’s periodicals through the years.
You can scroll the page shown above to see publication descriptions. Or you can use the links on the far left or far right to jump to specific content.
The archive contains the following publications:
IZ Express: All issues since inception in 1997. These are searchable by year, month, or keyword. The name changed from IAC Express to IZ Express in January 2022.
Needle Tips: Mailed to healthcare professionals from 1994 through 2010. From 2011 through November 2017, it was an online-only publication.
Technically Speaking: This column in the Vaccine Education Center’s Vaccine Update for Healthcare Professionals covered practical topics in immunization. Our archive ranges from 2016 to 2021.
Vaccinate Adults: This publication focused on increasing adult immunization. It started as a semiannual print publication in 1997 and became a quarterly online publication in 2010, running through 2017.
Vaccinate Women: This publication was published annually from 2002 to 2008 for obstetrics and gynecology professionals.
Vaccinating Adults: A Step-by-Step Guide: Published in 2017, this guide is designed to help implement or enhance adult immunization services in healthcare settings.
We hope educators, researchers, and curious clinicians find these historical resources interesting and valuable to your work.
Recap: Immunize.org updates “Standing Orders for Administering Meningococcal B Vaccine (MenB) to Adolescents and Adults”
Immunize.org updated its Standing Orders for Administering Meningococcal B Vaccine (MenB) to Adolescents and Adults to note the option to use pentavalent MenABCWY vaccine if a patient age 10 years or older needs both MenB and MenACWY vaccines in the same visit.
Recap: Immunize.org updates parent handout, “Top Ten Reasons to Protect Your Child by Vaccinating”
Immunize.org updated its parent handout, Top Ten Reasons to Protect Your Child by Vaccinating. Changes include adding RSV protection in item 3 and making minor wording adjustments.
Recap: Immunize.org updates “Don't Be Guilty of These Preventable Errors in Vaccine Administration!”
Immunize.org reviewed Don't Be Guilty of These Preventable Errors in Vaccine Administration! to incorporate updated CDC MMRV vaccine recommendations limiting its use to children age 4 years or older. It also incorporates minor changes to improve wording.
Recap: Immunize.org updates “Questions and Answers” resource on varicella Immunize.org updated Varicella (Chickenpox): Questions and Answers resource for patients and caregivers to incorporate updated MMRV vaccine recommendations on page three, which now states:
In the several years following the licensure of the combined measles-mumps-rubella (MMR) and varicella vaccines in 2005, surveillance of side effects showed that children who got their first dose as the combined product (MMRV) had more fevers and fever-related seizures (about 1 in 1,250) than children who got the first dose as separate shots of MMR and varicella on the same day. As a result, CDC preferred use of separate MMR and varicella vaccines for the first dose in the 2-dose series. In June of 2025, CDC recommended use of separate MMR and varicella vaccines for all doses given before age 4 years, although no increased risk of febrile seizures has been detected when using MMRV as a second dose in the series. The use of combination vaccine (MMRV) remains generally preferred over separate injections for children who are receiving their second dose or their first dose when age 4 through 12 years.
Recap: Immunize.org adds vaccine schedules and searchable database of recommendations published by healthcare professional organizations
Some healthcare professional organizations issue evidence-based vaccination guidance for their patient populations. They include the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Family Practitioners (AAFP), and others. To better support vaccination providers and educators who rely on our resources, at the end of December 2025 Immunize.org launched two new pages to connect with healthcare professional organization guidance in the new Healthcare Professional Organizations section on our website.
In this section, you will find links to:
These new pages are intended to help you make well-informed clinical decisions about vaccination by offering easy access to evidence-based clinical guidance. Visit Immunize.org's Healthcare Professional Organizations to view these two new web pages.
Updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults Confident healthcare provider recommendations for influenza vaccine are powerfully persuasive. As the nation faces a challenging influenza season, Immunize.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense website to help you maximize patient protection.
This helpful site includes information, tools, and tips for communicating with adults age 65 and older about the burden and severity of influenza. Resources include:
A clinician recommendation is the most important reason why a person will get vaccinated. Check out the updated 65+ Flu Defense website to assist your ongoing efforts in protecting this vulnerable population.
Immunize.org's elegant "Vaccination Saves Lives" blue enamel pins make wonderful workplace recognitions Immunize.org is pleased to offer our new lapel pin. Our “Vaccination Saves Lives” pins are meaningful gifts for people who understand that lives are not saved by vaccines on a shelf, but by the act of vaccination. The pin makes a refined statement in rich blue enamel with gold lettering and edges, measuring 1.65" x 0.75".
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Select the design that best suits how you plan to use your pin:
- Double stick-through posts: Two posts slide through fabric and are held securely by either rubber or locking-metal backings. Both types of backing are provided in the package.
- New! Magnetic clasp: Hold the pin firmly in place without piercing clothing.
 
Be first in your office to wear these elegant new pins on clothing, white coats, backpacks, or tote bags to remind everyone you meet of the value of vaccination.
Click here for "Vaccination Saves Lives" pin pricing and ordering information.
Needle anxiety is common at any age. Use Immunize.org’s clinical resources to offer a positive vaccination experience. In Clinical Resources: Improving the Vaccination Experience, Immunize.org provides print and video tools to create a positive vaccination experience and ease injection anxiety in children and adults. Links to additional resources from trusted partner organizations are also provided.
The web page links to eight printable resources on addressing vaccination anxiety (four for providers, four for recipients—also available in Spanish), two in-depth webinars, and six brief videos (listed below). As with all Immunize.org resources, these are free to download, link, copy, and share.
The video topics include:
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Help Immunize.org reach more vaccinators through your social media networks. Follow us and share our posts on Facebook, Instagram, and LinkedIn! Immunize.org offers a social media program to highlight our educational resources for a widespread audience of vaccinators. Our social media channels now feature our most popular printable resources and Ask the Experts questions, as well as announcements important to frontline vaccinators. Please view and share our newest feature, the Ask the Experts Video Series.
 
Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise:
“Updated Evidence for COVID-19, RSV, and Influenza Vaccines for 2025–2026” published in New England Journal of Medicine
In its October 29 issue, New England Journal of Medicine published Updated Evidence for COVID-19, RSV, and Influenza Vaccines for 2025–2026. A portion of the methods, results, and conclusions sections appear below.
We conducted a systematic review of U.S.-licensed immunizations against coronavirus disease 2019 (COVID-19), respiratory syncytial virus (RSV), and influenza. We searched databases on PubMed/MEDLINE, Embase, and Web of Science for updates of the most recent review by the Advisory Committee on Immunization Practices (ACIP) Evidence-to-Recommendations for each disease, which was performed during the 2023–2024 period. Outcomes included vaccine efficacy and effectiveness against hospitalization, other clinical end points, and safety. . . .
Of 17,263 identified references, 511 studies met the inclusion criteria. . . .
Ongoing peer-reviewed evidence supports the safety and effectiveness of immunizations against COVID-19, RSV, and influenza during the 2025–2026 season.
Virtual: Register for Immunize.org Website Office Hours. Join a 30-minute discussion about our new Official Guidance: Healthcare Professional Organization Schedules content on February 11 at 4:00 p.m. (ET) or February 12 at 12:00 p.m. (ET). Recorded sessions archived.
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