The recent decision by the Trump administration to no longer fully endorse a third of childhood vaccines has raised alarms among health experts, signifying a shift for the United States from a global leader in vaccination to a country potentially trailing behind other high-income nations in disease prevention.

This change, primarily advocated by Robert F. Kennedy Jr., a longtime vaccine skeptic and current secretary of the U.S. Department of Health and Human Services (HHS), has been termed the most significant alteration to vaccination protocols in modern American history.

In the words of infectious diseases specialist Jake Scott from Stanford University, “It’s the largest change in our vaccination schedule in modern American history.” Experts warn that this “astounding” decision was reached without scientific backing or public consultation, which could lead to decreased vaccine access and increased disease outbreaks.

Daniel Jernigan, former director of the National Center for Emerging Zoonotic Infectious Diseases, asserted, “U.S. health officials want fewer vaccines, inflating the risks while minimizing the benefits of vaccines, creating confusion among parents and healthcare providers.”

The revised recommendations classify several vaccines as only necessary for “high-risk” groups. These include vaccines for hepatitis A, respiratory syncytial virus (RSV), hepatitis B, and two types of meningitis. The dengue vaccine will continue to be recommended solely in high-risk areas, while other vaccines will require a clinician’s recommendation—a practice not typically applied until now.

The Centers for Disease Control and Prevention (CDC) stated this move will align the U.S. vaccination schedule with those of “peer, developed countries” as directed by Donald Trump last December. However, public health experts note that most other high-income nations still maintain similar vaccine schedules to the recommendations that the U.S. has now abandoned.

Countries such as the UK, Canada, Australia, Japan, and many European nations have universal childhood vaccination schedules that include influenza, rotavirus, and hepatitis B. With the exception of Japan, most routinely recommend vaccination for meningococcal disease. Furthermore, Canada, Japan, and many European nations advocate for RSV vaccines for all newborns, while Australia recommends it for all pregnant individuals.

Notably, some nations have even expanded their vaccine offerings. Japan added the rotavirus vaccine in 2020, while the UK has recently begun recommending the chickenpox vaccine for all children. Jernigan highlighted that such decisions are typically supported by substantial evidence on the safety and effectiveness of these vaccines, a standard that U.S. policy appears to be abandoning.

As Scott points out, many countries are enhancing their vaccine programs. “Numerous nations are broadening their vaccination schedules,” he said, emphasizing that they have traditionally looked to the U.S. for guidance.

Currently, the U.S. vaccine schedule is more similar to that of Denmark, noted for its minimalist childhood vaccination program despite being a smaller nation with universal healthcare. “Denmark stands out as an outlier,” Scott explained, emphasizing the need for the U.S. to consider adopting similar healthcare frameworks.

With a population of 330 million, the American healthcare system is notably fragmented, covering vast geographic and demographic diversity. Profound health disparities exist across the country, with nearly a third of the population lacking access to primary care. This limited access exacerbates the spread of preventable diseases before individuals seek medical attention.

Diverse urban centers juxtaposed with rural areas, alongside extensive interstate and international travel, means “disease spreads differently” in the U.S., Scott warned. This dynamic is particularly concerning when considering outbreaks, such as meningitis, among college students who may have moved from small towns to densely populated campuses.

In nations with comprehensive healthcare systems, vaccines, often recommended for high-risk populations, are more accessible. Unfortunately, in the U.S., children born to hepatitis B infected mothers are at a higher risk yet often remain unvaccinated due to barriers in accessing healthcare services for follow-up.

Andrew Nixon, an HHS spokesperson, acknowledged declining trust in public health but did not offer evidence indicating how the new vaccination schedule would influence public confidence.

“I have never witnessed anything like this, where recommendations from other countries carry the same weight as scientific evidence,” Jernigan remarked, emphasizing the impropriety of personalized policy changes without a robust scientific basis.

Scott argued that these recent recommendations appear more focused on justifying a predetermined agenda to scale back vaccination rather than aligning with international peers.

Moreover, established protocols for public engagement and transparent scientific discourse were overlooked in this decision-making process, with no public consultation or feedback from established health advisory committees, according to Jernigan.

Scott expressed deep concern over the lack of public debate regarding such critical health policy changes, calling it ominous that these alterations weren’t subjected to the thorough evidence evaluation typically conducted by the Advisory Committee on Immunization Practices (ACIP).

The administration’s approach to transparency has also been questioned. A limited group of journalists received briefings on the vaccination changes, raising concerns about the democratic nature of this policy shift.

Despite these unsettling developments, both Jernigan and Scott hope parents will continue to prioritize vaccinations for their children, recognizing the real risks associated with diseases like meningitis. “You don’t want to be the parent of a child who experiences an outbreak in college and suffers severe consequences,” Jernigan cautioned.