A Pediatrician’s Thoughts on Changing Vaccine Recommendations
I have been a practicing Pediatrician since 2011 – longer if you include the time spent in my Pediatric residency program from 2008-2011. During that time, I have seen the social landscape surrounding vaccines vary drastically – from a burgeoning anti-vaccine movement based largely on faulty claims that the MMR vaccine caused autism (The Wakefield studies), to a subsequent trend the opposite direction with increased trust and belief in the power of vaccination. Now, unfortunately, we are seeing an increase in delayed vaccines and vaccine hesitancy, stemming largely from a change in authority at the Department Health and Human Services and the Advisory Committee on Immunization Practices (ACIP). ACIP has long been comprised of both medical and public health experts, who develop recommendations on the use of vaccinations in the United States. In the past there was a rigorous process for members to be appointed to this committee. Unfortunately, this is no longer the case and an entirely new committee (who did not go through the same appointment process) has been created in the past year. This new committee has immediately begun to promote a negative outlook towards vaccine recommendations and vaccine safety, despite decades of research to back up the current recommendations.
This has prompted concern about legitimacy of the recommendations from ACIP from almost every medical society, including the American Academy of Pediatrics, the Infectious Disease Society of America, and the Pediatric Infectious Disease Society among countless others. In fact, following the recently published recommendations regarding Hepatitis B dosing, there was a joint statement released from many of these leading medical and patient advocacy groups on December 5, 2025.
“We are deeply alarmed by the actions taken this week by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP). The apparent goal of this meeting was to sow doubt in vaccines rather than advance sound vaccine policy, and we will all pay a price for that.
This is a significant departure from the historic role ACIP has played in shaping vaccine policy in the United States. Previously, we could expect science to drive decisions, experts to debate evidence, and consensus to lead to shared, clear recommendations. That is not the case with the current committee, and this change puts Americans’ health at risk.”
(See source for quote along with the rest of the statement in the Resources section below).
In light of this change in attitude towards vaccines, as well as changes in the vaccine recommendations themselves from a previously-trusted entity, the American Academy of Pediatrics has advised continuing to follow the original, science-based vaccine schedule. At first glance it appears complex, but it is well-established and well-known by Pediatricians and is the best way to protect children from preventable diseases as early and as safely as possible.
Additionally, I think it is important to reinforce the knowledge that we DO have regarding vaccine recommendations.
Important facts regarding United States Vaccine Recommendations:
- Vaccine recommendations are primarily based upon exposure risk. This can vary based on population, and thus vaccine recommendations vary based on the population they are intended to protect. For instance, we do not recommend routine vaccination for typhoid, yellow fever, tuberculosis, or malaria in the US – but these are routinely recommended in other countries where these diseases are more prevalent.
- The recommended vaccine schedule, which determines the number of vaccines and how often they are given, is determined based on the age at which the child is the most vulnerable combined with the age at with the vaccine will stimulate the immune system in a beneficial way. For example, infants and young children are most vulnerable to serious disease from Pneumococcal bacteria, so the Pneumococcal conjugate vaccine (PCV) is given starting in infancy and is not recommended to be given after five years of age. Haemophilus influenza b vaccine has a similar recommendation based on infection risk.
- Often it is recommended to give children multiple vaccines at once. This is, again, due to the risks of more severe disease in this more vulnerable population. Splitting up the timing of vaccines or delaying routing vaccines prolongs this risk. There is no evidence that shows a delayed vaccine schedule is beneficial or necessary.
- Vaccine distribution differs by country as well. In the US, we incorporate routine childhood vaccinations into the regular well-check visits, while in other countries this may occur through public health programs instead.
Final thoughts
Prevention is a huge part of pediatrics. We counsel on safety, giving advice and gentle reminders about car seats, safe sleeping techniques, choking hazards, and use of helmets. We discuss nutrition and how best to ensure children have the best opportunity to grow in a healthy manner. A large part of pediatrics, however, is the use of vaccines to prevent illness. Vaccination has had an immense impact on the lives of children in the US. In fact, a report published by the CDC in 2024 states that
“Among children born [in the United States] during 1994–2023, routine childhood vaccinations will have prevented approximately 508 million lifetime cases of illness, 32 million hospitalizations, and 1,129,000 deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.”
Even if you set aside the monetary impact, the prevention of illness and avoidance of hospitalization are huge benefits. The prevention of over a million deaths during that thirty year period is immeasurable. These impacts are the reason so many Pediatricians like myself are fearful of the potential effects of the new recommendations by ACIP that contradict decades of research and safety profiles. We will continue to work to give parents information regarding vaccines that is accurate and evidence-based, and hope that they trust this of us who provide care for their children enough to believe it.
Resources
–Statement from Leading Medical, Health, and Patient Advocacy Groups on CDC Vaccine Meeting
–Fact Checked – US Vaccine Recommendations
–CHOP Article on Vaccines and Autism – information on the Wakefield studies
–AAP recommended vaccine schedule
–astheygrow.blog – Alternative Vaccine Schedules
–astheygrow.blog – Vaccine Hesitancy and Refusal
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