By unilaterally gutting the U.S. childhood vaccination schedule, President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. have replaced decades of successful evidence-based public health policy with ideology, conspiracy thinking, and medical malpractice. This is not reform. It is vandalism.
Without meaningful consultation with pediatricians, public health officials, or the Advisory Committee on Immunization Practices — the expert body legally charged with making vaccine recommendations — the administration has slashed the number of universally recommended pediatric vaccines from 17 to 11. Some have been demoted to only high-risk individuals or to “shared clinical decision-making,” both of which are euphemisms that translate in practice to delays, missed doses, and declining coverage.
Here are some of the specific changes that have been implemented:
The recommended dosage for the HPV vaccine, which has been shown not only to reduce the incidence of acute infection but virtually to eliminate subsequent cervical cancer, was reduced from two doses to one. A lower dose will reduce efficacy and leave women prone to both infection and later malignancy.
Immunizations no longer universally recommended but only henceforth for certain high-risk groups or populations will include RSV; hepatitis A; hepatitis B; dengue; Neisseria meningitidis bacteria serogroups A, C, W, and Y; and meningococcal B. A similar category is immunization based on “shared clinical decision-making” between patients and healthcare providers, which includes vaccines for rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B.
Turning routine vaccines into “shared clinical decisions” does one thing reliably: It reduces vaccination rates. It forces extra appointments. It creates hesitation. It signals to parents that vaccines once considered standard are now somehow suspect. That is not an accident; it is intentional.
The result will be a greater incidence of acute, sometimes life-threatening infections, as well as long-term sequelae for some people, such as persistent “long COVID” symptoms for COVID-19 and chronic infection, cirrhosis, and liver cancer from hepatitis.
The justification offered by federal officials, that the United States is merely aligning its vaccine schedule with those of “peer nations,” is a fig leaf. It is also nonsense. Many wealthy countries maintain vaccine schedules that closely resemble the one just discarded, and those that don’t have public policies such as universal healthcare and paid parental leave that make comprehensive vaccination less imperative. The administration did not discover a global consensus; it manufactured one to rationalize a policy outcome demanded by Kennedy, a person who built his career attacking childhood immunization.
Kennedy is not a skeptic cautiously weighing new data. He is a lifelong anti-vaccine zealot who spent years promoting debunked claims about autism, questioning the legitimacy of measles vaccination, and portraying routine immunization as a public health menace. That record is not incidental; it is the point. The new policy is the culmination of his worldview, now imposed from the top down.
Most alarming is the deliberate sidelining of ACIP. The committee was not consulted despite earlier assurances that it would lead efforts to evaluate the childhood vaccine schedule. By bypassing it entirely, the administration has rendered the committee functionally obsolete. If expert advisory bodies can simply be ignored when their conclusions are inconvenient, then evidence-based regulation has been replaced by political whim.
Officials insist that insurance coverage for dropped vaccines will remain intact, but that is a distraction. Vaccine uptake depends on clarity, normalization, and ease of access — not on whether a billing code technically exists. Pediatricians know this. Public health officials know this. The administration knows this, too.
The administration has gone further, claiming that the existing vaccine schedule itself contributed to declining public trust and that “unknown risks” and “limited safety data” justify retreat. This is a grotesque inversion of reality. Childhood vaccines are among the most rigorously studied medical products in existence. I should know: I reviewed vaccines at the Food and Drug Administration in the 1980s. When real risks have emerged, recommendations have changed — openly, transparently, and based on evidence. What is happening now is the opposite: evidence-free policy driven by a predetermined, false narrative.
The predictable result will be fewer children vaccinated on time. We already know that infants who miss early doses are far more likely to miss later ones, including the measles vaccine. We also know what follows declining coverage: outbreaks, hospitalizations, and preventable deaths. These are not abstractions. They are historical certainties.
Health officials and hospital leaders have warned that this move will sow chaos in pediatric practices, increase liability risks, and confuse families. Even HHS lawyers reportedly questioned the legality of the policy. None of that mattered. The decision was made first; the consequences are someone else’s problem.
This is not a conservative defense of limited government. It is the most intrusive kind of governance: the politicization of medical standards in the service of personal ideology. Trump has handed national immunization policy to a man who spent decades trying to undermine it, and the result is exactly what anyone paying attention would expect.
HHS CURTAILS CHILDHOOD VACCINATION SCHEDULE
The damage will not be immediate, which is what makes this move politically tempting. It will come quietly: missed appointments, delayed shots, a resurgence of diseases Americans once considered relics of the past. And preventable deaths.
When that happens, there should be no confusion about responsibility. This was not an accident. It was a choice. And it is one that puts children at risk to satisfy a long-standing anti-vaccine crusade now dressed up as public policy.
Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger distinguished scholar at the Science Literacy Project. He was the founding director of the FDA’s Office of Biotechnology.