Overview
In his second term, President Donald Trump has moved to fundamentally recast U.S. childhood vaccination policy, arguing that the country gives too many shots compared with its peers. On December 5, 2025, after a federal vaccine advisory panel voted 8–3 to end the longstanding recommendation that all newborns receive a hepatitis B shot at birth, Trump signed a presidential memorandum ordering the Health and Human Services secretary and the CDC director to review the entire childhood schedule and align it where possible with “best practices from peer, developed countries.”
The hepatitis B shift caps a year of rapid, controversial changes under Health and Human Services Secretary Robert F. Kennedy Jr., including re-framing COVID-19 vaccination as a matter of individual decision-making and launching the Make America Healthy Again (MAHA) Commission to link chronic disease to environmental, dietary, and medical drivers, including vaccines. Major medical groups warn the new direction could erode vaccine coverage, fuel outbreaks of preventable diseases, and politicize scientific guidance, while supporters hail it as long-overdue scrutiny of an expansive schedule and of the health agencies that built it.
Key Indicators
People Involved
Organizations Involved
The executive branch of the U.S. federal government under President Donald Trump’s second, nonconsecutive term, driving major shifts in immigration, health, and regulatory policy.
A presidential commission chaired by the HHS Secretary and tasked with diagnosing and reversing the U.S. childhood chronic disease crisis through changes in food, environment, medical practice, and vaccination policy.
The lead U.S. public health agency, responsible for disease surveillance, outbreak control, and official immunization schedules, now operating amid political intervention and internal turmoil.
The expert body that advises CDC on vaccine recommendations, whose decisions shape official schedules and insurance coverage.
Timeline
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Medical Groups, States, and Experts Push Back
BacklashThe American Academy of Pediatrics and other professional societies announce they will continue to recommend hepatitis B vaccination at birth and maintain broader childhood schedules, while some state health departments signal they will follow AAP over federal guidance. Analysts warn of confusion for clinicians and families and predict legal and political fights over school mandates.
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Trump Signs Memo Ordering Review of Childhood Vaccine Schedule
Executive ActionWithin hours of the hepatitis B vote, Trump signs a presidential memorandum instructing the HHS Secretary and CDC Director to compare U.S. core childhood vaccine recommendations to those of peer developed countries and, where foreign practices are deemed scientifically superior, to update the U.S. schedule accordingly, while keeping vaccines available.
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ACIP Ends Universal Hepatitis B Birth Dose Recommendation
Advisory RecommendationACIP votes 8–3 to stop recommending that all U.S. newborns receive a hepatitis B shot within 24 hours of birth. The new guidance limits the birth dose to infants whose mothers are hepatitis B–positive or whose status is unknown, framing the rest as an individual decision for parents and clinicians and potentially delaying vaccination to two months or later.
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CDC Autism–Vaccine Webpage Rewritten to Leave Link ‘Open’
Communication ChangeUnder Kennedy’s direction, the CDC quietly updates its autism and vaccines webpage to suggest a link cannot be ruled out, reversing years of categorical statements that vaccines do not cause autism. Public health experts and AAP leaders denounce the change as contradicting decades of evidence and bypassing normal CDC scientific review.
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CDC Director Ousted; Jim O’Neill Installed as Acting Chief
Leadership ChangeCDC Director Susan Monarez is removed after resisting vaccine policy changes proposed by HHS leadership. Deputy HHS Secretary Jim O’Neill, a longtime associate of tech investor Peter Thiel and a critic of regulatory hurdles, is named acting director, prompting more resignations and concerns over politicization.
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CDC Updates Schedules, Embeds Individual-Based COVID-19 Guidance
Agency ActionCDC updates its adult and child immunization schedules to implement ACIP’s recommendations, making COVID-19 vaccination subject to individual-based decision-making and shifting toddlers to a standalone varicella vaccine instead of the MMRV combination.
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ACIP Makes COVID-19 Vaccination ‘Individual Decision-Making’ for All Ages
Advisory RecommendationACIP unanimously recommends that COVID-19 vaccination for everyone six months and older be determined by shared clinical decision-making rather than routine universal recommendation, emphasizing greater benefit for those at high risk. This later appears on the CDC schedules.
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MAHA Strategy Calls for New Vaccine Framework
Policy ReportThe MAHA Commission unveils its Make Our Children Healthy Again Strategy, a sweeping interagency plan that includes building a new framework for childhood vaccination recommendations as part of efforts to ‘end childhood chronic disease.’
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MAHA Commission Releases ‘Make Our Children Healthy Again’ Assessment
Policy ReportThe MAHA Commission publishes a 78‑page assessment attributing rising childhood chronic diseases to ultra-processed foods, chemical exposures, sedentary lifestyles, overuse of medications, and aspects of vaccination, setting the stage for a broad rethinking of pediatric health policy.
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Trump Establishes MAHA Commission on Childhood Health
Executive ActionPresident Trump signs an executive order creating the Make America Healthy Again (MAHA) Commission, chaired by HHS Secretary Robert F. Kennedy Jr., with a mandate to investigate chronic disease and children’s health, including medical drivers such as psychiatric drugs and vaccines.
Scenarios
Targeted but Substantial Rollbacks of the U.S. Childhood Vaccine Schedule
Discussed by: Reuters, The Washington Post, Time, vaccine policy analysts quoted in major outlets
Under this scenario, the Trump–Kennedy team uses the new memo and ACIP’s reconstituted membership to narrow or delay several vaccines deemed low-priority or controversial, beyond hepatitis B. COVID-19 shots remain non-routine for most children, universal birth dosing for hepatitis B is eliminated, and additional changes could include later timing or risk-based recommendations for HPV, some boosters, and certain combination vaccines. The White House frames these changes as bringing the U.S. closer to Denmark, Japan, or Germany, and as part of a broader MAHA push to cut ‘unnecessary’ medical exposures. This outcome becomes more likely if the CDC director formally adopts the hepatitis B change, if MAHA’s vaccine framework gains political traction, and if early disease upticks are modest enough to be explained away or blamed on other causes.
Symbolic Review, Minimal Structural Change
Discussed by: Some public health experts interviewed by U.S. media and advocacy groups
Here, political and professional backlash from medical societies, state health departments, and parts of Congress constrain the administration’s ambition. The formal ‘review’ cites differences in foreign schedules but emphasizes local disease patterns and health-system gaps, leading to only limited changes beyond hepatitis B and the already-implemented COVID-19 shift. The memo becomes a talking point for the base, but insurers, states, and professional groups mostly keep the broader schedule intact in practice. This scenario would be reinforced if large pediatric systems, state immunization programs, and insurers quietly continue covering and recommending the full schedule, and if courts or Congress signal potential pushback against more radical departures.
Fragmented Patchwork: States and Professional Bodies Set De Facto Standard
Discussed by: State-level health officials, AAP leadership, legal scholars
In this outcome, the federal schedule weakens, but states, medical societies, and insurers respond by building their own reference standards. AAP and key states (e.g., California, Illinois, New York, some blue-leaning or public health–focused jurisdictions) continue to recommend universal hepatitis B birth doses, broad COVID-19 eligibility, and existing schedules for MMR, DTaP, and HPV. Other states use the new federal flexibility to roll back mandates for school entry. The result is a highly fragmented map of childhood vaccine expectations, with differential disease risk and school policies depending on geography. This scenario would be driven by rapid state-level legislative activity, high-profile outbreaks in low-vaccination states, and growing divergence between AAP and CDC recommendations.
Backlash After Outbreaks Forces Reversal and Rebuilding of Trust
Discussed by: Epidemiologists and historians citing DPT and MMR precedents, major health media
If reductions in coverage driven by the hepatitis B and other changes lead to visible outbreaks—such as increases in pediatric hepatitis B, measles, or whooping cough—public opinion could swing sharply. Historical experience shows that severe or fatal cases in infants can trigger rapid political reaction. A future administration or a re-aligned Congress could then move to restore or even strengthen federal recommendations and firewall scientific advisory bodies from political interference. However, rebuilding trust after years of mixed messages from CDC and HHS, and after online misinformation campaigns, would likely take many years and require structural reforms, not just policy reversals.
Historical Context
1970s–1980s Pertussis Vaccine Scares in the UK and Japan
1974–1983What Happened
In the mid‑1970s, fears about side effects from whole‑cell pertussis (whooping cough) vaccines led Japan to temporarily suspend infant DPT vaccination and then delay the first dose until age two, while coverage in the United Kingdom fell from around 80% to roughly 30%. Subsequent years saw major pertussis epidemics: in Japan, reported cases surged from a few hundred to more than 13,000 with dozens of infant deaths, and in England and Wales large outbreaks in 1978–79 and the early 1980s produced tens of thousands of cases and multiple deaths.
Outcome
Short term: Public confidence collapsed, disease returned on a large scale, and many children were hospitalized or died from a once‑declining illness.
Long term: Countries eventually restored trust through better safety monitoring and by switching to acellular pertussis vaccines, but only after preventable epidemics underscored the cost of reduced coverage.
Why It's Relevant
The pertussis experience shows how even temporary or partial retreats from established childhood vaccine policies—particularly when driven by safety fears amplified in politics and media—can produce deadly outbreaks that are difficult and slow to reverse. It offers a cautionary analogue for today’s U.S. shifts on hepatitis B and other vaccines.
The 1998 MMR–Autism Hoax and Measles Resurgence
1998–2010sWhat Happened
In 1998, a now‑discredited paper led by Andrew Wakefield in The Lancet falsely suggested a link between the measles–mumps–rubella (MMR) vaccine and autism. Despite being based on a small, biased case series and later exposed as fraudulent, the study sparked sharp drops in MMR coverage in the UK and parts of Europe, followed by large measles and mumps outbreaks. The paper was fully retracted in 2010, and multiple large epidemiologic studies have confirmed there is no causal link between MMR and autism.
Outcome
Short term: Vaccine uptake fell, measles returned in communities where it had been nearly eliminated, and public health authorities scrambled to counter misinformation.
Long term: Although coverage eventually recovered in many places, the episode seeded a durable global anti‑vaccine movement and contributed to renewed measles outbreaks decades later.
Why It's Relevant
The Wakefield episode illustrates how a single high‑profile challenge to vaccine safety can erode trust, drive down coverage, and fuel long‑term misinformation. The current U.S. effort—under Kennedy’s influence—to reopen questions about vaccine–autism links and to weaken schedules risks repeating this pattern on a larger scale.
Post‑COVID-19 Vaccine Hesitancy and Measles Comeback
2020–2024What Happened
In the years after the COVID‑19 pandemic, misinformation and politicization around COVID vaccines spilled over into skepticism of routine childhood shots. Countries that had long maintained high coverage saw rising pockets of under‑vaccination and renewed measles outbreaks, with global measles cases and deaths climbing sharply by 2022. Experts warned that politicized narratives and online disinformation were undermining confidence in well‑established vaccines even as the world had more tools than ever to prevent disease.
Outcome
Short term: Localized measles and pertussis outbreaks re‑emerged in high‑income countries, often concentrated in communities with falling vaccination rates.
Long term: Health authorities began reframing communication strategies and investing more heavily in countering misinformation, but progress has been uneven and fragile.
Why It's Relevant
This recent history underlines that U.S. schedule changes are unfolding in a context of already-fragile vaccine confidence. Even modest federal retreats from universal recommendations—such as for hepatitis B or COVID‑19—may disproportionately fuel broader hesitancy and disease resurgence.