Childhood Vaccines in 2026: What Changes, What Didn’t, and What Parents Should Know

The updated guidance groups vaccines into three practical categories:

1. Recommended for all children (universal routine vaccinations)
2. Recommended for specific high-risk groups, and
3. Recommended through shared clinical decision-making (discuss with your clinician based on individual risk and preference).¹

Framing the guidance this way helps families and clinicians focus discussions on risk, context (for example, travel or chronic medical conditions), and timing. 

The vaccinations that have been in place for decades remain recommended including DTP, HiB, Polio, and MMR. These vaccinations – apart from HiB – have been central to pediatric care for nearly 50 years (HiB for 35 years) and remain recommended for all children, and their public-health benefits are well established.²

• DTaP (Diphtheria, Tetanus, and Acellular pertussis) – standard pediatric formulation.
• Hib (Haemophilus influenzae type b).
• Polio (Inactivated poliovirus vaccine).
• MMR (Measles, Mups, Rubella).
• Pneumococcal (vaccine against Streptococcus pneumoniae), which – aside from preventing some pneumonias – has produced very large decreases in middle ear and sinus infections in children.³

These all remain on the universal schedule and continue to show favorable safety profiles and clear impacts on disease reduction. 

HPV (Human Papilloma Virus) continues to be recommended. Robust evidence shows 80% reduction in cervical cancer risk for females vaccinated before age 16 with a 37% overall reduction in incidence in well-vaccinated populations.⁴

The initial controversy was because the disease, cervical cancer, is primarily the result of a sexually transmitted infection. Some people recoiled against this linkage. While the direct benefit to males does not include cervical cancer, vaccinating males contributes to herd immunity and overall reduction in cancer rates in females and reduces genital warts (in both sexes) and other HPV-related conditions.⁵ 

A small number of vaccines were moved off the universal/standard list and are now recommended for specific high-risk populations with parents making informed, risk-based decisions.

• Hepatitis A and B – shifted to risk-based discussion for some populations. Hepatitis A is commonly transmitted by contaminated food and generally not a life-threatening disease – though infections are unpleasant. Good public health measures, as well as the relatively high vaccination rate up to now, have reduced the overall incidence, but many physicians question if removing the vaccine from the standard list will result in increased incidence over time. Hepatitis B can be life-threatening and chronic when acquired early in life. It is primarily transmitted by blood or body fluids and can lead to long term liver disease, including increased cancer risk. Although higher risk is often associated with socioeconomic factors, for higher-income families, frequent international travel (potential exposure to populations with increased Hepatitis B rates) and regular dining out (increased Hepatitis A exposure) can also increase risk .⁶
• RSV (respiratory syncytial virus) – RSV is a leading cause of hospitalization in infants and young children, and vaccination strategies have been shown to reduce RSV-related hospitalizations by over 50%. The most effective pediatric protection occurs through maternal vaccination 4-8 weeks before delivery, rather than routine infant vaccination. Because evidence for direct infant vaccination is less robust, RSV vaccination was removed from universal childhood recommendations, though it may still be appropriate for select high-risk infants when maternal vaccination did not occur.⁷
• Meningococcal – moved away from universal adolescent recommendation into a shared decision space for most adolescents. This infection is now very uncommon, but when it occurs it is often devastating. Even today, about 1 in 7 cases is fatal, and survivors frequently experience lifelong neurologic complications.⁸ Vaccinations has worked extremely well, reducing cases by roughly 90% and improving survival from 1 in 5 deaths to about 1 in 7.⁸ Because the disease is so rare, preventing a single adolescent death would require vaccinating around two million teenagers, which is why the CDC moved this vaccine out of the routine schedule.⁹ Many clinicians, however, will still recommend it during adolescence – especially before college – as part of a shared decision between families and their physician. Note that an outbreak is occurring in Chicago with 7 cases and 2 deaths as this is being written. 

It’s important to be explicit: most core vaccines remain recommended and covered. The update is primarily a reclassification intended to tailor recommendations to risk profiles and to encourage individualized clinical conversations. That means clinicians and families should expect more discussion about the relative risks and benefits for a handful of vaccines, rather than a cessation of routine childhood immunizations.¹ 

1. If your child has chronic medical conditions (ex., immunocompromise, chronic lung disease, congenital heart disease), ask your pediatrician whether the vaccine moved to “high risk” applies to them.
2. If you expect your family will travel internationally with children, discuss Hep A/B with your clinician before travel.⁶
3. For adolescents planning to live in communal settings (dorms, military, certain boarding schools), discuss timing of meningococcal vaccination and boosters – this remains part of a shared decision.⁸⁹
4. If you are pregnant or planning pregnancy, discuss RSV maternal immunization timing with your obstetrician and pediatrician to ensure optimal newborn protection.⁷ 

Families with frequent international travel, complex medical considerations, or multi-jurisdictional living arrangements may benefit from discussing health risk planning as part of a broader continuity and security strategy. Learn more about our global medical solutions.  

1. Centers for Disease Control and Prevention (CDC). CDC Acts on Presidential Memorandum to Update Childhood Immunization Schedule. January 5, 2026. https://www.cdc.gov/media/releases/2026/2026-cdc-acts-on-presidential-memorandum-to-update-childhood-immunization-schedule.html  

2. Children’s Hospital of Philadelphia, Vaccine Education Center. Vaccine History and Timelines. https://www.chop.edu/vaccine-education-center/science-history/vaccine-history  

3. Fortanier AC et al. Impact of pneumococcal conjugate vaccines on otitis media and upper respiratory infections in children. Clinical Infectious Diseases. https://www.sciencedirect.com/science/article/pii/S1098301522000158  

4. Lei J et al. HPV vaccination and the risk of invasive cervical cancer. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa1917338  

5. Centers for Disease Control and Prevention (CDC). HPV Vaccine Effectiveness and Impact. https://www.cdc.gov/hpv/hcp/vaccine-effectiveness.html  

6. Centers for Disease Control and Prevention (CDC). Hepatitis A and Hepatitis B Transmission and Risk Factors. https://www.cdc.gov/hepatitis  

7. Madhi SA et al. Maternal respiratory syncytial virus vaccination and infant hospitalization outcomes. The Lancet Infectious Diseases. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00231-2/fulltext

8. Centers for Disease Control and Prevention (CDC). Meningococcal Disease. Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book). https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-14-meningococcal-disease.html  

9. Centers for Disease Control and Prevention (CDC). ACIP Economic Analysis of Adolescent Meningococcal Vaccination. MMWR Recommendations and Reports. https://www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm