The story of childhood vaccines is, at its heart, one of the great triumphs of modern medicine. For the better part of a century, parents have walked through the doors of pediatricians’ offices across the country and emerged with children protected against diseases that once claimed young lives by the thousands. Polio, measles, diphtheria — names that once inspired terror in households — have been pushed to the margins of American life largely because of the commitment clinicians and families have made to following evidence-based immunization schedules. And smallpox has been eradicated from the world. That legacy deserves to be honored and celebrated.
In 2026, however, parents and pediatric healthcare providers are navigating a landscape that looks more complicated than it has in generations. Here’s what parents need to know about what’s affecting the landscape, the importance of vaccines, and how to make informed decisions.
What’s different about the childhood vaccine recommendation process for 2026?
In January 2026, that process changed in a significant way. Rather than following the standard ACIP evidence-review cycle, the 2026 federal immunization schedule was developed through a separate assessment commissioned at the executive level.
The result: The number of vaccines recommended for all U.S. children was reduced from 18 diseases to 11 under the new federal framework, whereas the AAP’s vaccine schedule continues to recommend vaccines protecting children against 18 diseases, maintaining the full scope of immunization guidance that pediatricians have relied upon for decades. As of July 2026, the federal recommendations have been “stayed” by a federal judge, and the CDC is recommending its 2025 guidance that includes 18 diseases. What this means is that the established schedule remains in place while the courts resolve the matter.
What does this mean for parents making decisions about childhood vaccines?
The most important thing for parents to know is that their child’s pediatrician remains their best resource for making vaccine decisions. The disagreement between the CDC and the AAP is an unusual moment in U.S. public health, marking the first divergence in their recommended immunization schedules in over 30 years. But for families, it’s also an opportunity to engage more deeply with their child’s care, ask questions, and understand which vaccines their child needs and when.
Here are resources to help you understand the organizations’ recommendations, terminology, and the 2026 immunization framework:
- The 2026 AAP Recommended Child and Adolescent Immunization Schedule is available alongside comprehensive information for parents about the changes in this year’s process and why the AAP constantly reviews the data, updates pediatricians, and finds very few reasons to vary from the immunization schedule.
- To view the CDC’s list, and more about the terminology and methodology, use the Child and Adolescent Immunization Schedule (addendum updated July 2, 2025).
How is the childhood vaccine schedule determined?
Both the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) review and update their pediatric immunization schedules annually — a collaborative practice that’s been in place since 1995.
Each year, the CDC’s Advisory Committee on Immunization Practices (ACIP) — a body of independent scientific and medical experts — leads a comprehensive review. That review evaluates new vaccine approvals by the FDA, updated safety and efficacy data, shifts in U.S. disease epidemiology, and recommendations from partner organizations including the AAP. The resulting schedule is published at the start of each new year and takes effect for clinicians immediately.
The AAP conducts its own parallel annual review through its Committee on Infectious Diseases, which historically participates in ACIP workgroups and applies the Evidence to Recommendations framework to arrive at its vaccine schedule. The American Academy of Family Physicians (AAFP) follows a similar cycle.
Beyond the annual publication, either the AAP or the CDC can issue a mid-year update when new vaccines are approved or significant guidance changes emerge. The result has been a vaccine schedule that has earned the trust of physicians, nurses, pharmacists, and families nationwide.
What concerns and questions are parents bringing to their pediatricians about childhood vaccines today?
Pediatricians are seeing more hesitancy about vaccines than ever before. In large part, vaccine hesitancy has become politicized outside the exam room. Inside the exam room, however, it’s not a political discussion.
Families tend to fall into one of five groups with regard to immunization:
- Outspoken about their support and desire for vaccines.
- Happy to follow medical guidance.
- Cautious; they ask questions but ultimately vaccinate.
- On the fence due to specific concerns.
- Outright refusers.
The specific concerns parents voice include administering vaccines at too young an age, questions about “long-term side effects,” concerns about additives, and concerns about specific vaccines. For example, COVID-19 and flu vaccines are frequently refused; some parents don’t want to give hepatitis B at birth; and some parents don’t want the HPV vaccine. Finally, pediatricians still hear concerns about a link between autism and vaccines. Fortunately, good studies have demonstrated that vaccines do not cause autism, hepatitis B is safe and important when given at birth, and vaccines such as HPV, flu, and COVID-19 are safe and effective.
What are the risks of not having my child vaccinated?
Vaccines are teachers and our bodies are the learners; getting your child immunized teaches the immune system to appropriately respond to infections. When a child is not vaccinated, they’re vulnerable to diseases that can cause serious, sometimes permanent, harm. Whooping cough can be fatal in infants. Meningitis caused by Hib bacteria can result in hearing loss, brain injury, and long-term disability. There’s also a broader reality: When vaccination rates fall, diseases resurge (as recent measles outbreaks have demonstrated).
Vaccines protect not only the child who receives them but also children who cannot receive vaccines for medical reasons and others who are medically vulnerable. The decision not to vaccinate carries consequences that extend well beyond one family.
What is the vaccination schedule for children and what if my child misses one or more?
The good news is that the experts at Nemours KidsHealth® have developed an immunization resource section to answer a number of different questions about childhood vaccines, including a childhood vaccine schedule. You can also view and print the AAP’s 2026 childhood immunization schedule. The AAP schedule is based on the times when the vaccines work best with your child’s immune system, and it is possible to catch up on your child’s vaccines if they miss a dose or if you change your mind about vaccines.
What is the one thing parents should know about immunizations?
There are no serious, long-term side effects of the routine vaccines that are currently recommended for children in the United States.
Where can I find care?
The early childhood years represent one of the most critical windows for immunization, as infants and toddlers face the greatest vulnerability to many of the diseases that vaccines prevent. Talk to your pediatrician if you have questions about how many vaccines your child needs and to learn more about your child’s pediatric vaccine schedule. Nemours Children’s offers primary care locations throughout our health system.
