Recent updates to the child and adolescent immunization schedule from the U.S. Centers for Disease Control and Prevention (CDC) have sparked questions from families. 

Are there new vaccines? Has the recommended schedule changed? Should parents be concerned?

Joseph Pachunka, MD, a combined internal medicine and pediatrics doctor, explains what’s changed and what hasn’t.

Are there new vaccines on the schedule?

“There were no new vaccines added,” says Dr. Pachunka. “Most of the routine childhood vaccines remain the same.”

The biggest change is how certain vaccines are categorized, not which vaccines children can get.

What actually changed?

The CDC adjusted some of the wording in the schedule. Vaccines are now grouped into categories like:

• Recommended for all children.
• For high-risk children.
• Based on shared clinical decision-making.

Dr. Pachunka explains that, in practice, pediatricians already use shared decision-making every day.

“We’ve always had conversations with families,” he explains. “No doctor is forcing a vaccine. We’re happy to talk through risks, benefits and concerns.”

It’s worth noting that several major medical organizations did not change their guidance at the same time as the CDC. The American Academy of Pediatrics (AAP) republished the previous vaccine schedule without reflecting these changes, noting there is no new data necessitating any change to the recommended vaccine schedule. 

The AAP schedule was further endorsed by several major medical organizations, including the American Academy of Family Physicians (AAFP), the American Medical Association (AMA) and the Infectious Diseases Society of America (IDSA).

“This is unusual,” says Dr. Pachunka. “Typically, these organizations and the CDC release changes together.”

What about the hepatitis B vaccine at birth?

One area that received attention is the hepatitis B vaccine given shortly after birth. The CDC’s new language emphasizes risk-based considerations and shared decision-making. 

But Nebraska Medicine continues to recommend the birth dose. It helps protect infants who may be unknowingly exposed, prevents missed opportunities later and supports community-wide protection. 

“If parents have concerns, we’ll always talk about them,” says Dr. Pachunka. “It’s not a mandate. But in general, we recommend it because it protects babies early.”

If the birth dose is declined, the vaccine can still be given later and is part of the schedule.

Are meningitis and HPV vaccines now “optional”?

Some adolescent vaccines, including certain meningococcal and HPV recommendations, were placed in the shared decision-making category. This doesn’t mean they aren’t important.

Meningococcal vaccines protect against rare but devastating forms of bacterial meningitis. 

“Meningococcal meningitis can progress quickly and can be life-threatening,” says Dr. Pachunka. “In severe cases, teens can lose limbs due to blood pressure collapse.”

While cases are rare, the vaccine is safe and effective. That is why pediatricians continue to strongly recommend it.

The HPV vaccine helps prevent several types of cancer later in life. Current recommendations call for two doses if started before age 15 and three doses if started later.

In the U.S., providers continue to follow evidence-based guidance from manufacturers and specialty societies to ensure the strongest protection.

How are vaccines evaluated for safety?

Before a vaccine is approved, it goes through review by the U.S. Food and Drug Administration (FDA). This includes clinical trials, independent review panels and ongoing post-marketing safety monitoring.

All concerns are investigated. For example, the Advisory Committee on Immunization Practices (ACIP) reviews evidence and makes recommendations that guide CDC policies. 

“Vaccines undergo continuous safety monitoring, even after approval,” says Dr. Pachunka. “If the risk outweighs the benefits, action is taken.”

What if my child already started a vaccine series? 

The good news is that vaccine schedules are flexible. Doses can often be delayed and should not be given too close together. Any missed doses can almost always be caught up later.

“We frequently help teens finish HPV or meningococcal series they started earlier,” says Dr. Pachunka. 

If you’re unsure, your pediatrician can review your child’s record and create a catch-up plan.

Are too many vaccines given too soon?

This is one of the most common concerns among parents. But no parent is forced to vaccinate. 

“We’re here to answer questions,” says Dr. Pachunka. “If families aren’t comfortable with the full schedule at one visit, we talk through options.” 

Vaccines are timed to protect children when they’re most at risk. Delaying vaccines may leave children unprotected during high-risk periods.

Why measles is a growing concern

Measles cases are rising nationally, including recent cases reported in Nebraska. They spread extremely easily, often without direct contact. 

“You can get measles just by being in the same room where an infected person was, even after they’ve left,” says Dr. Pachunka.

About 90% of unvaccinated people exposed to measles will become infected. 

To protect the community, vaccination rates must stay in the high 90% range. This also protects babies too young for vaccination, pregnant women, children with cancer and individuals with weakened immune systems.

Contrary to recent claims, the measles, mumps and rubella (MMR) vaccine does not cause autism. Large population studies, including research published in the New England Journal of Medicine, have found no link.

“We have strong data,” says Dr. Pachunka. “There’s no association between the MMR vaccine and autism.”

How parents can stay informed

Talk directly with your child’s pediatrician or family medicine doctor. You can also use trusted sources like the American Academy of Pediatrics.

Dr. Pachunka urges families to discuss concerns openly during visits. 

“Feel empowered to ask questions,” he says. “We want families to feel comfortable and informed.”

Nebraska Medicine pediatric providers follow evidence-based guidance supported by national pediatric specialty organizations. 

“We’re continuing to do what we’ve always done,” says Dr. Pachunka. “We have conversations. We answer questions. We recommend what’s safest and most protective for children.”