Happy New Year, North Carolina Practice Managers and Staff!

As we begin 2026, the landscape of childhood immunizations is shifting—bringing both confusion and opportunity for clarity. The latest update from the CDC, following a Presidential directive to align U.S. recommendations with “peer nations” like Denmark, has resulted in significant changes to the recommended vaccine schedule for children. Here’s what you need to know, and how to support your teams and families through this transition.

What’s Changed?

• Fewer Routine Vaccines: The CDC now routinely recommends vaccines for 11 diseases instead of 17. For example, the HPV vaccine moves from a 2-dose to a 1-dose schedule.
• Risk-Based & Shared Decision-Making: Several vaccines previously recommended for all children are now either:
  • Recommended only for high-risk groups: RSV (for children whose mothers didn’t get the pregnancy vaccine), Hepatitis A, Hepatitis B, Meningococcal.
  • Left to “shared clinical decision-making” (SCDM): Rotavirus, COVID-19, Influenza, Hepatitis A, Hepatitis B, Meningococcal. This means clinicians and families decide together, based on individual risk and benefit.
• No Change for Pediatric Vaccines Coverage: Medicaid and Prepaid Health Plans (PHPs) have not changed their position—coverage for pediatric vaccines remains unchanged at this time.

New HHS Childhood Immunization Schedule (Released January 5, 2026)

Key Points for Your Practice

1. Access Remains: Families can still access the full range of childhood immunizations recommended by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP). The AAP schedule remains unchanged and is available .
2. No Out-of-Pocket Cost: All vaccines—including those now under SCDM—are still covered with no out-of-pocket cost by ACA-regulated private insurance, Medicaid, and the Vaccines for Children (VFC) program. HHS has affirmed this commitment.
3. Evidence Is Unchanged: The scientific evidence supporting the full AAP and AAFP vaccination schedules remains robust. These changes do not reflect new safety or efficacy concerns.
4. Anticipate Challenges: Expect confusion and operational challenges around school vaccine requirements, clinical workflows, and supply of combination vaccines. Clear communication and updated workflows will be essential.

Practical Guidance for Practice Managers & Staff

• Continue to Offer and Recommend Vaccines: Pediatricians and primary care teams can still offer vaccines according to the evidence-based U.S. schedule. Parents can request them, and clinicians should reassure families about continued access and coverage.
• Update Clinical Workflows: Integrate prompts and education into EHRs and point-of-care tools to maintain routine vaccination workflows and avoid missed opportunities.
• Communicate Clearly: Use talking points that focus on health outcomes (illnesses prevented, hospitalizations avoided) rather than the number of vaccines. Emphasize that fewer vaccines does not mean better health outcomes.
• Monitor for Policy Updates: Stay tuned for further guidance from NC Medicaid, VFC, and state health agencies. Forward any updates you receive to the NC Immunization Coalition (NCIC) and share with your teams.
• Educate Staff and Families: Address misconceptions proactively. For example:
  • The U.S. is not an outlier—most peer nations have schedules similar to ours, not Denmark’s.
  • The broader U.S. schedule exists to fill gaps in healthcare access and disease screening.
  • The Hep B birth dose is a critical safety net, especially given gaps in maternal screening and follow-up in the U.S.
  • Combination vaccines help reduce the number of shots, not the level of protection.

Questions or need more resources?
Contact NCIC or your local Area Health Education Center for support.

This post is for educational purposes only and does not substitute for medical advice. Please consult with your clinical leadership and state health authorities for operational guidance.