The Evolving Pediatric Vaccine Schedule: Policy, Coverage, and Access Issues

This roundtable series, Clinical Insights: Childhood Vaccine Schedule Changes, discusses ongoing changes to the pediatric vaccine schedule, the inner workings of the CDC’s Advisory Committee on Immunization Practices (ACIP), and how these changes are impacting US public health.

Recent revisions to the childhood immunization schedule have generated substantial discussion among clinicians, public health experts, and professional societies. Some updates involve shifts in recommendation status for several long-standing vaccines, including changes affecting routine use of hepatitis B vaccination at birth, meningococcal vaccination strategies in adolescents, and preventive approaches to respiratory syncytial virus (RSV) in infancy. Such modifications represent more than incremental adjustments; they may alter the long-standing framework through which pediatric infectious diseases have been prevented in the US.

In the roundtable discussion, Jacinda Abdul-Mutakabbir, PharmD, MPH; Sharon Nachman, MD; Mary Koslap-Petraco, DNP, PNP-BC, CPNP; and William Schaffner, MD addressed the broader policy and ethical implications of the schedule changes. The panelists highlighted concerns related to cost, disparities in vaccine uptake, and the need for clinicians to remain informed about evolving recommendations while continuing to emphasize the importance of vaccination for preventing serious infectious diseases.

Disclosures include Shionogi, GSK, NovaVax, CSL Sequiris, Innoviva Specialty Therapeutics, and Abbvie for Abdul-Mutakabbir.

References:

1. CDC adopts individual-based decision-making for hepatitis B immunization for infants born to women who test negative for hepatitis B virus. News release. US Centers for Disease Control and Prevention. Published December 16, 2025. Accessed March 10, 2026. https://www.cdc.gov/media/releases/2025/2025-hepatitis-b-immunization.html
2. Halsey G. ACIP votes to modify decades-long hepatitis B birth dose recommendation. Patient Care Online. December 5, 2025. Accessed March 10, 2026. https://www.patientcareonline.com/view/acip-votes-to-modify-decades-long-hepatitis-b-birth-dose-recommendation