A certified medical assistant holds a syringe for a flu vaccine at a clinic in Seattle, on Wednesday, Sept. 10, 2025. (AP Photo/Lindsey Wasson, File)2026-01-05T23:34:13Z WASHINGTON (AP) U.S. health officials made broad changes to childhood vaccine recommendations Monday, alarming pediatricians and other medical experts who say they will sow confusion and undermine childrens health. The overhaul is effective immediately, meaning that the U.S. Centers for Disease Control and Prevention will now recommend that all children get vaccinated against 11 diseases, down from 18 a year ago. The changes comes as U.S. vaccination rates have been slipping and the share of children with exemptions has reached an all-time high, according to federal data. At the same time, rates of diseases that can be protected against with vaccines, such as measles and whooping cough, are rising.Heres what to know about the changes: Heres what federal vaccine recommendations have changedOnce broadly recommended, the federal government now only recommends protection against these diseases for certain children at high risk or based on individual doctor advice in whats called shared decision-making. Flu Hepatitis A Hepatitis B Meningococcal disease Rotavirus RSV COVID-19, a change made in 2025 Heres what federal vaccine recommendations stayed the sameThe following vaccines were left on the recommended-for-all list: Measles, mumps and rubella (MMR) Diphtheria, tetanus and pertussis or whooping cough (DTaP) Polio Chickenpox Human papillomavirus, or HPV. But in a surprise, the guidance reduces the number of recommended vaccine doses against HPV from two or three shots to just one. Hib, or Haemophilus influenzae type B, bacteria that despite the name isnt related to flu PCV or pneumococcal conjugate vaccineWhy were the vaccine recommendations changed? The U.S. Department of Health and Human Services said the overhaul was in response to a request from President Donald Trump in December. Trump asked the agency to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly.HHS said its comparison to 20 peer nations found that the U.S. was an outlier in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.However, many European countries recommend some of the vaccines the U.S. removed from its list. What do doctors and pediatricians say?The nations large doctors groups, including the American Medical Association and the American Academy of Pediatrics, say they will continue to recommend the vaccines that the Trump administration has now demoted. They said there was no new science that warranted the changes, including no signs that the former U.S. vaccine schedule harmed children.Dr. Sean OLeary of the AAP said the changes could increase child illness and death from preventable disease. He voiced special concern that the U.S. would no longer recommend flu vaccine for children, just as the flu season is becoming severe and after last winters particularly harsh season.The pediatricians group has issued its own child vaccine recommendations. Also, states, not the federal government, have the authority to require vaccinations for schoolchildren. While CDC requirements often influence those state regulations, some states have begun creating their own alliances to counter the Trump administrations guidance on vaccines. What will change for families?Its not yet clear. Because of the countering recommendations from pediatricians, doctor visits may not change. However, medical specialists say when the U.S. government doesnt explicitly recommend a shot, it will raise questions among parents, leading to more difficult conversations at the doctors office.If the changes mean fewer children are vaccinated, outbreaks that have historically been prevented by high vaccination rates could spread more widely, leading to more disease and more missed school and work. Will insurance continue to cover vaccines?The Trump administration said coverage will continue for families that still want the shots. Health insurers generally find vaccination a good deal, as shots are cheaper than hospitalizations, and many had previously said theyd planned to cover what was recommended last year through 2026.___AP writers Ali Swenson and Mike Stobbe contributed to this report from New York. ___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institutes Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content. LAURAN NEERGAARD Neergaard is an Associated Press medical writer who covers research on brain health, infectious diseases, organ transplantation and more. She is based in Washington, D.C. mailto