Realigning United States Core Childhood Vaccine Recommendations With Best Practices From Peer, Developed Countries

Pursuant to the Presidential Memorandum of December 5, 2025 (Aligning United States Core Childhood Vaccine Recommendations with Best Practices from Peer, Developed Countries) (Memorandum), the Department of Health and Human Services (HHS) completed a scientific assessment that compared United States childhood immunization recommendations with those of peer nations, analyzed vaccine uptake and public trust, evaluated clinical and epidemiological evidence and knowledge gaps, and examined vaccine mandates (scientific assessment). The scientific assessment found that the United States currently recommends more childhood vaccines than any peer nation, including more than twice as many vaccine doses as some European nations, and identified a set of consensus vaccines that are consistently recommended in all peer countries. The scientific assessment also found that, instead of implementing vaccination mandates, most peer nations maintain high childhood vaccination rates through public trust and education. My Administration is committed to ensuring that Americans are receiving the best scientifically supported medical advice in the world. Additionally, my Administration is committed to protecting religious liberty and parental authority. Therefore, it is the policy of the United States that the core childhood vaccine schedule should be aligned with scientific evidence and best practices from peer, developed countries while preserving access to vaccines currently available to Americans and that the Federal Government will continue to protect religious freedom and enforce all legal protections for parents.

(a) The scientific assessment, with its proposed updates to the categories of the vaccine schedule, is acknowledged as a guiding resource for the Federal Government. (b) The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) shall review the scientific assessment and the latest clinical data and, to the extent permitted by law, take any appropriate steps to update the United States childhood and adolescent vaccine schedule. ACIP's review should consider ways to provide maximum flexibility to parents and doctors through recommendations for timing and sequencing of the administration of routine immunizations. (c) Each executive department and agency shall ensure all actions, regulations, funding, and coverage related to child and adolescent immunizations align with the schedule recommended by the ACIP and adopted by the CDC, including fulfilling all legal obligations with respect to parental authority, religious freedom, disability accommodations, and equal protection under the law. Specifically, consistent with the Memorandum and as recommended in the scientific assessment, all the immunizations that are in any category on the schedule recommended by the ACIP and adopted by the CDC should continue to be covered without cost sharing by private insurance and covered by Medicaid, the Children's Health Insurance Program, and the Vaccines for Children Program. (d) The HHS Director of the Office of Intergovernmental and External Affairs shall ensure that State government and health officials are informed of the policies in this order and should ensure that the scientific assessment is available as a resource to inform their consideration of State vaccination laws.

(a) Nothing in this order shall be construed to impair or otherwise affect: (i) the authority granted by law to an executive department or agency, or the head thereof; or (ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals. (b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations. (c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. (d) The costs for publication of this order shall be borne by the Department of Health and Human Services.