Jeffrey A. Singer
The American Academy of Pediatrics (AAP) released its 2026 childhood immunization schedule today. The 2026 recommendations are the same as those the AAP provided last year at this time. This is a notable departure from the revised immunization schedule released earlier this month by the Centers for Disease Control and Prevention (CDC).
At the urging of Health and Human Services Secretary Robert F. Kennedy, Jr., the CDC removed hepatitis A and B, rotavirus, respiratory syncytial virus (RSV), influenza, and meningococcal vaccines from the list of routinely recommended childhood immunizations.
The AAP strongly disagrees with the new CDC schedule. So do several other professional medical and public health societies, including the American College of Physicians, the Society for Maternal-Fetal Medicine, the Infectious Diseases Society of America, the American Public Health Association, and the Massachusetts Public Health Alliance. Furthermore, at least 20 state and several county public health departments have announced they won’t follow the new CDC guidelines and instead will adhere to the AAP’s recommendations.
I’m a general surgeon, not an immunologist or epidemiologist, and I don’t claim to have special expertise in the finer points of the childhood immunization schedule. Like most people who aren’t trained in virology, bacteriology, or public health, I do what any responsible professional does: I read the literature and consult with people who actually work in these fields—both colleagues I know personally and academic experts—about their opinions. That’s the advice I trust when making decisions for my family and for those who seek my guidance.
That’s why I believe the current “rebellion” of medical and public health societies against the federal government’s new guidelines is not only understandable but also healthy in the long run.
As Terence Kealey, Bautista Vivanco, and I wrote on a tangentially related matter, “There is no one right answer, but when the federal government makes recommendations, health care providers and patients often treat them as authoritative.”
The CDC didn’t originally serve as a central command for American life. Founded in 1946—initially called the Communicable Disease Center—it had a simple, practical goal: assist states and localities in fighting serious infectious diseases such as malaria, tuberculosis, and smallpox. Its role was to conduct research, share expertise, and support local health departments, rather than micromanage personal health decisions.
Since then, the agency’s portfolio has gradually expanded into areas only loosely connected to traditional public health, including things like firearm policy. That’s classic mission creep, and it naturally turns the agency into a political battleground and a magnet for lobbyists.
Public health is inherently local. Communities vary in density, demographics, and risk factors, and no single federal approach can capture that diversity.
The CDC would function better—and stay more true to its purpose—if it returned to its original goal: supporting and coordinating with state and local health agencies and leaving personal medical decisions to patients and their doctors.
Kealey, Vivanco, and I recently proposed a Pyramid of Epistemic Authority for Nutrition Advice. There’s nothing about that framework that limits it to food—it applies just as well to immunization and preventive medicine, and helps explain why this kind of professional dissent ought to be a feature, not a bug.
That’s why, while I won’t pretend to decide the merits of this dispute, I’m encouraged by it—and by its potential to lessen the automatic deference we give to federal health authorities.
As I wrote last month, “If there’s a silver lining, it’s that controversies like this may finally encourage clinicians, researchers, and patients to rely less on federal pronouncements and more on diverse, independent medical expertise.”