CDC Childhood Immunization Schedule Updates (January 2026)

Description

John Schoen, Senior Clinical Manager of Evidence-Based Medicine and Drug Information in Vizient's Center for Pharmacy Practice Excellence and Vizient's vaccine subject matter expert, joins host Stacy Lauderdale to discuss key updates to the CDC's childhood Immunization schedule and what they mean for practice.

Guest speaker: 

John Schoen, PharmD, BCPS 

Senior Clinical Manager of Evidence-Based Medicine and Drug Information  

Vizient Center for Pharmacy Practice Excellence 

Host: 

Stacy Lauderdale, PharmD, BCPS 

Associate Vice President

Vizient Center for Pharmacy Practice Excellence 

Verified Rx Host

00:00 — Introduction

Announcer welcomes listeners to Verified Rx, produced by the Vizient Center for Pharmacy Practice Excellence.

00:14 — Episode Overview

Host Stacy Lauderdale introduces the topic:
updates to the CDC’s U.S. Childhood Immunization Schedule, revised January 20, 2026.
Goal of the episode: explain what changed, what didn’t, and what it means in practice for providers, pharmacists, and families.
Guest: John Schoen, Senior Clinical Manager of Evidence-Based Medicine and Drug Information at Vizient and vaccine subject matter expert.

01:16 — What Changed in the CDC Immunization Schedule

CDC reorganized the schedule into three recommendation categories.
Vaccines were reclassified, not removed.
Number of diseases covered under “routine” recommendations decreased from 17 to 11 due to recategorization.

01:50 — Stated Rationale Behind the Changes

Rationale provided in executive summary of scientific assessment.
The supporting scientific assessment is available online and referenced for transparency (link in resources below).

03:19 — Were Any Vaccines Removed?

No vaccines were removed from the CDC schedule.
Some vaccines were shifted into different recommendation categories.

03:40 — Category 1: Routine Childhood Vaccinations

Vaccines still routinely recommended for all children include:

MMR (measles, mumps, rubella)
Polio
Tdap / DTaP
Hib (Haemophilus influenzae type B)
Pneumococcal
HPV
Varicella (chickenpox)

04:27 — Category 2: Vaccines for High-Risk Populations

Vaccines recommended for children who meet specific high-risk criteria:

RSV monoclonal antibodies (mAb)
Hepatitis A
Hepatitis B
Quadrivalent meningococcal
Meningococcal group B
Dengue

05:19 — What Changed vs. Stayed the Same

Hepatitis A, Hepatitis B, and quadrivalent meningococcal moved from routine to high-risk
RSV mAb recommendations are effectively unchanged, as high-risk infants are defined as those born to mothers who did not receive the maternal RSV vaccine.
Dengue remains risk-based.
Meningococcal group B remains a mix of risk-based and shared clinical decision-making.

06:31 — Category 3: Shared Clinical Decision Making (SCDM)

Defined by ACIP as an individualized decision made jointly by provider and parent/guardian.
Allows vaccination when risk-based criteria are not met but benefit is still considered.

06:52 — Vaccines Under SCDM

Vaccines now include:

Influenza
COVID-19
Rotavirus
Hepatitis A
Hepatitis B
Quadrivalent meningococcal
Meningococcal group B

08:05 — What’s New in SCDM

Influenza and rotavirus moved from routine to SCDM.
Hepatitis A, hepatitis B, and quadrivalent meningococcal also shifted.
COVID-19 moved to SCDM in September 2025 for individuals ≥6 months.

08:28 — Insurance Coverage Implications

No expected changes in coverage.
Vaccines recommended by CDC as of December 31, 2025 remain:
- Covered without cost-sharing under Affordable Care Act (ACA) plans.
- Covered by Medicaid, Children’s Health Insurance Program (CHIP), and Vaccines for Children (VFC) program.

09:14 — Impact on Pharmacy Vaccine Access

Pharmacists are considered healthcare providers under CDC SCDM definitions.
Authority to administer vaccines primarily determined by state laws.

Standing orders, protocols, and collaborative practice agreements may need to be updated, as applicable, to address language related to ‘routine’ immunizations for children.

10:27 — Recommendations for Providers & Organizations

For providers:

Become familiar with schedule changes.
Be prepared for patient and parent education.
Recognize differences between CDC and other professional guidelines.

For organizations:

Review EHR documentation and order sets.
Consult local state regulations to ensure compliance with vaccine administration practices. Review standing orders/protocols and collaborative practice agreements to determine if revisions are needed. Monitor vaccine utilization and adjust inventory accordingly.

11:24 — Resources & Closing