By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

The idiom “keeping up with the Joneses” refers to social pressure to match or keep up with the wealth or status of your neighbors. In 2016, this common idiom was made into an action-comedy film starring Jon Hamm. The plot reveals the neighbors are jealous of the new couple who have moved in next door until they find out they are actually spies and the drama begins!

On January 2, 2026, the FDA released an extensive paper with consultation from CDC, FDA, National Institutes of Health (NIH), and Centers for Medicare & Medicaid Services (CMS) titled, “Assessment of the U.S. Childhood and Adolescent Immunization Schedule Compared to Other Countries.”  The 33-page paper reveals the methodology behind the recently announced changes to the childhood immunization schedule. 

This paper led to the January 5, 2026, press release from the U.S. Department of Health and Human Services about the new changes.  This press release was a directive from the President to review international best practices from peer, developed countries. 

The media, including social media, have grabbed onto these changes and there is quite a bit of misinformation being spread. When looking at the original documents, what are the recommendations and how can the public and healthcare professionals manage the new changes?

The assessment of childhood vaccines compared 20 peer, developed nations' practices to the U.S. When making the comparisons, the U.S. recommended more childhood vaccines than any other peer nation, including twice as many doses. On the surface, this may seem alarming. However, some of these countries have very different insurance coverage and a different distribution of risks.  

The comparator countries included the United Kingdom, Denmark, Australia, Austria, Canada, Germany, France, Finland, Italy, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, Japan, Ireland, Greece, Belgium, and the Netherlands. The U.S. was at the higher end of giving vaccines in terms of disease numbers (17) and doses (84-88) compared to Denmark at the low end with 10 diseases and a total of 30 doses.  The United States, Australia, and Portugal start vaccine coverage at birth, while the other countries typically gave the first vaccines at 18 months to 2 years of age.  

There was a set of vaccines with consensus among the 20 countries and the U.S. Where the U.S. differed was related to vaccines for hepatitis A, varicella (chicken pox), influenza (flu), rotavirus, and meningococcal. The comparison showed that the other countries have a higher level of public trust in vaccines than the U.S. 

The paper does acknowledge differences in the patterns of some of these diseases by country, as well as the land mass and population numbers can be significantly different from the United States. 

Based on the new recommendations, what are the important aspects to understand with the changes?

The new recommendations have 4 distinct categories for childhood vaccine classification. The first one is Immunizations Recommended for All Children, with the second being Immunizations Recommended for Certain High-Risk Groups or Populations.  The third category is Immunizations Based on Shared Clinical Decision-Making, with the fourth being Not Recommended Immunizations.

None of the current childhood vaccines moved into the Not Recommended Immunization category. Therefore, all of the current vaccines are in the other 3 categories and are still available to children. 

The Immunizations Recommended for All Children include MMR (measles, mumps, rubella), Tdap (tetanus, diphtheria, pertussis or whooping cough), IPV (polio) , Hib (Haemophilus influenzae type b bacteria), and PCV (Pneumococcal Conjugate Vaccine).  

Those not included in this list are recommended within the other 2 categories. Children at high risk of certain diseases may receive vaccines such as hepatitis A and hepatitis B based on underlying diseases or unusual exposure.  

The category of shared decision-making is an important aspect for the public and parents. This category is meant to stimulate an informed recommendation for a vaccine between a healthcare provider and the patient or parent/guardian.  This category allows for consideration for family preferences and beliefs as well as considering patient-specific health aspects. Talk to your doctor, nurse, or pharmacist!

Another important aspect of the report is that any childhood vaccine in the first 3 categories should be covered with insurance and/or government health plans with no out-of-pocket expense to the patient or family.  Only vaccines placed in the Not Recommended Immunization category would not be covered by CMS plans. 

Many professional organizations have come out in strong opposition to these new recommendations and often indicate the science may be lacking to support the changes. Some of the most prominent groups include the American Academy of Pediatrics (AAP), the American Medical Association (AMA), the Infectious Disease Society of America (IDSA), the American Public Health Association (APHA), and the American Osteopathic Association (AOA). 

Keep up with the Joneses and talk to your healthcare professional for more advice!

If you are interested in more information, please contact ONU HealthWise Pharmacy at 419-722-3784.