The Diseases Rfk Jr. Says Children Don’t Need To Be Routinely Vaccinated For

America is about to get a real-world test of how well vaccines keep us healthy.

Robert F. Kennedy Jr.’s move Monday to drop recommendations that all children get shots for four diseases is likely to mean fewer kids do, and more kids contract hepatitis A, meningitis, rotavirus and the flu.

That’s a tradeoff Kennedy has long believed worthwhile. Before becoming health secretary, he said he thinks kids get too many shots and that it’s likely the cause of other health issues, such as autism, a neurological condition that affects communication and behaviors.

Most public health experts say there’s no evidence to support Kennedy’s concerns but they’re certain vaccinating less is going to lead to more disease.

"Half of my pediatric ward would be kids with rotavirus, and the other half would be kids with RSV," said Nava Yeganeh, medical director for vaccine preventable disease control at the Los Angeles County Department of Public Health, recalling the time before vaccines for those diseases were widely available.

Kennedy’s new childhood vaccine schedule recommends children get immunized against 11 diseases, compared with 17 that were routinely recommended at the end of 2024.

The downgraded shots will still be available, and covered by insurance, Kennedy’s Health and Human Services Department says, but public health experts expect the change will confuse parents and fuel growing distrust in vaccines. Fewer people are expected to get them. Falling vaccination rates, public health experts warn, could usher in more cases of diseases Americans haven’t worried about in decades.

While children are still hospitalized for rotavirus and RSV, cases don't fill hospital beds like they once did, Yeganeh said, largely because "people are using the vaccine and it's working the way it's supposed to.”

Kennedy upended the schedule Monday without a vote from a panel of outside experts who usually evaluate changes before the Centers for Disease Control and Prevention, an arm of Kennedy’s department, adopts them.

Last year, the panel voted to drop universal recommendations for Covid-19 vaccines and the hepatitis birth dose, moves the acting CDC director affirmed.

Now, Americans will no longer be told to vaccinate their children for hepatitis A, influenza, meningitis and rotavirus. Those shots, experts say, have made childhood immeasurably healthier since they were developed.

Hepatitis A

What to know: Hepatitis A is a viral liver infection. It is extremely contagious and spreads through feces, often through contaminated food or close person-to-person contact. In a fraction of cases, it can cause sudden liver failure or chronic liver inflammation.

The CDC received reports of 1,648 new hepatitis A infections in 2023 — the latest agency data available — though it estimates new infections are likely closer to 3,300 after accounting for under-testing and underreporting. Most of the cases were in adults, and at least 85 people died from hepatitis A in the U.S. that year.

Hepatitis A case rates have varied drastically over the past decade, however, with nearly 19,000 new reported cases in 2019, corresponding to more than 37,000 estimated new cases.

The hepatitis A vaccine became available in the U.S. in 1995. In 2006, ACIP recommended that all children get vaccinated against the disease. Cases dropped dramatically, more than 95 percent from 1996 to 2011, after the shot was introduced and recommended for children.

Vaccine uptake: Eighty percent of children born in 2019 and 2020 received two doses of the shot by age 35 months, according to the CDC's National Immunization Survey.

Herd immunity: The science is not settled on how much of the population must be vaccinated in order for hepatitis A to no longer spread easily, but studies of high-risk groups, like people who inject drugs, estimate around 80 percent coverage of that population would prevent outbreaks.

The CDC’s old recommendation: Until Monday, the agency recommended the two-dose series for all children ages 12-23 months.

The change: Moving forward, only children at high risk for hepatitis A will routinely be recommended to get the series. Low-risk children won't be recommended the shot, but they can still get it after their parents or guardians confer with a health care provider about the decision.

Vaccine details: Two single-antigen hepatitis A vaccines are available for children in the U.S.: Havrix, made by GlaxoSmithKline Biologicals, and Vaqta, made by Merck Sharp & Dohme Corp.

Influenza

What to know: The 2024-2025 flu season was especially deadly for children, with 289 pediatric deaths reported to CDC. The majority of deaths were in children who were unvaccinated or had an unknown vaccination status.

This year’s flu season, which runs from October to May, is expected to rival last year’s, which saw at least 43 million symptomatic cases across the entire population. All but two states currently have high or very high flu activity, according to the CDC.

At least nine children have died from influenza during the 2025-2026 season so far, according to reports provided to the agency, though the actual number is likely higher: The CDC estimates that there have been 5,000 deaths from flu so far this season among all ages.

Vaccine uptake: Fewer children are vaccinated against the flu this year than were protected last year. As of December 27, 42.5 percent of kids 6 months to 17 years old had been immunized, compared with 43.5 percent at the same time last year. Pediatric flu vaccination has declined over the past decade, with nearly 50 percent of children getting their flu shot by the end of last year’s influenza season, compared with more than 62 percent for the 2019-2020 season.

Herd immunity: Estimates of vaccination levels needed to reach herd immunity vary drastically depending on the year and flu strain. Even so, the U.S. set a target of 70 percent vaccination in its “Healthy People 2030” framework, a detailed set of goals intended to improve the population’s health, released in 2020.

The CDC’s old recommendation: The agency previously recommended that everyone 6 months and older get a flu shot.

The change: On the downgraded pediatric schedule, the flu shot now falls under a “shared clinical decision-making” recommendation, meaning parents should consult with health care providers when deciding whether to vaccinate their child.

Vaccine details: A handful of flu vaccines are available to U.S. children, including Fluzone, made by Sanofi Pasteur; Afluria, made by CSL Seqirus; and Fluarix, made by GlaxoSmithKline. Children 9 and older can also receive Flublok, made by Sanofi Pasteur.

Meningitis

What to know: Meningitis is an inflammation of the tissue surrounding the brain and spinal cord. Swelling triggered by inflammation can put pressure on the brain or spinal cord, which can result in cognitive problems, seizures, paralysis or death.

Meningococcal disease, which causes meningitis, is rare in the U.S., but has been on the rise in recent years. According to preliminary data, 503 confirmed or probable meningococcal disease cases were reported to the CDC in 2024 — the highest number of cases in the U.S. since 2013. The rise in cases was driven by the Y group of meningococcal bacteria, which older children were routinely advised to vaccinate against until Monday.

The disease spreads through mucus or saliva, usually through close contact with an infected person. It has a history of causing outbreaks in college dorms, and many universities require vaccination for students living on campus.

Vaccine uptake: In 2024, among teenagers 13 to 17 years old, over 90 percent had received at least one dose of the two-dose series protecting against the A, C, W and Y groups of meningococcal bacteria, according to results from the CDC’s National Immunization Survey. The number represents an increase from 2023, when coverage was around 88 percent. 

Herd immunity: There's little research into how much vaccination it would take to achieve herd immunity for meningitis.

The CDC’s old recommendation: CDC previously advised all 11- and 12-year-olds get the MenACWY vaccine series, which protects against several types of the bacteria that cause meningococcal disease, and get a booster at 16.

The change: The agency now recommends “shared clinical decision-making” for the MenACWY vaccine, meaning parents should consult with providers when deciding whether to vaccinate their child. The shot is also listed as recommended for certain high-risk groups.

The CDC continues to recommend a vaccine protecting against the B group of meningococcal bacteria to high-risk groups.

Vaccine details: Both GSK and Sanofi make MenACWY vaccines approved for use in the U.S.

Rotavirus

What to know: Rotavirus is a gastrointestinal infection, which causes diarrhea, vomiting, fever and dehydration. It’s passed primarily by ingesting fecal matter, and is often spread in places where young children are together, like daycares and family settings.

According to the CDC, around nine out of 10 children who get the vaccine will be protected from severe rotavirus disease, while seven out of 10 children will be protected from rotavirus disease “of any severity.”

Before a vaccine was available, rotavirus caused around 55,000 to 70,000 hospitalizations and 20 to 60 deaths in children younger than 5 every year. According to estimates, the vaccine averts 45,000 hospitalizations annually.

The first rotavirus vaccine was taken off the market in 1999 because it caused a bowel obstruction in some infants, but a new vaccine became available in 2006, and the government recommended routine vaccination.

Vaccine uptake: The CDC estimates that among children born in 2019 and 2020, 76.6 percent of children were fully vaccinated for rotavirus by 8 months, according to the agency’s National Immunization Survey.

Herd immunity: It’s unclear what coverage level would achieve herd immunity, but federal health authorities previously set a goal of reaching 80 percent coverage in U.S. children by 2020.

The CDC’s old recommendation: The agency previously recommended all children get vaccinated against rotavirus, starting the series at 2 months.

The change: The new schedule recommends “shared clinical decision-making” for the rotavirus vaccine.

Vaccine details: Both Merck and GSK make rotavirus vaccines for children.