Vaccination policy of the United States

Vaccination policy of the United States is the subset of U.S. federal health policy that deals with immunization against infectious disease. It is decided at various levels of government, including the individual states. This policy has been developed over the approximately two centuries since the invention of vaccination with the purpose of eradicating disease from the U.S. population, or creating a herd immunity. Policies intended to encourage vaccination impact numerous areas of law, including regulation of vaccine safety, funding of vaccination programs, vaccine mandates, adverse event reporting requirements, and compensation for injuries asserted to be associated with vaccination. The Advisory Committee on Immunization Practices (ACIP) is responsible for making vaccine policies and recommendations for the vaccination schedule used in the United States. As of June 2025, after Secretary of Health and Human Services Robert F. Kennedy Jr. fired all 17 ACIP members and replaced them, the new members were either anti-vaccine activists or lacked expertise with vaccines. The resulting lack of trust in future changes to vaccine recommendations resulted in the creation of two interstate collaborations, the West Coast Health Alliance and Northeast Public Health Collaborative.

Regulation of vaccine safety The Food and Drug Administration (FDA) has the authority to enforce the safety of vaccines. The FDA requires that all new vaccines first be tested in laboratory settings and on animals, and must then carry out a series of increasingly stringent tests in human subjects. Once vaccines are introduced to the market, the FDA regularly inspects their production facilities, tests their quality, and receives reports of adverse reactions. In the 2012 court case Coalition for Mercury-Free Drugs v. Sebelius, the U.S. Court of Appeals for the District of Columbia Circuit held that opponents of thimerosal-preserved vaccines lacked standing to challenge determinations by the Food and Drug Administration that the vaccines and their components were safe and effective. In the opinion, Judge Brett M. Kavanaugh (joined by Judith W. Rogers and Stephen F. Williams) therefore rejected the challenge on standing grounds. The court further found it irrelevant that thimerosal was included in some versions of mandated vaccines, because it was possible for those seeking to avoid the ingredient to receive thimerosal-free vaccines.

Vaccination schedule and mandates On January 5, 2026, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced unprecedented reductions by HHS in the CDC childhood vaccine schedule, eliminating recommendations that all children be immunized for rotavirus, influenza, RSV, meningococcal disease, hepatitis A, and hepatitis B. The American Public Health Association (APHA) portrayed the Trump administration’s reduced vaccine recommendations as "public health malpractice at the highest level" in a January 5, 2026, public statement, pointing out that the dangerously opaque decision-making process at play was completely devoid of scientific backing. Numerous other organizations and medical experts followed suit, immediately condemning the decision as well, characterizing it as a political move lacking transparency and scientific legitimacy; many health practitioners thus plan to follow the vaccine schedule recommended by the American Academy of Pediatrics instead, which is far more rigorously supported by data. Furthermore, experts fully expect these changes would increase preventable illness, hospitalization, and deaths among youth—endangering not only children and adolescents, but medically vulnerable community members, too, should the questionable process used by HHS in revising the recommendations survive court challenges. One such challenge is the March 16, 2026, ruling in U.S. District Court on the lawsuit American Academy of Pediatrics et al. v. Kennedy et al., which has blocked the downgraded vaccine recommendations on the grounds that these reductions in the immunization schedule were "arbitrary and capricious"; in addition to the American Academy of Pediatrics, plaintiffs include: the American College of Physicians, the American Public Health Association, and the Infectious Diseases Society of America. The Advisory Committee on Immunization Practices (ACIP) makes scientific recommendations which are generally followed by the federal government, state governments, and private health insurance companies, including making recommendations for the vaccination schedule used in the United States. On June 23, 2025, Secretary of Health and Human Services Robert F. Kennedy Jr. fired all 17 ACIP members and—with one exception—appointed members who were either anti-vaccine activists or who lacked expertise with vaccines. The resulting lack of trust in future changes to vaccine recommendations resulted in the creation of two interstate collaborations, the West Coast Health Alliance and Northeast Public Health Collaborative. Also, in American Academy of Pediatrics et al. v. Kennedy et al., the court’s ruling imposed a stay on the ACIP appointments by Kennedy and invalidated any policy decisions those appointees have made since he purged the previous committee (formerly composed of immunization experts). The American Academy of Pediatrics (AAP) advises physicians to respect the refusal of parents to vaccinate their child after adequate discussion, unless the child is put at significant risk of harm (e.g., during an epidemic, or after a deep and contaminated puncture wound). Under such circumstances, the AAP states that parental refusal of immunization constitutes a form of medical neglect and should be reported to state child protective services agencies.

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