Rethinking Vaccination Policy and Reinforcing Public Health’s Foundation

By Rodney Rohde, PhD, MS, SM(ASCP) CM, SVCM, MBCM, FACSc

This article originally appeared in the Jan-Feb 2026 issue of Healthcare Hygiene magazine.

Recent decisions to overhaul the U.S. childhood immunization schedule represent one of the most consequential shifts in public health policy in generations. As public health professionals, clinicians, and educators, we must examine not only the clinical implications of these changes, but also their broader impact on public health infrastructure, trust in science, and our ability to prevent disease. The conversation ahead is not simply about vaccines—but about the role of evidence, expertise, and infrastructure in protecting community health.

1. What the New Childhood Vaccination Recommendations Mean for Public Health

On Jan. 5, 2026, the Centers for Disease Control and Prevention (CDC), acting under a presidential memorandum, announced a sweeping revision of the U.S. childhood immunization schedule. The revised guidance reduces the set of vaccines universally recommended for all children from coverage of approximately 17 diseases to a narrower list focused on about 11 diseases, such as measles, mumps, rubella, polio, and a one-dose human papillomavirus (HPV) recommendation. Other vaccines—such as those for influenza, COVID-19, rotavirus, hepatitis A and B, meningococcal disease, and RSV—have been shifted to a “shared clinical decision-making” model or targeted at high-risk groups instead of a blanket recommendation for all children.

Proponents of the change argue that aligning the U.S. schedule with peer nations can restore public confidence and reduce what they describe as “over-vaccination,” noting that many developed countries recommend fewer routine vaccines yet achieve strong outcomes. They frame the shift as empowering parents and clinicians to make individualized decisions.

However, with such dramatic policy shifts come profound consequences:
Most importantly, trust in public health—already eroded in recent years—risks further decline. Between 2020 and 2024, public confidence in healthcare institutions significantly waned, in part due to pandemic response tensions and polarization—an issue that played a role in prompting this revision.

International comparisons can be misleading. Nations with fewer recommended vaccines often simultaneously maintain universal healthcare, robust public health systems, and high baseline vaccination coverage. The U.S. health ecosystem—including fragmented access, variable insurance coverage, and unequal health literacy—differs in fundamental ways from many European and Asian systems. Policy developers must recognize these core differences when contemplating changes that hinge on cross-national comparisons.

Lowering the bar on what constitutes a universal vaccine recommendation may unintentionally signal that certain preventable diseases are less serious or require less protection. This messaging can exacerbate vaccine hesitancy in an era where misinformation already undermines uptake. Institutions like the Pediatric Infectious Diseases Society (PIDS) have warned that confusing guidance could reduce coverage and increase outbreaks of preventable diseases; such warnings must be taken seriously by health leaders.

2. The Broader Public Health Picture: Infrastructure, Experts & Education

A robust vaccination schedule is deeply intertwined with the strength of our public health system at every level: federal, state, local, and community. Vaccination programs do not operate in isolation—their success depends on a reliable workforce, trusted communicators, accessible infrastructure, surveillance systems, and public education.

Public health infrastructure is the bedrock of disease prevention and health promotion in communities. It encompasses not only physical systems like laboratories and electronic surveillance, but also workforce capacity, data systems, policy frameworks, and community partnerships. Healthy People 2030 identifies public health infrastructure as essential to delivering foundational health services, including vaccinations, chronic disease prevention, emergency preparedness, and health monitoring.

Yet structural weaknesses persist. Decades of underfunding have restricted the ability of health departments to recruit, train, and retain skilled professionals, maintain up-to-date laboratories, and leverage data for rapid response. Reports have highlighted workforce shortages, difficulty filling specialized roles such as epidemiologists and informatics specialists, and significant turnover in public health staffing—challenges that weaken preparedness and response.

Supporting expert public health personnel is not a luxury—it is a strategic imperative. Highly trained epidemiologists, infection preventionists, laboratory scientists, and health communicators form the backbone of our ability to detect outbreaks early, evaluate vaccine safety and effectiveness, and educate the public in culturally sensitive ways. This expertise cannot be substituted by rhetoric or ad hoc decision-making. Federal and state initiatives must prioritize hiring incentives, retention strategies, advanced training, and continuing education to create a resilient workforce.

Education—both for professionals and the public—is equally critical. Health literacy equips individuals to understand risks, benefits, and the scientific foundations of preventive care. Continuous professional education ensures that clinicians and health department staff stay abreast of evolving evidence, new technologies, and emerging pathogens. Schools of public health, professional associations, and academic partnerships play a vital role in ensuring the next generation of public health leaders is equipped with the skills needed for 21st-century challenges.

A Call to Action for Health Professionals and Policy Makers

To mitigate the potential negative impacts of the new vaccination framework and strengthen the broader public health system, we must pursue the following:

1. Advocate for evidence-based policy. Public health decisions should be grounded in transparent, peer‐reviewed science, with clear communication of the rationale, benefits, and limitations. Public trust depends on clarity and consistency.
2. Invest in infrastructure and workforce development. Adequate funding, workforce pipelines, competitive compensation, and support for local health departments are non-negotiable if we are to sustain disease prevention and rapid response capabilities.
3. Expand public education and engagement. Combating misinformation and increasing health literacy must be central to public health strategy. Communities should understand not only what the recommendations are, but why they matter.
4. Strengthen partnerships across sectors. Collaboration with clinical medicine, academia, community organizations, and media can amplify accurate information and integrate public health perspectives into broader societal decision-making.

The path forward requires courage, collaboration, and commitment to the principles of science and equity. Vaccination schedules, infrastructure investment, and educational outreach are not isolated tasks—they are components of a comprehensive strategy to protect children, communities, and our collective future. As healthcare and public health professionals, we must continue to champion these foundations with integrity, expertise, and a deep commitment to public wellbeing.

Rodney E. Rohde, PhD, MS, SM(ASCP) CM, SVCM,MBCM, FACSc, is the Regents’ Professor, Texas State University System; University Distinguished Chair & Professor, Clinical Laboratory Science (CLS); TEDx Speaker & Global Fellow – Global Citizenship Alliance; Texas State Honorary Professor of International Studies; Associate Director, Translational Health Research Initiative; Past President, Texas Association for CLS.