Public Health Hot Topic | Child and adolescent immunization schedule recommendations

The San Juan County Board of Health signed a letter reaffirming their commitment to the American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule. This aligns with the West Coast Health Alliance and Washington State Department of Health recommendations.

“It’s really important to have local voices in support of recommendations form national medical organizations that continue to be science-based,” said San Juan County Health Officer Dr. Amy Harley at the January Board of Health meeting. “The departures from evidence-based vaccine science at the federal level have made it necessary to organize on the state and regional levels.”

Background

On Jan. 5, 2025, the Acting Director of the Centers for Disease Control and Prevention signed a decision memorandum to reduce the number of vaccines it recommends for all U.S. children. The change was made without input from the CDC’s vaccine advisory committee and against established procedures. Federal health officials said that the update is intended to align the U.S. with nations like Denmark, but they did not provide scientific rationale for the changes.

Public health recommendations reflect the specific health systems and population contexts of each country. The U.S. and Denmark are considerably different in many respects. Denmark has a universal health care system and a smaller population than New York City, so it is not a directly comparable model for the U.S.

The West Coast Health Alliance, Washington State Department of Health, and San Juan County Health & Community Services continue to recommend vaccination in alignment with American Academy of Pediatrics (AAP) guidance, as this is the most effective way to protect children against 17 preventable and potentially serious diseases.

“Washington state is still adhering to the AAP Child and Adolescent Recommended Vaccine Schedule not because it’s aligning with an institution, but because of its basis in science and decades of real-world experience showing that this is what our populations need in order to be protected,” said Dr. Harley.

Bottom Line: The Science Hasn’t Changed

Decades of research support the safety and effectiveness of childhood vaccines. The AAP immunization schedule for children and adolescents is based on established vaccine safety and effectiveness evidence. The AAP evidence-based plan provides the ideal vaccine timeline for healthy children as their immune system develops. The recommendations are designed for kids who live in the U.S. and are based on U.S. data, disease patterns, and our health system.

It is because of vaccines and community immunity that children rarely get serious diseases like tetanus, measles, rubella, and polio. We cannot predict which children will have a mild case and who will get severely sick when infected with these diseases. Children getting sick from the diseases that can be prevented by recommended immunizations leads to missed school for children, missed work for parents, and even hospitalization and death in some children.

Smallpox is the only disease that has been eliminated completely by vaccines. We still need vaccines for the other disease that can spread in our communities. For example, the measles, mumps, rubella (MMR) vaccine has worked very well in the U.S. for decades. Lately, fewer people have had all recommended doses of MMR vaccine. This has made it possible for illnesses like measles to start to spread again.

What Does This All Mean for Insurance Coverage?

We do not expect these changes to affect insurance coverage for vaccines this plan year. All child and adolescent immunizations recommended as of Dec. 31, 2025 will remain available and covered by public and private insurers; however, the changes create confusion and will put more children at risk of vaccine preventable diseases. 

The West Coast Health Alliance will continue to review available vaccine science and ensure continued access to recommended vaccines. Each state is examining the impact of these federal changes on vaccine access in our respective states. The West Coast Health Alliance and AAP continue to support these longstanding recommendations, including informed parental decisions for the best protection of their children.

Questions? 

If you have questions about vaccines or the recommended vaccine schedule, do not hesitate to talk with your pediatrician or one of our public health nurses. Call 360-378-4474 and ask to speak with a public health nurse. We are always happy to speak with you and encourage any questions you may have about vaccines.

Relevant URLs:

• SJC Letter of Support of West Coast Health Alliance Affirmation of Science-Based Vaccine Recommendations | SJC
• Immunization Clinics | SJC
• Recommended Child and Adolescent Immunization Schedule | AAP
• What is the difference between the AAP immunization recommendations and other vaccine schedules? | AAP
• All About the AAP Recommended Immunization Schedule | AAP
• West Coast Health Alliance | DOH
• West Coast Health Alliance | DOH

About San Juan County’s Department of Health & Community Services    

San Juan County’s Department of Health & Community Services is responsible for community and environmental health, mental health and substance abuse programs, senior services, affordable housing projects, and more. The department has staff and offices on Lopez, Orcas, and San Juan Islands. For more information about San Juan County’s Department of Health & Community Services, visit www.sanjuancountywa.gov/1777/Health-Community-Services.