ACP backs pediatricians' vaccine schedule over new CDC guidance, citing stronger evidence
The American College of Physicians has taken the unusual step of publicly siding with the American Academy of Pediatrics against the CDC on childhood vaccination guidance - a split that reflects growing tension over whether recent federal changes to the U.S. immunization schedule are scientifically justified.
What changed at the CDC
According to a paper published in Annals of Internal Medicine, the CDC has introduced a new, more limited vaccination schedule for U.S. children based on the Danish childhood vaccine schedule. The ACP warns that this shift abandons long-standing, science-based standards and could put children at risk.
The ACP's Immunization Committee reviewed the AAP's independently produced 2026 schedule and concluded it is more evidence-based than the current CDC recommendations in three key areas: expanded options for protecting infants from RSV, targeted COVID-19 vaccination based on updated risk patterns, and earlier initiation of HPV vaccination.
Why internists weigh in on childhood vaccines
The ACP represents internal medicine physicians - doctors who primarily treat adults. Their decision to weigh in on a childhood vaccination schedule is deliberate. The paper notes that well-vaccinated children are an essential component of population health strategy, and adult patients frequently ask their own physicians about issues related to their children's health.
Pediatric vaccination rates affect the broader community through herd immunity dynamics. When childhood vaccination coverage drops, vulnerable adults - the immunocompromised, the elderly, pregnant women - face increased exposure to preventable diseases. Internal medicine physicians see those consequences in their own patient populations.
Three areas of disagreement
The specific disputes center on practical clinical questions. For RSV, the AAP schedule provides more options for infant protection than the CDC's revised guidance. For COVID-19, the AAP recommendations target vaccination based on current risk patterns rather than a one-size approach. And for HPV, the AAP supports earlier initiation of the vaccine series - a change supported by evidence that earlier vaccination produces stronger and more durable immune responses.
The ACP argues these updates better protect children and support public health outcomes than what the CDC has newly issued.
Also in the same issue of Annals
The same issue of Annals of Internal Medicine includes two other notable studies. One estimates that nearly 30 million American adults acquired firearms between 2021 and 2024, with 11 million becoming first-time gun owners. Women made up 46% of new owners, and 46% were Hispanic or people of color - groups historically underrepresented among gun owners. The research, from Northeastern University and Harvard, found that these acquisitions newly exposed roughly 9 million adults and 6.6 million children to household firearms.
A second analysis examined the 2025 AHA/ACC hypertension guidelines and found that under the new risk-based treatment criteria, about 11% of adults aged 65 to 79 with stage I hypertension would no longer qualify for blood pressure medication - a shift from previous guidelines that recommended treatment for all adults in this age range. The newly exempt group consists of generally healthy, lower-risk older adults, typically women in their mid-60s.
Each of these studies addresses a different dimension of public health policy, but together they reflect the journal's focus on evidence that directly informs clinical practice and population health decisions.