Trump Administration Cuts Childhood Vaccine Schedule from 17 to 11 Diseases, Impacting Major Vaccine Manufacturers
Key Insights
The U.S. federal government ended recommendations for children to receive vaccines against flu and five other diseases, reducing the routine schedule from 17 diseases to 11 in a unilateral move made Monday.
The changes will impact Merck (search)'s rotavirus (search) vaccine RotaTeq and reduce recommended Gardasil HPV (search) vaccine doses from two shots to one, while pneumococcal vaccines remain recommended.
Public health groups universally criticized the changes, citing concerns about ongoing outbreaks of vaccine-preventable diseases and lack of clear evidence supporting the policy shift.
The U.S. federal government has ended its recommendations that all children receive vaccines against the flu and five other diseases, reducing the routine schedule from 17 diseases to 11 in a unilateral move made Monday at the behest of President Donald Trump. The Department of Health and Human Services (search) said the U.S. was an "outlier" for both the number of childhood vaccines administered and the number of doses recommended, leading the agency to revise its guidance in an effort to rebuild public trust by focusing only on the most essential vaccinations for children.
Policy Changes and Affected Vaccines
The Centers for Disease Control and Prevention's new policy removes routine vaccine recommendations for several childhood immunizations, including rotavirus (search), COVID-19 (search), influenza (search), meningococcal disease (search), and hepatitis A (search) and B, shifting decisions to parents in consultation with healthcare providers. Previously, the CDC (search) recommended at least one COVID-19 vaccine dose, two rotavirus vaccine doses and one influenza vaccine dose. All of those vaccines are now left to "individual choice."
President Donald Trump announced on Truth Social that the required vaccines have been reduced from 72 to 11 for the most serious diseases, while also allowing parents to opt for all vaccines. The change will not cause any families to lose vaccine access or insurance coverage.
Impact on Vaccine Manufacturers
The changes will hit Merck (search), among other companies, which manufactures the rotavirus (search) vaccine RotaTeq, and reduce the recommended number of doses of the company's Gardasil HPV (search) vaccine from two shots to one. RotaTeq netted Merck $711 million worldwide in 2024, while Gardasil took in about $2.2 billion, according to the company's year-end earnings report.
Merck (search) has already seen declining revenue from Gardasil, driven by lowered demand in other countries, particularly China. Excluding China, sales of Gardasil declined 2-3% in the third quarter of 2025, according to the company's earnings report, where it highlighted dropping demand in Japan. At the same time, sales of the vaccine have recently been rising in the U.S., "due to higher net pricing and favorable public-sector purchasing patterns."
Pneumococcal Vaccine Market Remains Stable
The recommendation for children to receive a pneumococcal vaccine was left in place, and that's "a good thing for the pneumococcal disease (search) landscape," Salim Syed, the managing director of equity research at Mizuho, told BioSpace in an email. That industry captures "a large market ($8Bn+), and where children represent about 2/3 of revenue," Syed added.
This includes major manufacturers like Pfizer and Merck (search), as well as smaller up-and-comers like Vaxcyte. Vaxcyte, which does not have any approved vaccines, is prepping a 31-valent shot to go up against Pfizer's Prevnar, which accounted for $1.6 billion in sales in 2024. Another rival is Merck's Capvaxive, which took in $244 million in sales in the third quarter of 2025.
Industry and Public Health Response
Public health groups universally decried the changes to the vaccine schedule. "Making these changes amid ongoing outbreaks of vaccine-preventable diseases shows a disregard for the real confusion families already face," Ronald Nahass, the president of the Infectious Disease Society of America (search), wrote in a statement after the news broke.
"As we are already seeing signs of a severe respiratory season, this is not the right time to make changes that are not supported by clear evidence," Robert Hopkins, medical director of the National Foundation for Infectious Disease (search), said in a statement.
The development comes after vaccine makers, in December, expressed concern over the U.S. advisory panel's decision to remove the long-standing recommendation for a birth-dose hepatitis B (search) vaccine. Merck (search), the producer of Recombivax HB, warned the move could put infants at risk of chronic infection, liver cancer, and death, while GSK emphasized its confidence in the science behind its vaccine, Engerix-B.
Market Outlook and Investment Implications
For vaccine manufacturers, the change is "all in not great, but this can be managed," BMO Capital Markets analyst Evan David Seigerman told BioSpace in an email. "Investors have been more cautious on the upside from vaccines given the current administration and recent ACIP meetings," he added, noting the reformulated CDC (search) vaccine advisory committee's frequent anti-vaccine activity.
"Investors have been quite bearish for some time now that this administration would treat all vaccines equally (vs Covid-19 (search) vaccines), but this is clearly not the case, so should help sentiment for stocks in this vaccine sleeve," Syed said.
On the industry side of the vaccine space, investors are likely to keep their heads down and hunt for other opportunities in biopharma while current anti-vaccine headwinds are blowing, Seigerman said. "Vaccines are not going to be the driver of an investment in Merck (search)—at least under the current admin," he concluded. "Too much uncertainty and policy headwinds for folks to get excited."