How Changes to the Vaccine Schedule Could Affect Older Adults

Health experts say a decline in vaccination rates puts others at risk for illness

Rachel Nania,

AARP

Comments

En español

Published January 09, 2026

close-up of a healthcare provider’s gloved hands holding a syringe in a pediatrician’s office, with a young patient blurred in the background

Stocksy

In an unprecedented move, federal health officials have updated the nation’s childhood immunization schedule, narrowing the list of universally recommended vaccines for infants and children from 17 to 11. Six vaccines, including the flu shot, are now recommended only for kids at high risk or in consultation with a physician, a practice known as shared clinical decision-making.

This change, pediatricians and public health experts warn, will not only affect the health of children but could also have an impact on adults, including older individuals who are more susceptible to severe illness from common infections.

The reason for the overhaul, Trump administration officials said, was to align the U.S. vaccine schedule with other wealthy nations, like Denmark — a country that Dr. Robert H. Hopkins Jr., medical director of the National Foundation for Infectious Diseases, points out has a much smaller population, a universal health care system and “a very different disease epidemiology” from that in the U.S.

“And I think that’s a dangerous idea, particularly doing that without any evidence or science behind making that change,” says Hopkins, who is also a professor of internal medicine and pediatrics at the University of Arkansas for Medical Sciences.

A new report from KFF, a nonpartisan health policy organization, finds that trimming the number of recommended vaccines makes the U.S. an outlier among peer nations.

Changes could fuel declining vaccination rates

While many pediatricians, insurers and professional organizations plan to stick with the previous schedule that recommended all 17 vaccines, public health experts worry that the recent changes “will lead to a false sense of mistrust in these vaccines,” says Dr. Vandana Madhavan, clinical director of the pediatric infectious disease division at Boston’s Mass General Brigham for Children.

They also introduce barriers that weren’t there before.

“Shared decision-making is not a huge issue for somebody who has a trusted health care team, because we talk about the reasons behind vaccinating as it is,” Hopkins says.

“But it’s a real challenge for people that are in health care deserts,” he adds, and for those without routine access to a provider.

The result, many health experts fear, will be a decline in vaccination rates for preventable diseases, which “will actually have an impact on the larger community,” Madhavan says.

Most Popular

“Yes, children will get sick and will have complications [if fewer are being vaccinated for these illnesses], but that means they are more likely to spread to older adults as well,” she says.

The U.S. is already seeing a decline in childhood vaccination rates, says Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University’s School of Medicine in Nashville, Tennessee. In 2016, roughly 95 percent of kindergarteners were up to date on their routine vaccines; this share dropped to about 92 percent in 2024.

“In other words, we’re already starting to turn the clock back to the bad old days, and this will continue,” Schaffner says.

Consider what’s happening with measles. “Measles, being the most contagious virus, is the one that would show up first,” Schaffner says. “And we’ve had more measles in the last two years in the United States than we’ve had for decades. And that’s just a harbinger of other previously vaccine-preventable diseases that will once again show up.”

Whooping cough, which can cause dangerous respiratory complications in older adults, “is already sticking its nose up,” Schaffner says. More than six times as many cases of the illness were reported in 2024 than in the previous year, according to data from the U.S. Centers for Disease Control and Prevention (CDC).

Immunization rates for the vaccine that protects against whooping cough, or pertussis, have declined in recent years, dropping from nearly 95 percent in 2019 to 2020 to 92 percent in 2024 to 2025, CDC data shows.

Fewer vaccines, more illness

Different vaccines work in different ways. Some, like the measles vaccine, help prevent illness (although no vaccine is 100 percent effective). Others are better at reducing the severity of an infection. Either way, vaccines help curb the spread of disease in a community and make it more difficult for germs to travel through a population.

Take, for example, influenza. Research shows that the flu shot can reduce a person’s risk of getting the flu, and if there are fewer people sick with the flu, there are fewer people to spread it.

“You get influenza from somewhere, and you don’t exist in a vacuum,” Madhavan says. “If there is a larger pool of children who get influenza because of declining vaccination rates, that will increase the number of adults with influenza and increase their rates of complications, ICU admissions and deaths as well.”

So far this flu season — which is shaping up to be a particularly bad one, largely because of a new influenza strain, experts say — the U.S. has recorded 5,000 deaths from flu. It’s estimated that 70 to 85 percent of seasonal flu-related deaths occur in adults 65 and older, according to the CDC. Overall, studies show that unvaccinated individuals have a higher risk of dying from the flu than vaccinated people.

Schaffner also points to the pneumococcal vaccine, which is recommended for all children starting at 2 months, as an example of how immunizations can have ripple effects.

“Once we introduced pneumococcal vaccination routinely in children, the rates of pneumococcal disease in adults, even though they were not directly vaccinated, plummeted,” he says. “And that’s because children [were giving] those pneumococcal bacteria to the adults.”

After the introduction of the pneumococcal conjugate vaccine in children in 2000, rates of the disease the following year were 32 percent lower for adults ages 20 to 39, 8 percent lower for people 40 to 64, and 18 percent lower for adults 65 and older, a study published in The New England Journal of Medicine found.

Turn to trusted sources

Health experts interviewed for this article emphasize the importance of talking to your doctor if you have questions or concerns about vaccines — whether for yourself or a grandchild.

Organizations such as the National Foundation for Infectious Diseases, the American Academy of Family Physicians, the American College of Physicians and the American Academy of Pediatrics also serve as trusted sources, Schaffner says.

It’s also important to note that states ultimately determine which vaccines are required for school entry, as KFF’s recent report points out. Hopkins says the recent adjustments to the vaccine schedule should serve as a call for parents, grandparents and other adults to ensure they are up to date on all their vaccines.

Several immunizations are recommended for adults aged 50 and older, including vaccines for tetanus, diphtheria, pertussis, shingles, pneumococcal disease and common respiratory illnesses, such as flu, COVID-19 and RSV.

“It’s extraordinarily important right now to stay vaccinated,” Madhavan says. “We haven’t seen the peak of influenza yet. We are seeing our winter cases of COVID.… So really make sure, especially right now, that you’re up to date on respiratory vaccines for your family.”

%{postComment}%