The American Academy of Pediatrics (AAP) released its 2026 Child and Adolescent Immunization Plan, which continues to recommend routine immunization to protect against 18 diseases[1]. This recommendation differs from changes implemented by the Centers for Disease Control and Prevention (CDC) on January 5, 2026, when it reduced the number of diseases with a universal recommendation from 18 to 11[3]. The CDC has moved vaccines against rotavirus, influenza, meningococcal disease, hepatitis A and B, and COVID-19 into the category of risk-based or shared clinical decision-making between health professionals and parents[3][4]. The AAP and other pediatric organizations have criticized the CDC's changes, warning that they could increase confusion, undermine confidence, and reduce vaccination rates[3]. According to public health experts, these steps could lead to preventable hospitalizations and deaths[2]. CDC's changes were approved without the agency's usual external peer review[2].