Which countries revised their national immunization schedules for 2025-2026 and why?
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Executive summary
Multiple national immunization schedules were revised for 2025–2026 across high‑ and low‑income settings, driven by new WHO/SAGE guidance, country‑level safety or programmatic data, and updates from advisory bodies such as ACIP; WHO documents and SAGE summaries note changes in polio/IPV strategy, flexibility on pneumococcal/varicella/herpes zoster schedules, and targeted influenza/COVID vaccine guidance [1] [2] [3]. National authorities including the United States and Australia updated their 2025 schedules — the U.S. (ACIP/CDC) changed COVID‑19 and adult/child schedule elements and the Australian National Immunisation Program published its 1 September 2025 schedule — citing new product authorizations, vaccine effectiveness data and safety evidence [4] [5] [6].
1. Who changed national schedules — and where the evidence came from
Countries revise schedules after global or national expert reviews; WHO’s SAGE and Strategic Advisory Group meetings in 2025 provided updated recommendations (including an IPV‑based polio schedule and greater flexibility for pneumococcal, varicella and zoster vaccines), and these shaped national decisions [2]. The U.S. ACIP approved multiple 2025 schedule updates that CDC adopted — including new COVID‑19 guidance and adult schedule edits — and those were published as the 2025 U.S. immunization schedules [4] [6]. Australia published its National Immunisation Program schedule effective 1 September 2025 reflecting national policy choices [5].
2. Why polio and IPV dominated some revisions
WHO’s January 2025 routine immunization guidance and SAGE discussions emphasized IPV strategy as part of OPV withdrawal and recommended schedules that optimize immunogenicity (full‑dose IPV, fractional schedules in some settings) while countries weigh local epidemiology and programmatic feasibility [1] [2]. WHO/UNICEF reporting noted some countries already using fractional IPV doses (Bangladesh, Cuba, Ecuador, India, Nepal, Sri Lanka) and signalled that IPV2 introduction was the next step for several national programs [7]. National changes therefore responded to global polio policy shifts and supply/feasibility trade‑offs [1] [7].
3. COVID‑19 and influenza: seasonal product updates and individualised decisions
U.S. schedules and CDC documents show active changes tied to annual COVID‑19 and influenza vaccine formulations and effectiveness data; CDC updated child and adult guidance in 2025 to reflect 2024–2025 and 2025–2026 product recommendations and moved to shared clinical decision‑making for COVID‑19 vaccination in some pediatric age groups [4] [6]. CDC and U.S. agencies also issued guidance on northern‑hemisphere 2025–2026 influenza vaccine composition and its use, which drives national schedule text for the season [8] [9].
4. Safety signals and programmatic evidence altered delivery choices
HHS and CDC adopted changes such as recommending standalone varicella immunization for toddlers after safety data presented to ACIP suggested a higher febrile‑seizure risk with the combined MMRV product in certain ages [10]. SAGE likewise urged countries to weigh trade‑offs when introducing higher‑valency vaccines and stressed the need for stronger surveillance to guide decisions [2]. These examples show countries change both what is recommended and how vaccines are delivered in response to safety and programmatic evidence [10] [2].
5. Politics, budgets and divergent national choices
Global agencies warned that funding cuts and shifting domestic priorities threaten routine immunization gains; WHO highlighted mounting pressures in 2025 and urged renewed commitment [2]. Independent reporting also documents political pressure in some countries to reconsider long‑standing recommendations — for example, U.S. federal review actions and public debate around the newborn hepatitis B recommendation — illustrating how political priorities can prompt schedule reviews alongside technical evidence [11] [12].
6. What reporting does not yet say
Available sources document global guidance (WHO/SAGE), country schedule publications (U.S., Australia) and programmatic signals for polio/IPV and other vaccines, but they do not provide a comprehensive, single list of every country that revised its 2025–2026 schedule; WHO’s immunization data portal records country schedules but a consolidated enumeration of “which countries changed in 2025–2026 and exactly why” is not presented in these documents [13] [14] [15]. National rationales beyond those cited here (for example, specific ministerial statements from many low‑ and middle‑income countries) are not included in the provided sources.
7. Bottom line for policy‑makers and clinicians
Global technical guidance (WHO/SAGE) and national advisory bodies (ACIP/CDC, national health departments) continue to drive schedule revisions; changes in 2025–2026 were motivated by evolving vaccine effectiveness data, safety signals, polio endgame strategy and operational considerations [2] [1] [4]. Clinicians and programme managers should consult country‑specific schedule pages (WHO immunization data portal, national health departments) for the authoritative, up‑to‑date rules because a global synopsis in the sources does not list every national change or rationale [13] [15].