Jamilia Sherls on the child vaccine schedule overhaul and coverage | HSES 2026

A proposed overhaul of the U.S. child and adolescent immunization schedule is the federal vaccine policy change health system leaders may not yet fully appreciate, according to Jamilia Sherls, DNP, MPH, RN, CPN, CDP, director of the Office of Immunization at the Washington State Department of Health. Sherls spoke with Managed Healthcare Executive at the 2026 Health System Executive Summit.

The revised schedule is currently stayed amid federal court rulings in AAP v. HHS, Sherls said, but it could still become reality. It would cut the number of recommended vaccines from 17 to 11. Other vaccines from the CDC schedule would remain but be categorized differently, with some recommended only for high-risk children and others not recommended but still available through shared clinical decision-making between a provider and a patient.

That shift carries coverage implications. Health plans are currently required to cover vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the CDC director. “If a vaccine falls out of that bucket and it’s not technically recommended, they technically don’t have to cover it, and that could have huge implications on population health and the patients that healthcare systems take care of,” Sherls said. The Vaccines for Children (VFC) program, which serves children who are uninsured, underinsured, on Medicaid or American Indian or Alaska Native, likewise covers only ACIP-recommended vaccines, so changes there would affect “our nation’s most vulnerable children” and could widen disparities, she said.

Offering her professional opinion rather than her agency’s position, Sherls said health systems should keep practice grounded in evidence even when policy changes are not. That means examining the scientific rationale behind any new recommendations and looking to the American Academy of Pediatrics (AAP), which she said is “fully committed to the science and evidence-based practice for the best care of kids,” for child and adolescent immunization guidance.

If insurance coverage eventually decouples from the federal schedule, Sherls said, the population health consequences could be grave. Children in the VFC program, and some with employer-based coverage, could lose access, leaving vaccines available mainly to children from more privileged families, and only if their providers still carry them. Health systems could see more vaccine-preventable disease in their patient populations, she said, and should track these policies closely and work with major insurers to verify and confirm coverage.

In this video, Sherls discusses what the schedule overhaul could mean for coverage and access and how health systems should respond.