Amid a record-breaking flu season, the Centers for Disease Control and Prevention announced Monday that multiple vaccinations, including for flu, RSV, and COVID, are no longer universally recommended for all children, a departure from previous, long-standing guidance to parents and caregivers.

Here are five things parents and caregivers should know about the new vaccination schedule changes for children.

1. The CDC cut the number of vaccines universally recommended for kids

The new guidelines no longer universally recommend children receive vaccines for rotavirus, hepatitis A and hepatitis B, meningitis (meningococcal disease), RSV (respiratory syncytial virus), COVID, and influenza (the flu).

The change is effective immediately and cuts the number of recommended vaccines for children from 18 vaccine preventable illnesses down to 11, compared to the schedule in 2024.

2. The vaccination schedule changed without an independent review

Although Health and Human Services Secretary Robert F. Kennedy Jr., who has long sought to reduce the number of vaccines children get, said the changes were approved after an "exhaustive review of the evidence" and is aligned with what other high-income countries recommend, there was no independent review of the updates.

Kennedy wrote in part in a statement, "This decision protects children, respects families, and rebuilds trust in public health."

CDC changes childhood immunization schedule, removing universal recommendation for multiple shots

3. Vaccines for children will now be split into three categories

The CDC now recommends dividing vaccinations for children into three categories: universally recommended vaccines that all children should receive, vaccines for children that are high risk and vaccines that should be discussed as a shared decision with a child's provider.

For example, the CDC now recommends the rotavirus and flu vaccines only be given to a child if a doctor recommends them.

The remaining universally recommended vaccines include those for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox).

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4. Medical groups are speaking out against changes

Medical groups like the American Academy of Pediatrics are calling the updates to the kids vaccine schedule "dangerous and unnecessary."

Dr. Molly O'Shea, a pediatrician and AAP spokesperson, told ABC News the vaccination schedule updates may also have secondary impacts, including how often children and families see their pediatrician.

"Whether or not a parent's going to opt in or opt out of vaccines, children still need their wellness visit," O'Shea said. "Absent vaccines, kids are really going to miss out on important other screening aspects of the wellness visits if their parents are opting out."

In a separate statement, the Infectious Diseases Society of America spoke out against the changes to the childhood vaccination schedule, saying they will "put families and communities at risk and will make America sicker."

"Making these changes amid ongoing outbreaks of vaccine-preventable diseases shows a disregard for the real confusion families already face," IDSA President Dr. Ronald G. Nahass said in part. "Disease prevalence differs country to country, and there has been demonstrated and ongoing need in the U.S. for the vaccines included in the childhood vaccine schedule. Most other high-income countries have universal health care and parental leave, both of which can support prevention and early care and contribute to lower disease prevalence."

In a statement, the American Lung Association said it is "deeply concerned about the changes made to the childhood immunization schedule." The organization specifically criticized the decision to no longer recommend the flu shot for all kids without any science to support the change amid record-breaking spikes in flu illnesses this season, and the most pediatric flu deaths ever recorded last season.

"The Lung Association continues to urge that everyone over six months get vaccinated for influenza and COVID-19," the organization stated. "Vaccination remains one of the most effective tools to protect children from serious illness, hospitalization and death."

5. What parents with questions can do

Medical professionals recommend parents and caregivers talk to their child's pediatrician, who will continue to make expert recommendations. Parents should still bring their children to the doctor for wellness visits, regardless of their immunization preferences.

The changes by the CDC are recommendations and have never been mandatory. Parents can still seek previously recommended vaccines for children, in consultation with their kids' pediatrician. HHS officials and the CDC also said the changes will not affect health insurance coverage of vaccines.

"Your pediatrician really is your trusted source of information and we have nothing to gain in the way things are going here," O'Shea said. "Vaccines are certainly not a way in which we make any money. But [a] pediatrician's goal is to partner with parents to make the right decision for your child, and so, bringing your concerns and questions to your pediatrician is the best way to get quality information."