Characterizing the landscape of pediatric immunization schedules in the US and Europe.
Level 4 - case-series / case-control
Cross-sectional descriptive policy analysis by design analogy
PubMed 41313491 · doi:10.1007/s00431-025-06667-8
What was done
This cross-sectional descriptive study examined general pediatric immunization schedules across 32 United States and European (primarily high-income) countries. Schedules were retrieved from publicly accessible government websites and analyzed for normal-risk, non-pregnant children up to and including age 18 to compare vaccine inclusion, dose counts, initial dosing age, and mandatory status.
What was found
Of 24 identified vaccines, 20 (83.3%) appeared on at least one country's schedule, while 9 (45.0%) were recommended by all 32 countries. The total number of recommended vaccines per country ranged from 11 to 18. Mandatory vaccination for at least one shot was present in 12 of 32 (37.5%) countries, with mandate frequencies ranging from 7.1% to 93.8%. Among generally recommended vaccines, 16 of 19 (84.2%) had a consistent number of doses across ≥50% of recommending countries. First-dose timing was broadly aligned overall, but numerical differences were noted for meningococcal, Hepatitis B, and COVID-19 vaccines.
Why it matters
This paper provides a cross-national baseline of pediatric immunization policies among high-income countries, demonstrating broad consensus on core vaccines alongside substantial policy variance in mandates, specific vaccine inclusion, and timing.
Limits
The sample was restricted to 32 primarily high-income US and European nations, limiting global generalizability. The study examined only published schedules for normal-risk children and did not measure actual vaccination coverage, compliance, risk-group variations, or clinical health outcomes.
Cited by
- supports Many international vaccination schedules do not require hepatitis B, hepatitis A, or varicella vaccines, schedule the MMR vaccine later, and administer the meningococcal vaccine earlier compared to the United States.