Non-Federal Immunization & Vaccine Recommendations as of 20 February 2026

Preparedness Core at the Michigan Public Health Integrated Center for Outbreak Analytics & Modeling (MICOM)

Published

February 20, 2026

Introduction & Background

Beginning in 2025, many changes have been made to the Advisory Committee on Immunization Practices (ACIP) immunization recommendations and vaccine schedules. Such changes have led to the divergence of ACIP from other national medical organization’s recommendations and uncertainty surrounding vaccine accessibility, insurance coverage, and school vaccine requirements across the country.

Vaccine policy decisions have thus largely shifted to state legislators and public health officials. Some states have released standing orders that defer to recommendations published by national medical organizations such as the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG) rather than to ACIP in an effort to maintain vaccine availability and insurance coverage in their states. Furthermore, a number of states on the west and east coasts have created the West Coast Public Health Alliance (WCHA) and the Northeast Public Health Coalition (NEPHC), respectively, to publish their own immunization recommendations based on AAP, AAFP, and ACOG guidance.

In an effort to track the many changes outlined above, the Preparedness Core at the Michigan Public Health Integrated Center for Outbreak Analytics & Modeling (MICOM) has compiled vaccine recommendations from AAP, ACOG, AAFP, WCHA, and NEPH and individual state’s vaccine policies into a database. In doing so, we intend to compile current guidance options for state legislators and public health officials as they continue navigating changes to vaccine recommendations going forward.

Vaccine Recommendation Database

Preparedness Core compiled this information into a Vaccine Recommendation Database, which exists as a Google Sheets spreadsheet with four distinct pages:

  1. A list of all current vaccine recommendations from the AAP, AAFP, ACOG, WCHA, and NEPHC.
  2. A list of all US states, the recommendations they are currently aligned with, and any changes to their vaccine policies made over the past year.
  3. A list of all US states and their current school vaccine requirements.
  4. A data dictionary for page 1.

These pages are described in more detail in the sections below.

Immunization Schedules & Recommendations [Page 1]

This page of the database includes recommendations from three non-federal medical organizations that publish annual immunization recommendations and vaccine schedules independently from ACIP:

Though these organizations’ recommendations have historically aligned with ACIP’s, they have all diverged to some degree within the last year.

This page also includes recommendations published by two newly-created regional public health networks:

Their recommendations serve the states that are part of each respective network and are based on those from the AAP, ACOG, and AAFP.

The information on this page is organized first by the five recommending bodies listed above and subsequently by disease/immunizing agent. Links to the website (and PDF version of the website) where each recommendation was found are included, as well as links to supplemental resources such as fact sheets provided by the Children’s Hospital of Philadelphia Vaccine Education Center on each disease and vaccine referenced in this database.

Note: a complete data dictionary for this page of the database, including column labels and descriptions, can be found on page 4 of the database.

State Alignments and Policies [Page 2]

This page is structured after a table found in the September 2025 Tracking State Actions on Vaccine Policy and Access policy brief, in which the authors document the states that had made changes to their vaccine policies as of September of 2025. We included all of the information and sources cited in this brief and added in any additional information we could find that was published between September 2025 and 1 February 2026.

All of the states are listed from A-Z in the left-most column. The list of sources pertaining to each state may be viewed and hidden by clicking on the plus-sign and minus-sign buttons to the left of each state’s name, respectively. Sources are listed top-down from least to most recent, meaning that the last source listed should be treated as the most up-to-date information currently available for that state. The information found in each source is documented as appropriate. Important information from each source is quoted in the “Details” column, and the weblinks to or viewable PDFs of each source are listed in the “Sources” column.

State School Vaccine Recommendations [Page 3]

This page of the database summarizes information found from Immunize.org on each state’s current school vaccine requirements. All of the states are listed from A-Z in the left-most column, and the vaccines for which school requirements exist are listed horizontally across the top. Under each vaccine, there is a column for each school setting (eg. childcare, school, secondary school, and/or college/university) in which requirements may exist. If a school setting is not listed under a particular vaccine, no such requirements exist in any state.

This page of our database is intended to provide a simple overview of this information, and to allow for the easy comparison of requirements across states. For a more detailed breakdown of this information, including expanded tables and geographic visualizations, please visit the Vaccine-Specific Requirements Page on Immunize.org, or see the bottom two rows of this page of the database to view the PDF versions of the Immunize.org site from 10 February 2026.

Data Dictionary [Page 4]

This page serves as a data dictionary for Page 1 (Immunization Schedules & Recommendations) of the database. The data dictionary is intended to provide information (such as full variable names and definitions) to make the Google Sheets version of the database more readable to the average viewer. It also documents information that was used to code the database into the R-Shiny application.

Coming Soon: Interactive R-Shiny Application

In addition to the database in the Google Sheets format, we have created a Recommendation Look-Up Tool that allows users to view the first page of the database as a table of vaccine recommendations that can be filtered by various search criteria. This tool is intended to streamline the process of searching for or comparing specific recommendations within the larger database. This tool will be available in the coming weeks.

The navigation bar on the left-hand side of the page can be used to select different search criteria.

Notes

Please note that all of the information included in this database was compiled from publicly available webpages and resources. Most of the information was published within the past year, and all of it is up-to-date as of 18 February 2026. As such, this resource is intended only to provide a snapshot of this information at this point in time. MICOM is not presently updating this resource on a continual basis.

If you

  • are interested in using the resources we have provided on this webpage for your own purposes

  • would you like to see any additional or updated information in the database

  • want more useful features built into the R-Shiny look-up tool

or

  • have any other questions, comments, or concerns

please email us at micom-info@umich.edu.