Characterizing the landscape of pediatric immunization schedules in the US and Europe

Vaccines are a cornerstone of pediatric medicine and public health. However, no prior. studies have described the similarities and differences between the pediatric immunization schedules of different countries. This study sought to characterize the landscape of general pediatric vaccine recommendations for 32 United States (US) and European, primarily high-income countries. In this cross-sectional descriptive study, pediatric vaccine schedules from 32 countries were collected from publicly accessible government websites. All recommendations for normal-risk, non-pregnant children up to and including the age of 18 were considered. 83.3% (20/24) of vaccines identified were included within at least one country's general pediatric vaccine schedule. Of these, 9 (45%) were recommended by all 32 countries. The total number of vaccines on countries' schedules ranged from 11 to 18. Twelve of 32 (37.5%) countries' schedules included at least one mandatory vaccination, with mandate frequency ranging from 7.1% to 93.8%. Among vaccines with general recommendations, 16 (84.2%) had a consistent number of doses across at least 50% of countries that included them. For most shots, there was general agreement about the age of the first recommended dose. However, numerical differences were noted for the meningococcal, Hepatitis B, and coronavirus disease 2019 (COVID-19) vaccines. Conclusion: While pediatric immunization schedules share broad similarities, including consensus on vaccine inclusion and dosing patterns, differences remain regarding mandates and timing. These findings highlight areas for further research to inform evidence-based immunization policies and national recommendations. What is known: •Pediatric immunizations provide long-term public health benefits, including reductions in infectious disease and infant mortality. •There is a relative paucity of studies comparing entire pediatric immunization schedules across countries. What is New: •This study systematically compared pediatric vaccine schedules across 32 countries, identifying which vaccines, doses, and first-dose ages are consistently recommended. •Although broad consensus was identified for many recommendations, our findings also highlight notable differences that illustrate the diversity of national immunization practices.