The Trump administration made good on its vows to upend childhood vaccinations just days into the new year, ensuring that public health will be a prominent midterm campaign issue.

Why it matters: The slimmed-down vaccine schedule resembling Denmark's suggests that the administration is undaunted by public support for childhood vaccines — or by warnings about the return of preventable diseases.

Driving the news: The U.S. is now only recommending that all kids receive 11 vaccines, with additional shots for high-risk children. Before Trump's second inauguration, the U.S. had recommended 17 vaccines.

• The CDC now says that parents should consult with physicians before inoculating their children with previously recommended shots for six diseases, including rotavirus, COVID-19 and influenza.
• All vaccines previously recommended by the federal government will continue to be covered by insurers, officials said.

"We are aligning the U.S. childhood vaccine schedule with international consensus while strengthening transparency and informed consent," said Health Secretary Robert F. Kennedy Jr. "This decision protects children, respects families, and rebuilds trust in public health."

The big picture: Such significant changes to the childhood vaccine schedule will have an impact on public health, one way or another. But they also all but ensure vaccines will be front and center in the political discourse.

• Administration officials maintain the decision — announced without any new data exactly one month after Trump demanded a review of the vaccine schedule — will actually restore public trust in vaccines, by focusing on what one called "the most important diseases."
• But many medical experts argue they'll have the exact opposite effect, an argument Democrats have quickly adopted as their own.

What we're watching: The vaccine schedule change is likely to prompt litigation — either in the form of direct challenges to the schedule change or new vaccine injury lawsuits testing whether the revised recommendations have loosened federal liability protections for manufacturers.

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Federal guidelines for cervical cancer screening for the first time will include an option for women to self-collect their samples as an alternative to Pap smears.

Why it matters: Self-collected swabs are less invasive and require less equipment. That can make them preferable to Pap smears, which can cause extreme discomfort, including for those patients with a history of sexual trauma or chronic pain.

• Cervical cancer screening has helped decrease incidence and mortality rates by 50% over the last half century. But about 1 in 4 women in the U.S. aren't up to date on their screening.

Health insurers will have to cover the self-collection tests starting in 2027, according to the updated Health Resources and Services Administration guidelines.

State of play: HRSA updated its recommendation that women age 30 to 65 get screened for cervical cancer every five years to note that testing can be done via self-collection, if preferred.

• The agency still recommends that women ages 21 to 29 get a Pap smear every three years.

Zoom out: The American Cancer Society last month added the option of self-collection to its own cervical cancer screening guidelines, but said clinician-collected samples are still preferred.

The FDA first approved a self-collection test for use in clinical settings in 2024, and approved a kit for at-home use in May.

More than 40 million people globally turn to ChatGPT daily for health information, according to a report OpenAI shared exclusively with Axios.

The big picture: Patients see ChatGPT as an "ally" in navigating their health care, according to analysis of anonymized interactions with ChatGPT and a survey of ChatGPT users by the AI-powered tool Knit.

• Users turn to ChatGPT to decode medical bills, spot overcharges, appeal insurance denials, and when access to doctors is limited, some even use it to self-diagnose or manage their care.

By the numbers: OpenAI found that users ask 1.6 to 1.9 million health insurance questions per week for guidance comparing plans, handling claims and billing and other coverage queries.

• In underserved rural communities, OpenAI says users send an average of nearly 600,000 health care-related messages every week.
• Seven in 10 health care conversations in ChatGPT happen outside of normal clinic hours.

Reality check: ChatGPT can give wrong and potentially dangerous advice, especially in conversations around mental health.

Our thought bubble: The end of enhanced Affordable Care Act subsidies and new Medicaid work requirements could accelerate AI dependence as uninsured and underinsured patients lean on chatbots for health care guidance.

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"The vaccine schedule IS NOT A MANDATE. It's a recommendation giving parents the power. Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors, and will make America sicker."

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