WASHINGTON - The United States on Monday said it was revising its childhood immunization schedule to recommend four fewer vaccines, a move it said aligns the country with other developed nations while also advancing one of Health Secretary Robert F. Kennedy Jr.'s long-term goals.

Acting Centers for Disease Control and Prevention Director Jim O'Neill approved the updated guidelines, the Department of Health and Human Services said on Monday, a month after President Donald Trump called for reducing the number of vaccines in children's schedules.

Vaccines for rotavirus, influenza, meningococcal disease, and hepatitis A have been moved to shared decision-making between parents and healthcare providers, HHS said.

The decision to remove the vaccines from the schedule occurred outside the typical process for vaccine recommendations in which an outside panel of expert advisers considers the merits of each vaccine with an eye toward public health.

Two top HHS officials, Martin Kulldorf and Tracy Beth Hoeg, reviewed vaccine protocols in 20 other developed countries and made the recommendations to change the U.S. schedule, the agency said.

The updated recommendations maintain immunizations for 11 diseases, including measles, mumps, and varicella, while categorizing others as either targeted for high-risk groups or subject to the shared-decision-making category, HHS said.

Insurance providers will continue covering immunization costs regardless of the category, senior HHS officials told reporters on a call. Among the changes, the CDC now recommends a single dose of the human papillomavirus vaccine instead of two.

-Reporting by Ahmed Aboulenein in Washington and Michael Erman in New York; Editing by Caroline Humer and Bill Berkrot/Reuters