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Ahead of possible changes to the childhood vaccine schedule, a new report highlights growing confusion over the best time to protect infants from serious infectious diseases.

With the United States likely to lose its measles elimination status in the next few months and the possibility of looming changes to the childhood vaccine schedule, new research highlights the risk of delaying vaccination.

The study, which was published Friday in JAMA Network Open, analyzed the health records of 321,743 children with regular access to care, finding that getting the vaccines recommended in the first four months is the most likely sign that a child will receive the first dose of the measles, mumps and rubella (MMR) vaccine at 12 to 15 months.

The findings underscore a growing confusion over the best time to protect very young children from serious infectious diseases, as well as increased distrust of vaccination among parents, said Nina Masters, the study’s lead author and a senior applied research scientist at Truveta, a health care data and analytics company.