What you need to know
- In shared clinical decision-making, a health care provider and patient (or caregiver) discuss the benefits and risks of a health care decision, like vaccination.
- Parents and caregivers have always made health decisions for their kids. Reclassifying some vaccines from “recommended” to “shared clinical decision-making” doesn’t change that.
- Despite shifting federal guidance, parents can still follow the full childhood vaccine schedule recommended by medical organizations like the American Academy of Pediatrics.
On January 5, the Centers for Disease Control and Prevention reduced the number of vaccines recommended for all children. Now, some vaccines are recommended only for “high-risk” groups or after parents talk with a child’s health care provider, a process called “shared clinical decision-making.”
These updates weren’t based on new safety data, and they worry pediatricians and public health experts, especially as outbreaks of preventable diseases like measles spread across the country.
“My biggest concern is that parents will be confused about which vaccines are beneficial for their children,” Dr. Kristen Panthagani, a resident physician at Yale New Haven Hospital, tells Public Good News. That confusion, she says, could lead some families to delay or skip vaccines that are proven to protect kids and communities.
Vaccination remains a safe way to protect kids from dangerous diseases, backed by decades of research showing that the benefits far outweigh any potential risks. Parents can still follow the full vaccine schedule recommended by the American Academy of Pediatrics, which is evidence-based and supported by other major medical organizations.
Read on to learn more about what shared clinical decision-making means and where to find reliable information about childhood vaccines.
Why did the CDC’s recommended childhood vaccine schedule change?
The CDC’s updated childhood vaccine schedule recommends that all children receive immunizations that protect against 11 diseases, down from 17. The other immunizations were not removed or deemed unsafe. Instead, they were reclassified. Immunizations that protect against the flu, COVID-19, RSV, hepatitis A, hepatitis B, and meningococcal diseases—which were previously universally recommended—are now recommended only for children considered at higher risk for severe illness or through shared clinical decision-making.
“These changes were not based on any new evidence about the safety or effectiveness of these vaccines,” Dr. Douglas J. Opel, a pediatrician and professor at the University of Washington School of Medicine, tells PGN.
Major medical organizations like the AAP continue to recommend the full schedule because it remains the best way to protect all children.
What is shared clinical decision-making?
In shared clinical decision-making, a health care provider and patient—or a patient’s caregiver—discuss the benefits and risks of a health care decision, like vaccination. According to the CDC, health care providers that can initiate this process include “anyone who provides or administers vaccines: primary care physicians, specialists, physician assistants, nurse practitioners, registered nurses, and pharmacists.”
However, Panthagani explains that “in the medical world, shared clinical decision-making is typically used when there is not a clear evidence-based recommendation for a treatment.”
But decades of research show that vaccines are safe for children and that the benefits of vaccination outweigh any potential risks.
“This shift in language implies that there isn’t a clear recommendation for these vaccines, contrary to the data,” Panthagani wrote in a January post for Your Local Epidemiologist. “It gives the appearance of supporting parent autonomy while undermining vaccine recommendations.” For families, that can create uncertainty about vaccines that doctors overwhelmingly agree are beneficial.
Parents and caregivers have always made health decisions for their kids, including decisions about vaccines. Shifting some vaccines from “recommended” to shared clinical decision-making does not limit parents’ ability to choose vaccination for their children.
Can kids still get the full vaccine schedule?
Yes. Parents can continue vaccinating their children based on the recommendations from national medical organizations like the AAP. Most private insurance plans and government programs continue to cover all routine childhood vaccines.
“Vaccines continue to be an important way to keep children healthy and maintain community immunity, and pediatricians remain an important trusted resource for families for reliable information about vaccines,” Opel says.
For more information, talk to your child’s health care provider.