Shared decision-making for childhood vaccines could reduce access for stretched families

On Jan. 5, 2026, federal officials moved six childhood vaccines off the routine schedule into a shared clinical decision-making category, meaning they are optional after a clinician conversation. Coverage is reported to continue through 2026 under Medicaid, the Vaccines for Children program and many private insurers, and experts say requiring conversations may reduce access for families with limited time and resources.

Federal health officials announced on Jan. 5, 2026, that six childhood vaccines would be moved off the routine immunization schedule and placed in a shared clinical decision-making category. Under this approach, those vaccines are to be offered after a conversation between a clinician and a parent or caregiver rather than given by default. The Centers for Disease Control and Prevention uses shared clinical decision-making for interventions that might suit some people after a clinician discussion. Health policy researchers note that changing routine vaccinations into optional ones shifts the work of deliberation onto clinicians and families who already face time and resource constraints. Key facts: - On Jan. 5, 2026, officials moved six of 17 childhood vaccines to a shared clinical decision-making category. - The six vaccines named are hepatitis A, hepatitis B, influenza, rotavirus, meningococcal disease and COVID-19. - Those vaccines are reported to remain covered by Medicaid, the Vaccines for Children program and private insurers at least through 2026. - In the shared decision-making category there is no automatic default to vaccinate; a clinician-family conversation is required before the vaccine is given. Summary: Requiring conversations that were previously handled through routine clinic workflow may add time and administrative steps and could reduce timely vaccination, particularly for families with shorter appointments or barriers to follow-up. Undetermined at this time.