Shared decision-making for childhood vaccines may reduce access for some families

Federal officials moved six childhood vaccines from the routine immunization schedule to a 'shared clinical decision-making' category, and those vaccines will remain covered by federal programs and private insurers through 2026.

On Jan. 5, 2026, federal health officials announced that six childhood vaccines were removed from the routine immunization schedule and placed into a "shared clinical decision-making" category. Under this approach, the vaccines are available after a conversation between a clinician and the family instead of being given by default. Officials said the six vaccines will continue to be covered by federal programs such as Medicaid and the Vaccines for Children program, and by private insurers, at least through 2026. Key facts: - Six vaccines were moved off the routine schedule: hepatitis A, hepatitis B, influenza, rotavirus, meningococcal disease and COVID-19. - "Shared clinical decision-making" means these vaccines are offered after a clinician-family discussion rather than being automatically administered. - Officials stated coverage will continue under federal programs and private insurers through 2026. - The change shifts more of the decision and documentation burden onto clinicians and families; if conversations do not occur, the vaccines may not be given. Summary: The policy change alters the default for these six vaccines from automatic administration to requiring a clinician-family discussion, which could affect how clinics manage vaccination during routine visits and who receives the shots. Undetermined at this time.