‘Shared decision-making ’ for childhood vaccines sounds empowering – but it may mean less access for families already stretched thin |
When federal health officials announced on Jan. 5, 2026, that they were taking six out of 17 vaccines off the childhood immunization schedule, they argued that the move would give parents and caregivers more choice.
Instead of all U.S. children routinely receiving them, these six vaccines are now optional – available to families who request them after consulting a clinician, through a process called shared clinical decision-making, officials said. All six – hepatitis A, hepatitis B, influenza, rotavirus, meningococcal disease and COVID-19 – will still be covered by federal programs such as Medicaid and the Vaccines for Children program, and by private insurers, at least through 2026.
I’m a health policy researcher and the co-author of the book “Vaccine Law and Policy.” I’ve spent years studying how vaccine laws and regulations affect uptake – and who gets left behind when policies change.
Shared decision-making sounds straightforward: a patient and their doctor putting their heads together to make an informed choice. But when applied to routine childhood vaccines, the concept shifts the burden of deliberation onto already-stretched clinicians and parents.
Shared decision-making is an approach doctors use when there’s genuinely more than one reasonable choice – say, weighing........