On January 5, the Centers for Disease Control and Prevention (CDC) announced a reduction in the number of recommended childhood vaccinations from 17 to 11. The CDC explained that this change aligns with practices in countries such as Denmark, Germany, and Japan. Under the new policy, parents may choose to have their children receive certain vaccines—including those for flu, rotavirus, Covid-19, meningitis, and hepatitis A and B—after participating in "shared clinical decision-making" with health care providers.
This announcement follows similar decisions by federal health officials. In December, the CDC's vaccination advisory committee revised its recommendation regarding the birth dose of the hepatitis B vaccine. Instead of recommending it for all infants, the Advisory Committee on Immunization Practices (ACIP) now suggests automatic vaccination only for infants whose mothers test positive for hepatitis B. For other infants, parents can decide about vaccination after engaging in shared clinical decision-making.
Two months prior to this change, the CDC updated its immunization schedules to recommend shared clinical decision-making for Covid-19 vaccination among individuals aged six months and older.
According to ACIP's definition posted online in January 2025, shared clinical decision-making is "individually based and informed by a decision process between the health care provider and the patient or parent/guardian." The CDC lists primary care physicians, specialists, physician assistants, nurse practitioners, registered nurses, and pharmacists as professionals who can be consulted during this process.
The Annenberg Public Policy Center (APPC) conducted two national surveys—in August and December 2025—to assess Americans' understanding of these new policies. The August survey included 1,699 adults; the December survey included 1,637 respondents. Results showed significant gaps in public understanding about what shared decision-making means regarding childhood vaccinations.
Patrick E. Jamieson, director of APPC's Annenberg Health and Risk Communication Institute stated: "Expecting parents to engage in shared decision-making with health care providers about routine, thoroughly studied childhood vaccinations suggests that the public health community has doubts about the safety and efficacy of these vaccines when it does not," adding: "These vaccines have been part of the recommended childhood schedule because the benefits of taking them substantially outweigh the risks."
Survey data indicated confusion over which professionals are considered appropriate health care providers for shared decision-making. While most adults identified physicians (86%) or physician assistants/nurse practitioners (66%) as relevant providers:
- Only half selected registered nurses.
- About one-third chose pharmacists.
- Small numbers identified professions not included by ACIP such as clinical social workers or acupuncturists.
Ken Winneg, APPC's managing director of survey research said: "With many vaccines available at pharmacies without a prescription, it is important for Americans to know they can talk to their pharmacist directly about their vaccination decisions."
The surveys were conducted by SSRS using nationally representative panels with margins of error ±3.5 percentage points at a 95% confidence level.
