“As vaccine guidance evolves, Zion HealthShare remains committed to supporting our members’ health and wellness. We will continue to share into vaccines recommended by the CDC, helping ensure members have access to preventive care aligned with trusted public health standards.”
The Centers for Disease Control and Prevention (CDC) has announced updates to its recommended childhood and adolescent immunization schedule, reducing the number of vaccines classified as routine from 17 to 11.
The change reflects a reassessment of disease risk and shifts several vaccines into a category known as shared clinical decision-making (SCDM), where vaccination decisions are made collaboratively between patients, families, and healthcare providers.
Through this approach individuals are encouraged to stay informed, ask questions, and take an active role in their healthcare choices by discussing risks, benefits, and personal circumstances with a trusted medical professional.
Under the updated guidance, six vaccines previously considered routine are now categorized as SCDM and recommended primarily for children and adolescents at higher risk.
These include vaccines for rotavirus, COVID-19, influenza, hepatitis A, hepatitis B, and meningococcal disease. The updated guidance does not remove these vaccines from use, but shifts how decisions about them are discussed between families and healthcare providers.
According to the CDC’s frequently asked questions, “For shared clinical decision-making recommendations, there is no default. The decision about whether or not to vaccinate may be informed by the best available evidence of who may benefit from vaccination; the individual’s characteristics, values, and preferences; the health care provider’s clinical discretion; and the characteristics of the vaccine being considered.”
In addition to vaccines moved into the SCDM category, certain immunizations have been placed under a high-risk designation and are recommended based on individual medical assessments. These include the respiratory syncytial virus (RSV) vaccine. The CDC also updated its guidance for the human papillomavirus (HPV) vaccine, reducing the recommended series to a single dose.
Public health experts have offered varying perspectives on how the updated guidance may be interpreted.
Jason Schwartz, PhD, a professor at the Yale School of Public Health, cautioned that the shift “…is going to create widespread confusion about when those ‘special-category’ vaccines should be used, which will doubtlessly mean fewer kids will get those vaccines and more kids will get those diseases.”
Health officials note that the shared decision making framework is designed to support informed conversations, particularly when individual risk factors vary
Notably, there have been no changes to core childhood vaccines, including those for chickenpox, measles, and tetanus, which remain part of the routine immunization schedule.
How States Are Responding
While the CDC provides national guidance, vaccine policy implementation varies by state. According to the Berkley School of Public Health, “States can set their own vaccine policies. But CDC guidelines are highly influential on regional decision-making and can also impact insurance coverage and access.”
The CDC fact sheet states that this change follows a scientific review comparing the U.S. child and adolescent immunization schedule with those of peer developed nations.
According to the agency, “the data support(s) a more focused schedule that protects children from the most serious infectious diseases while improving clarity, adherence, and public confidence,” said acting CDC Director Jim O’Neill.
Approximately 20 states, including California, Massachusetts, and Colorado, have indicated they will continue to follow the vaccine schedule recommended by the American Academy of Pediatrics (AAP).
Several states emphasized that the updated guidance does not change existing vaccine access or recommendations at the state level.
New York officials have also stated that there will be no changes to vaccine access or coverage. The state continues to rely on protections provided through the federal Vaccines for Children (VFC) program, which ensures eligible children can receive recommended vaccines at no cost.
The CDC’s immunization schedule remains the national reference point, while states determine how guidance is applied locally.
What This Means for Consumers
For consumers, the updated guidance places greater emphasis on understanding personal health factors and having informed conversations with healthcare providers.
When asked how the updated guidance would affect immunization sharing, Katie Warren, manager of the Needs Department at Zion HealthShare, stated, “As vaccine guidance evolves, Zion HealthShare remains committed to supporting our members’ health and wellness. We will continue to share into vaccines recommended by the CDC, helping ensure members have access to preventive care aligned with trusted public health standards.”
As families and providers navigate the updated guidance, healthcare professionals emphasize the importance of informed conversations that consider individual health risks, access to care, and personal preferences.
The CDC’s shift toward shared clinical decision-making reflects a broader move toward personalized healthcare, emphasizing clear communication and education so families can make informed vaccination decisions.
* Zion HealthShare is not an insurance company. Neither this publication nor membership in Zion HealthShare are offered by an insurance company. Visit ZionHealthShare.org to view your state-specific notice.