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U.S. Reclassifies Six Childhood Vaccines to Shared Decision-Making, Raising Access Concerns

Health experts warn the shift adds hurdles likely to lower uptake for disadvantaged families.

Overview

  • On Jan. 5, federal officials moved hepatitis A, hepatitis B, influenza, rotavirus, meningococcal, and COVID-19 shots off the routine pediatric schedule.
  • The vaccines now require an explicit clinician–family discussion, and without that conversation there is no default vaccination.
  • Medicaid, the Vaccines for Children program, and private insurers pledged coverage for these shots at least through 2026.
  • Pediatric workflow will be strained because routine EHR prompts and standing orders no longer trigger these doses during short well-child visits.
  • The approach, previously used for limited adult cases such as HPV for ages 27–45, could widen existing income-related gaps as counseling time and follow-up demands increase.