Doctors say changes to US vaccine recommendations are confusing parents
and could harm kids
[January 12, 2026]
By LAURA UNGAR
Dr. Molly O’Shea has noticed growing skepticism about vaccines at both
of her Michigan pediatric offices and says this week's unprecedented and
confusing changes to federal vaccine guidance will only make things
worse.
One of her offices is in a Democratic area, where more of the parents
she sees are opting for alternative schedules that spread out shots. The
other is in a Republican area, where some parents have stopped
immunizing their children altogether.
She and other doctors fear the new recommendations and the terminology
around them will stoke vaccine hesitancy even more, pose challenges for
pediatricians and parents that make it harder for kids to get shots, and
ultimately lead to more illness and death.
The biggest change was to stop blanket recommendations for protection
against six diseases and recommend those vaccines only for at-risk
children or through something called “shared clinical decision-making”
with a health care provider.
The phrase, experts say, is confusing and dangerous: “It sends a message
to a parent that actually there’s only a rarefied group of people who
really need the vaccine,” O’Shea said. “It’s creating an environment
that puts a sense of uncertainty about the value and necessity or
importance of the vaccines in that category.”
Health Secretary Robert F. Kennedy Jr., who helped lead the anti-vaccine
movement for years, said in announcing the changes that they better
align the U.S. with peer nations “while strengthening transparency and
informed consent.”
But doctors say they are sowing doubt — the vaccines have been
extensively studied and proven to be safe and effective at shielding
kids from nasty diseases — at a time when childhood vaccination rates
are already falling and some of those infectious diseases are spreading.
On Friday, the American Academy of Pediatrics and more than 200 medical,
public health and patient advocacy groups sent a letter to Congress
about the new childhood immunization schedule.
“We urge you to investigate why the schedule was changed, why credible
scientific evidence was ignored, and why the committee charged with
advising the HHS Secretary on immunizations did not discuss the schedule
changes as a part of their public meeting process," they wrote.
Many don't know what ’shared decision-making' means
O’Shea said she and other pediatricians discuss vaccines with parents at
every visit where they are given. But that’s not necessarily “shared
clinical decision-making,” which has a particular definition.
On its website, the Advisory Committee on Immunization Practices says:
“Unlike routine, catch-up, and risk-based recommendations, shared
clinical decision-making vaccinations are not recommended for everyone
in a particular age group or everyone in an identifiable risk group.
Rather, shared clinical decision-making recommendations are individually
based and informed by a decision process between the health care
provider and the patient or parent/guardian.”
In this context, health care providers include primary care physicians,
specialists, physician assistants, nurse practitioners, registered
nurses and pharmacists.
A pair of surveys conducted last year by the Annenberg Public Policy
Center at the University of Pennsylvania suggested that many people
don’t fully understand the concept, which came up last year when the
federal government changed recommendations around COVID-19 vaccinations.
Only about 2 in 10 U.S. adults knew that one meaning behind shared
decision-making is that “taking the vaccine may not be a good idea for
everyone but would benefit some.” And only about one-third realized
pharmacists count as health care providers to talk with during the
process, even though they frequently administer vaccines.
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Vaccines are prepared for students during a pop-up immunization
clinic at a school in Louisville, Ky., on Thursday, Aug. 8, 2024.
(AP Photo/Mary Conlon, File)
 As of this week, vaccines that
protect against hepatitis A, hepatitis B, rotavirus, RSV, flu and
meningococcal disease are no longer universally recommended for
kids. RSV, hepatitis A, hepatitis B and meningococcal vaccines are
recommended for certain high-risk populations; flu, rotavirus,
hepatitis A, hepatitis B and meningococcal vaccines are recommended
through shared decision-making — as is the COVID-19 vaccine,
although that change was made last year.
Shortly after the federal announcement Monday, Dr.
Steven Abelowitz heard from half a dozen parents. “It’s causing
concern for us, but more importantly, concern for parents with kids,
especially young kids, and confusion,” said Abelowitz, founder of
Ocean Pediatrics in Orange County, California.
Though federal recommendations are not mandates — states have the
authority to require vaccinations for schoolchildren — they can
affect how easy it is for kids to get shots if doctors choose to
follow them.
Under the new guidelines, O'Shea said, parents seeking shots in the
shared decision-making category might no longer bring their kids in
for a quick, vaccine-only appointment with staff. They'd sit down
with a health care provider and discuss the vaccine. And it could be
tougher to have a flu clinic, where parents drive up and kids get
shots without seeing a doctor.
Staying the course as challenges mount
Still, doctors say they won’t let the changes stop them from helping
children get the vaccines they need. Leading medical groups are
sticking with prior vaccine recommendations. Many parents are, too.
Megan Landry, whose 4-year-old son Zackary is one of O’Shea’s
patients, is among them.
“It’s my responsibility as a parent to protect my child’s health and
well-being,” she said. “Vaccines are a really effective and
well-studied way to do that.”
She plans to keep having the same conversations she’s always had
with O’Shea before getting vaccines for Zackary.
“Relying on evidence and trusted medical guidance really helps me to
make those decisions,” she said. “And for me, it’s not just a
personal choice for my own son but a way to contribute to the health
of everybody.”
But for other families, confidence about vaccines is waning as trust
in science erodes. O'Shea lamented that parents are getting the
message that they can't trust medical experts.
“If I take my car to the mechanic, I don’t go do my own research
ahead of time," she said. “I go to a person I trust and I trust them
to tell me what’s going on.”
Abelowitz, the California doctor, likened the latest federal move to
pouring gasoline on a fire of mistrust that was already burning.
“We’re worried the fire’s out of control,” he said. “Already we’ve
seen that with measles and pertussis, there are increased
hospitalizations and even increasing deaths. So the way that I look
at it — and my colleagues look at it — we’re basically regressing
decades.”
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