Here's how 'shared decision making' for childhood vaccines could limit access

"In a major change in vaccine policy, the Trump administration recently dropped recommendations that all kids get six immunizations long considered routine. Instead, they're now in a category called "shared clinical decision-making." That's when the patient (or the parents if the patient's a child) has a conversation with a health care provider to decide if a treatment is appropriate, says Wendy Parmet, who studies health care policy at Northeastern University in Boston."

"The problem with shared decision making in this context, is "you're suggesting that both options are equally valid," says Dr. Lainie Friedman Ross, a pediatrician and bioethicist at the University of Rochester School of Medicine. "And the fact is: Not getting vaccinated puts your own child at risk, puts you at risk and puts your community at risk. So it is not an equal decision.""

Six routine childhood vaccines were reclassified as 'shared clinical decision-making,' shifting recommendations from universal to individualized parental-provider conversations. Shared clinical decision-making is intended for complex cases with unclear answers, such as surgical choices or PSA screening. Many clinicians argue these six vaccines—hepatitis A, hepatitis B, influenza, meningitis, respiratory syncytial virus (RSV), and rotavirus—have clear evidence of broad safety and benefit for all children. Moving them into shared decision-making can create the appearance of scientific uncertainty and suggest options are equally valid, despite higher risks from remaining unvaccinated to the child, family, and community.

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