The US CDC’s Advisory Committee on Immunization Practices (ACIP) issued guidance on COVID-19 vaccination recommending “shared clinical decision-making,” according to a Department of Health and Human Services (HHS) news release.

According to HHS:

ACIP’s recommendation applies to all individuals six months and older. It includes an emphasis that the risk-benefit of vaccination in individuals under age 65 is most favorable for those who are at an increased risk for severe COVID-19 and lowest for individuals who are not at an increased risk, according to the CDC list of COVID-19 risk factors.

Individual decision-making is referred to on the CDC’s adult and child immunization schedules as vaccination based on shared clinical decision-making, which references providers including physicians, nurses, and pharmacists. It allows for immunization coverage through all payment mechanisms including entitlement programs such as the Vaccines for Children Program, Children’s Health Insurance Program, Medicaid, and Medicare, as well as insurance plans through the federal Health Insurance Marketplace.

According to Yale School of Public Health’s Jason L. Schwartz, PhD, associate professor of Public Health (Health Policy), the guidance is a step down from previous recommendations.

“…This ‘shared clinical decision-making’ guideline is a step down from the ACIP’s far more common, ‘routine’ recommendations for vaccines. It is used in situations where the committee wishes to highlight vaccination as an option for individuals (ie, may vaccinate) without actively encouraging it (ie, should vaccinate),” Schwartz said in an interview with the Yale School of Public Health.

Industry Response

In response to the new ACIP guidance, the American Lung Association’s president/CEO Harold Wimmer issued the following statement:

“Today, ACIP voted to maintain access to COVID-19 vaccination for everyone six months and older but added a barrier to people getting vaccinated. They changed from recommending widespread vaccination to recommending shared clinical decision-making (a discussion between a patient or caregiver and their healthcare provider) be added to the adult and childhood vaccination schedules. This change adds a burden and causes confusion, and no science was presented to support this action.

The American Lung Association strongly supports widespread vaccination, which is crucial for public health and this is especially true for respiratory viruses, including COVID-19.

COVID-19 is still a significant public health threat, and vaccination is the best way to help keep parents at work, kids at school and families healthy. From October 1, 2024, through September 13 of this year, there were 370,000-530,000 COVID-19 hospitalizations and up to 61,000 deaths.

The evidence-based, transparent process for developing these recommendations has been disrupted. The Advisory Committee on Immunization Practices (ACIP) has long been recognized for its rigorous scientific review and open deliberations. Unlike previous ACIP meetings, recent proceedings did not provide votes in advance, limiting the opportunity for public comment and scientific discussion. It is essential that ACIP return to its established role as a trusted, evidence-based body where careful analysis of the data and peer-reviewed science guide decision-making.

We continue to urge that everyone over six months get vaccinated for COVID-19. As long as today’s votes are ratified by the acting CDC director, the COVID-19 vaccine will be covered for most people without any cost.”
-Harold Wimmer, ALA