ACIP Recommends Shared Decision-Making for COVID-19 Vaccination

The CDC’s Advisory Committee on Immunization Practices (ACIP) voted 12-0 that vaccination for COVID-19 should be determined by individual decision-making. The recommendation applies to all patients 6 months and older, but it places an emphasis that the risk-benefit of vaccination for patients under 65 is the most favorable for those at an increased risk of severe COVID-19 and the lowest for those who are not at an increased risk, according to the Department of Health and Human Services (HHS).¹

The vote for state and local jurisdictions requiring a prescription for administration of COVID-vaccines failed after a tiebreaker vote from the committee chair. | Image Credit: myskin - stock.adobe.com

Members took to a second vote for determining if state and local jurisdictions should require a prescription for the administration of a COVID-19 vaccine, which tied at 6-6 and the chair, Martin Kulldorff, PhD, broke the tie and ensured the vote failed.²

Shared clinical decision-making vaccines are not blanket recommendations for the general public or subgroups of the population, such as patients at high risk. Instead, they are recommendations based on a decision process between the health care provider and the patient or parent/guardian. As for coverage, the requirements include shared clinical decision-making recommendations that were adopted by the CDC and listed on the immunization schedule.³

Additionally, the decision is made from the individuals’ characteristics, values, preferences, and the health care provider’s clinical discretion, according to the CDC. Health care providers included in shared clinical decision-making are health care professionals who provide or administer vaccines, such as primary care physicians, specialists, physician assistants, nurse practitioners, registered nurses, and pharmacists.³

In addition to COVID-19 recommendations, ACIP also recommended that all pregnant women get tested for hepatitis B, which will be covered across all insurance programs. ACIP also approved a provision for the measles, mumps, rubella, and varicella (MMRV) virus through the Vaccines for Children Program, which will create consistent coverage for all vaccine payment and other entitlement programs. According to HHS, this follows the recommendation that children aged 3 years should be immunized for varicella as a standalone vaccination at the same time as the MMR vaccine instead of the combination MMRV vaccine. According to the September 18 meeting, data show that healthy children 12 to 23 months old have an increased risk of febrile seizure 7 to 10 days after receiving the MMRV vaccine compared with those who receive separate immunizations.¹

Recently, Governor Gavin Newsom of California, Governor Tina Kotek of Oregon, Governor Bob Ferguson of Washington, and Governor Josh Green of Hawaii announced respiratory season vaccination recommendations through the West Coast Health Alliance, which was launched earlier in September 2025. For COVID-19, the organization recommended the vaccine for all children 6 through 23 months, children 2 through 18 years with a risk factor for severe disease or who have never been vaccinated for COVID-19, all children in close contact with people with risk factors, and children and parents/guardians who wish them to have protection. The recommendations extend to patients who are planning to be pregnant, pregnant, postpartum, or lactating, as well as patients 65 years and older, those younger than 64 years with risk factors, those who are in close contact with others who have risk factors, and patients who choose to get vaccinated.⁴

Connecticut, Maine, Massachusetts, New Jersey, New York State, New York City, Pennsylvania, and Rhode Island all joined the Northeast Public Health Collaborative, which uses clinical data for public health and community health as well as strengthens confidence in vaccines and science-based medicine.⁵

READ MORE: Immunization Resource Center

Are you ready to elevate your pharmacy practice? Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips straight to your inbox.

REFERENCES

1. ACIP recommends COVID-19 immunization based on individual decision-making. News release. Health and Human Services. September 19, 2025. Accessed September 22, 2025. https://www.hhs.gov/press-room/acip-recommends-covid19-vaccination-individual-decision-making.html

2. Halpern L. ACIP Meeting: COVID-19 vaccine to be administered through shared clinical decision making. Pharmacy Times. September 19, 2025. Accessed September 22, 2025. https://www.pharmacytimes.com/view/acip-meeting-covid-19-vaccines-to-be-administered-through-shared-clinical-decision-making

3. CDC. ACIP shared clinical decision-making recommendations. Updated January 7, 2025. Accessed September 22, 2025. https://www.cdc.gov/acip/vaccine-recommendations/shared-clinical-decision-making.html

4. Gallagher A. California and West Coast states release recommendation on Respiratory Vaccination. Drug Topics. September 19, 2025. Accessed September 22, 2025. https://www.drugtopics.com/view/california-and-west-coast-states-release-recommendations-on-respiratory-vaccination

5. Several Northeastern states and America’s largest city announce the Northeast Public Health Collaborative. News release. September 18, 2025. Accessed September 22, 2025. https://www.nyc.gov/site/doh/about/press/pr2025/announce-northeast-public-health-collaborative.page