As Immunization Schedules Change, Vaccine Confidence Among Patients Falters

In fall 2025, the CDC’s Advisory Committee on Immunization Practices voted to recommend individual decision-making for COVID-19 vaccination for adults and children, which was officially updated by October 7, 2025. In addition, the CDC also voted to recommend that toddlers receive protection from varicella, also known as chicken pox, as a stand-alone immunization instead of in combination with the measles, mumps, and rubella (MMR) vaccination.¹

As part of the child and adolescent immunization schedule, the CDC stated that healthy children 12 to 23 months old have an increased risk of febrile seizure approximately 7 to 10 days post vaccination when receiving the combined MMR and varicella vaccine compared with those who received the immunization separately.¹

“The space around vaccines is changing so rapidly,” Laura Knockel, PharmD, BCACP, clinical associate professor at the University of Iowa College of Pharmacy, said.² “There’s so much misinformation and disinformation out there, so I really think the first step is to acknowledge that concern, and again, coming from the point of they want to do what’s best for their child.”

Although vaccine hesitancy has been on the rise, one strategy that can be used is the coadministration of various vaccines, which can provide multiple vaccinations during the same appointment and reduce missed opportunities of vaccination and save time. According to authors of a study published in Preventive Medicine Reports, coadministration of vaccines is generally considered safe and effective and is most common for travel and childhood immunizations. However, there is limited evidence for covaccination comfort.²

“Individuals with higher capability scores reported greater co-vaccination comfort, with lower vaccine hesitancy and greater health literacy, confidence in scheduling a co-vaccination appointment, and awareness of available co-vaccination offerings associated with greater co-vaccination comfort,” the investigators concluded. However, they also noted that over 70% of US and Canadian patients reported concerns about the adverse effects of covaccination.³

“We continue to see common misconceptions, like the flu vaccine causes flu, or it has severe [adverse] effects,” Samantha Picking, PharmD, senior director of immunizations at Walgreens, said.⁴ “That delays or deters eligible patients from getting vaccinated. It’s always troubling. As we know, vaccine-preventable viruses [such as] flu, measles, and pneumonia are highly contagious and can spread quickly.”

When it comes to childhood vaccination, the credibility of health-related information does inform parental decisions on vaccination, according to authors of a study published in Frontiers in Public Health. In the study, investigators examined the type of health information used by patients, categorizing it as verified (from a health care provider or scientific journal) and unverified (from family or friends, social media, or opinion blogs). There were 887 parents who completed an anonymous online survey, with 55.1% being male and having a mean age of 36.42 years. In the survey, patients reported their demographic characteristics, primary health information sources, and whether their child received the 12 vaccines recommended by the CDC.⁵

“Misinformation, especially from social media and informal online networks, has been found to undermine trust in public health recommendations and exacerbate vaccine hesitancy,” the authors said.⁵

Patients who used verified sources had significantly higher odds of vaccinating their child across diphtheria, tetanus, and acellular pertussis; Haemophilus influenzae type b; hepatitis A; hepatitis B; influenza; MMR; meningococcal disease; pneumonia; polio; and rotavirus compared with patients who used unverified sources. Further, patients using verified sources also reported significantly higher overall vaccination rates. However, there were no differences found for varicella or COVID-19 immunizations.⁵

“When it comes to vaccination, it is definitely one of the most effective ways to reduce infectious disease in a community, whether it is COVID, [influenza, or] meningitis. It’s obviously scientifically proved to be effective. When it comes to community pharmacy, it is the most accessible location to get a vaccination,” Hashim Zaibak, PharmD, CEO of Hayat Pharmacy, said.⁶ “You can walk into a community pharmacy and get vaccinated 7 days a week.... It’s a lot more convenient for people who are busy to come and get the vaccine in a community pharmacy vs getting it in a clinic or by appointment.”

REFERENCES

1. CDC immunization schedule adopts individual-based decision-making for COVID-19 and standalone vaccination for chickenpox in toddlers. News release. US Department of Health and Human Services. October 6, 2025. Accessed October 23, 2025. https://www.hhs.gov/press-room/cdc-immunization-schedule-individual-decision-covid19-standalone-chickenpox-toddlers.html

2. Gallagher A, Knockel L. Q&A: pharmacist advocates for evidence-based immunization guidelines for COVID-19 vaccines. Drug Topics. September 1, 2025. Accessed October 23, 2025. https://www.drugtopics.com/view/q-a-pharmacist-advocates-for-evidence-based-immunization-guidelines-for-covid-19-vaccines

3. Frith E, Deedat S, Blazek ES, Bucher A. Comfort or hesitancy: a cross-sectional study of modifiable factors associated with co-vaccination behavior among United States and Canadian adults. Prev Med Rep. 2025;57:103199. doi:10.1016/j.pmedr.2025.103199

4. Nowosielski B, Picking S. Q&A: persistent vaccine hesitancy amid increased coadministration rates. Drug Topics. August 20, 2025. Accessed October 23, 2025. https://www.drugtopics.com/view/persistent-vaccine-hesitancy-amid-increased-coadministration-rates

5. Geller KS, Montaine-O’Brien SJ, Branscum PW, Reeves-Doyle BN. Associations between health information source and childhood vaccination. Front Public Health. 2025;13:1627916. Published 2025 Sep 29. doi:10.3389/fpubh.2025.1627916

6. Nowosielski B, Zaibak H. Q&A: community pharmacies help increase immunization convenience, uptake. Drug Topics. August 3, 2025. Accessed October 23, 2025. https://www.drugtopics.com/view/community-pharmacies-help-increase-immunization-convenience-uptake