Last week CDC updated its immunization schedules for the COVID-19 vaccination to apply “individual-based decision-making,” as was recommended by the CDC Advisory Committee on Immunization Practices (ACIP). Taking effect October 7 for adults and children, the intent is for patients and parents to discuss the risks and benefits with a health care provider prior to getting the vaccination. But what does this “blanket recommendation” to “Informed consent” mean in practicality? With little information provided with the change, it carries as many questions and complications as answers – for both individuals and health care providers.
An overarching question is that of: Who is considered to be a “health care provider”? According to a January 7 ACIP publication on the topic, it can be “anyone who provides or administers vaccines: primary care physicians, specialists, physician assistants, nurse practitioners, registered nurses, and pharmacists.” Does this mean you can just go to your regular pharmacy and discuss it with the person who is giving the shot? According to the ACIP definition, that would be a yes, if it is through a “shared decision-making process … informed by the best available evidence of who may benefit from vaccination; the individual’s characteristics, values, and preferences; the health care provider’s clinical discretion; and the characteristics of the vaccine being considered.”
So, does the pharmacist need to know your history for valid “shared decision-making”? Or do you need the recommendation of a physician who has that history? To make it even less clear, the ACIP publication states, “There is not a prescribed set of considerations or decision points in the decision-making process,” and because of that, different pharmacists may have differing interpretations and openness to give the vaccine without a prescription.
It also raises the question of free access and insurance coverage. While many of the insurers and free programs will be continuing to cover the vaccine, at least through 2026, there remains some confusion on whether insurers are required to cover the full cost of the vaccine.
While there are currently no solid answers to the questions, we can provide a few resources for more information and your own decision-making:
- The Washington Post has a good explainer article from which some of the above information was compiled (open link).
- CDC Media Release of October 6, 2025, on the immunization schedule change (CDC)
- ACIP Shared Clinical Decision-Making Recommendations of January 7, 2025 (CDC)
- TAG public health experts. Contact us!
Public Health News:
- Measles cases are surging in Mexico, with more than 4,800 cases reported as of October 10, with the highest incidence among children aged 0-4. 22 deaths have been reported. More cases are reported in areas with lower vaccination rates and limited healthcare.
- As of Oct 7, 2025, the US has reported more than 1,500 measles cases in 2025. The majority of cases are in unvaccinated persons, with the highest incidence in people aged 5-19.
- 20 children in Madhya Pradesh, India, have died from kidney failure after consuming cough syrup from one particular manufacturer, contaminated with diethylene glycol and ethylene glycol. The contamination can occur through mislabeling, accidental contamination due to human error or deliberate adulteration. An investigation to determine the cause is underway.
- Influenza circulation in the EU and in the US remains at low levels.
- Research was published on H5N1 influenza virus stability and transmission risk in raw milk and cheese, indicating that the virus persisted in cheese at pH 6.0 and 5.8. but not at 5.0, for up to 120 days of aging. After the aging process, samples of the infected cheese were fed to ferrets, and none became ill, though they did show symptoms after consuming H5N1-infected raw milk.
- A recent mass firing of over 1,000 CDC employees has raised serious concerns about the Trump Administration’s commitment to public health. The layoffs, announced via email late Friday night, were partially reversed the next morning when around 700 staff were rehired, with officials blaming a “coding error.” Among those affected were key personnel like the CDC’s disease detectives, scientific editors, and the entire D.C. office. Critics, including former CDC officials and public health leaders, say the episode reflects growing instability and political interference at the agency, especially since Robert F. Kennedy Jr. became HHS Secretary. They warn that the firings could disrupt critical public health functions, from disease surveillance to laboratory testing and clinical guidance.
