Surveys Find Significant Gaps in Public’s Understanding of Shared Decision-Making on Vaccinations

Two surveys conducted by the Annenberg Public Policy Center (APPC), in which Americans were asked about their understanding of new policies from federal health authorities, found significant gaps in survey takers’ understanding of shared decision-making when vaccinating their children.¹ The survey results’ release follows the CDC reducing the number of recommended childhood vaccinations from 17 to 11 and recommending parents participate in "shared decision-making” with providers prior to vaccinating their children.²

According to a news release from the APPC, the Advisory Committee on Immunization Practices (ACIP) defines shared clinical decision-making as individually based and informed by a decision process between a health care provider and the patient or parent/guardian.¹

What Do the Recent Updated CDC Guidelines Say?

The CDC and Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr revised the number of routine shots to reduce diseases prevented in US children from 17 to 11, according to a news release. This announcement was described as a significant shift in federal vaccine policy.²

This update, among others made by the CDC and HHS throughout 2025, was described by critics as a change that “compromise[s] decades of evidence-based clinical data on vaccine safety and efficacy.” These include reconstituting the ACIP—a key body that advises the CDC on the use of vaccines in the US—by removing and replacing 17 members of the committee and revising COVID-19 vaccination guidance by removing recommendations for routine immunization for healthy children and pregnant women.²

What Are the APPC Surveys, and What Did the Results Show?

The pair of nationally representative panel surveys were conducted in August and December 2025 and asked Americans about their understanding of this new policy from federal health authorities. In an August 2025 survey of 1699 US adults, APPC asked about Americans’ understanding of “shared decision-making,” and in the December 2025 follow-up survey, 1637 respondents were asked about their understanding of what a “health care provider” is in the context of shared decision-making.¹

The surveys determined significant gaps in Americans’ understanding of shared decision-making when it comes to getting vaccinated and having their babies and children vaccinated against potentially deadly illnesses.¹

The August 2025 survey determined that about 68% of respondents knew shared decision-making means they should review their or their child’s medical history with their health care provider prior to deciding whether a vaccine is right for them or their child. Alternatively, 22% believed that shared decision-making also meant that “taking the vaccine may not be a good idea for everyone but would benefit some.” About 20% also chose this regarding vaccination of children against COVID-19.¹

However, the survey showed that more than 2 in 5 people incorrectly defined shared decision-making as an individual’s decision to consult with their health care provider prior to taking a vaccine about whether it would be a good idea. In the surveys, 42% said this about taking a new vaccine, and 45% specifically said this about having a child vaccinated against COVID-19.¹

The APPC news release stated that ACIP’s shared clinical decision-making recommendations do not advise patients to receive vaccines without first consulting a health care provider; rather, they clarify that clinicians have discretion in determining which patients to discuss specific vaccinations with.

The survey findings further show that misunderstandings about this concept are common; approximately 25% of respondents believed shared decision-making means discussing vaccination choices with family members (23% for vaccines overall; 25% for children and the COVID-19 vaccine), even though family discussions are not included in ACIP’s shared clinical decision-making framework. Additionally, more than 1 in 10 respondents reported uncertainty about what shared decision-making entails, both for new vaccines (13%) and for COVID-19 vaccination in children (12%).¹

“Expecting parents to engage in shared decision-making with health care providers about routine, thoroughly studied childhood vaccinations suggests that the public health community has doubts about the safety and efficacy of these vaccines when it does not,” Patrick E. Jamieson, PhD, director of APPC’s Annenberg Health and Risk Communication Institute, said in the news release. “These vaccines have been part of the recommended childhood schedule because the benefits of taking them substantially outweigh the risks.”¹

The Pharmacist’s Role in Bridging Gaps in Knowledge

The surveys also found that only 33% of respondents would choose a pharmacist as their go-to health care professional for consultation purposes.¹ Now more than ever, it is imperative that pharmacists educate patients, parents, and caregivers on the benefits of vaccination as guidelines frequently change.

“The withdrawal of clear recommendations for these vaccines will sow confusion and raise doubts about their value and about whether people can access them. As a result, fewer children will be vaccinated with these vaccines and, potentially, others. There will ultimately be more disease and more outbreaks. Schools and communities will be less healthy places,” Jesse Goodman, MD, MPH, former chief scientist of the FDA and current director of COMPASS at Georgetown University, explained in a Pharmacy Times interview. “Casting doubt on and undermining trust in vaccines risks further undermining US preparedness and response capabilities. Reducing predictability of vaccine recommendations and use will disincentivize manufacturers from investing in vaccine innovation and maintaining the infrastructure needed to keep vaccines safe and available and to respond to future emergencies.”³

Goodman states that “the integrity of vaccine assessment and recommendation process and protection from future political interference” must be restored to improve conditions amid the health care landscape. In the meantime, pharmacists and other medical professionals have a responsibility to engage in full and open discussions when patients, caregivers, and parents express concerns and uncertainties.³

REFERENCES

1. CDC Urges ‘Shared Decision-Making’ on Some Childhood Vaccines; Many Unclear About What That Means. Annenberg Public Policy Center – University of Pennsylvania. January 5, 2026. Accessed January 7, 2026. https://www.annenbergpublicpolicycenter.org/cdc-urges-shared-decision-making-on-some-childhood-vaccines-many-unclear-about-what-that-means/

2. McGovern G. Federal Health Officials Scale Back Number of Recommended Vaccines for Children. Pharmacy Times. January 5, 2026. Accessed January 7, 2026. https://www.pharmacytimes.com/view/federal-health-officials-scale-back-number-of-recommended-vaccines-for-children

3. Goodman J. Former FDA Chief Scientist Jesse Goodman Breaks Down the Implications of Pediatric Vaccine Guideline Changes. Pharmacy Times. January 6, 2026. Accessed January 7, 2026. https://www.pharmacytimes.com/view/former-fda-chief-scientist-jesse-goodman-breaks-down-the-implications-of-pediatric-vaccine-guideline-changes