The U.S. Department of Health and Human Services announced a Request for Information on August 21 seeking public input on whether the three categories currently used in federal vaccine recommendations are adequate, as RFK Jr. pursues changes to how childhood immunizations are categorized.
The RFI invites the public to comment on the three existing categories — routine (universal), risk-based, and shared clinical decision-making — and asks whether new or different categories should be adopted. The request proposes potential alternatives including “recommended, but not during infancy” or “recommended with qualification,” which could affect insurance coverage and vaccination uptake.
The effort advances President Trump’s August 10 Executive Order on childhood vaccine recommendations and supports the Task Force on Safer Childhood Vaccines. The RFI asks the public to consider factors such as the strength of scientific evidence, individual autonomy and informed consent, and communication practices needed to earn public trust in vaccine recommendations.
This move follows RFK Jr.’s earlier attempt to reshape the childhood vaccine schedule. In January 2026, HHS reduced the number of routinely recommended vaccines for all children from 17 to 11 diseases, moving vaccines for conditions including influenza, COVID-19, hepatitis A, and hepatitis B to either risk-based or shared clinical decision-making categories. When shared clinical decision-making applies, vaccines are no longer universally recommended but instead require discussion between parents and healthcare providers — a distinction that can affect whether insurers cover the full cost without cost-sharing.
A federal judge in Boston blocked those January changes in March 2026, ruling them “arbitrary and capricious” and finding that HHS had bypassed established procedures. The court’s decision temporarily invalidated the vaccine schedule overhaul and the appointment of new members to the CDC’s Advisory Committee on Immunization Practices. Despite that legal setback, the administration is pressing forward through this public comment process, which accepts input through September 20, 2026.
The RFI also addresses confusion about shared clinical decision-making in practice, noting that many healthcare providers and parents remain unclear about what the category means and how it affects vaccination recommendations. The document states that “transparent communication about negative or uncertain features of vaccines may reduce acceptance in the short term but increases trust in health authorities, whereas vague reassurance fails to increase acceptance and reduces trust.”
Sources
- HHS Press Office — announcement of Request for Information on vaccine recommendation categories and shared clinical decision-making, dated August 21, 2026
- Federal Register — full text of the RFI with proposed new vaccine categories and public comment period through September 20, 2026
- Axios — reporting on RFK Jr.’s proposed new vaccine categories and insurance coverage implications
- PBS NewsHour — reporting on the March 2026 federal court block of the January vaccine schedule changes
- CDC — announcement of the January 2026 childhood immunization schedule changes reducing vaccines from 17 to 11 diseases
