Shared clinical decision-making, also known as individual-based decision-making, is a key term used in several recent votes by the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP). Use this messaging to explain what shared clinical decision-making is, and the role it plays in your community members’ decisions about vaccines.
What is Shared Clinical Decision-Making?
- Shared clinical decision-making, also known as individual-based decision-making, is a conversation between a patient and a healthcare professional to help inform treatment plans. Primary care physicians, pharmacists, specialists, physician assistants, registered nurses, and nurse practitioners can engage in shared clinical decision-making.
How is Shared Clinical Decision-Making Different From a Universal Vaccine Recommendation?
- In the United States, most vaccines are universally recommended because the evidence shows they benefit nearly everyone in a specific group. Historically, shared clinical decision-making has been recommended when the evidence** about a vaccine’s effectiveness is not definitive enough to recommend it for everyone. A shared clinical decision-making recommendation is intended to support healthcare professionals and patients in determining whether a patient should receive a vaccine based on their individual health circumstances, rather than their personal preferences.
- All vaccines available to the public have been thoroughly tested and continuously monitored by scientists and health experts. A shared clinical decision-making recommendation is an extra measure to ensure individuals understand what the vaccine will offer them, specifically. Shared clinical decision-making does not indicate any uncertainty about the vaccine’s safety.
**Please note: The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) most recently recommended shared clinical decision-making for the 2025-26 COVID-19 vaccine and birth dose of the Hep B vaccine, despite a lack of evidence for these recommendations. Learn more about accessing the 2025-26 COVID-19 vaccine and birth dose of the Hep B vaccine.
Understanding Shared Clinical Decision-Making vs. Informed Consent
- Shared clinical decision-making is not the same as informed consent. Healthcare professionals are legally and ethically obligated to ensure informed consent is part of their patients’ care. This means all individuals must receive information about the benefits, risks, and alternatives of any health intervention, including vaccination, and voluntarily agree to move forward with the intervention.
- Healthcare professionals confirm a patient’s informed consent via a signed document before administering any and all vaccines, regardless of whether shared clinical decision-making is recommended.
What Does Shared Clinical Decision-Making Look Like in Practice?
- Shared clinical decision-making can often occur at the vaccination appointment. It does not typically require booking an additional appointment. If you’re pregnant and making vaccine decisions for your baby, you can have conversations about key vaccines with a healthcare professional at any point during the lead-up to your baby’s birth.
- Not all states are following federal recommendations about shared clinical decision-making. If you live in one of these states, shared clinical decision-making may not be recommended to get certain vaccines. For more information, talk to a local healthcare professional or check with your local health department.
- Note to public health professionals: Check ASTHO’s legislation tracker to understand if your state has enacted or introduced legislation that may impact whether certain vaccines will require shared clinical decision-making, and communicate this information accordingly with your community members.
- If you have insurance, shared clinical decision-making should not impact whether your vaccine is covered. People should check with their insurance provider if they have any questions about coverage. For those who do not have insurance, free or very low-cost options for vaccines with a shared clinical decision-making recommendation may be available, but they can be difficult to find. People should talk to a local pharmacist or a healthcare professional, or check with their local health department about their options.
Best Practices: Communicating About Shared Clinical Decision-Making
Here are some suggestions and questions to consider when communicating about shared clinical decision-making recommendations.
Understand your audience.
- The more specific you can get about your audience, the more effective you can be in providing useful, relevant information. Answer the following:
- Which demographics have the highest or lowest vaccination rates? What messages and/or support do they need?
- What do I know about my community’s feelings about vaccines like Hep B for babies and COVID-19? How have perceptions changed in recent years and in relation to other public health issues?
- Where can I effectively communicate the various ways my community can protect themselves and others from severe respiratory illness this season?
Encourage people to make informed choices.
- By engaging without dictating, you can build trust in your community and increase their willingness to act on your message.
- Suggest that your community members seek guidance from their local health departments and healthcare professionals.
- Gather and share multiple and diverse trusted resources so people can find guidance that resonates with them.
- Balance positive, encouraging language with realistic, scientific language to clearly communicate the effectiveness of vaccines in preventing severe illness.
- Use consistent language. Vaccine, inoculation, and immunization have similar meanings. Select one to use throughout your communications.
Showcase the scientific rigor behind vaccines.
- In general, concerns about vaccines are often rooted in fear of the unknown and widely circulated false claims about the approval process for vaccines. Discuss the details of vaccine development to bust myths while addressing FAQs.
- Share resources about how vaccines were developed from research to distribution.
- Create plain language and visually interesting illustrations of clinical trial reports, vaccine success, or other data that support vaccines.
- Develop resources specifically for different age groups (e.g., older adults, college students, or parents with children of specific age groups) to explain what makes the vaccine safe.
Highlight vaccines’ ability to reduce disease spread and serious illness.
- Share plain language information on the safety and effectiveness of vaccines.
- Communicate about how vaccines have reduced deaths and severe illness since they became available.
- Use social media content that educates followers about the benefits of vaccination.
- Highlight personal stories of vaccination that have impacted your community’s health.
Additional Information About Shared Clinical Decision-Making
- For more information about shared clinical decision-making recommendations for visits, visit this resource from the Children’s Hospital of Philadelphia or talk to a healthcare professional.
