Provider Liability Concerns with Changes to the CDC Childhood Immunization Schedule

Recently, many have questioned how the Center for Disease Control and Prevention’s (CDC) January 5, 2026, announcement of changes to its immunization schedule might increase healthcare provider exposure to liability if they make recommendations for previously routinely administered vaccines that CDC now lists as “Recommended for Certain High-Risk Groups or Populations” (e.g., meningococcal ACWY or hepatitis B vaccines) or “Immunizations Based on Shared Clinical Decision-Making” (e.g., seasonal influenza and rotavirus).

AIM has been part of recent conversations with legal scholars who have provided reassurance that the risk of liability remains unchanged.

Here’s a brief summary of the talking points from “Navigating Conflicting Vaccination Recommendations: Guidance for Clinicians,” published in JAMA on January 13, 2026, and authored by attorney Michelle Mello, former CDC director Dr. Rochelle Walensky, Director of CIDRAP, Dr. Michael Osterholm, PhD, MPH, et. al.:

• Informed consent has always been required for vaccines, and parents have always been free to refuse vaccines and accept whatever consequences come with that decision
• Clinicians can still use a presumptive approach to vaccines, but should be prepared with an explanation as to why they continue to recommend vaccines
• Plaintiffs attempting to file suit against a provider for recommending a vaccine that is no longer “routinely” recommended would have to prove negligence, which would likely be difficult
• When there are differing recommendations by established authoritative bodies (e.g., CDC and the American Academy of Pediatrics (AAP)), adherence to either is considered reasonable. If a large number of clinicians follow each recommendation, both would meet the legal standard of care
• The standard of care does not change merely because an entity made a new recommendation

A few things to note about vaccine coverage concerns:

• America’s Health Insurance Plans (AHIP) and BlueCross BlueShield Association have both guaranteed coverage through 2026. Note that UnitedHealthcare is not a member of AHIP and has not released a statement
• Vaccines included in the Vaccines for Children (VFC) Program do not change unless there is an ACIP resolution to modify coverage. The CDC’s communications so far have indicated that all previously recommended vaccines will remain available through the VFC program. If vaccines are removed from the VFC program, state Medicaid programs would need to submit a waiver to the Centers for Medicare and Medicaid Services (CMS) to provide the vaccine, and the state would need to cover the cost
• Similar to childhood vaccines, if/when adult immunization recommendations change and if state Medicaid programs decide to continue coverage, the state Medicaid plan will need to file a waiver with CMS and cover the cost of the vaccines
• Medicare Part B covers pneumococcal, hepatitis B, influenza, and COVID-19 vaccinations with no cost-sharing and independently of ACIP recommendations, so those vaccines are less likely to be affected by cost-sharing
• Medicare Part D DOES base no-cost coverage on ACIP recommendations, so shingles, RSV, Tdap, hepatitis A, and MMR vaccines may incur cost sharing if adult vaccine recommendations are altered similarly to the childhood schedule.

The Bottom Line:

• There is agreement among some legal scholars that clinicians are at no greater risk of successful litigation now than they were before January 5, 2026; however, baseless suits and complaints to licensing boards could still be brought, and those can be stressful and expensive, even if not ultimately successful
• Vaccine access through VFC and commercial insurance appears to be maintained (but at risk), but check with large payers like UnitedHealthCare, which has not committed to covering vaccines not currently recommended by ACIP without cost sharing. VFC changes should not be made without an ACIP resolution. The next scheduled ACIP meeting is February 25-26, 2026, but AAP and partners that have filed suit against the U.S. Department of Health and Human Services (HHS) have a hearing for an injunction against future meetings of ACIP and the changes to the CDC’s childhood immunization schedule on February 13, 2026
• If/when the adult immunization schedules are impacted, vaccines covered under Medicare Part D (shingles, RSV, Tdap, hepatitis A, and MMR) may have cost sharing, and vaccines currently covered by Medicaid may need to be funded by states with a waiver filed with CMS
• States may want to consider exploring alternative purchasing and funding options for some vaccines if vaccines are removed from VFC contracts or coverage through Medicare/Medicaid becomes more costly for patients