NEJM Interviews NEJM Interview: Douglas Opel on the importance of clinician–parent communication amid changes to the childhood vaccine schedule.
Mar 25, 2026
Douglas Opel, a pediatrician and vaccine communication expert, explains recent federal changes that reclassify several childhood vaccines. He unpacks what shared decision-making means and why the shift surprised many. He discusses professional responses and practical communication strategies clinicians can use to maintain trust and clarity.
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Federal Reclassification Of Childhood Vaccines
- HHS reclassified several childhood vaccines from routine recommendation to shared decision-making.
- Hepatitis A, rotavirus, meningococcal, and influenza joined hepatitis B and COVID-19 under this designation this administration applied.
Shared Decision Making Can Mean Optional Vaccination
- Shared decision-making here was framed to treat vaccinating and not vaccinating as both reasonable options.
- Opel argues the definition's emphasis on exploring values effectively reclassifies these vaccines as optional despite no new safety or efficacy data.
Schedule Changes Lack Scientific Justification
- HHS provided no new scientific data or usual procedural justification for the schedule changes.
- Opel says absence of accompanying evidence explains why many pediatric clinicians struggle to adopt the new recommendations.