How docs expect the vaccine policy shift will reshape primary care in 2026
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[This] will cause confusion, and more time will be spent during the primary care visit explaining the importance of the vaccines than was required previously... This could take time away from other important health maintenance topics such as nutrition, behavior, safety, sleep, development.
—Jennifer Dwyer, MD, chief of primary care at Akron Children's
As shared decision-making expands across pediatric vaccines, clinicians are preparing for longer visits, rising disease risk, and a reframing of preventive care.
Below, docs discuss the top operational consequences—some of which are already underway.
What will now get overlooked in patient visits?
Jennifer Dwyer, MD, chief of primary care at Akron Children's, explains how visit flow will change, while warning about opportunity cost: “The CDC’s recent decision to change how they classify certain routine vaccines will cause confusion, and more time will be spent during the primary care visit explaining the importance of the vaccines than was required previously,” she says. “This could take time away from other important health maintenance topics such as nutrition, behavior, safety, sleep, development.”
Dr. Dwyer also expects disease patterns to shift, noting an expected increase in vaccine-preventable diseases. Training gaps are also a related concern. “Many physicians and APPs trained in the past 15-20 years have not seen these illnesses, because vaccines have been so successful in preventing them.”
She lists specific risks: “Hib, Prevnar, pertussis, rotavirus, RSV – these vaccines prevent illness, hospitalization, and death in infants and young toddlers.”
Amy Edwards, MD, assistant professor of pediatrics at the School of Medicine at Case Western Reserve University, says her primary concern is perception. “The biggest concern is the element of uncertainty that this introduces and the idea that there could be ‘risk’ with vaccination, which is simply not true.” She adds, “I would anticipate fewer families consenting to the full panel of vaccines, leaving more children vulnerable to disease, which will increase sick visits and outbreaks.”
On the precedent this sets, she is blunt. “It is clear that they are comfortable making changes without good science to support it, so I could see them doing it again.”
Increased administrative burdens
Dr. Dwyer highlights system-level effects. “Many insurance companies’ ACO programs track performance with vaccine administration, and payment tiers are based on success with vaccination rates.”
Dr. Edwards anticipates documentation strain more than workflow redesign. “It will likely require more documentation but it won’t change practice that much.”
Jason Schroder, DO, an anesthesiologist, described the change as part of a move away from standardized preventive care. “Recent HHS policy decisions will increase inefficiency in primary care and will replace evidence-based standardized objective measures of health with subjective debate,” says Dr. Schroder. “Thus, the HHS policy decision currently being made is not simply about vaccine mandates but is reflective of a greater trend away from federal standards for preventive medicine and a fragmentation of the delivery of healthcare services using data-driven standards of practice vs individualized consensus,” he adds.
Supply chain disruptions and liability exposure
Supply chain disruption ranks high among physician concerns.
Tyler B. Evans, MD, MS, MPH, AAHIVS, DTM&H, FIDSA, a public health expert and infectious disease specialist, highlighted how shared clinical decision-making, or SCDM, complicates vaccine stocking and availability, particularly for combination products. “The hepatitis B decision could affect the use and supply of combination and component vaccines—SCDM means that combination vaccines used at 2-month visits may not be usable, and there is inadequate supply of component vaccines.”
Dr. Evans said the policy rationale itself raises red flags. “The ‘data assessment’ lacks evidence to justify these changes and reads like an anti-vaccine argument against mandates.”
He further adds, “This will create confusion around school vaccine requirements in some states, as certain SCDM vaccines are included in school schedules.”
Liability exposure remains unclear. The Vaccine Injury Compensation Program (VICP) historically links eligibility to CDC-recommended vaccines. Physicians warn that ambiguity invites litigation. “It is unclear how the SCDM section will affect VICP; legal challenges from anti-vaccine lawyers are expected,” says Dr. Evans.
Rising infection rates
David Dodd, CEO of GeoVax, a U.S.-based biotech company developing MVA-platform vaccines for infectious diseases, said, “The key is ensuring that ‘optional’ is not misinterpreted as ‘unnecessary,’ especially for children, who may still derive meaningful benefit from vaccination.”
Nurse practitioner Octavia Schlueter, MSN, RN, CPNP, PMHS, says, “Moving several routine vaccines away from universal recommendations risks creating confusion for families and inconsistency across practices.”
Care should be individualized, but removing broad recommendations creates an unnecessary hurdle.
—Nurse practitioner Octavia Schlueter, MSN, RN, CPNP, PMHS
Schlueter remains clear on influenza. “I’m continuing to recommend annual influenza vaccination for children, because flu is unpredictable and can be severe.”
For primary care, 2026 will demand stronger communication skills, deeper disease recognition, and deliberate protection of time for core pediatric care. The work will shift from delivery to defending the need for prevention.
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