HHS Seeks Public Input on How Federal Vaccine Recommendations Should Be Made

The U.S. Department of Health and Human Services is asking the public to weigh in on how federal vaccine recommendations are categorized, evaluated and communicated—a review that could eventually affect how patients, parents and healthcare providers interpret federal vaccination guidance.

HHS published a formal Request for Information in the Federal Register on August 24, 2026. The notice asks whether the government’s existing vaccine recommendation categories are adequate and whether additional or different categories should be adopted. Public comments must be received by September 20, 2026, to be assured consideration.

The review follows President Donald Trump’s August 10 executive order, “Delivering Gold Standard Childhood Vaccine Recommendations for Americans,” and supports the work of the HHS Task Force on Safer Childhood Vaccines. The order directs HHS to reassess aspects of federal childhood vaccine recommendations, including timing and sequencing.

HHS Is Reviewing Three Types of Vaccine Recommendations

Federal vaccine guidance currently uses three broad recommendation categories: routine or universal recommendations, risk-based recommendations, and recommendations based on shared clinical decision-making.

Routine recommendations generally establish vaccination as the default for people who meet the applicable age or eligibility criteria, absent contraindications. Risk-based recommendations target people with particular medical, occupational, behavioral or other factors that increase their risk.

Shared clinical decision-making, also called individual-based decision-making, works differently. Rather than establishing the same recommendation for everyone in a particular group, it calls for patients or parents and healthcare providers to consider individual circumstances when deciding whether vaccination is appropriate.

HHS is now asking whether those three categories are “adequate, clear, and well understood” and whether the government should create additional or different categories.

The Review Goes Beyond Simply Renaming Categories

The request is broader than a terminology change.

HHS wants feedback on the type and strength of scientific evidence that should support federal vaccine recommendations, including how officials should proceed when randomized controlled trial evidence is limited or unavailable. The agency is also seeking views on individual autonomy, informed consent and religious freedom, as well as the legal and programmatic consequences that can follow from placing a vaccine into a particular recommendation category.

Another issue is communication. HHS says it wants input on how vaccine recommendations can be communicated in ways that maintain public trust and help people understand what a recommendation actually means.

That distinction could be important because federal vaccine recommendations can influence far more than what appears on a CDC schedule.

Recommendation Categories Can Have Real-World Consequences

How a vaccine is categorized can potentially affect the way patients, clinicians, insurers and government programs approach vaccination.

For example, HHS has previously said that vaccines recommended through individual-based decision-making can remain covered through programs including Medicare, Medicaid, the Children’s Health Insurance Program and the Vaccines for Children Program, as well as insurance plans regulated by the Affordable Care Act.

The current Request for Information specifically asks commenters to consider the “downstream legal and programmatic consequences” associated with recommendation categories.

That makes the review relevant not only to parents of young children but also to physicians, pharmacists, insurers, public-health agencies and adults who rely on federal immunization recommendations when discussing vaccines with healthcare providers.

Individual Decision-Making Has Already Been Used for Some Vaccines

The concept is not entirely new.

In October 2025, the CDC immunization schedules adopted individual-based decision-making for COVID-19 vaccination. HHS described that approach as considering patient-specific characteristics, disease risk, vaccine characteristics and available evidence through a discussion with a healthcare provider.

The approach was also adopted in December 2025 for hepatitis B vaccination of infants born to women who test negative for hepatitis B. HHS said parents and healthcare providers should consider vaccine benefits, vaccine risks and infection risks when making that decision.

The new HHS review asks, in part, whether shared clinical decision-making works effectively in practice or whether the framework should be modified.

The Review Follows a Broader Change in Federal Childhood Vaccine Policy

The August 10 executive order established three categories of what the administration calls its “Gold Standard Childhood Vaccine Recommendations.” It also directs federal agencies to review those recommendations and take appropriate steps to advance them within their legal authority.

The order further directs the HHS Task Force on Safer Childhood Vaccines to examine issues including vaccine timing and sequencing, safety monitoring and the risk-benefit profiles of childhood vaccines.

The task force itself was reinstated by HHS in August 2025 and includes senior leadership from the National Institutes of Health, Food and Drug Administration and Centers for Disease Control and Prevention.

Importantly, the current Federal Register notice is a request for information. It seeks public input that HHS says will inform its consideration of the recommendation framework; it is not itself a final rule establishing an entirely new federal vaccine recommendation system.

How to Submit a Public Comment

People who want their views considered can submit written comments using Docket No. HHS-OS-2026-0332 through the federal rulemaking portal.

Submit or view comments at Regulations.gov

Comments can also be mailed to Cynthia Goss, 200 Independence Ave. SW, Washington, DC 20201. HHS says comments must be received by September 20, 2026, to be assured consideration.

One detail commenters should know before submitting: the Federal Register notice says submissions will be posted publicly without change, including personal information provided as part of the comment.

For patients wondering whether they personally should receive a particular vaccine, the public-comment process is separate from individualized medical guidance. Those decisions should be discussed with an appropriate healthcare professional based on current recommendations and the patient’s circumstances.