Global Healthy Living Foundation Report Warns That Complex Vaccine Guidelines May Be Slowing Adult Immunization Rates

UPPER NYACK, N.Y., March 28, 2025–(BUSINESS WIRE)–A new report, “Enhancing Adult Vaccine Uptake: Challenges in Shared Clinical Decision Making and Risk-Based Recommendations,” released by the Global Healthy Living Foundation (GHLF), investigates how certain CDC Advisory Committee on Immunization Practices (ACIP) vaccine policies—particularly Shared Clinical Decision Making (SCDM) and risk-based recommendations—are contributing to lower vaccination rates among adults, especially in underserved communities.

While intended to foster individualized care and thoughtful patient-provider dialogue, these policies often lead to ambiguity for both patients and health care professionals. The report details how misalignment with FDA labeling, insurance coverage confusion, and complex eligibility assessments can create real-world barriers that reduces vaccine uptake.

“Our goal with this report is not to dismiss the intent behind SCDM and risk-based guidance but to examine how these approaches work in real-world clinical settings,” said Robert Popovian, PharmD, MS, Founder of Conquest Advisors and GHLF’s Chief Science Policy Officer, who authored the report. “Unfortunately, the data show that these policies can create unintended barriers to immunization, particularly when providers lack full access to patient histories or are burdened by unclear reimbursement protocols. When policies lack clarity, the burden falls on providers and patients to navigate a confusing system—often with serious consequences. This report highlights how complexity in vaccine recommendations can delay or prevent immunization entirely.”

Key Findings

• Significant Drop in Uptake After SCDM: The PCV13 pneumococcal vaccine saw uptake decline from over 70% to under 60% following SCDM implementation, including among vulnerable and immunocompromised individuals.

• Stark Disparity Between Routine and SCDM Guidance: Only 11.9% of eligible adolescents received the Meningitis B vaccine under SCDM, compared to 60.8% of the same group who received the quadrivalent meningococcal vaccine (ACWY), which has a routine recommendation from ACIP.

• Equity Gaps Prompt Policy Reversal: The CDC’s SCDM policy for Hepatitis B was modified in 2022 after evidence showed suboptimal uptake among older adults and racial minorities—highlighting the failure of risk-based strategies to reach vulnerable groups.

• Provider Burden in Real-World Settings: Many pharmacists and non-primary care physicians lack access to full medical histories, making it difficult to apply complex criteria or verify patient risk—a critical issue given that nearly 90% of adult vaccines are now administered in pharmacies.