Why Safety-Net Hospitals Are Leading the Way on Childhood Vaccine Uptake

As sweeping changes to the childhood vaccine schedule create confusion among clinicians and families alike, a panel of experts is urging health systems to look to an unlikely model for guidance: the safety-net hospital.

Not long after HHS Secretary Robert F. Kennedy Jr removed and replaced each member of the CDC’s Advisory Committee on Immunization Practices (ACIP),¹ the new ACIP committee has dramatically restructured its vaccine recommendations in recent months, reducing the list of universally recommended childhood vaccines from 17 diseases to 11.² Several vaccines, including those for rotavirus, COVID-19, influenza, hepatitis A, and hepatitis B, have been moved into a new "shared clinical decision-making" category, suggesting they may not be necessary for everyone. The changes have left clinicians and families navigating more uncertainty than clarity.

To address the continued changes and associated confusion, The American Journal of Managed Care^® and its sister publications Contagion^®, Pharmacy Times^®, Contemporary Pediatrics^®, HCPLive^®, and Contemporary OB/GYN^® called upon several experts to join the “Clinical Insights: Childhood Vaccine Schedule Changes” roundtable and break down the recent changes to the federal vaccine schedule. John Parkinson, assistant managing editor of Contagion, moderated this discussion.

This roundtable features a panel of clinicians:

• Jacinda Abdul-Mutakabbir, PharmD, MPH, assistant professor of clinical pharmacy and antimicrobial resistance researcher at UC San Diego
• Sharon Nachman, MD, chief of pediatric infectious diseases, Stony Brook Children's Hospital
• Mary Koslap-Petraco, DNP, PNP-BC, CPNP, clinical assistant professor at Stony Brook University School of Nursing
• William Schaffner, MD, professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine

In this segment, Abdul-Mutakabbir described the ground-level reality in high-vulnerability communities, where 73% of participants in her outreach program had never heard of the respiratory syncytial virus vaccine. With many of these individuals serving as primary caregivers for grandchildren, the knowledge gap carries serious downstream consequences.

Yet the panel pointed to a compelling counter-narrative. A recent study found that safety-net hospitals, including Howard University, had driven Hepatitis B vaccine refusal rates to zero—across all racial, ethnic, and socioeconomic groups—through integrated, multidisciplinary education programs that begin prenatally.³ Koslap-Petraco and Nachman described nearly identical results in Suffolk County and New York City, respectively, crediting culturally concordant staff as trusted community messengers.

The full series can be viewed at Contagion Live.

References

1. Grossi G. RFK Jr sweeps clean CDC vaccine advisory panel, aiming to bolster public confidence. AJMC. June 9, 2025. Accessed March 13, 2026. https://www.ajmc.com/view/rfk-jr-sweeps-clean-cdc-vaccine-advisory-panel-aiming-to-bolster-public-confidence
2. Grossi G. CDC reduces US childhood immunization schedule from 17 to 11 diseases. AJMC. January 5, 2026. Accessed March 13, 2026. https://www.ajmc.com/view/cdc-reduces-us-childhood-immunization-schedule-from-17-to-11-diseases
3. Leslie TF, Delamater PL, Abutaleb AO, Yang YT. Institutional drivers of newborn hepatitis B vaccine disparities: a multi-hospital analysis in Washington, DC, 2017-2023. Hum Vaccin Immunother. 2026;22(1):2616952. doi:10.1080/21645515.2026.2616952