The vaccine establishment went into full panic mode last week when CNN reported that HHS was planning to align the U.S. childhood vaccine schedule with Denmark’s. The headlines screamed: Denmark recommends only 11 vaccine doses targeting 10 diseases; the U.S. recommends 72 doses targeting 18 diseases. Scott Gottlieb warned we’d need to “build new pediatric hospitals.” The AAP predicted “devastating results.” Paul Offit accused HHS of wanting children to suffer.

But CNN missed half the story.

The next day, the Washington Post reported what CNN had overlooked: “Unlike Denmark, the U.S. is planning a more limited approach for recommending vaccines to children known as shared clinical decision-making, which has not been reported.”
That’s the buried lede. The plan isn’t just about fewer vaccines, it’s about moving childhood vaccines to “shared clinical decision-making” (SCDM), shifting from mandatory universal recommendations to individualized parent-physician decisions.

That’s what this piece is about. Not the Denmark comparison (though it’s worth noting that Denmark has better childhood health outcomes than we do). The real story is SCDM, what it actually means, what it changes, and why the vaccine establishment is so terrified of it.
Let me explain what actually changes, and what doesn’t, if childhood vaccines move to SCDM.
But first, let’s talk about why this discussion is happening at all.

Why SCDM, Why Now?

COVID changed everything.
For three years, Americans were told the COVID vaccines were “safe and effective,” would “stop transmission,” and that anyone who questioned the narrative was an anti-science conspiracy theorist. The vaccine establishment—CDC, FDA, AAP, the whole alphabet soup—spoke with one voice: Trust us. Don’t ask questions. Just comply.

Then the truth started leaking out. The vaccines didn’t stop transmission—Pfizer never even tested for it. The “95% effective” claim was relative risk reduction, not absolute risk reduction. Exposed, it turned out to be more like 0.85 percent effective. Myocarditis in young men wasn’t “rare”—it was systematically undercounted. Natural immunity was dismissed as irrelevant, then quietly acknowledged. The six-foot rule? Made up. Exposed as not based on science. Masks for toddlers? No evidence.

All of this only came to the public’s attention because, and only because, of the courageous doctors and scientists who called it out during the pandemic, like Piere Kory, MD (lead plaintiff in Kory v. Bonta, one of my Covid misinformation cases presently pending before the Supreme Court, Richard Eggleson and Thomas Siler, plaintiffs in another one of my Covid misinformation First Amendment cases also pending before the Supreme Court,. And to those, I must add the person I would call “doctor zero” (like in patient zero in mass infection cases), Simone Gold (double trouble because she’s both a doctor and a lawyer).

The COVID debacle might not have created the public’s district of public health authorities, but it surely reinforced that the public’s mistrust was justified.

The lying didn’t start with COVID, but it did reveal for all to see how they operate. More to the point, unlike mandatory school vaccination, COVID restrictions and mandates hit everyone, not just parents with school aged kids in the states without a religious exemption.

The Foundational Lie: “Vaccines Conquered Infectious Disease”

The vaccine establishment’s origin story goes like this: Before vaccines, children died in droves from infectious diseases. Then vaccines came along and saved us all. Anyone who questions this narrative wants children to die.
It’s a powerful story. It’s also mostly false.

In September 2025, Senator Maria Cantwell waved a chart at HHS Secretary Robert Kennedy claiming vaccines had saved “154 million lives” by nearly eradicating infectious disease mortality. Kennedy’s response should be required viewing for every American.
The data tells a different story. A CDC-funded study from Johns Hopkins—Guyer et al., published in Pediatrics in 2000—analyzed 100 years of U.S. mortality data. The conclusion: nearly all the mortality reductions from infectious diseases occurred BEFORE vaccines were introduced.

The numbers are stark:

Measles: Deaths fell from 13,000 annually in 1900 to a few hundred by 1960. The vaccine wasn’t introduced until 1963—three years later. A 98% reduction before a single dose was administered.

Pertussis (whooping cough): The largest mortality drop happened before the vaccine.

Polio: Mortality fell 90% between 1923 and 1955, before the Salk vaccine.

Tuberculosis: Deaths virtually eliminated in the U.S. without mass vaccination.

Scarlet fever: Mortality plummeted along the same timeline. No vaccine ever developed.

What actually caused these dramatic declines?

Clean water. Sanitation. Refrigeration. Better nutrition. Chlorination. Flush toilets. The mundane infrastructure of modern civilization—not pharmaceutical products.

McKinlay and McKinlay’s landmark 1977 study estimated that medical interventions—including vaccines AND antibiotics—accounted for less than 3.5% of the total mortality decline. Three and a half percent.
Yet the vaccine establishment has spent decades taking credit for the other 96.5%. That’s not science. That’s marketing.

So, What Does SCDM Actually Threaten?

Not children’s health. The data proves that.

What SCDM threatens is the mythology—the carefully constructed narrative that vaccines are responsible for modern civilization’s triumph over infectious disease, and therefore must never be questioned.

If parents can have real informed consent conversations with their doctors—if they can weigh actual risks and benefits for their individual child—the whole edifice starts to crumble. Not because parents will stop vaccinating (they won’t, as we’ll see), but because they’ll start asking questions. And the vaccine establishment has never had good answers.

That’s what the hysteria is really about. Now let’s look at what SCDM actually does and doesn’t change.

Insurance Coverage: No Change

The loudest claim is that SCDM vaccines won’t be covered by insurance. This is false, and the people saying it know it’s false.

Here’s the CDC’s own FAQ:
“This coverage requirement includes shared clinical decision-making recommendations when they have been adopted by CDC and are listed on the immunization schedules.”
https://www.cdc.gov/acip/vaccine-recommendations/shared-clinical-decision-making.html

KFF confirms:
“The insurance requirement extends to vaccines with ‘individual decision-making’ (also known as ‘shared clinical decision-making’) recommendations as well, which are those ‘individually based and informed by a decision process between the health care provider and the patient or parent/guardian’.”
https://www.kff.org/other-health/recent-changes-in-federal-vaccine-recommendations-whats-the-impact-on-insurance-coverage/

The Avalere Guide to Vaccine Coverage Policies states that payers must cover without cost-sharing “all on-schedule products with routine and SCDM.”
https://advisory.avalerehealth.com/wp-content/uploads/2023/10/Guide-to-Vaccine-Coverage-Policies.pdf

CHOP’s Vaccine Education Center:
“For children, the Vaccines for Children (VFC) program is designed to ensure payment for all vaccines on the childhood immunization schedule, including those that are recommended with SCDM. For adults, most private insurance plans pay for routinely recommended vaccines as well as those with SCDM, under Affordable Care Act (ACA) regulations.”
https://www.chop.edu/vaccine-update-healthcare-professionals/newsletter/shared-clinical-decision-making-what-it-and-why-it-matters

We already have SCDM vaccines. MenB for adolescents 16-23. HPV for adults 27-45. Hepatitis B for adults 60+ with diabetes. All covered. The sky hasn’t fallen.

The insurance argument is simply wrong.

Manufacturer Immunity: Genuinely Unclear

What about liability? Does SCDM affect the manufacturer immunity created by the 1986 National Childhood Vaccine Injury Act?
This is where it gets legally interesting and frankly murky.

The liability shield in 42 U.S.C. § 300aa-22(b)(1) applies to vaccines covered by the Vaccine Injury Compensation Program. For a vaccine to be covered, 42 U.S.C. § 300aa-14 requires that CDC recommend it for “routine administration to children.” The Vaccine Injury Table, maintained by the Secretary, lists covered vaccines.

The untested legal question: Does “routinely recommended for children” include Category B/SCDM recommendations, or only Category A routine recommendations?

Current SCDM vaccines like MenB remain on the VICP table—but they also have routine recommendations for high-risk populations. A vaccine that went to pure SCDM for everyone, with no routine recommendation for any childhood population, would present a novel question.
The statute doesn’t define “routine administration.” No court has interpreted whether SCDM qualifies. If it doesn’t, vaccines moved to pure SCDM might fall outside VICP coverage—and outside the liability shield.

It is no secret that in his past, pre-government days, Secretary Kennedy repeatedly complained about vaccine manufacturer’s immunity and called for its end. The question is whether he has administrative pathways to do so, or whether it requires congressional action.

The cleanest path would be legislation—Representative Gosar’s “End the Vaccine Carveout Act” (H.R. 9828) would directly repeal the immunity provisions in § 300aa-22(b)(1). But Congress is Congress, enough said.

Administratively, the Secretary could potentially:
– Change CDC recommendations to pure SCDM, creating the legal ambiguity described above
– Attempt to remove vaccines from the VICP table through rulemaking under his authority to “modify” the table (42 U.S.C. § 300aa-14(c))

Either path would trigger immediate litigation. Post-Loper Bright, courts would most likely interpret “routine administration” de novo, giving no deference to agency interpretation. And the Major Questions Doctrine would loom over any attempt to strip immunity from a multi-billion-dollar market.

But “would face litigation” isn’t the same as “would lose.”

This is genuinely unsettled legal territory. The uncertainty itself may be significant; manufacturers facing years of litigation over their liability status is not nothing.

More importantly, after 39 years of living with manufacturer immunity for the products which seem to have played a significant role in the dramatic deterioration in the health of American children (my view), it is well past time we have this serious discussion about whether this whole immunity thing is doing American children more harm than good.

And Let’s Put the Immunity Question into World Perspective

Care to guess how many other countries in the world give manufacturers immunity from lawsuits for vaccine injury?
You got it: NONE, ZERO.

No other country gives immunity from civil liability and prohibits civil tort suits against vaccine manufactures (with one exception which I’ll discuss). Many countries have administrative remedies in addition to civil tort suits, but the U.S. is the only country in the world that has a civil liability system that prohibits the vaccine injured from accessing it. (New Zealand, like the US, forces the vaccine injured into an administrative process, but that is because that country has done away with civil tort remedies for all injuries.)

So, circling back to the main question:

Unlike the insurance question, which is clearly settled in favor of SCDM coverage, the immunity question is open. Moving childhood vaccines to SCDM might create a pathway to challenge manufacturer immunity. However, it’s untested, and anyone who tells you they know the answer is guessing.

State Mandates: No Direct Federal Effect

The federal government doesn’t mandate vaccines. States do, under 10th Amendment police powers. ACIP recommends; states decide whether to require.

Forty-six states have religious exemptions. Only California, Connecticut, Maine, and New York have medical-only exemptions. And California has already decoupled from ACIP through AB 144.

So, in the vast majority of states, parents who want to decline vaccines for their kids, already can. Moving from Category A to Category B changes nothing for them.

The International Evidence: We’re Not Just Talking About Denmark

Critics dismiss comparisons to Denmark with the repartee “We’re not Denmark, a homogeneous country of 6 million people.” Fair enough. So, let’s look at the full picture.

A 2024 study in Vaccines (Farina et al.) systematically mapped childhood vaccination policies across all 30 EU/EEA countries. The findings are striking:

Countries with NO mandatory childhood vaccinations—recommendation-only (17 countries): Austria, Cyprus, Denmark, Estonia, Finland, Greece, Iceland, Ireland, Liechtenstein, Lithuania, Luxembourg, Netherlands, Norway, Portugal, Romania, Spain, Sweden

In these countries, all childhood vaccines are offered and covered, but parents decide. That’s functionally identical to what ACIP calls “shared clinical decision-making.” But there’s a critical difference: these European nations have full sovereign authority to mandate vaccines—and chose not to. Per the above, in the U.S., the federal government cannot mandate vaccines; under the 10th Amendment, that power belongs exclusively to states. So, when ACIP “recommends,” it’s the only a recommendation to the states and has no direct force, unless state law couples their mandates to CDC/ACIP recommendations. When Denmark or Spain “recommends,” it’s a deliberate policy choice by governments that could mandate but decided parental choice works better.

Countries with LIMITED mandates—one to three vaccines mandatory, rest recommendation-only (3 countries):
– Belgium: Only polio mandatory; all other vaccines parental choice
– Germany: Only measles mandatory; all other vaccines parental choice
– Malta: Only tetanus, diphtheria, and polio mandatory; all other vaccines parental choice

Countries with COMPREHENSIVE mandates—most vaccines mandatory (10 countries): Bulgaria, Croatia, Czech Republic, France, Hungary, Italy, Latvia, Poland, Slovakia, Slovenia

So, even among the 13 countries with “at least one mandate,” three of them—Belgium, Germany, and Malta—operate essentially on shared clinical decision-making for the vast majority of their vaccine schedule. Germany, Europe’s largest economy with 84 million people, mandates only measles and recommends everything else.

That means 20 out of 30 EU/EEA countries either have no mandates at all or operate primarily on a recommendation basis with only limited mandates for specific high-concern vaccines. Only 10 countries have comprehensive mandate systems like the U.S. model.

Add the UK (67 million, recommendation-only with 92% DTP coverage) and Japan (125 million, abolished mandates in 1994, 98% coverage), and the picture is clear: the majority of the developed world trusts parents with vaccine decisions and achieves excellent coverage.

The international data demolishes the CDC’s premise that eliminating parental choice is necessary for public health. Countries respecting medical freedom have lower infant mortality, less chronic disease, and comparable vaccination rates. American exceptionalism has produced exceptionally sick children.

AND HERE ARE TWO FACTS THAT SHOULD STOP EVERY VACCINE MANDATE DEFENDER IN THEIR TRACKS:

Russia’s federal law explicitly allows parents to refuse childhood vaccinations. No exemption required. Just say no.

China’s “mandatory” vaccination system? No penalties for refusal. The decision-making process is required; the actual vaccination isn’t.

Meanwhile, in New York and California, parents have zero choice. Vaccinate or your child doesn’t attend school. No religious exemption. No philosophical exemption.

Let that sink in:

On childhood vaccine choice, Vladimir Putin’s Russia and Xi Jinping’s China offer parents more freedom than New York or California.
In those states (and in Connecticut and Maine) The “land of the free” has become the land of “inject your kids with whatever Pfizer is selling this year or we’ll lock them out of kindergarten; if something goes wrong, too bad, you can’t sue.”

To me, that sounds like a criminal protection racket. One of these days, I might just do something to push back.

Vaccination Rates: No Change

Here’s the data point that demolishes the hysteria: Massachusetts has a religious exemption and a 95%+ kindergarten vaccination rate. New Jersey, Virginia, Rhode Island—same story. Religious exemptions available, rates above 95%.

If SCDM would cause parents to stop vaccinating, we’d see it in these states. We don’t.
Parents in states where they can already opt out are choosing to vaccinate anyway. Clearly, the mandates aren’t driving compliance; Parental choice is.

So why not formalize what’s already happening? If informed consent doesn’t reduce vaccination rates, why fight it so hard?

What SCDM Actually Changes

If insurance stays, immunity is uncertain but probably unchanged, mandates aren’t federally controlled, and vaccination rates don’t change—what’s the point?

Three things matter:
First, the clinical encounter changes. Doctors must actually discuss risks and benefits with each patient. Informed consent becomes real, not theater.

Second, physician protection. Doctors who individualize care—who look at a particular child’s history and make a judgment call—can no longer be hauled before medical boards for “deviating from the standard of care.” The standard of care becomes individualized assessment.

Third, practice coercion weakens. “Vaccinate or leave our practice” becomes harder to justify when ACIP itself says it’s an individual decision.

These aren’t nothing. They’re a step in the right direction—treating vaccines like every other medical intervention, subject to informed consent and professional judgment.

The Hepatitis B Proof of Concept

We just watched this play out in real time. On December 5, 2025, ACIP voted 8-3 to recommend “individual decision-making” for the hepatitis B birth dose in low-risk infants. That’s 99.6% of U.S. births—infants born to mothers who test negative for hepatitis B.

The response from AAP was immediate and hysterical. President Susan Kressly called it “irresponsible and purposely misleading,” warning of “thousands” of infections and “devastating results.” Committee members predicted “children will die preventable deaths” and “liver cancers.”

Paul Offit told CNN there would be a “four-fold increase” in infections and claimed 30,000 children under 10 contracted hepatitis B annually before universal vaccination.

The actual CDC data? Approximately 400 cases annually in that age group. Offit overstated by 75-fold.
Meanwhile, the UK and Canada already delay the birth dose. No infection surge. No liver cancer epidemic. No devastation.

This is what SCDM panic looks like: fabricated statistics, invented catastrophes, and complete disregard for what other developed countries do safely.

The Real Fear

They’re not afraid SCDM will change vaccination rates. The data proves it won’t.
They’re afraid of losing the narrative of compulsion. That “CDC and AAP say so, shut up and comply.” The authority to punish dissenting physicians. The power to label questioning parents as “anti-vax.”

SCDM treats vaccines like the medicines they are. And apparently, that’s intolerable to the vaccine mafia.

So, it seems that all the hysteria isn’t about protecting children; it’s about protecting a system that doesn’t tolerate questions.

Rick Jaffe, Esq. (more to come soon I hope.)

Disclosure: As some may know, I am counsel in Thomas v. Monarez (D.D.C., Case No. 1:25-cv-02685), a lawsuit challenging the CDC’s childhood vaccine schedule and seeking reclassification of all childhood vaccines to shared clinical decision-making. So yes, I have a stake in this debate.