Shared Clinical Decision-Making: Understanding the Recommendations from the CDC

The immunization schedules for 2020 recently published by the Center for Disease Control (CDC) four recommendations for vaccination based on shared clinical decision-making. These vaccines are:

  • Meningococcal B (MenB) vaccination for adolescents and young adults aged 16–23 years
  • Human papillomavirus (HPV) vaccination for adults aged 27–45 years
  • Pneumococcal conjugate vaccination (PCV13) for adults aged 65 years and older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant
  • Hepatitis B (HepB) vaccination for adults age 60 years and older with diabetes mellitus

But what is a shared clinical decision-making recommendation? According to the CDC, an immunization is given this designation when it is not indicated for all members of a population. The vaccination may benefit some members of the age or risk group, but broad vaccination of people in that group is unlikely to have population-level impacts. For shared clinical decision-making immunizations, patients and providers should discuss the potential benefits of vaccination and come to a personalized decision together.

Over the next month, we will examine the individual immunizations that the ACIP recommends for shared clinical decision-making.


The HPV vaccination is routinely recommended for ages 11 or 12 with catch-up recommendations for those not vaccinated on time.

In June 2019, the ACIP recommended shared clinical decision-making for HPV vaccination of adults aged 27–45 years. According to the ACIP Shared Clinical Decision-Making Recommendations, HPV acquisition generally occurs soon after first sexual activity. Vaccine effectiveness is lower in older age groups because of prior infections and lower risk of exposure (for example, among persons who are in a long-term, mutually monogamous sexual partnership). The ACIP recommended shared clinical decision-making rather than catch-up vaccination because most adults in this age group would have no or minimal benefits from vaccination. However, some individuals who are not already immune to HPV through vaccination or natural infection (e.g., a previously unvaccinated person who has never had sex) and who might be at risk for acquiring a new HPV infection in the future (e.g., plans to have sex with a new partner in the future) might benefit from vaccination.

A detailed explanation of the ACIP’s recommendation and considerations for shared clinical decision making regarding HPV vaccination of adults aged 27 through 45 years can be found on the HPV Updated Recommendations webpage.

Vaccine Pins, Buttons, and Stickers

Immunization Action Coalition is offering several options to display your support for immunizations. The “Vaccines Save Lives” pin is black enamel with gold lettering and is small enough to fit on a lapel. Prices range from $20 for a single pin to $5.25 each when ordering 15 or more.

Flu Vaccine Buttons and Stickers are available for staff and patients. Order buttons for staff to show that flu vaccine is available in your clinic. Buttons are sold in bags of 10 and range from $20 for one bag to $55 for 10 bags. Purchase stickers for patients to wear after receiving their flu shot. Stickers are sold in bundles of 100 and range from $23 for one bundle to $67 for 10 bundles. All prices include shipping.

Visit for these and other immunization related products.

Has your practice received all of your flu shipments for the 2014-2015 flu season?

Despite the fact that many practices have received their flu shipments later in the season this year compared to prior years, CPP members have received 94% of all flu doses they reserved with Sanofi Pasteur to date. Depending on the presentation and quantity ordered by your practice, you may have seen more or less than this average.

CPP members who are also Sanofi Pasteur Fluzone Partners (flu reservations were confirmed by March 31, 2014), had the following shipping guarantees in place for all presentations except high dose for this flu season:

20% of reserve flu order by August 31, 2014

75% of reserve flu order by September 30, 2014

100% of reserve flu order by October 31, 2014

If these shipping commitments were not met for your practice, you may be eligible for credits to use towards future purchases for the 2015-2016 flu season. Please reach out to your Sanofi Pasteur representative during 2015-2016 pre-book period (January-March 2015) if you feel you are eligible for these credits.

CPP Rebates are on the way to your practice!

Current CPP Members – Keep an eye out for your CPP rebate that will be coming by mail starting in October! Your rebate is based on vaccine purchases made between July 1, 2013 and June 30, 2014.

Please make sure you have both your Sanofi Pasteur and Merck direct accounts linked to the CPP program to maximize your annual rebate for the 2014-2015 fiscal period!  Soon, we will post some other helpful hints for maximizing your CPP rebate.   If you have any questions or need help determining how to get the most value from your CPP membership, please don’t hesitate to contact the CPP office at 614-722-2145 or

Where is the vaccine-related waste in your practice?

CPP has created a contest challenge to help you identify vaccine-related waste in your practice.  We know delivering quality healthcare is important to you. Vaccines are a major part of comprehensive primary care. A commitment to quality should lead to a healthy bottom line.

Take the CPP Challenge to see what you may be missing! Go to and enter for a chance to win an iPad Mini.

Small changes can make a big difference.

Did you know that there is a team of people looking out for you?

Let’s introduce you to the CPP team so you know who’s here to help you!

    • Rhonda Tallman is our Administrative Assistant and she will most likely be the one who answers the phone when you call.  Everything begins and ends with Rhonda!  She knows the right person or resource to get for you based on what you need.
    •  Jeannie Lilly provides administrative support and helps to make sure all pieces of the membership application are complete and accurate.  You may hear from Jeannie if we are verifying your contact information or need a W9 from you in order to issue your rebate!
    • Charlotte Brown is our Senior Vaccine Program Manager and she will work with you to get your direct accounts with the vendors linked to the CPP contract.  Charlotte is also a wealth of information when it comes to purchasing vaccines, understanding CPP program compliance and maximizing your vaccine discounts!
    • Jennifer Koerner is our Buying Group National Administrator so if you are stopping by the CPP booth at any of our conferences, Jenny will be the one you’ll see.  She develops the valuable programs and resources that help support our members’ vaccination efforts.  Jenny is responsible for the day to day operation of the CPP Buying Group.
    • Christina Drakulich is our Assistant Executive Director and heads up educational opportunities and initiatives with our local member practices located in Central Ohio.  He is also a great facilitator of practice administrators, enabling the sharing of best practices and development of resources unique to this group.
    • Finally, I am Frank Combs.  I’m not only the author of this blog but also the Executive Director of CPP.  I have the great honor of working with you and this committed team.  Together with our Board of primary care physicians we provide leadership and guidance to offer the most value to our members that we can and make sure that while you take care of your patients, we take care of you.

Thanks for giving us the opportunity to work for you!