Let’s Talk About the COVID-19 Vaccine – by Dr. Brandon Greene, Chief of Pediatrics

This year’s COVID-19 vaccine recommendations have been finalized and for the first time in 30 years, we are seeing differences between what federal health officials, state health officials, and associations of healthcare professionals are saying. This can understandably create uncertainty, a feeling none of us want - especially when it comes to our health. 
One of my responsibilities as a healthcare provider (and one of Bassett Healthcare Network’s responsibilities as a whole) is to keep you, the patient, informed, so you can make medical choices for yourself or your child with confidence.

CDC Guidance: What’s Changed

The Centers for Disease Control and Prevention recently changed its COVID-19 vaccine recommendations for most people. In years past, the CDC has recommended vaccination for everyone six months and older, including pregnant people. The strong language of this universal recommendation, at a time when it was most needed, ensured broad and easy access to the vaccine for everyone and guaranteed that insurers would pay for it, which was important as healthcare workers across the country worked to get as many people protected in as short a timeframe as possible from a deadly disease. With the latest guidance from CDC, they’ve shifted their universal recommendation to what they call “individual-based decision-making.” This change has raised a lot of questions, especially when paired with statements from the CDC like “informed consent is back.”

The concern from many of us healthcare providers is that patients may inaccurately see the CDC’s softened language as a sign that the COVID-19 vaccine should be approached with an extra level of caution beyond other vaccines, or as questioning the credibility of healthcare professionals who might still recommend it based on the best available evidence, or worse, as a reason to write off vaccination altogether due to apprehension or confusion. 
Let’s unpack what this change means for you and your family.

Your Right to Make Decisions for Your Family Has Always Been There

Whether it be for a surgery, a new medication, or a vaccine, parents and patients have always had the final say in medical decisions for themselves and for their children. Suggesting that “informed consent is back” implies that it was gone. It wasn’t. As your healthcare team, we’re here to help you navigate the evidence, to share our experiences and expertise, and to answer your questions honestly and completely. It’s always been your job to make the final decision, and our job to ensure that decision is as informed as possible. That hasn’t changed—and it never will.

What “Individual-Based Decision-Making” Means

Individual-based decision-making means that there’s no “yes for everyone” recommendation for the vaccine. Instead, the decision depends on your child’s health situation, risk factors, and your family’s preferences. This hasn’t changed, either. There has never been a “yes for everyone” recommendation for any vaccine as there are always risks and benefits to weigh and individual circumstances that may tip the balance in one direction or another. Certain medical conditions like immunodeficiencies, cancers, and severe allergic reactions might tip it in one direction, while high-risk exposures or immunocompromised family members might tip it in the other.

What the Medical Community and New York State Recommend

Back in September, New York joined the Northeast Public Health Collaborative, a regional partnership that brings together the best health experts across a number of states in the region to coordinate efforts, share knowledge, and make decisions for their states regarding public health.

This coalition’s evidence-based recommendations for the COVID-19 vaccine, which are being backed by the New York State Department of Health and are closely aligned with those brought forward by the nation’s clinical experts at American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), and the Infectious Disease Society of America (IDSA) are as follows: 

• All infants and toddlers between 6 and 23 months old should be vaccinated.
• Children and teens between 2 and 18 years old should be vaccinated if they have never been vaccinated before, they or a person they live with is at high risk of experiencing severe symptoms from COVID-19, or they live in a long-term care facility or other congregate setting. Other children and teens in this age range who do not fall into those categories may be vaccinated.
• Vaccination is recommended for all adults between 19 and 64 years old. Adults in this age range should be vaccinated if they or a person they live with are at risk of experiencing severe symptoms from COVID-19 or if they have a higher risk of exposure than the general public, like if they work in healthcare or live in a congregate care setting.
• All adults 65 years old and older should be vaccinated.
• People who are pregnant or who are lactating should be vaccinated. The vaccine can be administered safely during any trimester and breastfeeding does not need to be delayed. 

The above guidance applies to all available COVID-19 vaccines (Pfizer, Moderna, and Novavax). When guidance mentions those at high risk of severe COVID-19 symptoms, this includes people who are overweight or obese and people who have asthma, certain chronic lung diseases, diabetes, or certain mental health conditions. The collaborative’s list of underlying medical conditions that could increase a person’s risk of severe COVID-19 is available here.

Keep in mind, none of this guidance represents a vaccine requirement. Just like the last few years, the vaccine is expected to be available at pharmacies and doctors’ offices across New York State to those patients and families who choose to receive it, similar to how the flu vaccine is administered each year.

Let’s Talk

Shifts like this can feel confusing, especially when they make headlines. That’s why real conversations matter, and why your family’s relationship with your primary care practitioner or pediatrician is more important than ever. With us, you have an experienced professional with deep medical knowledge and years of experience navigating the data in your corner.

We follow the evidence, not the headlines. And unlike some headlines or social media posts, we don’t want to pressure or coerce—we want to inform, to listen, and to partner with you to maximize your family’s health and well-being, and we can’t do it without you. Policies may change, but our commitment to you will not.

So, we’re ready to listen. We want to hear your questions and concerns. We’ll walk through the evidence together, we’ll talk openly about uncertainties, and we’ll respect your values and decisions—whether or not they align with our own, or with any agency’s recommendation. But you can always trust that our guidance will be grounded in the latest medical science. Let’s talk.

About the Author
Brandon Greene, MD, FAAP, joined Bassett Healthcare Network in 2022 as the Director of Inpatient Pediatrics and practicing as an Inpatient Pediatric hospitalist. He was appointed Chief of Pediatrics in 2024. As chief, Dr. Greene oversees all of the network’s pediatric providers, including those who see patients at Bassett’s hospitals, outpatient clinics, and school-based health centers. Prior to joining Bassett, Dr. Greene practiced at Island Hospital in Anacortes, Washington. He is a 2012 graduate of Cornell Medical College. Originally from Texas, Dr. Greene’s residency took him to the University of Chicago Medical Center’s Comer Children's Hospital.

“Let’s Talk About It” is brought to you through a partnership between Bassett Healthcare Network and the Rotary Club of Cooperstown