Trump HHS Ends Mandatory Reporting of Patient Vaccine Status

The Trump administration has ended the practice of requiring healthcare providers to report the vaccination status of patients.

“Government bureaucracies should never coerce doctors or families into accepting vaccines or penalize physicians for respecting patient choice,” Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. posted to X Wednesday. “That practice ends now. Under the Trump administration, HHS will protect informed consent, respect religious liberty, and uphold medical freedom.”

Screenshot: X

According to a letter sent somewhat quietly Tuesday to state health officials from the Centers for Medicare and Medicaid Services (CMS), healthcare providers who receive reimbursement through Medicaid and the Children’s Health Insurance Program (CHIP) are no longer mandated to report their patients’ immunization status.

Kennedy’s priorities of “informed consent,” respect for “religious liberty,” and “medical freedom” are clearly spelled out in the letter:

In 2026 and beyond, CMS will explore options to facilitate the development of new vaccine measures that capture information about whether parents and families were informed about vaccine choices, vaccine safety and side effects, and alternative vaccine schedules. CMS plans to engage with stakeholders, including states, quality measure stewards, immunization registry managers, providers, and electronic health record vendors to learn how new measures could capture person and family preferences related to vaccines. CMS will also explore how religious exemptions for vaccinations can be accounted for in the data and the subsequent measures.

The other blockbuster notice in the letter is the end to the federal government’s incentivization of providers to promote vaccines. The new policy says the number of prenatal and childhood vaccines administered are no longer to be tied to federal Medicaid and CHIP funds.

“CMS does not tie payment to performance on immunization quality measures in Medicaid and CHIP at the federal level,” the letter continues. “While states have flexibility and discretion to use quality measures in state developed value-based purchasing and payment incentive fee for service or managed care programs, CMS strongly discourages states from using immunization measures in payment arrangements.”

Writing at his Substack Popular Rationalism, scientist and author James Lyons-Weiler, Ph.D. described Thursday the announcement as a “tectonic shift in CMS vaccine uptake tracking for pediatric vaccines,” and a move that essentially “nuked one of the most entrenched and ethically fraught financial mechanisms in modern American healthcare: the reimbursement-linked vaccine incentive system.”

“This marks the beginning of a long-overdue rebalancing,” Lyons-Weiler wrote. “The metrics that once rewarded raw vaccine uptake as a proxy for care quality have been pulled from the federally mandated quality reporting framework.”

Additionally, he highlighted that CMS’ assertion that it “strongly discourages” states from continuing vaccine measures in payment systems with doctors, “realigns the national posture on quality metrics and financial incentives.”

Read Lyons-Weiler’s column for background on the federal government’s history of incentivizing providers who promote vaccines with bonus payments.

At the Gold Report with Dr. Simone Gold, Yudi Sherman also called attention to the announcement whereby “CMS pulls the plug on vaccine bonuses.”

“Doctors will no longer get extra cash for vaccinating children—at least not from the federal government,” Sherman shared, adding, “In a quiet but significant policy shift, the Centers for Medicare and Medicaid Services (CMS) announced it is retiring a long-criticized system that paid physicians bonuses for administering childhood vaccines.”

Sherman refers readers to CMS.gov’s website page providing “Medicare Payment Rates for Administering COVID-19 Vaccines.”

During 2025, healthcare providers were paid “[a]pproximately $45 for single-dose vaccines,” and “[f]or vaccines requiring multiple doses, approximately $45 for each dose in the series, including any additional doses and booster doses.”

2025’s $45 rate was $5 more than what providers were paid between 2021 and 2024.

From CMS.gov

“Until now, vaccinating kids could be surprisingly lucrative,” Sherman noted, adding that parents have objected to the financial incentives, arguing that the system “distort[s] medical judgment, leading to high-pressure tactics around childhood vaccinations.”

“Some say doctors push shots parents believe are unnecessary or unsafe,” Sherman wrote. “Others report being dismissed from pediatric practices altogether if they decline vaccines.”

While the letter announcing the change at the federal level is a positive step, Lyons-Weiler says there’s still “more to do.”

“States must now re-evaluate their own structures,” he urges. “Researchers must track whether incentive realignment improves trust, choice, and ultimately health outcomes. And families must remain vigilant that their right to informed, preference-sensitive medical decision-making is preserved.”

“But today, CMS is no longer part of the problem,” he observes.