Montana Doubles Down on Vaccine Promotion Despite Federal Policy Shift to Individual Choice

HELENA, MT — As federal health officials shift toward “shared clinical decision-making” for vaccines rather than universal recommendations, Montana health officials are doubling down on aggressive promotional campaigns, suggesting healthcare offices decorate with vaccine materials alongside “fall decor” while providing no guidance on how to implement the new federal approach emphasizing individual choice.

The disconnect between evolving federal guidance and Montana’s promotional push is highlighted by the department’s response priorities. While deploying intensive campaigns for 32 measles cases with just two hospitalizations and zero deaths, Montana has reported nearly 2,400 sexually transmitted disease cases this year—including a 13% increase in gonorrhea—yet these receive only routine statistical reporting buried in epidemiology newsletters from the state.

In a single week ending October 11, Montana reported 52 new chlamydia cases—more than the 32 total measles cases reported for the entire year.

Yet the department’s response strategies differ dramatically between the two health issues.

For measles—which has resulted in just two hospitalizations and zero deaths—DPHHS has created dashboard updates, promotional toolkits, provider training webinars, and detailed guidance suggesting healthcare offices decorate with “pumpkins or fall leaves alongside flyers with vaccine facts.” The October immunization newsletter recommends social media campaigns to “unmask vaccine myths” and instructs clinic staff to “confidently talk about vaccines.”

For sexually transmitted diseases affecting 75 times more Montanans, the department provides only statistical updates in weekly epidemiology reports sent to public health professionals.

The contrasting approaches come as federal health officials have shifted COVID-19 vaccine recommendations away from universal guidance toward “shared clinical decision-making,” acknowledging individual choice in vaccination decisions.

According to the CDC, shared clinical decision-making means “there is no default” to vaccinate, and “the decision about whether or not to vaccinate may be informed by the best available evidence of who may benefit from vaccination; the individual’s characteristics, values, and preferences; the health care provider’s clinical discretion; and the characteristics of the vaccine being considered.” Deputy Secretary of Health and Human Services Jim O’Neill recently stated “Informed consent is back,” noting that previous “blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits” with patients.

The Montana newsletter mentions this policy change but immediately pivots to promotional strategies without addressing how providers should navigate conversations with vaccine-hesitant patients using this new individualized approach.

The federal guidance also recommends separating the combined MMRV vaccine for children under 4 years old, instead giving separate MMR and varicella shots. Again, Montana’s newsletter mentions this change but provides no guidance on how to discuss this new approach with parents or what it means for vaccination schedules.

Post-COVID vaccine hesitancy remains a significant challenge for health officials nationwide, yet Montana’s guidance focuses on promotional tactics rather than trust-building approaches. The newsletter provides no guidance on acknowledging past communication missteps or having genuine conversations about patient concerns.

When asked specifically what steps DPHHS is taking to rebuild public trust after COVID-19 communication challenges, department officials did not respond.

The STD increases represent a measurable public health crisis. Gonorrhea cases have risen steadily, and chlamydia remains the most reported communicable disease in Montana with nearly 1,900 cases year-to-date. Both infections can cause serious long-term health complications if untreated, including infertility and increased HIV risk.

Meanwhile, Montana’s 32 measles cases remain contained to six counties. Hill County even rescinded enhanced vaccination recommendations in July due to lack of recent measles activity in that jurisdiction.

The department’s resource allocation raises questions about public health priorities and communication effectiveness in an era of decreased institutional trust. With aggressive promotional campaigns for a contained outbreak while a genuine STD epidemic receives minimal public attention, critics question whether current strategies address Montana’s actual health challenges.

Montana health officials did not respond to questions about how the department determines which conditions warrant aggressive promotional campaigns, what steps are being taken to rebuild vaccine confidence beyond promotional tactics, and how current communication strategies address underlying trust issues identified during the COVID-19 pandemic.