- The CDC’s vaccine panel, ACIP, changed its recommendations for childhood vaccines and updated COVID-19 shots, further limiting access.
- The changes align with vaccine skepticism within the Trump administration.
- HHS Secretary RFK Jr. reformed ACIP this year to include doctors and researchers who have publicly questioned vaccine safety.
The CDC’s vaccine panel voted this month to update the childhood vaccination schedule and narrow its recommendations for COVID-19 shots.
The changes, though modest, reflect the prominent vaccine skepticism within the Trump administration and could have far-reaching implications for public health, vaccine access, and insurance coverage.
Health and Human Services Secretary Robert F. Kennedy Jr. has pledged to “restore public trust” in the CDC and, more broadly, in vaccines and public health.
Kennedy subsequently hand-picked new members, including doctors and researchers who have publicly questioned vaccine safety.
William Schaffner, MD, a professor of preventive medicine at Vanderbilt University who attended the meeting virtually, called the proceedings “disappointing and very concerning.”
“There is at least the appearance that there is skepticism, despite all the evidence about vaccine effectiveness and safety,” he told Healthline.
Schaffner pointed out the apparent lack of preparedness of the members of the panel. “It was certainly out of the ordinary, and there were major elements of disorganization and confusion in the meeting. Previous meetings were run very rigorously,” he said.
Charles Stoecker, PhD, J.P. Morgan Chase Professor in Healthcare Finance at the Tulane University Celia Scott Weatherhood School of Public Health and Tropical Medicine, said that internal working groups spend months and months preparing to present data — both clinical and economic — on specific issues in preparation for these meetings.
However, such typically meticulous preparation was not on display.
“The ACIP charter requires them to consider economic evaluation. Let’s see the cost-benefit analysis. Let’s see what kind of returns we get for what we’re going to expect. I didn’t see any of those things. So, I’m not sure how they consider themselves in compliance with that rule,” Stoecker told Healthline.
Instead, attendees were presented with anecdotal reports and unsupported claims, which Schaffner called “the equivalent of gossip.”
“It’s always good to raise questions. That’s what science does. But then you have to address the questions with rigor and on the basis of solid science, not rumors and anecdotes,” Schaffner said.
ACIP members voted 8–3 to stop recommending the combined MMRV vaccine for children under age 4.
The panel said it based its decision on data showing that the combined MMRV vaccine carries a slightly higher risk of febrile seizures. According to the panel, MMRV doubles that risk compared with giving the measles, mumps, and rubella (MMR) and varicella vaccines separately, without offering additional benefits.
However, this data is not new, raising questions about why the panel acted now. Furthermore, even though the risk of febrile seizures is doubled with MMRV, the overall risk remains very low, and such seizures are typically not serious in infants.
“They tried to solve a problem that didn’t exist. Parents who worry about febrile seizures could already choose separate shots,” said Jake Scott, MD, clinical associate professor of infectious diseases at Stanford Medicine.
According to data presented at the meetings, only about
“These people [on the ACIP panel] supposedly advocate for medical freedom, and they eliminated parental choice,” said Scott. The result of that, he said, will be “more needle sticks for crying toddlers.”
The ACIP panel also, after heated debate, indefinitely tabled a vote on delaying the hepatitis B vaccine, currently given at birth.
Like the MMRV vaccine, the panel did not present new safety data as a rationale for a potential change in the vaccine schedule.
“They created a lot of doubt and they questioned 40 years of success for no justifiable reason. Then they tabled the vote. So they accomplished, I think, maximum damage to public confidence with no policy change,” said Scott.
Hepatitis B is an incurable infection that is the
“No country, once initiating the birth dose, has ever gone back to the bad old days. We’re discussing going back to the bad old days,” said Schaffner.
However, the Trump administration has characterized hepatitis B primarily as a sexually transmitted disease, insisting that newborns don’t need the shot.
When or if the ACIP will vote again on the issue is unclear.
“It’s with great relief that they decided to indefinitely table that,” said Stoecker.
Under the new guidance, U.S. adults 65 and older are advised to get the vaccine using this approach.
People between the ages of six months and 64 are not prohibited from getting the shot, but are encouraged to consult their healthcare professional to weigh the risks and benefits before vaccination.
A more extreme proposal — which would have required states to mandate prescriptions for COVID-19 vaccines — narrowly failed to pass. The final vote was 6–6, with the panel chair casting the tie-breaking vote to defeat it.
The new recommendations have led to confusion among patients, pharmacists, and doctors alike.
“There are issues of how this shared clinical decision making model will work in practice. Can anyone then come into a pharmacy and say, give me the vaccine? Or are they going to have to provide some documentation?” said Schaffner.
Stoecker echoed those concerns, noting that pharmacies and pharmacists could find themselves in trouble.
“If the ACIP introduces this kind of less strong recommendation, is it still recommended? What we’ve seen is that places like Walgreens and CVS start holding back. They don’t want to get to a place where their pharmacists are put in legal jeopardy,” Stoecker said.
For now, insurance coverage of COVID-19 shots will stay in place for most. AHIP, a trade association of health insurance companies that includes Medicare Advantage and Medicaid, has stated it will continue to cover COVID-19 and flu vaccines through the end of 2026.
ACIP’s new recommendations for MMRV and COVID-19 vaccines are modest changes and are unlikely to significantly affect vaccine access for most Americans. However, experts say that they may portend more severe changes on the horizon.
“The bigger problem is the signal,” said Scott.
“Pediatricians and family doctors rely on stable vaccine recommendations. So when a 20-year-old policy suddenly changes without new safety data, it makes the providers question what’s next. Will other combination vaccines be eliminated?” he warned.
Stoecker points out that weakening recommendations will likely have a trickle down effect on insurance coverage and vaccine uptake.
“It’s kind of amazing how price-responsive people are to these things. So if you start charging for these vaccines, almost assuredly, we’re going to see the coverage rates go down. That’s what previous experience has told us,” he said.
Vaccine policies have also become increasingly politicized, playing out in opposite ways across blue and red state lines.
The politicization of vaccine policy and public health is deeply concerning to doctors in the field.
“Diseases don’t respect state lines,” said Scott.
“Viruses exploit every gap in population immunity. So these disparate policies create this sort of swiss cheese model where eventually the holes align.”
