{"database": "openregs", "table": "crs_reports", "rows": [["IN12684", "Changes to CDC Vaccine Recommendations in 2025 and 2026", "2026-04-28T04:00:00Z", "2026-04-30T09:23:14Z", "Active", "Posts", "Kavya Sekar, Alexandria K. Mickler", null, "Since U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. (hereinafter, HHS Secretary) was sworn in on February 13, 2025, HHS has changed several long-standing federal vaccine recommendations. In addition, HHS has issued recommendations for vaccines newly licensed (i.e., approved) by the Food and Drug Administration. This CRS Insight summarizes vaccine recommendation changes to date and related developments. \nFor over 60 years prior to 2025, the Advisory Committee on Immunization Practices (ACIP)\u2014a committee of scientific and health experts in immunization\u2014made vaccine recommendations to HHS, particularly the Centers for Disease Control and Prevention (CDC). For each vaccine recommendation, ACIP typically reviewed scientific evidence, developed a new or updated recommendation, and then voted on the recommendation. ACIP\u2019s recommendation was subsequently reviewed by the CDC Director, who decided whether to adopt it as an official HHS/CDC recommendation. \nACIP also voted annually, typically in the fall, to update the following year\u2019s childhood/adolescent and adult immunization schedules. These consolidated schedules list CDC\u2019s recommendations for vaccines routinely offered to patients, presented in a format to aid clinical practice. Many federal and state laws reference ACIP\u2019s recommendations and CDC\u2019s immunization schedules. \nIn 2025 and 2026, HHS changed several aspects of policy and practice related to ACIP and CDC vaccine recommendations. On June 9, 2025, the HHS Secretary removed all 17 then-sitting ACIP committee members and subsequently appointed new members. At the June, September, and December meetings, the reconstituted committee voted on several vaccine recommendations, which CDC/HHS subsequently adopted. HHS also changed multiple vaccine recommendations without consulting ACIP, including for the entire childhood immunization schedule in January 2026. The changes made after June 11, 2025, are currently stayed by a district court order, meaning that they presently have no effect and the agency cannot implement them (as discussed further below).\nHHS Vaccine Recommendation Changes in 2025 and 2026\nThe following changes in federal vaccine recommendations include both changes in ACIP recommendations that were officially adopted as CDC/HHS recommendations and CDC/HHS changes made without ACIP consultation. The following does not summarize changes to travel vaccine recommendations.\nApril 15-16, 2025 (ACIP Meeting) \nACIP recommended that the meningitis vaccine, MenACWY, may be used when both MenACWY and MenB vaccines are indicated at the same visit. \nACIP recommended that adults 50-59 years of age who are at increased risk of severe RSV disease receive a single dose of RSV vaccine. \nMay 27, 2025\nThe HHS Secretary posted on X that CDC would stop recommending COVID-19 vaccines for children and pregnant women. \nCDC\u2019s webpages subsequently reflected changes to COVID-19 vaccine recommendations, which changed from all children to a \u201cshared clinical-decision making\u201d recommendation (SCDM), where patients and providers discuss the benefits and risks of vaccination to determine whether to vaccinate; for pregnant women, the recommendation changed to \u201cno guidance/not applicable.\u201d\nJune 25-26, 2025 (ACIP Meeting) \nACIP recommended one dose of a new RSV immunization, clesrovimab, for infants eight months of age or less born during or entering their first RSV season who are not protected by maternal vaccination. ACIP did not issue a preferential recommendation for either of the approved RSV immunizations for this population (i.e., clesrovimab and nirsevimab).\nACIP reaffirmed its recommendations for routine annual influenza (flu) vaccination for all persons aged six months and older who do not have contraindications for the 2025-2026 season. \nACIP recommended to discontinue use of flu vaccines that contain thimerosal.\nSeptember 18-19, 2025 (ACIP Meeting)\nACIP changed COVID-19 vaccine recommendations for adults and children from universal to SCDM. \nACIP recommended against the use of measles, mumps, rubella and varicella (MMRV) vaccines. Children were recommended to receive separate varicella vaccine and MMR vaccines. Prior to this change, the MMRV vaccine was preferentially recommended over separate vaccinations in certain situations. \nDecember 4-5, 2025 (ACIP Meeting) \nACIP changed the Hepatitis B recommendation for infants, including newborns, from universal to SCDM. ACIP also recommended evaluating the need for subsequent Hepatitis B doses in children based on antibody testing results. \nJanuary 5, 2026\nCDC announced a new 2026 childhood immunization schedule that included six changes reflecting vaccine recommendations developed by federal health officials and two prior ACIP-recommended changes (see COVID-19 changes under \u201cMay 27, 2025\u201d and Hepatitis B changes under \u201cDecember 4-5, 2025 (ACIP Meeting)\u201d and Figure 1). \nFigure 1. Comparison of 2025 and 2026 Childhood Immunization Schedules\n/\nSource: Figure developed by CRS. The \u201cPrev. CDC/ACIP Recommendation\u201d column is from CDC, Recommended Child and Adolescent Immunization Schedule for Ages 18 Years and Younger, 2025. The \u201c2026 CDC Recommendation\u201d column is from U.S. Department of Health and Human Services, Childhood Immunization Schedule by Recommended Group, 2026.\nNotes: *Changed by ACIP in 2025 and reaffirmed in the January 2026 schedule.\n**CDC previously categorized the recommendation to receive one-dose of RSV immunization as a recommendation for \u201cAll Children\u201d and specified that this recommendation is for infants (<7 months) unprotected by maternal vaccination. The CDC also recommended a second dose for \u201ccertain high-risk groups or populations.\u201d The 2026 change maintains both recommendations but recategorizes the first recommendation of \u201cAll Children\u201d as a recommendation for \u201cCertain High-Risk Groups or Populations.\u201d\nCurrent Status of Vaccine Recommendations\nIn American Academy of Pediatrics v. Kennedy, the U.S. District Court for the District of Massachusetts issued a stay on March 16, 2026, postponing the effective date of the revised 2026 childhood immunization schedule, the appointments of 13 ACIP members appointed by the HHS Secretary beginning in June 2025, and all committee votes after June 11, 2025.\nThe stay stops the CDC from implementing changed vaccine recommendations after June 11, 2025, mostly reverting the childhood and adult immunization schedules to the 2025 versions (except for the April 2025 CDC/ACIP recommendations that remain in effect). The now-stayed ACIP members\u2019 votes included a June 2025 vote to recommend a new RSV immunization, clesrovimab, for infants (as discussed above), which was not on the 2025 CDC immunization schedule. It is unclear whether a CDC/ACIP recommendation for clesrovimab remains, which could affect health care coverage of that immunization under federal law. The CDC/ACIP recommendation for the other RSV immunization for infants, nirsevimab, remains in effect.\nAlthough the stay affected several 2025 and 2026 CDC vaccine recommendations, HHS may continue to change or issue new vaccine recommendations without violating the court\u2019s order. On April 6, 2026, CDC published a Federal Register notice to renew a revised version of ACIP\u2019s charter, which outlines ACIP\u2019s objectives, scope of activities, and duties. The revised charter expands the potential scope of expertise for committee membership, modifies the committee\u2019s objectives to focus more on vaccine safety considerations, and may signal that HHS/CDC intends to appoint new ACIP members. A newly formed committee could then vote on additional vaccine recommendations. 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