Vaccine Policy & Access: Tracking State Actions
Okay, here’s a summary of teh key changes to COVID-19 vaccine recommendations and pediatric vaccine guidance as described in the provided text, broken down for clarity:
I. COVID-19 Vaccine Changes (2025)
* Initial Shift to ”shared Clinical Decision-Making”: the CDC initially moved away from universal recommendations for COVID-19 vaccination, adopting a “shared clinical decision-making” approach for individuals aged 6 months to 17 years. This meant a healthcare provider needed to assess each person to determine if the vaccine was appropriate. Vaccination during pregnancy was no longer recommended.
* FDA Narrowed approvals (August 27, 2025): the FDA substantially narrowed the approved use of updated COVID-19 vaccines for the 2025-2026 season to:
* Individuals 65 years and older.
* Individuals 6 months to 64 years (Moderna) or 5 to 64 years (Pfizer) with at least one underlying condition that increases their risk of severe COVID-19.
* Prescribing outside these parameters would be considered “off-label” use.
* ACIP Followed Suit (September 19, 2025): The CDC’s ACIP voted to extend the “shared clinical decision-making” approach to all ages, including those 65 and older.
* Thay emphasized that the risk-benefit of vaccination is highest for those at increased risk of severe disease (according to CDC risk factors) and lowest for those not at increased risk.
* If adopted by the CDC Director, this would mean everyone requires an individual assessment by a healthcare provider to determine if vaccination is recommended.
* Insurance should cover the vaccine if recommended, but challenges for consumers are possible.
II. Pediatric Vaccine Guidance Changes (Under the Trump/Kennedy Governance)
* Intent to Revise Schedule: Secretary Kennedy intends to revise the pediatric vaccine schedule to reduce the number of vaccines and potentially remove some altogether.
* Thimerosal Removal (June 26, 2025): ACIP voted to remove thimerosal (a preservative) from all flu vaccines distributed in the U.S. This was despite existing data showing the safety of the thimerosal-containing formulation. Multi-dose flu vaccines, which used thimerosal, were a small percentage of those administered, but offered an additional option.
in essence, the trend is towards more individualized decision-making regarding vaccines, with a narrowing of recommended use for COVID-19 vaccines and a stated intention to reduce the number of vaccines on the pediatric schedule.