CDC Advisers Vote to Make COVID-19 Shots a Personal Choice

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On September 23, 2025

The Advisory Committee on Immunization Practices (ACIP) — a panel that works on behalf of the Centers for Disease Control and Prevention (CDC) to devise vaccine policy — voted last week against recommending COVID-19 shots.

Instead, the committee unanimously agreed that COVID vaccination should rely on “individual decision-making” in consultation with a healthcare provider, including physicians, nurses, and pharmacists.

Previously, the CDC recommended COVID shots for everyone ages 6 months and older.

ACIP urged that more detailed information regarding “risks and uncertainties” of vaccination be added to handouts given to patients before immunizations.

The group narrowly rejected a measure that would have required people get a doctor’s prescription in order to receive a COVID vaccine.

The ACIP also voted to restrict access to a combination childhood vaccine for measles, mumps, rubella, and chicken pox.

Recommendations by the ACIP do not become final until approved by the CDC director. The acting director, Jim O’Neill, is expected to review and approve the guidelines soon.

Physicians’ Group Continues to Recommend the COVID Vaccine

In June, Health and Human Services Secretary Robert F. Kennedy Jr. removed all 17 sitting members of the ACIP, who were appointed under the Biden Administration, stating that “a clean sweep is necessary to reestablish public confidence in vaccine science.”

Some of his handpicked replacements, five of whom were appointed days before last week’s ACIP meeting, have voiced deep concerns about vaccines, including the vaccine against COVID-19.

But national physician organizations continue to recommend the COVID vaccine as safe, effective, and necessary to protect against severe infections that can lead to hospitalization or even death.

The American Academy of Family Physicians (AAFP) advises that all adults 19 and older get a COVID shot, especially those who are 65 years and older, at increased risk of severe COVID because they have factors such as an underlying medical condition, or have never received a COVID vaccine.

The AAFP’s stance aligns with recommendations by the American Academy of Pediatrics advising COVID vaccines for young children ages 6 to 23 months (who are at high risk for severe COVID) and for children ages 2 to 18 who have medical conditions or other issues that increase their risk.

The AAFP position on COVID vaccines also echoes those of the American College of Obstetricians and Gynecologists, which recommends COVID vaccines for pregnant patients during any trimester (and during the lactation period as well) because of their increased risk of severe COVID and because expectant mothers can pass protective antibodies to babies in utero.

Committee Decision Follows New FDA Restrictions on COVID Vaccines

The CDC and the U.S. Food and Drug Administration (FDA) have different roles, and at times their stances differ. That seems to be the case with the COVID-19 vaccine.

The FDA’s role is to determine whether a medical product is safe and effective, and whether its benefits outweigh its risks.

In contrast, the CDC is tasked with providing clinical guidance on how a medical product should be used in the U.S. population. A CDC endorsement or recommendation generally triggers public and private insurance coverage.

In August, the FDA approved the most recent COVID shot for adults 65 and older and people with certain conditions that raise the risk of serious complications from infection. (Doctors can still prescribe the shot “off-label” for individuals who don’t meet those requirements, but access can vary significantly depending on location.)

Then came the ACIP decision. If the CDC director signs off on it, the COVID vaccine will be removed from routine vaccination schedules for eligible patients, leaving individuals to seek it out.

The ACIP echoed the FDA by emphasizing that the risk-benefit of vaccination in people under age 65 is most favorable for those who are at an increased risk for severe COVID and lowest for individuals who are not at an increased risk.

In addition to age (65 and up), factors that increase the risk of severe COVID include chronic conditions like diabetes, HIV, and heart, lung, or kidney disease; being overweight or having obesity; and behaviors like smoking or physical inactivity.

Could the New Recommendations Limit COVID Vaccine Access?

For Peter Chin-Hong, MD, an infectious-disease specialist and a professor of medicine at the University of California San Francisco School of Medicine, many questions remain unanswered about the ACIP stance.

For example, he says, how will the federal government determine whether informed clinical decision making has happened? And, he adds, will patients skip vaccination based on the hoops they have to jump through?

“Usually an ‘informed clinical decision’ means that patients and providers discuss risks and benefits of the vaccine based on individual health status,” says Dr. Chin-Hong. But he estimates that almost a third of Americans don’t have a primary care clinician, so finding a healthcare provider to talk with may be a challenge.

“Many high-risk individuals who would have normally received the vaccine may not do so this year,” he says. “What I worry about most of all is that the people who need immunity reminders — like those over 65, those who are pregnant, and immunocompromised people — may not get their vaccines and that may contribute to additional hospitalizations and death.”

It’s also difficult to know whether the new ACIP guidelines, if endorsed by the CDC, would allow any healthy person who wants a COVID vaccine to get one.

“I think access to the vaccine is going to vary from state to state, and even in some cases from pharmacy to pharmacy,” said Sean O’Leary, MD, the chair of the American Academy of Pediatrics infectious disease committee, at a press conference.

“What we’re seeing is that clinicians and pharmacists are confused. By the rules, I would say that they [healthy individuals] should be able to get vaccinated. What actually happens in reality is hard to say.”

Will Insurance Cover COVID Vaccines?

Some public health officials have expressed concerns that the ACIP vote could restrict coverage through so-called entitlement programs like Medicare and Medicaid for people who meet FDA eligibility requirements.

But HHS maintains that the new guidelines allow for “immunization coverage through all payment mechanisms including entitlement programs.”

In addition to Medicare and Medicaid, federal programs that offer access to vaccines include the Vaccines for Children Program, Children’s Health Insurance Program, and insurance plans through the federal Health Insurance Marketplace (also known as ACA or Affordable Care Act plans or Obamacare).

America’s Health Insurance Plans (AHIP), a national trade association representing health insurers, including private insurers, said that its members would continue to cover all vaccines recommended by the ACIP as of September 1, 2025 — meaning prior to the recent meeting — including COVID shots, with no cost-sharing for patients through the end of 2026.

Panel Rejects Combo Shot for Measles, Mumps, Rubella, and Chicken Pox for Young Kids

The decision, in effect, eliminates the combined vaccine option for younger children.

In making the ruling, ACIP members weighed data from the CDC Immunization Safety Office indicating that healthy children between 12 and 23 months old have an increased risk of febrile seizure (occurring during a high fever) 7 to 10 days after MMRV vaccination, compared with children given separate MMR and chicken pox shots.

The CDC data indicate that the excess risk from a combined MMRV shot is relatively small, accounting for about five more febrile seizures per 10,000 doses (meaning a .05 percent higher risk).

Febrile seizures can be scary to watch, but those triggered by vaccines are rare, and they pass quickly with no lasting impact.

A Minority of Children Get a Combined MMRV Shot

About 85 percent of children already get their MMR and chicken pox vaccines separately, says Chin-Hong, so he doesn’t expect this decision to “change the dial” much.

He does, however, find the policy shift troubling, because there has been no new data or new safety concerns regarding the combination shot.

“This recommendation potentially increases the uncertainty that people may have about vaccines in general,” says Chin-Hong.

In response to the ACIP decision, the West Coast Health Alliance (representing the states of California, Oregon, Washington, and Hawaii) issued a statement affirming the preexisting recommendations (from both the CDC and the American Academy of Pediatrics) that parents have an option to choose whether a child younger than 4 years receives separate or combined vaccines.