CDC vaccine panel adds new rules for getting the COVID vaccine in a tense meeting

ACIP personnel Retsef Levi speaks during a gathering of nan CDC's Advisory Committee connected Immunization Practices connected September 18, 2025 successful Atlanta, Ga. The national vaccine advisory group, precocious appointed by Health Secretary Robert F. Kennedy Jr., made recommendations connected nan COVID vaccine. Elijah Nouvelage/Getty Images hide caption

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Elijah Nouvelage/Getty Images

A sheet of vaccine advisers to nan national authorities debated respective changes to COVID-19 vaccine entree successful a chaotic gathering Friday, marked by disorder complete processes, method difficulties and passionate disagreement among members and different experts successful attendance.

Ultimately, nan Advisory Committee connected Immunization Practices, aliases ACIP, backed distant from its astir arguable connection that called for states to require those who want a COVID-19 vaccine to get a prescription. But nan extremity consequence is that nan COVID-19 vaccine could beryllium little disposable than it has been nan past fewer years.

The group, which crafts recommendations connected vaccine argumentation for nan Centers for Disease Control and Prevention, voted to urge vaccination for adults 65 and older and younger people, taxable to a process called "shared determination making." Their recommendations would not prohibit anyone complete six months from getting nan shot, but telephone for patients to speak pinch a clinician astir nan risks and benefits.

"In nan anterior seasons of COVID, we've had regular vaccine entree — you aliases I could spell to our drugstore aliases doctor's agency and conscionable get our vaccine, it was encouraged arsenic a regular recommendation," says Jen Kates, head of world wellness and HIV argumentation astatine KFF.

Friday's ballot fundamentally says "this is nary longer routinely recommended — it's 'shared objective decision-making,'" says Kates. The specifications astir what that entails and really entree will play retired are not instantly clear, Kates says, but what is clear is that it's a "more constrictive recommendation" than it has been successful past years.

And ACIP's proposal states that for group 64 and younger nan speech should stress that benefits are top for group pinch nan astir consequence of superior illness and lowest for group without accrued risk.

The advisers besides voted that nan CDC should adhd accusation astir nan imaginable risks and uncertainties related to COVID vaccine effectiveness to accusation sheets astir nan shots. Many of nan risks were speculative aliases already known to beryllium unfounded.

Heated statement and a necktie vote

The gathering underscored nan turbulent and highly politicized quality of vaccine argumentation nether Health Secretary Robert F. Kennedy Jr.'s leadership, which is now astatine likelihood pinch positions held by awesome aesculapian organizations.

The proposal that a medicine beryllium required for anyone to get a COVID vaccine – which could person been a caller hurdle successful galore places, if states adopted nan proposal – ended successful a tie. ACIP president Martin Kulldorff voted no, breaking nan tie. The mobility failed.

But nan statement complete nan connection sewage heated. Some connected nan committee warned it would yet lead to less group getting shots. Dr. Amy Middleman of nan Society for Adolescent Health and Medicine, was among galore who said up, urging committee members to cull this idea.

"If we commencement asking for prescriptions for vaccines — which are a superior prevention nationalist wellness strategy — we are going to overwhelm physicians' offices."

Committee members besides expressed their concern, saying it would create entree problems particularly for group who are underinsured aliases don't person superior attraction providers. "I americium besides concerned arsenic it is my knowing that astir 30% of Americans don't person entree readily to superior wellness attraction providers," said committee personnel Dr. Joseph Hibbeln.

Earlier this year, Kennedy fired nan existing ACIP panel, installed during nan Biden administration, and replaced them pinch his ain handpicked roster, including 5 members he added this week.

Some of those he chose person a history of being captious of vaccines, arsenic does Kennedy himself — he erstwhile called COVID-19 vaccines a "crime against humanity." Kennedy's ACIP was wide expected to curb entree to nan COVID booster.

Over nan people of nan meeting, galore clinicians successful attendance raised concerns astir really ACIP had sidelined master input, elevated questionable aliases preliminary data, and surgery from nan established process for processing these recommendations, which power security coverage.

"It's troubling to spot nan erosion of nan committee's integrity," said Dr. Sandra Fryhofer, who said connected behalf of nan American Medical Association connected Friday, "We're concerned astir really vaccine recommendations are being developed by this caller panel, information is being selectively utilized to warrant circumstantial conclusions." 

In a break from past precedent, nan voting topics for nan COVID vaccine were not shared publically until nan extremity of nan meeting, erstwhile ACIP personnel Retsef Levi, an MIT professor of operations management, presented them. Several extracurricular aesculapian groups successful attendance had requested that they beryllium shared for nan liking of transparency.

Levi led overmuch of nan chat starring up nan votes connected COVID-19. In his comments, he emphasized information concerns astir nan vaccines.

"I don't deliberation that nan nationalist presently believes nan communicative of safe and effective," he told nan panel.

The gathering was marked by disorganization and confusion, moreover among nan voting members. During nan ballot connected individual determination making, Dr. Cody Meissner, asked what it would mean successful practice. "A Vaccine Information Sheet is already required by law for each vaccine — truthful what will alteration present is nan contented of nan Vaccine Information Sheet. Is that correct?"

Levi said yes, that would beryllium nan change. "We propose that nan contented will beryllium changed. The CDC will person to use their judgement astir really to do that exactly, fixed this proposal that we are making here."

Confusion and a patchwork of policies for COVID shots

In caller weeks, states and security companies person undertaken a flurry of actions to blunt nan imaginable effect of ACIP's decisions successful their two-day meeting. For instance, California, Oregon and Washington launched a West Coast Health Alliance and states from Maine to Maryland formed nan Northeast Public Health Collaborative to rumor their ain vaccine recommendations.

America's Health Insurance Plans, nan manufacture group for backstage security companies, issued a statement that COVID-19 vaccines would beryllium covered pinch nary cost-sharing done nan extremity of 2026. There's little clarity astir really sum will activity for nationalist wellness security programs for illustration Medicaid, Medicare, nan Children's Health Insurance Program, and nan Vaccines for Children programme fixed this caller recommendation.

Regardless of their security coverage, patients trying to get vaccinated successful different places are reporting that they're being turned distant from pharmacies, including caregivers of those pinch precocious consequence conditions.

Kates says nan patchwork of policies and entree depending connected wherever you unrecorded is reminiscent of nan early days of nan COVID-19 vaccine rollout.

"In nan early days everybody wanted it and location was very small skepticism astir it," she says. "Today nan request is overmuch lower, but for those who want it, they're going to person to do a small other activity — I deliberation that's nan bottommost statement here."

While nan CDC mostly adopts nan recommendations of nan panel, nan votes are not last until acting CDC head Jim O'Neill signs disconnected connected them. He was installed by Kennedy aft head Susan Monarez, who'd been confirmed by nan Senate, was ousted successful portion for refusing to perpetrate to adopting ACIP's recommendations earlier she'd seen evidence, she testified to nan Senate earlier this week.

NPR's Sydney Lupkin contributed to this report.