As the Advisory Committee on Immunization Practices (ACIP) convenes in Atlanta on September 18 and 19, 2025, Americans are bracing for significant changes to their access to COVID-19 vaccines and two essential childhood immunizations. The stakes of this meeting extend far beyond the committee’s conference room, with ripple effects expected to shape how doctors and pharmacists administer vaccines, whether insurance companies will cover them, and, ultimately, who will be protected from potentially deadly diseases this winter.
ACIP’s recommendations have long served as the gold standard for immunization protocols in the United States, guiding the Centers for Disease Control and Prevention (CDC) on child and adult vaccine schedules. As Dr. Ashley Chinchilla, a pharmacy professor at the University of Georgia, explained to Healthbeat, “The panel’s recommendations create the standards most health care providers follow and are considered the gold standard.” In states like Georgia, ACIP’s guidance even determines which vaccines pharmacists are legally allowed to administer. But this year, the process has become anything but routine.
At the heart of the current turmoil is Health and Human Services Secretary Robert F. Kennedy Jr., who has dramatically reshaped the ACIP by firing its previous expert members and installing his own picks—many of whom hold anti-vaccine views. This overhaul has drawn fierce criticism and lawsuits from leading medical societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America. “The committee is staffed [with] a very small number of very extreme people,” Matt Motta, a professor at Boston University School of Public Health, told Healthbeat. “Yes, they have scientific credentials. Yes, many of them are medical doctors, but their opinions do not reflect where most of the scientific community is on those issues.”
This new, more ideological ACIP has left professional organizations uncertain about their role in the process. Dr. Yvonne Maldonado, a former ACIP voting member and pediatric infectious disease professor at Stanford, remarked, “It feels like this new ACIP since the June meeting has been incredibly ideological. That’s very concerning when it comes to understanding how we’re going to be able to utilize vaccines to protect public health.”
The confusion has already begun to affect patients and providers. In August 2025, the Food and Drug Administration (FDA) approved updated COVID-19 vaccines, but only for people over 65 and adults with underlying health conditions. ACIP, however, has yet to issue its own recommendation, leaving many pharmacies requiring prescriptions for the shot—a sharp departure from past practice, when nearly everyone over six months old was eligible. Dr. Chinchilla summed up the uncertainty: “We’re in this holding pattern until there is an official recommendation.”
This lack of clarity is particularly troubling as the U.S. heads into another winter of respiratory illness. In Ohio, for example, COVID-19 hospitalizations nearly doubled in the past month, according to data from the Ohio Department of Health. In the last week alone, 281 Ohioans were hospitalized with COVID-19—up from 148 just four weeks earlier. Two outbreaks of other respiratory illnesses, influenza and RSV, have also been reported in Southeast Ohio, raising further alarm.
Public health experts are sounding the alarm about the new restrictions. Rebekah Crawford, a health communication professor at Ohio University, warned that limiting vaccine access could have unintended—and potentially tragic—consequences. “If somebody dies from COVID or intense influenza that they could have not gotten if they had been able to have the vaccine, that’s a nuclear bomb these politicians are going to have on their hands,” Crawford told National Public Radio. She added, somewhat ironically, “RFK Jr might be starting the pendulum swing back toward acceptance by prohibiting their access. As soon as you take away humans’ autonomy, they want to reassert their autonomy.”
Megan Buller, an infectious disease specialist with OhioHealth, echoed these concerns, saying, “We have recommended it for all eligible patients or patients who are interested. We are still waiting for additional information to come out of upcoming meetings from the CDC to re-evaluate how exactly we are going to approach vaccination going forward in our patient population.” Buller noted that many patients now excluded from eligibility are confused about whether they can still access the vaccine and whether insurance will cover it: “We don’t condone falsifying health information, but I appreciate the fact that people are wanting to find a way to get these covered. We know vaccinations are important. The COVID vaccines are very effective. We’ve seen that, there’s no denying they’re safe.”
ACIP’s agenda this week isn’t limited to COVID-19. The committee is also set to discuss the MMRV vaccine, which combines the measles, mumps, rubella, and varicella (chickenpox) vaccines into one shot. While this combination was designed to make vaccination easier for families, Dr. Maldonado noted that it carries a higher risk of febrile seizures in young children. “In many cases, it’s just easier to give the combination and saves the baby an extra shot,” she said, but acknowledged families should be informed of the risks and allowed to choose separate shots if preferred. If ACIP recommends separating the vaccines, Maldonado warned, “It does make it harder for people to get vaccines, and it starts to make people question … what the schedule was.”
The hepatitis B vaccine is also under review, specifically the current recommendation for a birth dose for all infants. Dr. Tony Fiore, a retired CDC infectious disease expert, stressed the importance of this early protection: “The vaccine is very safe,” he said. Removing the birth dose recommendation, he cautioned, could lead to an increase in hepatitis B cases, as screening pregnant women is complex and the birth dose ensures babies born to infected mothers are protected.
Meanwhile, the broader context is troubling. Since 2020, over 44,976 Ohioans have died from COVID-19, and the state’s health care system, like much of the U.S., has faced overwhelming demand, staffing shortages, and eroding public trust. The eligibility changes for the COVID-19 vaccine, which follow a May 2025 video by Kennedy stating the CDC would no longer recommend the shots for healthy children and pregnant women, have only deepened concerns. The CDC has not updated its guidance since. On August 27, 2025, former CDC Director Susan Monarez was ousted, with Jim O’Neill, a Health and Human Services official with ties to GOP donor Peter Thiel, set to take over amid a broader leadership exodus.
With only 23% of U.S. adults and 13% of children having received the updated 2024–25 COVID-19 vaccine, and those numbers expected to fall further under the new restrictions, public health officials are preparing for a challenging winter. Hospitals in Ohio and elsewhere are bracing for increased demand, not just from eligible patients but also from those now excluded from vaccine access.
Amidst all the uncertainty, one thing is clear: the science of vaccines is complex, and the policymaking around them even more so. “Science is a lot messier than people want to think, and it makes its progress kind of in a zigzag way, but it still makes its progress,” Crawford reflected. She emphasized the overwhelming evidence supporting vaccines as “one of the best breakthroughs for community-level human health that we’ve ever made as a species.”
As ACIP prepares to issue its recommendations, Americans are left waiting—hoping for clarity, access, and a path forward that puts public health first.
