The Centers for Disease Control and Prevention (CDC) has upended its longstanding approach to COVID-19 vaccination, announcing on October 6, 2025, that Americans must now consult with a health professional before receiving the updated COVID-19 vaccine. This new policy, which the CDC says is intended to promote shared decision-making, marks a significant departure from the agency’s previous blanket recommendation that anyone aged six months and older should get vaccinated annually.
The change follows a recommendation last month by the newly reconstituted Advisory Committee on Immunization Practices (ACIP), a panel now composed of members appointed by Health Secretary Robert F. Kennedy Jr. According to The Hill, the ACIP’s new guidance adds a hurdle to vaccine access, but it also ensures that most private insurers and government programs will continue to cover the cost of the shots. In practice, this means that while people are not barred from getting the vaccine, they must first discuss the risks and benefits with a doctor, pharmacist, or nurse.
"Informed consent is back," said acting CDC Director Jim O’Neill in a statement announcing the policy. "CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today." O’Neill’s comments, reported by NPR, reflect the administration’s emphasis on individual choice—a stance that has drawn both praise and sharp criticism from the medical community.
For years, the CDC’s universal vaccination guidance made it easy for anyone to walk into a pharmacy or clinic and receive a COVID-19 shot. That approach was based on the recommendations of the previous ACIP, a group of infectious disease experts who were dismissed earlier this year by Kennedy. The new panel, many of whom have expressed skepticism about COVID-19 vaccines, voted in September to end the universal recommendation. Instead, they advised that Americans of all ages should make vaccination decisions in consultation with their health providers.
Health Secretary Kennedy’s influence on vaccine policy has been controversial. According to Newsweek, Kennedy, a longtime critic of vaccines, moved in May to restrict access by removing recommendations for healthy children and pregnant women. His newly appointed advisory panel has pushed for stronger language about potential vaccine risks, a move some experts fear could further discourage vaccination.
The CDC’s updated guidance does not prohibit vaccination for people under 65, but it does require a conversation with a healthcare provider. The ACIP stopped short of requiring a prescription, but in some states, a prescription may still be necessary. According to Bloomberg, the new policy applies to everyone aged six months and older, though the most explicit recommendation is for those 65 and above or with specific risk factors.
The result is a patchwork of vaccine policies across the United States. As NBC News reports, 26 states—many with Democratic leadership—have maintained broader access to COVID-19 shots, while others have adopted the CDC’s more restrictive guidance. Illinois, Maryland, and Washington, D.C. continue to recommend universal vaccination for everyone six months and older, whereas California, Michigan, and Minnesota recommend shots for those three years and older. "Viruses don’t respect state borders," Dr. Ofer Levy of Boston Children’s Hospital told NBC News. "From the perspective of protecting the public against infectious diseases, the last thing you would want as a strategy is to protect different states differently. It’s confusing, it’s inconsistent, and it leaves certain people vulnerable."
Pharmacies are adapting to the new landscape. CVS Health says it will administer COVID-19 vaccines to people aged five and older without requiring a prescription, while Walgreens will offer shots starting at age three. However, some doctor’s offices may opt not to stock the vaccine, given the narrower CDC recommendation and lingering uncertainty about demand.
Medical organizations have voiced concern that the new policy could reverse progress in controlling severe COVID-19 illness and death. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Infectious Diseases Society of America continue to recommend vaccines for children, pregnant women, and high-risk groups. "There is no basis to claim that routine recommendations prevent doctors from discussing risks and benefits with patients," said Dorit Reiss, a vaccine policy expert at the University of California, San Francisco, in comments to NPR. Dr. Tina Tan, president of the Infectious Diseases Society of America, went further: "The claim that the past recommendations deterred health care professionals from talking to patients about risks is completely untrue and is another example of the misinformation and made up information that this administration continues to release to the public and further creates confusion and distrust in healthcare providers and vaccines."
Despite these criticisms, the CDC’s new approach does guarantee continued insurance coverage for COVID-19 vaccines through Medicare, Medicaid, and the Vaccines for Children Program. According to NPR, private insurance plans will also continue to cover CDC-recommended vaccines as of September 1, 2025. For many Americans, this means the vaccine remains free at the point of care, but the process to receive it may be more complicated, depending on where they live and their provider’s policies.
Vaccine uptake has already been modest. Last season, only 23% of adults and 13% of children received the COVID-19 vaccine, according to CDC data cited by NBC News. The updated Pfizer and Moderna shots target the LP.8.1 variant, which was dominant earlier in 2025 but now represents just 3% of cases. The XFG variant is currently responsible for at least 85% of new infections, and Novavax’s shot targets the older JN.1 strain. While the COVID-19 vaccine may not prevent infection outright, it does reduce the risk of severe illness, hospitalization, and death—benefits that public health officials continue to emphasize.
The CDC’s policy shift has also affected recommendations for other vaccines. The agency now endorses giving toddlers a standalone chickenpox vaccine rather than the combined MMRV shot, which also protects against measles, mumps, and rubella. The change follows evidence of a slightly higher risk of fever-related seizures in children under four who receive the combination shot, though such seizures are rare and not associated with long-term problems. The new guidance means that federal programs will no longer cover the MMRV vaccine for young children, a move that some experts worry could limit parental choice and create confusion.
Some public health experts see the new approach as a step backward. "This is effectively removing a choice from parents," said Dr. Katrina Kretsinger, a former CDC vaccine policy expert, in comments to NPR. Others warn that the policy could lead to shortages of separate vaccines until manufacturers can ramp up production to meet demand.
As the country heads into another respiratory virus season, the CDC’s new vaccine policy is likely to remain contentious. The agency insists it is restoring open conversations between patients and providers, but many in the medical community worry that the added hurdles and mixed messages will further erode public trust in vaccines and undermine the nation’s ability to control preventable diseases.
Amid the shifting landscape, Americans seeking COVID-19 or other routine vaccinations will need to navigate a more complex, and in some places uncertain, process—one that now depends as much on individual conversations as on public health mandates.
