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CDC embraces individual choice in new COVID vaccine guidance

September 22, 2025

In a significant policy shift, CDC’s Advisory Committee on Immunization Practices (ACIP) voted to recommend COVID-19 vaccination based on individual decision-making, rather than universal guidance. The change applies to everyone ≥6 months of age, including those ≥65 years and younger individuals at high infection risk for whom vaccination is no longer broadly advised without a health care consultation.

While the committee considered requiring prescriptions, it ultimately rejected the idea to avoid creating barriers for underinsured populations. Instead, the updated guidance encourages patients to discuss the risks and benefits of vaccination with a health care provider such as a doctor, nurse, or pharmacist before making a decision.

ACIP’s vote breakdown reflects a strong consensus on shared decision-making. The committee voted 12-0 in favor of recommending that vaccination for adults ≥65 years, as well as younger individuals, be based on shared clinical decision-making. Another 12-0 vote supported encouraging health care providers to discuss risks, benefits, and uncertainties with patients. A proposal to require prescriptions for COVID-19 vaccines was narrowly defeated in a 6-6 split (chair voted no). Additionally, the committee voted 11-1 to recommend that CDC include accessible language for patients and providers to explain the risks and uncertainties outlined by the working group.

This move aligns with recent FDA updates narrowing vaccine approvals to high-risk groups and marks a departure from previous CDC recommendations that promoted annual COVID-19 shots for all Americans. Despite the shift, insurers have committed to covering COVID-19 vaccines recommended as of September 1, 2025, through the end of 2026.

Experts caution that the lack of a clear recommendation may lead to confusion and reduced vaccine uptake, particularly among vulnerable groups who stand to benefit most from immunization.

Sources:

(2025, September 19). U.S. Department of Health and Human Services. ACIP recommends COVID-19 immunization based on individual decision-making [Press release]. https://www.hhs.gov/press-room/acip-recommends-covid19-vaccination-individual-decision-making.html

Stobbe, M. et al. (2025, September 19). AP News. Kennedy’s vaccine advisers change COVID shot guidance, calling them an individual choice. https://apnews.com/article/cdc-advisers-vaccines-hepatitis-b-covid19-a1fb61ef7e29d93d2828618d890cceb3

Moniuszko, S. (2025, September 19). CBS News. CDC advisory panel recommends keeping COVID-19 vaccine prescription-free. https://www.cbsnews.com/live-updates/cdc-vaccine-advisory-panel-covid-19-hepatitis-b-vaccines/