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The Advisory Committee on Immunization Practices (ACIP) met on June 25 and 26. This was the first meeting with the 7 new members recently appointed by Health and Human Services Secretary Robert F. Kennedy Jr. after he dismissed all 17 members of the previous committee.
COVID-19 vaccines
There was no vote on COVID-19 vaccine recommendations at this meeting. However, an overview was provided on the revised COVID-19 vaccine recommendations following the directive issued by RFK Jr on Tuesday, May 27:
- COVID-19 vaccination is now based on shared clinical decision making for all children ages 6 months to 17 years.
- For both the recommended adult and the recommended child and adolescent immunization schedules, pregnancy is now shaded gray to reflect no guidance/no recommendation. Learn more at CDC: Vaccines & Immunizations: Immunization Schedules.
- COVID-19 vaccination is still recommended for all adults 18 and older. There are no changes for this group.
Between October 1, 2024, and June 7, 2025, there were 32,000-51,000 COVID-19 related deaths in the United States. Keep in mind that pregnant women are at significantly higher risk of severe illness, hospitalization, and death as well as poor pregnancy outcomes including preterm and stillbirth. COVID-19 vaccines are safe and recommended to be given during pregnancy by the American College of Obstetrics and Gynecology (ACOG). Learn more at ACOG: COVID-19 Vaccines and Pregnancy: Conversation Guide for Clinicians. Pregnant people can still be vaccinated based on their personal situation and their doctor’s advice.
Influenza vaccines
The CDC presented information on the 2024-2025 influenza season. This past season was the most severe season since 2017-2018 and had the highest disease burden in the US in the past decade. 250 pediatric deaths were reported. Influenza vaccine is estimated to have prevented 240,000 hospitalizations mostly in adults aged 65 years and older.
VOTE: The ACIP voted to affirm the recommendation for routine annual influenza vaccination of all persons aged >6 months who do not have contradictions.
Thimerosal
The ACIP also discussed and voted on thimerosal which is a mercury compound used as a preservative in multi-dose vials of influenza vaccine. For decades, there has been controversy and confusion surrounding its use in vaccines mostly related to the differences between ethylmercury (a safe form of mercury in thimerosal) and methylmercury (a harmful form of mercury not in thimerosal).
As a precautionary measure, thimerosal was removed from childhood vaccines in 2001. Extensive research has found no evidence of harm from the small amount of thimerosal used in vaccines. People who have received vaccines containing thimerosal in the past should have no concerns about their safety. Learn more about thimerosal safety at Children's Hospital of Philadelphia: Vaccine Ingredients: Thimerosal and CDC: Vaccine Safety: Thimerosal and Vaccines.
VOTE: Despite clear evidence that thimerosal is safe, the ACIP voted to recommend that children, pregnant women and adults receive seasonal influenza vaccines only in single dose formulations that are free of thimerosal as a preservative.
This vote will impact multi-dose vials of influenza vaccine which are approximately 5% of the influenza vaccine available in the US. If your practice pre-booked multi-dose vials of flu vaccine, the VFC program will reach out to you to find an alternative.
Maternal and pediatric respiratory syncytial virus (RSV) immunization
Merck’s long-acting monoclonal antibody RSV product, clesrovimab, was approved by the FDA in June 2025 and is now approved by ACIP.
VOTE: ACIP recommends infants aged <8 months born during or entering their first RSV season who are not protected by maternal vaccination receive one dose of clesrovimab.
Clinical considerations:
- Clesrovimab will be added to the VFC program for the prevention of RSV.
- Clesrovimab is a single-dose immunization. The same dose is given regardless of weight.
- Clesrovimab and nirsevimab recommendations are the same for use in infants younger than 8 months of age born during or entering their first RSV season.
- There is no preferential recommendation for use of clesrovimab versus nirsevimab.
- Only nirsevimab is recommended for children ages 8 through 19 months who are at increased risk of severe RSV disease and entering their second RSV season.
These ACIP recommendations will need to be approved by CDC before becoming official. For more information about the ACIP meeting and access to the presentation materials CDC: ACIP: ACIP Meeting Materials: June 25-26, 2025 Meeting and CDC: ACIP: Advisory Committee on Immunization Practices (ACIP).
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