Members of the Advisory Committee on Immunization Practices listen to a presentation about Covid-19 during an ACIP meeting at the Centers for Disease Control and Prevention in Atlanta, Sept. 19, 2025.

Alyssa Pointer | Reuters

Health and Human Services Secretary Robert F. Kennedy Jr.’s hand-picked vaccine panel on Friday weakened Covid shot recommendations in the U.S., advising that all Americans consult a health-care provider before deciding whether to receive the vaccine.

The 12-member panel, called the Advisory Committee on Immunization Practices, or ACIP, recommended that people 6 months and up receive vaccines based on so-called “shared clinical decision-making,” which refers to a decision process between a health-care provider and a patient or their guardian. The group also voted to emphasize that for those under 65, the Covid vaccine is most beneficial for those at high risk of severe illness from the disease.

The guidance breaks from previous years, where the committee recommended that all Americans ages 6 months and up receive an updated Covid shot. 

While ACIP did not restrict the use of the Covid vaccine, the panel’s softer recommendation may further confuse Americans about whether to take a shot and make it more difficult for them to access one. ACIP sets recommendations on who should receive certain shots and which vaccines insurers must cover at no cost. 

The panel’s chair, Martin Kulldorff, said it was his understanding that the new recommendation means that government-run insurance plans will still cover Covid vaccines. But it’s unclear if all private health plans will maintain coverage of the shots.

The CDC, whose latest director was ousted by the Trump administration earlier this month, still has to adopt the panel’s recommendations. 

The vote is no surprise, as Kennedy appointed several vocal critics of mRNA Covid shots to the panel after ousting all previous members in June. During the meeting Friday, some members cast doubt on the safety and efficacy of Covid shots and mRNA technology, and questioned the reliability of data on hospitalization rates due to the virus.

Massachusetts Institute of Technology professor Retsef Levi speaks during an Advisory Committee on Immunization Practices meeting at the Centers for Disease Control and Prevention in Atlanta, Sept. 19, 2025.

Alyssa Pointer | Reuters

It also follows Kennedy’s other recent moves to change U.S. Covid vaccine policy, which have created new hurdles for some people to access vaccines, including prescription requirements in certain states. The CDC dropped Covid shot recommendations for healthy children and pregnant women, and the Food and Drug Administration approved new Covid jabs with limits on who can get them. 

The ability to get vaccines may vary by state: In a break from federal guidelines, four Democratic states on Wednesday recommended that broad swaths of the population receive an updated Covid shot, including “all who choose protection.” Still, the new recommendations could weaken vaccination rates against the virus and heighten the threat of the disease spreading. 

A study published Thursday in JAMA Network Open showed that sticking to a universal Covid vaccine recommendation in the U.S., the guidance that has been in place in recent years, has the potential to prevent thousands more hospitalizations and deaths than limiting the advisory to high-risk groups. 

Numerous studies have demonstrated that shots using mRNA technology, including Covid vaccines from Pfizer and Moderna, are safe and effective, and serious side effects have happened in extremely rare cases. One paper in August estimates that Covid vaccines saved more than 2 million lives, mostly among older adults, worldwide between 2020 and October 2024. 

In a statement Friday, Pfizer said the company and its partner BioNTech “remain steadfast in our dedication to vaccine safety, quality and effectiveness through constant safety monitoring and ongoing research.”

One major health insurance group on Wednesday said its member plans will cover all vaccines already recommended by ACIP, including updated Covid and flu shots, despite any changes the new slate of appointees makes this week. Member plans of the group, America’s Health Insurance Plans, collectively provide coverage and services to over 200 million Americans. That includes more than a dozen Blue Cross Blue Shield plans, Centene, CVS’ Aetna, Elevance Health, Humana, Kaiser Permanente, Molina, and Cigna.

Debating Covid vaccines

One ACIP member, Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology, led a work group that reviewed data and proposed recommendations around Covid vaccines. Levi’s presentation on the group’s findings questioned the safety and efficacy of Covid shots and cast doubt on mRNA technology.

“We have a range of things on the mRNA platforms that really suggest that it doesn’t work as intended,” said Levi, who has previously pushed to stop giving mRNA shots.

He said the majority of the work group felt that individual decisions on whether to receive a Covid vaccine are “appropriate” and specifically, that people should now have to obtain prescriptions for the shot. “You get to a level of nuance” where some patients may have recent prior infections or different comorbidities that should be discussed with a physician as part of a prescription, Levi said. 

But one work group member, Dr. Henry Bernstein, said during another presentation that “shared clinical decision-making and a need for a prescription creates barriers” to Covid vaccine access. 

“Simple, stable recommendations can increase vaccine coverage,” said Bernstein, a professor of pediatrics at Zucker School of Medicine at Hofstra/Northwell. “Covid-19 vaccines are highly safe and effective.” He is not a member of Kennedy’s panel who votes on recommendations.

“Covid-19 vaccination matters for pregnant women, pediatric patients, especially those less than two years of age, people 65 years and older, those of any age with a weakened immune system, medical conditions, and anyone who feels they want protection for themselves or their families,” he said. 

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The exterior view of the entrance to Merck headquarters in Rahway, New Jersey, on Feb. 5, 2024.

Spencer Platt | Getty Images

Robert F. Kennedy Jr.’s revamped government panel of outside vaccine advisors on Thursday recommended the use of Merck‘s shot to protect infants from respiratory syncytial virus, a temporary reprieve for public health officials and companies concerned about the Health and Human Services secretary’s immunization policy.

The group, called the Advisory Committee on Immunization Practices, or ACIP, also voted unanimously to include Merck’s shot in the government’s list of recommended childhood immunizations that receive wide insurance coverage.

The votes in favor of the injectable antibody, Enflonsia, are a sigh of relief for drugmakers and the medical community after Kennedy earlier this month gutted the panel and tapped replacements, some of whom are well-known vaccine critics. 

The signoff will allow the company to launch the shot ahead of the RSV season that typically kicks off around fall and winter and lasts through the spring. Enflonsia, recommended for infants during their first RSV season, will compete head-to-head with a rival shot from Sanofi and AstraZeneca called Beyfortus.

Both are preventative monoclonal antibodies, which deliver antibodies directly into the bloodstream to provide immediate protection. But each targets a different part of the virus, making it difficult to compare them directly.

ACIP’s “recommendations are an important step forward in efforts to help reduce the significant burden RSV continues to place on infants, families, and health care systems,” said Dr. Richard M. Haupt, Merck’s head of global medical & scientific affairs, vaccines and infectious diseases, in a statement.

 RSV causes thousands of deaths among older Americans and hundreds of deaths among infants each year, and complications from the virus are the leading cause of hospitalization among newborns. In a mid- to late-stage trial on Enflonsia, the shot reduced RSV-related hospitalizations by more than 84% and decreased hospitalizations due to lower respiratory infections by 90% compared with a placebo among infants through five months.

Two of the vaccine critics on the panel, Retsef Levi and Vicky Pebsworth, voted against recommending Merck’s shot and questioned its safety throughout the meeting. 

But some other members underscored the safety of Merck’s shot, which won approval from the Food and Drug Administration earlier this month. 

“These are truly remarkable products. They are safe and they’re effective, and I don’t think there’s any further data that needs to be presented,” said member Dr. Cody Meissner, a professor of pediatrics at the Geisel School of Medicine at Dartmouth. 

The ACIP “work group has spent an enormous amount of time, the FDA has spent an enormous amount of effort looking at safety and efficacy, and it is simply not an issue here,” said Meissner, who has also held advisory roles at the CDC and FDA.

Other experts at the meeting, who aren’t members of the committee, agreed. 

“This is a tremendous advance for medical science, and I urge the committee to approve and pass this resolution so that we can continue to protect our children and keep them healthy,” said Dr. Jason Goldman, president of the American College of Physicians. 

Levi said he voted against the shot because he believes it is not “ready to be administered to all healthy babies. He added, “I think we should take a more precautionary approach to this.”

The vote specifically recommends one dose of Merck’s shot for infants ages 8 months or younger born during or entering their first RSV season. 

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A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia.

Tami Chappell | Reuters

Health and Human Services Secretary Robert F. Kennedy Jr.’s revamped government panel of vaccine advisors will start a review of long-approved shots in the U.S., the leader of the group said Wednesday in the first meeting with new members.

The panel, called the Advisory Committee on Immunization Practices, or ACIP, will also review the childhood vaccination schedule. Earlier this month, Kennedy in a stunning step removed and replaced all members of the group, which advises the Centers for Disease Control and Prevention.

ACIP members are independent medical and public health experts who review vaccine data and make recommendations that determine who is eligible for shots and whether insurers should cover them, among other efforts. But Kennedy appointed some vaccine critics, including Dr. Robert Malone, who could shape immunization policy and affect availability in the U.S. 

ACIP will create new work groups, which are staff that review published and unpublished data and develop recommendation options to present to the committee, Dr. Martin Kulldorff, the new chair of the panel, said during the meeting. One new work group will review the childhood vaccine schedule, while another will examine shots that have not been subject to reviews in more than seven years, he said.

The latter group may examine the universally recommended hepatitis B vaccine and ask whether it is “wise” to administer the shot to every newborn before they leave the hospital, Kulldorff added. He also said the group could review the combination measles, mumps and rubella shot, along with the chickenpox jab. Vaccine skeptics have questioned the safety of both shots.

“This was supposed to be a regular practice of the ACIP, but it has not been done in a thorough and systematic way. We will change that,” Kulldorff said.

Dr. Sean O’Leary, an infectious disease expert with the American Academy of Pediatrics, told reporters later Wednesday that reviewing the vaccine schedule has been “an anti-vaccine trope for many, many years.” O’Leary said many vaccines are “essentially always reviewed in real-time through a number of different mechanisms,” including several safety surveillance and disease surveillance tools.

The American Academy of Pediatrics did not participate in the ACIP meeting on Wednesday because “we view it as illegitimate,” O’Leary said. He added that the organization will continue to provide vaccine schedules for children independently of the CDC.

“What we’re seeing today, and if this were to continue, the medical providers, public health professionals, the entire country is no longer going to trust ACIP. That’s clear,” O’Leary said, saying the goal is to reinstate the 17 members that Kennedy fired and return to “a normal process.”

During a full-day meeting Wednesday in Atlanta, the panel evaluated data on Covid-19 vaccines and RSV shots. A vote on recommendations for the latter was postponed until the group’s meeting on Thursday.

Also on Thursday, the group will review data on shots for the flu and other diseases. 

The CDC director has to sign off on those recommendations for them to become official policy.

“Vaccines are not all good or bad,” Kulldorff said in opening remarks.

“If you think that all vaccines are safe and effective and want them all, or if you think that all vaccines are dangerous and don’t want any of them, then you don’t have much use for us. You already know what you want,” said Kulldorff, a biostatistician and epidemiologist who questioned lockdowns and other public health measures early in the Covid-19 pandemic.

“But if you wish to know which vaccines are suitable for you and your children and at what ages, then we will provide you with evidence-based recommendations,” he added.

Ahead of the meeting, one of Kennedy’s new appointees stepped down from the panel.

In a statement, an HHS spokesperson said Dr. Michael Ross withdrew from ACIP during a mandatory review of each member’s financial holdings, without providing further details. It is unclear what his financial holdings are.

Ross is a clinical professor of obstetrics and gynecology and has served on another CDC advisory panel focused on breast and cervical cancer.

A CDC web page on conflict of interest disclosures for ACIP members does not appear to list any for Kennedy’s members, apart from Dr. Cody Meissner.

What new panel members have said about vaccines

Kennedy’s eight new members include some well-known vaccine critics, such as Dr. Robert Malone.

Malone bills himself as having played a key role in the creation of mRNA vaccines, but has gained a large following for making baseless and disproven claims about Covid-19 shots. 

Another new member, Retsef Levi, has pushed to stop giving mRNA vaccines, falsely claiming in a post on X that they cause “serious harm including death, especially among young people.”

Another member, Vicky Pebsworth, is a nurse on the board of The National Vaccine Information Center. That organization has been widely criticized as a leading source of misinformation and fearmongering about immunization.

During the meeting on Wednesday, Pebsworth revealed that she owns stock and health-care sector funds that include vaccine manufacturers. But she said her holdings are under the amount the government considers to be a conflict of interest, allowing her to participate in the ACIP meeting.

Kennedy fired previous ACIP members for having what he called “persistent conflicts of interest.” But all HHS agencies and their advisory panels have had rigorous policies for conflicts of interest, and there have been no related issues for years.

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U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. testifies before the Senate Committee on Appropriations hearing on the Department of Health and Human Services budget, on Capitol Hill in Washington, D.C., U.S., May 20, 2025.

Ken Cedeno | Reuters

Health and Human Services Secretary Robert F. Kennedy Jr. on Monday said he is “retiring” all 17 members of a crucial government panel of vaccine advisors, a shocking step that could help to sow doubts about immunizations in the U.S.

“A clean sweep is needed to re-establish public confidence in vaccine science,” Kennedy said in an opinion piece in the Wall Street Journal on Monday.

Kennedy is removing all members of the Advisory Committee on Immunization Practices, or ACIP, which advises the Centers for Disease Control and Prevention. The group reviews vaccine data and makes recommendations that determine who is eligible for shots and whether insurers should cover them, among other efforts.

ACIP members are independent medical and public experts who make recommendations based on rigorous scientific review and evidence. The CDC director has to sign off on those recommendations for them to become official policy.

It is unclear who Kennedy will appoint to the new group. In a release, HHS said ACIP will still hold a planned meeting from June 25 to 27 to make recommendations. A person familiar with the matter told CNBC that new members will run that meeting.

The advisor overhaul is the latest move by Kennedy – a prominent vaccine skeptic – to change and potentially undermine vaccinations in the U.S. since he took the helm at HHS. Under Kennedy, HHS stopped recommending routine Covid-19 vaccines for healthy children and healthy pregnant women and canceled programs intended to discover new vaccines to prevent future pandemics, among other changes.

Kennedy said Monday HHS will put “the restoration of public trust above any pro- or antivaccine agenda.”

Kennedy added some of the members on the committee were last-minute appointees of the Biden administration and noted that, without ousting advisors from the current group, the Trump administration would not have been able to appoint a majority of new members until 2028.

Kennedy claimed that the panel has been “plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine.”

But all HHS agencies and their advisory panels have had rigorous policies for conflicts of interest, and there have been no related issues for years. All members of federal vaccine advisory committees are already required to comply with regulations around disclosing potential conflicts of interest.

The announcement comes days after pediatric infectious disease expert Dr. Lakshmi Panagiotakopoulos resigned as co-leader of ACIP due to the belief she is “no longer able to help the most vulnerable members” of the U.S. population.

Health policy experts previously told CNBC that a shake-up of the advisory committee could produce politicized recommendations that highlight the harms rather than the benefits of shots. Those recommendations could also create greater distrust in the CDC and Trump administration among scientists and public health experts.

ACIP has also scrutinized vaccine products in the past, in contrast to what Kennedy and other Trump administration figures have argued. In certain instances, the group has recommended more restricted use of vaccines than their approval under the Food and Drug Administration would permit.

For example, the FDA approved Merck’s HPV vaccine for use in women and men ages 9 to 45. But the CDC only recommends its use in patients ages 9 to 26, because there is a lower public health benefit of the vaccine in those ages 27 to 45.

— CNBC’s Angelica Peebles contributed to this report.

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