CDC eyes narrower COVID-19 vaccine guidance ahead of 2025-2026 season

Dr. Lakshmi Panagiotakopoulos of the CDC is expected to present guidance on COVID-19 vaccine use for 2025-2026 and suggest the department adopt a "narrow" recommendation for it, "and only maintain this series for certain populations within these groups who we determine should be vaccinated."

Currently, annual COVID-19 shots are recommended for ages 6 months and older. One proposed policy option would continue the current universal policy, while another would recommend vaccines only for people at higher risk of severe illness, such as older adults, those with underlying health conditions, pregnant women and healthcare workers. 

A third option would blend the two, keeping universal recommendations for people 65 and older but limiting shots for younger groups to those at higher risk.

"When initially presented with 2025-2026 COVID-19 vaccine policy options in November 2024, the Work Group appreciated pros and cons of both risk-based and universal vaccine recommendations," Panagiotakopoulos wrote. "At that time, there was not yet a consensus on what the recommendation for the 2025-2026 COVID-19 vaccine should be. The Work Group requested additional information to help inform the decision-making process on risk-factors for severe COVID-19, transmission and immunity, vaccine implementation and access, and cost-effectiveness."

The presentation will also propose how to define "increased risk," looking at both health factors and increased exposure, like living in long-term care facilities or working in high-contact jobs.

The two-day meeting of the Advisory Committee on Immunization Practices will examine information for members to vote on as official recommendations, which will then be passed on to the CDC for consideration in June.

The end of the presentation will include discussion questions about the pros and cons of a universal vs. risk-based COVID-19 vaccine recommendation for 2025 to 2026. Key discussion points include whether any groups should be excluded from vaccination, what data is still needed to guide decisions, and whether a risk-based approach makes sense if most people are already considered "at risk."

Members of the committee will vote on Wednesday on recommendations for the Meningococcal Vaccines, Meningococcal Vaccines VFC, RSV Adult and the Chikungunya Vaccines.