CDC panel backs individual decision-making on COVID vaccines, keeps access open

Friday, Sept. 19, 2025, a U.S. Centers for Disease Control and Prevention advisory panel endorsed shifting COVID-19 vaccine guidance toward 'shared clinical decision-making,' effectively placing more emphasis on individual choice in consultation with healthcare providers. The decision keeps vaccines broadly accessible and covered by major payers, including Medicaid, Medicare, CHIP and private insurance. It moves away from a universal, age-based vaccination directive for everyone six months and older, instead urging people to discuss with their clinicians whether to receive an updated shot. The vote reflects a broader effort to tailor vaccination decisions to a person’s health status and risk profile as data on COVID-19 evolves.

ACIP members voted 11-1 to strengthen informed consent by adding language about risks and uncertainties to vaccine information sheets and to encourage providers to discuss vaccination in light of a patient’s prior infections, immunosuppression and other conditions. Doctor Retsef Levi of MIT Sloan, a panelist, urged that the language used in CDC materials be precise about what is known and what remains uncertain so that patients and clinicians can have realistic discussions about risks and benefits. Levi said the current knowledge gaps warrant explicit acknowledgment in the information presented to patients. Several panelists stressed that the approach should reflect evolving science and patient circumstances. The committee also backed language urging providers to discuss how prior infections and immunosuppression influence the decision to vaccinate.

Perhaps the most contentious element was a proposal to require a prescription for the COVID shot. The motion failed in a 6-6 split, with ACIP Chair Martin Kulldorff breaking the tie by voting no. Dartmouth's Dr. Cody Meissner strongly opposed the prescription requirement, saying, 'Requiring a prescription is going to become a big barrier to administration of this vaccine. If a person wants it for himself or herself or her children, they should be able to get it without a prescription.' Proponents argued that treating vaccines like other non-emergency medicines would ensure ongoing physician-patient conversations, while others warned that access barriers would undermine trust. 'Science supports the COVID-19 vaccine works. It is incredibly safe and effective. But the vaccine also must be easily accessible for everyone who wants it,' said Dr. Henry Bernstein of the Zucker School of Medicine.

Separately, the committee voted 12-0 to update the pediatric and adult immunization schedule to reflect 'individualized decision-making' for FDA-approved COVID vaccines. Deputy Secretary of Health and Human Services and CDC acting Director Jim O’Neill praised the panel for bringing overdue scientific debate into the public eye and said the guidance aims to support clinicians and patients in making informed, context-specific choices. The CDC pointed Fox News Digital to a Sept. 19 press release confirming the panel’s actions.

Officials emphasized that the new approach centers on patient-specific risk factors. The CDC notes that the vaccination’s risk-benefit profile under age 65 is greatest for people with higher risk factors for severe disease and lowest for those without such risks, underscoring the need for conversations that account for prior infections, immunosuppression and other health conditions. Vaccines would remain available through standard coverage programs, and access remains a priority as the agency fosters individualized decisions rather than universal mandates. The shift marks a significant departure from earlier CDC guidance that broadly recommended updated vaccines for everyone six months and older, reflecting ongoing assessment of the evolving virus and the gaps in current knowledge about how best to tailor recommendations to individual risk profiles.

As the debate unfolded outside the policy arena, public demonstrations around the CDC building highlighted the public attention the Guidance change drew. The panel’s actions are likely to influence how clinics approach conversations about COVID vaccination, balancing the push for access with the imperative to convey uncertainties and individual risk considerations. In the coming weeks, healthcare providers may begin incorporating the new language into patient conversations and information materials as the updated guidance takes effect across vaccination programs.