The Centers for Disease Control and Prevention (CDC) has updated its immunization schedules for adults and children, introducing an individual-based approach to COVID-19 vaccination decisions and recommending that toddlers receive chickenpox (varicella) immunization separately from the measles, mumps, and rubella (MMR) vaccine.
These changes reflect recent guidance from the CDC’s Advisory Committee on Immunization Practices (ACIP), which were approved by Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O’Neill. The revised schedules are expected to be available on the CDC’s website by October 7, 2025.
“Informed consent is back,” said Deputy Secretary O’Neill. “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today.
“I commend the doctors and public health experts of ACIP for educating Americans about important vaccine safety signals. I also thank President Trump for his leadership in making sure we protect children from unintended side effects during routine immunization.”
While nearly 85% of U.S. adults received a primary COVID-19 vaccine series during Operation Warp Speed, only about 23% followed through with the most recent seasonal booster recommendation, according to CDC’s National Immunization Survey. This drop in uptake has been linked to concerns over safety and effectiveness as population-wide immunity developed following widespread exposure to COVID-19.
The new ACIP guidance states that vaccination benefits are highest among individuals under age 65 who are at increased risk for severe illness based on CDC-defined risk factors. The U.S. Food and Drug Administration has authorized COVID-19 vaccines specifically for those with these risk factors as well as people aged 65 or older.
Under this new policy, known as shared clinical decision-making, health care providers—including physicians, nurses, and pharmacists—are encouraged to assess each patient’s unique situation when recommending vaccines. Factors considered include not only age but also underlying health conditions, vaccine characteristics, and current evidence regarding who may benefit most from vaccination.
Immunizations delivered under individual-based decision-making will remain covered by programs such as Medicare, Medicaid, the Children’s Health Insurance Program, Vaccines for Children Program, and insurance plans governed by the Affordable Care Act.
For children ages one to three years old, the schedule now recommends standalone varicella vaccination instead of a combined MMRV shot. This follows data presented by the CDC Immunization Safety Office showing that healthy toddlers receiving the combination vaccine have a higher risk of febrile seizures seven to ten days after immunization compared to those who receive chickenpox protection separately. According to these findings, combining vaccines doubles seizure risk without providing extra protection against varicella.
