The Centers for Disease Control and Prevention (CDC) has updated its immunization schedules for adults and children, introducing a shift to individual-based decision-making for COVID-19 vaccination and recommending standalone chickenpox immunization for toddlers.
These changes reflect recommendations from the CDC 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 new schedules are set to be published on the CDC 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 the initial COVID-19 vaccinations developed under Operation Warp Speed, only 23% followed the most recent seasonal booster recommendation, according to data from the CDC’s National Immunization Survey. This decline in uptake has been linked to concerns over safety and efficacy as COVID-19 became endemic following widespread immunity during the pandemic.
ACIP’s guidance highlights that vaccination benefits are greatest for those under age 65 who have risk factors increasing their chances of severe COVID-19 illness, as identified by the CDC. The U.S. Food and Drug Administration has granted marketing authorization for COVID-19 vaccines to individuals with these risk factors as well as those aged 65 and older.
The approach known as individual-based decision-making—referred to on CDC schedules as shared clinical decision-making—involves healthcare providers tailoring vaccination decisions based on specific patient characteristics beyond age, such as underlying disease risk factors, vaccine properties, and current evidence regarding who may benefit most.
This method still allows coverage through all payment mechanisms including Medicare, Medicaid, Children’s Health Insurance Program, Vaccines for Children Program, and insurance plans regulated by the Affordable Care Act.
For young children, the revised schedule now recommends that toddlers up to age three receive chickenpox (varicella) immunization separately rather than combined with measles, mumps, and rubella vaccines. Evidence presented by the CDC Immunization Safety Office indicated that healthy toddlers aged 12–23 months face a higher risk of febrile seizures seven to ten days after receiving the combined vaccine compared to those given chickenpox immunization alone. The combination vaccine was found to double this risk without offering extra protection against varicella.
