The Centers for Disease Control and Prevention (CDC) has updated its immunization schedules for adults and children, shifting to an individual-based approach for COVID-19 vaccination and recommending that toddlers receive the varicella (chickenpox) vaccine separately from the measles, mumps, and rubella (MMR) vaccine.
These changes reflect recent recommendations by the CDC Advisory Committee on Immunization Practices (ACIP), which were approved last week by Acting CDC Director and Deputy Secretary of Health and Human Services Jim O’Neill. The new schedules are expected to be available 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 initial COVID-19 vaccinations achieved high uptake among U.S. adults—estimated at nearly 85% following Operation Warp Speed—only about 23% received the most recent seasonal booster, according to data from the CDC’s National Immunization Survey. This decline was linked to concerns over safety and efficacy as COVID-19 became endemic after widespread immunity developed during the pandemic.
ACIP's latest guidance states that COVID-19 vaccination offers the greatest benefit to people under age 65 who have increased risk factors for severe illness, as outlined by the CDC. For those without such risk factors, the benefit is lower. The U.S. Food and Drug Administration has granted marketing authorization for COVID-19 vaccines specifically for individuals with one or more risk factors as well as those aged 65 or older.
The revised immunization schedule refers to this approach as "shared clinical decision-making," meaning healthcare providers—including physicians, nurses, and pharmacists—should base vaccination decisions on patient-specific characteristics beyond just age. These considerations include underlying disease risk factors, vaccine properties, and current evidence regarding who may benefit most from vaccination.
Coverage through programs like Medicare, Medicaid, Children’s Health Insurance Program (CHIP), Vaccines for Children Program, and insurance plans under the Affordable Care Act remains unchanged under this new framework.
For young children, a new recommendation advises administering chickenpox vaccine alone rather than combined with MMR in toddlers up to age three. This follows evidence presented by the CDC Immunization Safety Office showing that healthy toddlers aged 12–23 months face a higher risk of febrile seizures seven to ten days after receiving the combined MMRV vaccine compared to separate administration of chickenpox vaccine. The combination doubles seizure risk without providing extra protection against varicella compared to standalone vaccination.
