A Look Back at CDC Advisory Panel's Reshaping of U.S. Vaccine Guidance via Landmark September Votes
This is the beginning of a rational period in which vaccines are no longer a sacred cow. More to come on aluminum and revisiting CDC's Vaccine Information Sheets
Atlanta, September 20, 2025 — The U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) closed a two-day meeting on September 18 and 19 with sweeping changes to vaccine guidance for coronavirus disease 2019 (COVID-19), the combined measles-mumps-rubella-varicella (MMRV) vaccine, and the hepatitis B (HepB) birth dose.
The decisions reflected months of preparation and years of accumulated science. Committee members worked from randomized controlled trials, peer-reviewed observational studies, post-marketing surveillance data, modeling exercises, and rapid systematic reviews. They emphasized that each decision followed explicit risk-benefit debate and that no members with pharmaceutical conflicts of interest (COIs) participated in these votes. The outcomes represent hundreds of thousands of hours of combined scientific work and were neither rushed nor rubber-stamped.
COVID-19 Vaccination: From Routine to Shared Clinical Decision-Making
The most far-reaching decision came on COVID-19 vaccination. ACIP voted unanimously, 12–0, to move COVID-19 vaccines into the category of shared clinical decision-making (SCDM) for everyone aged six months and older.
Shared clinical decision-making, an official ACIP designation, means vaccination is not automatically recommended for all, as had been the case when COVID-19 doses were treated like the annual influenza shot. Instead, physicians and patients are expected to weigh risks and benefits on an individual basis. The evidence presented showed that updated messenger RNA (mRNA) vaccines reduce the risk of hospitalization by roughly 65 to 75 percent in adults aged 65 and older during the three months following vaccination. In contrast, in healthy adults under age 50 the effectiveness falls to about 15 to 25 percent. Risks were also discussed. In young males, especially those aged 16 to 29, myocarditis has been observed after the second dose at a rate of about 10 to 20 cases per 100,000, almost always within seven days.
A motion to require prescriptions for COVID-19 vaccination split the committee evenly, 6–6, with ACIP Chair Martin Kulldorff, PhD, casting the deciding vote against the requirement. This preserved the ability of pharmacists, who currently administer most COVID-19 vaccinations, to continue doing so without a physician’s order. The committee also voted unanimously to strengthen informed consent. It asked the CDC to update the Vaccine Information Statement (VIS), the federally required patient handout, so that it clearly states the known risks and benefits, the uncertainties that remain, and the subgroups in which vaccination is most or least favorable.
Uncertainties acknowledged include the long-term outcomes of vaccine-associated myocarditis, the effectiveness and safety of repeated boosting in people at low baseline risk, and the possibility that SCDM could worsen disparities if counseling varies depending on provider time, setting, or resources.
MMRV Vaccine: Separate Doses for Young Children
ACIP also altered guidance on the combined measles-mumps-rubella-varicella vaccine. For years, families have had the option of a single injection covering all four diseases. Data from the Vaccine Safety Datalink (VSD), a large U.S. surveillance system, showed that for children 12 to 23 months old, the combined vaccine doubles the risk of febrile seizures compared with giving separate measles-mumps-rubella (MMR) and varicella (V) shots.
The absolute increase is small but measurable. About 25 febrile seizures occur per 10,000 doses of separate MMR and V, compared to about 30 per 10,000 doses of MMRV. That means four to five additional seizures per 10,000 doses, translating to a Number Needed to Harm (NNH) of approximately 2,200. Although these seizures are typically brief and without lasting neurological harm, ACIP concluded that the increased risk outweighs the convenience of one injection in toddlers.
By a vote of 8–3, with one abstention, the panel recommended that children under four years of age receive separate MMR and V vaccines. For children aged four to six, where the data show no excess seizure risk, MMRV remains an option. The next day, ACIP realigned the Vaccines for Children (VFC) program—a federal initiative that provides free vaccines to nearly half of American children—so that it no longer covers MMRV for children under four. Coverage of separate MMR and varicella vaccines remains intact.
The equity implications were discussed openly. While the health benefit of reducing seizure risk was clear, some members warned that families in lower-income communities might face added barriers if children now require two injections rather than one. Lower series completion rates could result, an effect the CDC will be monitoring.
Hepatitis B: Universal Birth Dose Reaffirmed, Proposal to Delay Tabled
A third major issue was the hepatitis B vaccine, which has long been recommended within 24 hours of birth regardless of maternal hepatitis B surface antigen (HBsAg) status. A proposal was introduced to allow infants of mothers who tested negative for HBsAg to delay the first dose until one month of age. After discussion, the committee voted to table the proposal. The current policy therefore remains in effect.
Data presented showed that without intervention, the risk of perinatal hepatitis B virus transmission is approximately one in 1,900 births. Vaccination alone reduces that risk by about 75 percent, hepatitis B immune globulin (HBIG) alone by about 71 percent, and the combination of HBIG plus vaccine by about 94 percent. When universal screening of pregnant women is combined with targeted use of HBIG and vaccine for exposed infants, the risk of transmission falls to about one in 31,800 births. With a universal day-0 dose for all infants, the risk is about one in 7,600.
The CDC’s rapid review of the safety literature was criticized by ACIP members for combining studies of vaccine given within 24 hours with studies of vaccine given within 30 days, obscuring the specific effects of a true birth dose. Only five of the 20 studies included actually examined vaccination in the first 24 hours of life. Neonatal outcomes such as encephalopathy or death were too rare in the available data to rule out small risks with confidence. Some committee members also noted that cases recorded as “no maternal test” in electronic records may reflect missing documentation rather than true screening failures, meaning the scale of the problem is uncertain. Universal maternal screening was reaffirmed, and CDC staff were asked to return with a clearer Evidence-to-Recommendation (EtR) framework and more precise analyses before the proposal could be reconsidered.
Deliberation and Process
The meeting highlighted a shift in ACIP’s tone toward greater caution and transparency. Unlike prior ACIP meetings, risk was explicitly discussed before each vote. The hepatitis B proposal was tabled precisely because of definitional ambiguity and limited data, a sign that the committee will not act without solid evidence. The Evidence-to-Recommendation (EtR) discipline—the requirement that recommendations follow a structured framework of evidence, benefits, harms, values, and feasibility—was evidently in play. Conflict-of-interest safeguards were observed, with no voting members tied to vaccine manufacturers. Liaisons from professional societies were present but did not vote.
What Comes Next
ACIP’s recommendations are advisory until approved by the CDC Director and published in the Morbidity and Mortality Weekly Report (MMWR), which formalizes federal guidance. Historically, the CDC Director has accepted ACIP recommendations, but official policy will be confirmed once published. Insurers and federal programs, including the VFC program, have pledged coverage of all ACIP-recommended vaccines through 2026, ensuring that access will not be interrupted as guidance transitions.
Conclusion
In two days of concentrated debate, ACIP reframed COVID-19 vaccination as a matter of individualized clinical judgment, limited use of the combined MMRV vaccine to children aged four and older, and reaffirmed the hepatitis B birth dose by tabling a proposal to delay it. These decisions were grounded in quantifiable benefits and risks, balanced against equity concerns and evidence gaps. Where data were strong, recommendations shifted. Where uncertainties remained, change was deferred.
The September 2025 meeting underscored ACIP’s role as a careful and methodical body, one that insists on precision and transparency. The outcomes highlight the tension between convenience and safety, between universal policy and individual risk, and between evidence that is clear and evidence that is still evolving. Far from routine, the votes reflect deliberate, evidence-based public health decision-making, designed to serve the public with rigor rather than expedience.
They are trying to trick us again. It is far too late for them to fix what they did. The damage and death are permanent and will continue. Now they are pretending to be on our side to regain trust. So they can continue the democide. I don’t believe anything they say. I will never trust any medical professional again. They murdered and maimed people to line their own pockets. They will do it again.
Will the changes for the Covid vaccines and children remove this from the Childhood vaccination schedule? If so, wouldn't that eliminate the blanket liability protection? Hopefully that's the case. That's how we essentially stop these vaccines from being given to the public. I can't imagine any physician would be willing to assume liability for these "vaccines." One can hope.