WASHINGTON, D.C. — The Centers for Disease Control and Prevention announced sweeping changes Friday to the nation’s adult and child immunization schedules, adopting a more individualized approach to COVID-19 vaccination and recommending that toddlers receive standalone varicella (chickenpox) shots rather than combination immunizations.
The updates follow recommendations from the CDC’s Advisory Committee on Immunization Practices (ACIP) and were approved by Acting CDC Director and Deputy Health and Human Services Secretary Jim O’Neill. The revised schedules are set to be published on CDC.gov by October 7.
“Informed consent is back,” O’Neill said in a statement. “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.”
The new approach marks a shift from the CDC’s previous universal COVID-19 booster recommendations toward “shared clinical decision-making,” which allows physicians, nurses, and pharmacists to tailor vaccination guidance to an individual’s health profile and risk factors. The agency said the move is designed to better reflect differences in age, underlying health conditions, and exposure risks.
The change comes amid declining COVID-19 booster uptake nationwide. While the initial vaccination campaign launched under Operation Warp Speed reached an estimated 85% of U.S. adults, CDC survey data show that only 23% of adults received the most recent seasonal booster. Health officials said the updated guidance acknowledges the evolving nature of the virus, widespread population immunity, and public concerns about risk-benefit balance as COVID-19 transitions into an endemic phase.
According to ACIP, COVID-19 vaccination remains most beneficial for adults age 65 and older and for individuals of any age with one or more CDC-listed risk factors for severe disease. The U.S. Food and Drug Administration continues to authorize vaccines for those populations while supporting provider discretion for others based on medical judgment.
The child and adolescent immunization schedule will also see a key change: children between 12 and 23 months will now receive varicella vaccination as a standalone dose instead of as part of the combined measles, mumps, rubella, and varicella (MMRV) vaccine. The CDC said the decision followed data showing that the combination vaccine roughly doubles the risk of febrile seizures in healthy toddlers compared to the separate chickenpox shot, without offering added protection against varicella.
Both the adult and pediatric schedule revisions will continue to ensure coverage under federal and private insurance programs, including Medicare, Medicaid, the Children’s Health Insurance Program, and the Vaccines for Children Program.
O’Neill credited ACIP scientists for “educating Americans about important vaccine safety signals” and thanked President Trump for “his leadership in making sure we protect children from unintended side effects during routine immunization.”
The CDC said it will provide additional implementation guidance for clinicians and public health officials ahead of the new immunization schedules’ publication next week.
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