Blog Post

Understanding the ACIP and
its Role in Vaccine Guidance

Introduction

For more than 60 years, the Advisory Committee on Immunization Practices (ACIP) has gone about its work in relative obscurity, serving as an advisory committee to the Centers for Disease Control (CDC) on various vaccine-related matters. That all changed though, in June 2025, when U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. removed all members of the committee, and again in September, when significant changes were announced regarding COVID-19 vaccine eligibility.

These actions generated significant attention for the ACIP, and put the spotlight on its role in influencing national vaccine policy. But before delving into the specifics of the recent vaccine changes, it’s worth taking the time to learn more about this entity. Where does ACIP get its authority, what is its purpose, how does it operate, and who are its members? And critically important, what is its timeline for acting on the recent HHS proposals? The following discussion will shed light on these and other areas of focus and hopefully clarify ACIP’s role in helping to set the nation’s vaccine policy.

The Centers for Disease Control (CDC) describes the ACIP as a committee of experts who make recommendations to the Department of Health and Human Services regarding the use of vaccines and related agents for the control of vaccine-preventable disease in the U.S. civilian population. ACIP recommendations, the analysis notes, inform the CDC’s annual immunization schedules of recommended vaccines for children and adolescents, as well as for adults.

The ACIP was established in 1964 by the Surgeon General of the United States, under Section 222 of the Public Health Service Act. The purpose of the committee was to assist in developing a single, coordinated national immunization policy. According to an overview prepared by the Centers for Disease Control, prior to establishment of the ACIP, public health agencies relied on “committees convened intermittently” to address various issues. A committee was formed, for example, in 1955 to consider the first polio vaccine developed by Jonas Salk. Subsequent committees were formed as additional vaccines were developed. “By the early 1960s,” the CDC overview explains, “it was evident that decision making on use of vaccines required a greater degree of continuity of expert technical advice rather than formation of ad hoc committees to address national immunization policy.”

ACIP has provided that direction and continuity since its inception in 1964. Later, in 1972, the ACIP was designated a federal advisory committee which formalized its operating procedures and mandates. Today the committee operates under a charter which, according to KFF outlines responsibilities and procedures that include:

Providing recommendations to the CDC regarding who should get a vaccine (e.g., specifying age and other criteria).

Recommending vaccine dosages, along with preferred timing and other types of guidance.

Responsibility for establishing the list of vaccines, number of doses, schedule, and contraindications for the Vaccines for Children (VFC) program. (The VFC program is a federal program that provides vaccines, free of charge, to children under the age of 18.)

Determination of vaccines that will be covered by health insurance plans. According to KFF, the Affordable Care Act and subsequent laws require most private health insurance plans and Medicaid programs to cover the full cost of ACIP-recommended immunizations.

Responsibility for recommending vaccine requirements for individuals immigrating to the United States.

The ACIP meets three times per year, with meetings open to the public unless otherwise indicated. The committee most recently met in September 2025 and will meet again in October. Details of the September meeting are highlighted below.

Meetings for 2026 are scheduled for February, June, and October.

Who are ACIP members, and how are they selected?

The ACIP is comprised of “up to 19 voting members” who are chosen by the secretary of the U.S. Department of Health and Human Services. Voting members are independent medical and public health experts who do not work for CDC.

Members are selected after completing an application and nomination process.

The ACIP also includes six ex officio members who, according to CDC, represent other federal agencies with responsibility for U.S. immunization programs. Ex officio members currently serving on the ACIP represent the Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), Health Resources and Services Administration (HRSA), Indian Health Service (IHS), Office of Infectious Disease and HIV/AIDS Policy (OIDP), and the National Institutes of Health (NIH).

In addition, 30 non-voting representatives of liaison organizations participate in ACIP work and offer immunization expertise. These representatives are from groups including the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the Infectious Diseases Society of America (IDSA), among others.

All members and representatives serve on ACIP voluntarily.

What Vaccine Policy Changes were Announced in 2025 – and how has ACIP Responded?

On June 9, 2025, HHS Secretary Kennedy addressed what he called a “crisis of public trust” with regard to the nation’s vaccine policy. “Whether toward health agencies, pharmaceutical companies or vaccines themselves, public confidence is waning,” he stated in a press release.

Secretary Kennedy announced plans to address this problem by “totally reconstituting” the ACIP. Specifically, 17 members of the current committee were “retired,” with Secretary Kennedy suggesting many members had conflicts of interest, including financial ties to pharmaceutical companies, and an “immersion in a system of industry-aligned incentives.”

New members of the ACIP have since been announced, with 11 voting members listed on the CDC’s website at the end of September.

2025 Proposed Vaccine Changes

The changes to the ACIP membership coincided with announcements regarding specific vaccine recommendations. According to a timeline prepared by U.S. News & World Report, more notable recommendations included:

COVID-19. In May, federal officials announced plans to limit COVID-19 immunization eligibility to adults 65 and older, and to children and younger adults with certain risk factors.

Also in May, Secretary Kennedy announced that COVID-19 vaccines were no longer recommended for healthy pregnant women and children.

These recommendations are a change from previous guidance which recommended immunization for everyone over the age of six months.

Childhood Vaccine Schedule. In August, HHS announced the reinstatement of the Task Force on Safer Childhood Vaccines, which oversees “the safety, quality, and oversight of vaccines administered to American children.” The task force was disbanded in 1988, but will now be reconstituted and charged with reporting to Congress, within two years, about possible recommendations to current vaccine guidelines.

ACIP Actions on Proposed Changes

The newly-formed ACIP met in September with an agenda that included recommendations for vaccines including Measles, Mumps, Rubella, and Varicella (MMRV), Hepatitis B, and COVID-19.

According to the New York Times, the committee took the following actions:

Approval to provide federal coverage for the combined MMRV vaccine.

Postponement of a vote to alter the current practice of administering the hepatitis B vaccine to newborns.

Rejection of a proposal to require prescriptions for the COVID-19 vaccine.

Unanimous approval for recommending that adults 65 and older receive the COVID-19 vaccine only after discussing the potential benefits and risks with a health care provider.

The committee also gave its support for allowing “everyone from 6 months to 64 years old” to get the vaccine after consulting with a provider.

The decision to expand access seemed to contradict the FDA’s proposal to limit vaccine access to adults over 65 and to individuals under 65 with certain health conditions.

“Together,” the Times analysis notes, “the decisions raise questions about whether Americans can continue to walk into their neighborhood pharmacies for routine vaccinations or whether in some states they will first need a doctor’s permission.”

The ACIP’s recommendations now move to the CDC, which will either implement the changes or reject them. However, notes Politico, there is speculation that, since the committee did not alter the vaccine schedule as dramatically as many had expected, Secretary Kennedy may decide to circumvent the ACIP and “create new recommendations without a vote from the panel.”

How do ACIP Vaccine Updates Impact Healthcare Providers?

Healthcare providers, including pharmacists, are unfortunately caught in the uncertainty that has resulted from the current status quo. For one thing, there is confusion with regard to COVID-19 vaccine eligibility, as patients learn they are no longer in the target group, and face the possibility that the cost of the vaccine may not be covered by their insurer.

Pharmacists also find themselves without meaningful guidance as parents question the best course to follow for their children’s vaccine schedules.

The regulatory landscape has also changed for pharmacies, but details remain elusive. “The biggest problem is that in some states,” the Times notes, “the law prohibits pharmacists from administering vaccines that are not recommended by the Advisory Committee on Immunization Practices (ACIP.” And, notes analysis by the Bloomberg School of Public Health, ACIP’s recommendations have important implications for insurance coverage. “Insurance companies don’t start covering costs based on FDA licensure. They start covering costs based on CDC recommendations.”

The current aura of uncertainty is a departure from “normal” ACIP practices, in which the committee serves as a trusted partner in offering recommendations to the CDC. But as the newly configured committee gets its footing and takes on the important work of overseeing vaccine practices, the ACIP will continue its vital role in the process.

PrimeRx for Pharmacy Immunization Management

Pharmacies can look to their state pharmacy boards and other professional associations for updated guidance regarding changes to immunization protocols, including eligibility, schedules, approved manufacturers, regulatory mandates and reporting requirements. Timely, accurate information will be essential as patients look to pharmacists for guidance and in some instances, for assistance in affording their immunizations.

But for assistance in managing their immunization programs, pharmacies need look no further than their technology management system. This includes PrimeRx, an industry-leading solution that offers seamless, end-to-end management of core pharmacy functions including immunization management.

Pharmacies can rely on PrimeRx for immunization-related functionality that includes:

Automated Reporting.

Pharmacists are required to transmit timely data about all pharmacy-administered vaccines to their state, and in some instances their local vaccine reporting registries. PrimeRx automates this process through direct integration with the Immunization Registry Reporting solution from Surescripts. The solution automatically transmits accurate, timely information to applicable state and local reporting registries. No need for pharmacy staff to spend time gathering data and filling out tedious paperwork, which leaves more time for direct patient interactions.

Vaccine Procurement.

Pharmacists can rely on another PrimeRx offering, PrimeRx MARKET, to ensure steady supplies of required vaccines at the best possible prices. PrimeRx MARKET is an online market that allows direct access to more than 40 of the nation’s leading drug wholesalers and suppliers. Pharmacies can identify sources for medications, vaccines, OTCs, injectables and other products, with real-time price comparisons between suppliers. Orders can be placed with multiple suppliers, all within the PrimeRx MARKET platform. With regard to vaccines, PrimeRx MARKET offers extensive supplies, including access to popular products that include:

Afluria

Fluad

Shingrix

Spikevax

Pneumovax.

PrimeRx MARKET allows pharmacies fast, direct access to needed vaccines and medications. This allows pharmacy staffs to recapture valuable time that previously was spent manually looking up this information. Less time looking up vaccine availability means more time to spend with patients.

Patient Records.

Pharmacists can maintain extensive patient health records for improved visibility when formulating treatment plans. PrimeRx automatically updates patient records each time a prescription is filled or an immunization administered. The pharmacist can record notes and observations after each visit, include information about supplement and OTC product usage, and capture information about family history and other important details. And critical for good recordkeeping, the system captures all patient signatures and receipts for each transaction. All records are securely stored and easily accessible.

Claims Processing

Immunization claims are seamlessly transmitted to the correct payer, with all accurate and relevant information automatically added. The system tracks each claim until a resolution is received.

Signature Capture.

The system allows patients to sign for each immunization via a HIPAA-complaint signature capture tool. Signatures are added to each patient’s record, and easily accessible for any audit or payer request.

Communication.

Pharmacies can generate texts and/or emails to patients with information about the importance of vaccines, and to let them know which vaccines are available at their local pharmacy.

For more than 60 years, the ACIP has offered invaluable guidance and expertise in helping to ensure the safety and efficacy of the nation’s vaccines. ACIP recommendations are the gold standard, developed by experts who selflessly volunteer their time to serve in an advisory role to the federal government.

Most Americans have never heard of the ACIP, as the committee usually conducts its work far from the glare of the media spotlight. But we can all be grateful for its efforts, and the ACIP’s commitment to keeping the nation safely vaccinated.