The Centers for Disease Control and Prevention (CDC) has updated its immunization schedules for adults and children, introducing individual-based decision-making for COVID-19 vaccination and recommending that toddlers receive a standalone chickenpox vaccine rather than a combined shot with measles, mumps, and rubella.
These changes follow recent 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’s 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 vaccine series under Operation Warp Speed, only 23% followed the CDC’s most recent seasonal booster recommendation, according to data from the National Immunization Survey. Concerns over risk-benefit ratios grew as COVID-19 became endemic following widespread immunity acquired during earlier phases of the pandemic.
ACIP’s latest guidance states that vaccination is most beneficial for people under age 65 who have increased risk factors for severe COVID-19. The U.S. Food and Drug Administration has authorized COVID-19 vaccines for individuals with one or more risk factors as well as those aged 65 and older.
On the updated immunization schedule, individual-based decision-making is described as shared clinical decision-making involving healthcare providers such as physicians, nurses, and pharmacists. This approach takes into account patient-specific characteristics beyond age—such as disease risk factors, vaccine attributes, and current evidence on benefit—when deciding whether to vaccinate.
Coverage through programs like Medicare, Medicaid, Children’s Health Insurance Program (CHIP), Vaccines for Children Program, and insurance plans regulated by the Affordable Care Act will continue to apply to both routine recommendations and those based on individual decisions.
The revised child immunization schedule now recommends that toddlers up to age three receive a standalone chickenpox (varicella) vaccine rather than a combination shot with measles, mumps, rubella, and varicella. This change follows findings presented by the CDC Immunization Safety Office showing that healthy toddlers aged 12–23 months face an increased risk of febrile seizure seven to ten days after receiving the combined vaccine compared to those given separate chickenpox immunizations. The combination vaccine was found to double this risk without providing extra protection against chickenpox relative to standalone administration.
