The first vaccine advisory committee meeting of the new administration took place this week. The CDC’s Advisory Committee on Immunization Practices (ACIP) met on April 15-16, 2025, a two-month delay from their typical February meeting.
Of note, a new page on the CDC website lists Conflicts of Interest of ACIP members, but it shows nothing new. The page draws information from what the members have disclosed publicly since 2000. So it’s a handy collection for at-a-glance info, but doesn’t dig deep – yet.
The committee heard presentations on vaccines for influenza, meningococcal, RSV, mpox, COVID-19, pneumococcal, HPV, cytomegalovirus, and chikungunya. Many members are new and, while the tone was relatively typical, there were some pointed questions about safety and need for some shots or expansions of recommendations that were welcome to hear after the head nodding of the COVID years.
Most notably, there were presentations on a next-generation COVID shot from Moderna that lays the groundwork for combo shots with flu, more discussion of reducing HPV shots but decreasing age, a vaccine soon to be licensed for the unknown threat of cytomegalovirus in infants, and a presentation on the notoriously ineffective and unsafe FluMist that is now available for home administration.
Here are some of the most compelling summaries:
COVID-19
Moderna is nearing the end of trials for a “next generation COVID-19 vaccine.” Presentations revealed only up to 20% of American adults got the last two rounds of COVID shots. So why is Moderna still working on a new shot? If you’re scratching your head, you’re not alone, but it becomes clear as you investigate. The presenter referenced the ongoing need for these products for those of advancing age, those with preexisting conditions, and the immunocompromised. Is that really what’s going on with that low of an uptake?
The next generation mRNA-1283 began human trials almost immediately after the approval of Moderna’s mRNA-1273 known as Spikevax.1 Why? How is this new shot different from Spikevax? This new shot would have only 1/5 the dose of the spike-protein C-shot; could be stored in a refrigerator rather than requiring extreme cold, making it much less expensive and difficult to transport (to rural areas and poor countries for example); and could be easily made into a combination product.2
In short, Moderna is looking for a revenue booster shot. Being first-to-market with an mRNA combo shot would be huge, and the company is hoping that will happen in 2025.3
One ACIP member asked if the lower dosage implied anything about natural immunity, but the question was sidestepped. Another asked why adverse events for the 1/5 dose were similar rather than lower, and was told it was because the mRNA product is just so “robust” you’d expect reactions no matter what dosage.
In another presentation, the “vaccine effectiveness” (VE) of the COVID shots to reduce severity of illness or hospitalization was summarized. It was noted that for the past two iterations, people who never received a vaccine at all could be included in the comparison group against those getting that year’s shot.
No matter how they sliced the data (by age, by preexisting condition, by how long since last shot, by immunocompromisation), at no point did VE go above 50%.4 No one talked about the shot stopping a person from getting COVID, showing that it’s now commonly accepted that the shot doesn’t prevent transmission, despite the initial fearmongering sales pitches that we’d “stop the spread” by getting the shots. The latest talking point (heard and seen many times in the presentation) was that we should think of “vaccine effectiveness” as an “added benefit,” whether we have natural or vaccine-induced immunity, or both.

Finally, in anticipation of voting on a COVID shot recommendation for the 2025-2026 season, an ACIP working group reviewed their policy and asked if there should be any changes. Notably, there was talk about changing the protocol for those in “high risk” categories. Instead of having a conversation with their doctor, they should all face a universal recommendation. Interestingly, the CDC definition of high risk includes 65% or more of Americans. There was a general disdain for a risk-based conversation with health care providers, following the trend toward “less informed, more consent” we’ve increasingly seen in these discussions over the past five years. Sandra Fryhoeffer from the AMA made the point that risk-based recommendations are more difficult for pharmacists who are authorized to give COVID shots, inadvertently reinforcing the position of those who argue that pharmacists shouldn’t be licensed to give COVID shots or any other immunizing agent.
If there is one slide deck we’d recommend you peruse, it’s this one on “Use of 2025-2026 COVID -19 Vaccines: Work Group Considerations.” It shows the best data the CDC can present to justify the shots and gives a relative look at the COVID threat as compared to other respiratory illnesses, especially for kids.
mpox
The CDC currently recommends the two-dose Jynneos vaccine for mpox for those over 18 who are at risk during an outbreak (which is determined by the CDC). Based on a recent NIH-funded study in adolescents, the ACIP Mpox Vaccine Work Group wants to vote in June 2025 on lowering the age of administration to 12. Unfortunately, there were some technical problems with the video so this presentation was not aired, though slides are available. Digging in a little more, we see the study author has been working in the Democratic Republic of Congo and has the goal of seeing “hundreds of thousands of teens” vaccinated with this product that was initially licensed for smallpox, but is now being repurposed for a disease primarily transmitted through risky sexual contact.5 At least one ACIP member pointed out there were very few cases in adolescents, and the cost for this shot was not revealed. Tracey Beth Hoeg, who works under our new FDA Commissioner Makary, also commented on the strikingly low case count and minimal safety data.
Lyme disease
The ACIP formed a new working group for Lyme vaccination, which will present info at the June ACIP meeting. The FDA licensed a Lyme vaccine, Lymrix, which was available from 1998-2002. The presenter said it was discontinued due to low demand, which makes no sense without context. If there was enough demand to make the vaccine and continued interest to get it back on the market, why would there be low demand? It does make sense when you learn the vaccine caused so many adverse events that a vaccine-injured citizen group called Lyme Disease Network formed. And since the shot was not on the childhood schedule and was shielded by the VICP, a class action lawsuit changed the bottom line for business, so the manufacturer took the product off the market.6 Stanley Plotkin, considered the “Godfather of vaccines,” called in to make a public comment exalting the possibility of a new vaccine and noting the previous attempt was marred by “mistakes.”
FluMist
In 2024, the FDA approved the nasal spray FluMist for in-home use by individuals and caregivers. This product, which includes a live-attenuated virus, the neurotoxin MSG, and an antibiotic7, is made to be shot directly up the nose, close to the blood-brain barrier. It was initially approved in 2003, and pulled from the market in 2016 for being ineffective.8 Regardless, the ACIP voted it back on the schedule in 2018, though it was “not an easy decision.” VAERS shows over 11,000 reports, including 43 deaths.9
The ACIP heard from the manufacturer about how home delivery and administration will work, with no discussion of safety or efficacy. The primary focus is “access” and uptake: How can we get this into more people? It’s the same formulation given at a provider’s office, but delivered to the home. Parents, caregivers, or individuals can go to the company’s online pharmacy to order it, fill out screening questions and become “empowered” to administer their own vaccines. It is being sold to parents in the name of convenience – no missed work or school for your annual flu vaccine.
ACIP members were treated to a step-by-step graphic presentation of how a person walks through the online ordering and unboxing at home. At no point did the presenter talk about the Vaccine Information Statement that by law must be given, but there was one line on one slide stating that it would be included in the package. The home delivery is being sold as a way to increase access to the product, but the flip side of that coin is that it decreases access to information and care. How far does the lack of communication of potential risks have to go before the 1986 Act is violated for lack of information?
No signature is required upon delivery, and whether the mist was administered is to be reported back via text. Errors in administration or whether it was given to the right person is to be assessed and reported (if known or noticed) by the person spraying it up a nose. When asked about what happens if there’s an adverse event at home, the presenter simply said it’s like any other medication a person takes at home; they can call the pharmacist, report back to the manufacturer AstraZeneca, and make a VAERS report.
There was one question about the fact that the age a pharmacist can administer a vaccine to is different in each state, and what if a parent wanted to get this at home but their kid was too young – could they simply call the pediatrician? The answer to skirting state law was, thankfully, no.
After your text confirmation, the pharmacist can report to the state immunization information system, and the patient can download their vaccination records. Registries will distinguish between self- or provider-administered flu vaccines. When all is done, caregivers send the “medical waste” back in the packaging provided.
Cytomegalovirus
Moderna has another new mRNA shot nearing the end of trials, this time for cytomegalovirus (CMV). The ACIP was told that CMV is a threat that most are not aware of, especially for pregnant women. This shot, claims the ACIP CMV Vaccine Work Group has no safety concerns and has “long-term protection” of up to 3 years. 10
So Moderna has created this vaccine and it is close to licensure, and the ACIP is now hearing about a disease threat to babies that most people don’t know about. Right now, the new working group has the job of ensuring that everyone knows this is a public health problem that only the CDC can solve.
This kind of thinking evokes the tale of the measles vaccine, where top epidemiologists at the CDC said measles was an illness we’d just live with – that it was a “self-limiting infection of short duration” – until a vaccine was created, and suddenly we needed to pivot and talk about “The Importance of Measles as a Public Health Problem”11 (Read more about this in Health Freedom Institute’s article “Shining a Light on Measles.”)
Conclusion
There were presentations on RSV, HPV, and meningococcal shots as well, with anticipated votes at the June 2025 ACIP regular meeting.
- The ACIP HPV Vaccine Work Group is considering changing the CDC recommendation for HPV shots to start at 9 years old rather than 12. They’re also considering whether to move from a two or three shot series down to only one shot to be considered fully vaccinated, following a global trend.
- RSV was reviewed for adults, and they voted to expand the recommendation down from 75 (or at-risk 60-year-olds) to 50 years old. A second session contemplated maternal and infant RSV options, with an eye toward adding a second monoclonal antibody option for infants. Vote anticipated in June.
- Meningococcal vaccine is currently recommended as two doses at 11 and 16 years old, and for at-risk children as young as 2. The ACIP voted to recommend the pentavalent Bexsero as a one-shot option when a child is indicated for both the four-valent shot and the meningitis B shot. Additionally, the group looked at expanding the recommendation for MenQuadfi (four-valent) to infants as young as 6 weeks old. That vote is anticipated in June 2025 as well. The presentation on safety and immunogenicity revealed a plethora of concerning events in the trial, up to and including death, but none of the injuries or sudden deaths or discontinuation in the trial were attributed to the shot by the manufacturer. It was admitted during questions that the ACIP Work Group had “unresolved questions” about the deaths.
With all of the anticipated votes in June on changing and adding to recommendations – mpox, COVID, meningitis, RSV, HPV, CMV – you can be sure we’ll be ready to keep you informed and let you know when you can take strategic action to protect our precious young children. Their health is our future.
References
- “First Participants Dosed in Phase 1 Study Evaluating MRNA-1283, Moderna’S Next Generation COVID-19 Vaccine.” Business Wire, (2021). https://www.businesswire.com/news/home/20210315005475/en/First-Participants-Dosed-in-Phase-1-Study-Evaluating-mRNA-1283-Modernas-Next-Generation-COVID-19-Vaccine. ↩︎
- Yassini, Patrick., et al. “Interim Analysis of a Phase 1 Randomized Clinical Trial on the Safety and Immunogenicity of the MRNA-1283 SARS-CoV-2 Vaccine in Adults.” Human Vaccines & Immunotherapeutics 19, no. 1 (2023). https://pmc.ncbi.nlm.nih.gov/articles/PMC10128428/. ↩︎
- Constantino, Annika K. “Moderna’S Combination COVID, Flu Vaccine Is More Effective than Existing Shots in Late-stage Trial.” CNBC, (2024). https://www.cnbc.com/2024/06/10/moderna-combination-covid-flu-vaccine-shows-positive-late-stage-data.html. ↩︎
- Link-Gelles, Ruth . “Interim Estimates of 2024-2025 COVID-19 Vaccine Effectiveness.” CDC, (2025). https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/04-Link-Gelles-COVID-508.pdf. ↩︎
- Abene, Sophia, and Buddy Creech MD, MPH. “Safety and Immunogenicity Results For Mpox Vaccine MVA-BN in Adolescents Amid Rising Concerns.” Contagion Live, (2024). https://www.contagionlive.com/view/safety-and-immunogenicity-results-for-mpox-vaccine-mva-bn-in-adolescents-amid-rising-concerns. ↩︎
- Nigrovic, L E., and K M. Thompson. “The Lyme Vaccine: A Cautionary Tale.” Epidemiology & Infection, (2006). https://pmc.ncbi.nlm.nih.gov/articles/PMC2870557/. ↩︎
- “FluMist Quadrivalent Package Insert.” FDA, (2023). https://www.fda.gov/media/160349/download. ↩︎
- Fox, Maggie. “FluMist Nasal Flu Vaccine Can Come Back, Vaccine Advisers Say.” NBC News, (2018). https://www.nbcnews.com/health/health-news/flumist-nasal-flu-vaccine-can-come-back-vaccine-advisers-say-n849986. ↩︎
- Nevradakis, Michael Ph.D. “Parents Now Allowed to Give Kids Nasal Flu Vaccine at Home, Despite Vaccine’S Link to Severe Reactions.” The Defender, (2025). https://childrenshealthdefense.org/defender/kids-nasal-flu-vaccines-at-home-administration-severe-reactions/. ↩︎
- Lanzieri, Tatiana M. MD, MPH. “ACIP CMV Vaccine Workgroup Initial Considerations for CMV Vaccine Policy.” CDC, (2025). https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/04-lanzieri-cmv-508.pdf. ↩︎
- Langmuir, Alexander, D. M.D., F.A.P.H.A., et al. “The Importance of Measles as a Health Problem.” American Journal of Public Health, (1962). https://pmc.ncbi.nlm.nih.gov/articles/PMC1522578/pdf/amjphnation00499-0004.pdf. ↩︎