ACIP Narrows COVID-19 Vaccination Recommendations

(Sept. 23, 2025) On Sept. 19, 2025, the Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC), voted to narrow its COVID-19 vaccination recommendations. This marks a significant shift in federal vaccine policy, emphasizing individualized decision-making over broad population-based guidance.

ACIP now recommends COVID-19 vaccination for:

Adults aged 65 and older.
Younger individuals only through shared decision-making with their health care providers.

This approach encourages patients to consult clinicians about the risks and benefits of vaccination, rather than receiving a blanket recommendation.

The recommendations are pending final approval by Acting CDC Director Jim O’Neill, who has publicly praised ACIP’s effort to bring the vaccination debate into the public sphere. His endorsement is expected imminently.

Implications for NYS

The narrowed federal guidance raises immediate questions about vaccine access and administration in NYS:

Pharmacy Protocols: It is uncertain whether pharmacies will require a patient-specific prescription for individuals outside the Food and Drug Administration (FDA)-approved populations.
Standing Orders: The role of the Health Commissioner’s non-patient-specific orders is under review. These orders have previously enabled broad access, but may now face limitations.
Pharmacist Authority: Under Governor Hochul’s Executive Order (EO) No. 52, pharmacists may issue patient-specific orders for off-label use. Whether this authority will be exercised widely remains to be seen.

Regional Collaboration: Northeast Public Health Collaborative

NYS is part of the Northeast Public Health Collaborative, a voluntary coalition that includes Connecticut, Maine, Massachusetts, New Jersey, Pennsylvania, Rhode Island, and NYC. The Collaborative recently issued its own COVID-19 vaccine recommendations for the 2025-2026 season, which are:

Aligned with national medical societies, including:
- American Academy of Pediatrics
- American College of Obstetrics and Gynecology
- American Academy of Family Physicians
Focused on regional coordination, emergency preparedness, infection prevention, and data sharing

A similar coalition, the West Coast Health Alliance, has formed among California, Oregon, and Washington, signaling a growing trend of regional public health governance.

Resources

Strategic Takeaway

The shift toward individualized vaccination guidance reflects a broader public health recalibration – balancing scientific evidence, patient autonomy, and operational feasibility. For NYS, the challenge lies in translating federal nuance into clear, actionable protocols for providers, pharmacies, and residents.

Contact: Amy Nelson, anelson@leadingageny.org, 518-867-8383 ext. 146