Four medical groups issue vaccine guidance as federal process remains frozen

New vaccine analyses support shots for groups excluded from federal guidance

Four major U.S. medical groups simultaneously issued independent vaccination guidelines for COVID-19, influenza and RSV on Wednesday, recommending Americans continue to get immunized as the newest versions of the vaccines become available and the fall and winter respiratory season approaches.

The coordinated recommendations from the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians and the Infectious Diseases Society of America aim to fill what the groups describe as a dangerous void left by the federal government’s failure to update its own guidance. The groups continue to recommend vaccines more broadly than the Trump administration, including routine COVID-19 shots for healthy younger adults, young children and pregnant people — groups for which current federal advice does not recommend vaccination. ACOG continues to urge COVID-19 vaccination for pregnant women, as well as those considering pregnancy or breastfeeding.

“These vaccines not only protect mom’s health and reduce the risk of adverse outcomes during pregnancy, but they also protect the newborn when they are unable to get vaccinated,” said Dr. Christina Davidson, ACOG’s chief medical officer.

The American Academy of Pediatrics broadened its recommendation for RSV immunization to include infants and children ages 8 to 19 months entering their second RSV season, in addition to infants under 8 months born during or entering their first season if their mothers were not vaccinated during pregnancy. The academy also recommends anyone age 6 months and older receive an annual flu shot.

“Every recommendation that you are hearing today begins with one simple question: What best protects children from preventable children and helps them to thrive?” said Dr. Andrew Racine of the pediatrics academy. “And what you are hearing from us today is an answer to that simple question.”

The guidance was coordinated by the Vaccine Integrity Project, an independent initiative based at the University of Minnesota, which worked with the American Medical Association to review thousands of the latest vaccine studies published in JAMA. The analyses found the latest COVID-19, flu and RSV immunizations remain very safe and highly effective for protecting against severe complications from the potentially life-threatening viruses.

“Unfortunately today, the federal government is not fulfilling that responsibility in the way that it historically has. But the need for that work has not disappeared,” said Bruce Gelin of the Vaccine Integrity Project. “We cannot allow the breakdown of the federal process to create a vacuum in evidence-based vaccine guidance.”

In a typical year, the Centers for Disease Control and Prevention would issue updated guidelines for how immunizations should be used. But the CDC’s advisory process was frozen by a lawsuit that blocked the Trump administration’s efforts to reduce the number of vaccines children routinely receive. Health and Human Services Secretary Robert F. Kennedy Jr., a longtime vaccine critic, attempted to cut the number of federally recommended routine vaccines. On Tuesday, the CDC extended the 2025 recommendations for flu vaccines to this year but has been silent on other vaccines. Neither HHS nor the CDC responded to NPR’s request for comment on the status of federal guidance.

“For decades physicians like me have relied on federal vaccine recommendations because they were based on science and careful review,” said Dr. Sandra Adamson Fryhofer, the American Medical Association’s president-elect. “But with the massive changes at the federal level, trust is waning.”

Dr. Demetre Daskalakis, who resigned last year as director of the CDC’s National Center for Immunization and Respiratory Diseases to protest the agency’s policies under Trump, told NPR the silence is harmful. “The problem is that silence at this point is complicit with trying to not make sure people know about the importance of vaccines,” Daskalakis said. “The bottom line is that this is dangerous.”

The absence of federal guidance worries public health officials because vaccination rates are already declining, leading to resurgences of dangerous diseases. “It’s unprecedented that we’re in this situation,” said Jennifer Kates, who studies vaccine policies at KFF, a nonpartisan health research group. “It creates confusion about what the current status is. And vaccination rates have already been going down because it’s hard for people to get good information and understand who they should trust.”

Despite the absence of new federal guidelines, most people should still be able to get the immunizations for free. Private insurers are pledging to continue covering them, federal programs like Medicare will still pay for them, and the Vaccines for Children Program, which provides vaccines for about half of U.S. children for free, is still expected to supply them. Most states have decoupled pharmacists’ ability to administer shots from federal guidelines, relying instead on medical group recommendations.

“We’re anticipating that this year for the fall respiratory virus season for flu and for COVID there will be far less challenge than there was last year this time,” said Brigid Groves of the American Pharmacists Association. “The vast majority of patients across the nation should be able to access these vaccinations with very little barriers, very little hiccup.”

For the first time this year, people ages 50 and older will be able to get a new flu shot that uses the same mRNA technology as the COVID-19 vaccines, which may provide stronger protection than traditional flu shots, though it can cause more mild side effects. Both COVID-19 and influenza still claim tens of thousands of lives in the U.S. each year, and last year’s flu season was unusually severe.

“The bottom line is that vaccines are one of the country’s greatest success stories. They prevent serious illness and death,” said Dr. Sarah Nosal, president of the American Academy of Family Physicians. “Making sure families get recommended vaccines during respiratory illness season not only keeps individuals healthy, but also helps protect entire communities.”

While the Vaccine Integrity Project’s efforts drew praise from medical groups, the absence of federal guidance is still likely to create confusion. “There is no substitute for the kind of clear, coherent messages and communication that the CDC has provided for decades,” said Jason Schwartz, who studies vaccine policies at Yale University. “And in its absence I expect that we will see more confusion, more uncertainty about how best to make use of vaccines as we approach this respiratory virus season.”

The medical groups’ guidance follows ongoing disruption to the federal vaccine recommendation process. In August, President Donald Trump signed an executive order attempting to reinstate childhood vaccine schedule changes that Kennedy made earlier in 2026 and that a federal judge later halted. (Trump signs vaccine order; CDC guidance remains, pediatricians report confusion)