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Advisory Committee on Immunization Practices
COVID -19 Session
Coronavirus and Other Respiratory Viruses Division
June 25, 2025National Center for Immunization and Respiratory Diseases
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Introduction Dr. Adam MacNeil (CDC/NCIRD)
COVID -19 epidemiology Dr. Adam MacNeil (CDC/NCIRD)
COVID -19 vaccine effectiveness update Dr. Adam MacNeil (CDC/NCIRD)
COVID -19 vaccine safety update Dr. Sarah Meyer (CDC/NCEZID)
COVID -19 vaccine coverage and
implementation Dr. Georgina Peacock (CDC/NCIRD)
Evidence to recommendations (partial) Dr. Adam MacNeil (CDC/NCIRD)Agenda COVID -19 session: June 25, 2025
•June 2024: ACIP recommended 2024 –2025 COVID -19 vaccination for all people ages 6 months and older (published in
September 2024 MMWR1).
•August 2024: FDA approved or authorized the Novavax, Moderna, and Pfizer -BioNTech 2024 –2025 COVID -19 vaccines.
•October 2024: ACIP recommended additional doses for adults ages 65 years and older and people ages 6 months and
older with moderate or severe immunocompromise (published December 2024 MMWR2).
•August, September, October 2024: The Interim Clinical Considerations for Use of COVID -19 vaccines was updated with
detailed guidance.3
•May 2025:
-Per HHS directive, CDC updated COVID -19 vaccine recommendations to shared clinical decision -making for healthy
children ages 6 months –17 years and no guidance/not applicable for pregnant women.
-FDA approved Novavax’s NUVAXOVID (2024 –2025 Formula) and Moderna’s MNEXSPIKE (2024 –2025 Formula) for
people ages 12 –64 years at high risk for severe COVID -19 and all adults ages 65 years and older.
-FDA’s Vaccines and Related Biological Products Advisory Committee met to discuss strain selection for the 2025 –
2026 COVID -19 vaccines. FDA advised manufacturers that 2025 –2026 Formula COVID -19 vaccines should be
monovalent JN.1 -lineage -based, preferentially using the LP .8.1 strain.4Federal COVID -19 vaccine updates, June 2024 –May 2025
1. Panagiotakopoulos L, et al. Use of COVID -19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Im munization Practices — United States, 2024 –2025. MMWR Morb Mortal Wkly Rep 2024;73:819 –824. DOI:
10.15585/mmwr.mm7337e2 .
2. Roper LE, et al. Use of Additional Doses of 2024 –2025 COVID -19 Vaccine for Adults Aged ≥65 Years and Persons Aged ≥6 Months with Moderate or Severe Immunocompromise: Recommendations of the Advisory Committee on Immunization
Practices — United States, 2024. MMWR Morb Mortal Wkly Rep 2024;73:1118 –1123. DOI: 10.15585/mmwr.mm7349a2 .
3. https://www.cdc.gov/covid/hcp/vaccine -considerations/index.html
4. https://www.fda.gov/vaccines -blood -biologics/industry -biologics/covid -19-vaccines -2025 -2026 -formula -use-united -states -beginning -fall-2025
ACIP: Advisory Committee on Immunization Practices | FDA: Food and Drug Administration | MMWR: Morbidity and Mortality Weekly Report3
•Children ages 6 months –4 years
-Unvaccinated: May receive a multidose initial series with a 2024 –2025 mRNA vaccine using shared
clinical decision -making
-Previously completed an initial series: May receive 1 dose of a 2024 –2025 mRNA vaccine from the same
manufacturer as the initial series using shared clinical decision -making
•People ages 5 –17 years:
-May receive 1 dose of an age -appropriate 2024 –2025 COVID -19 vaccine using shared clinical decision -
making
•Adults ages 18 –64 years:
-Should receive 1 dose of any 2024 –2025 COVID -19 vaccine
•Adults ages 65 years and older:
-Should receive 2 doses of any 2024 –2025 COVID -19 vaccine, spaced 6 months apart (minimum interval 2
months)Overview of the current COVID -19 vaccination schedule:
Routine vaccination
https://www.cdc.gov/covid/hcp/vaccine -considerations/routine -guidance.html 4
•Unvaccinated:
-Should receive a multidose initial vaccination series with an age -appropriate
2024 –2025 vaccine and receive 1 dose of 2024 –2025 vaccine 6 months after
completing the initial series (minimum interval 2 months)
•Previously completed an initial series:
-Should receive 2 doses of an age -appropriate 2024 –2025 COVID -19 vaccine,
spaced 6 months apart (minimum interval 2 months)
•May receive additional age -appropriate 2024 –2025 COVID -19 vaccine
doses under shared clinical decision -making (minimum interval 2
months) Overview of the current COVID -19 vaccination schedule:
Moderate or severe immunocompromise
5 https://www.cdc.gov/covid/hcp/vaccine -considerations/immunocompromised.html
September 20231June 20242April 20253June 2025Previous Work Group considerations of COVID -19 vaccine
non-universal recommendations
1 September 12, 2023. ACIP presentation, slide 124. https://www.cdc.gov/acip/downloads/slides -2023 -09-12/11 -COVID -Wallace -508.pdf
2 June 27, 2024. ACIP presentation, slide 83. https://www.cdc.gov/acip/downloads/slides -2024 -06-26-28/06 -COVID -Panagiotakopoulos -508.pdf
3 April 15, 2025. ACIP presentation, slide 65. https://www.cdc.gov/acip/downloads/slides -2025 -04-15-16/05 -Panagiotakopoulos -COVID -508.pdf
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•Age-appropriate 2025 –2026 COVID -19 vaccines* for all infants and children
ages 6–23 months
•Age-appropriate 2025 –2026 COVID -19 vaccine for persons ages 2–64 years for
the following groups:
•Persons at high risk of severe COVID -19, including p regnant women (for infant and maternal
protection)
•Persons at high risk of exposure to SARS -CoV-2
•Shared clinical decision -making for persons desiring additional protection from COVID -19
•2 doses of 2025 –2026 COVID -19 vaccine for all adults ages ≥65 years and
persons ages ≥6 months with moderate or severe immunocompromise **Summary of recent COVID -19 Work Group discussions
*Number of doses depends on age, vaccine manufacturer, and vaccine history.
** Persons with immunocompromise who are unvaccinated or did not complete an initial series with 2024 -2025 vaccine should comple te the initial series followed by 1 dose of
2025 -2026 vaccine 6 months after the initial series. 7