Covid shot access, coverage at stake as RFK Jr.’s vaccine panel meets

Covid shot access and coverage in the U.S. hang in the balance as an influential government vaccine panel hand-picked by Health and Human Services Secretary Robert F. Kennedy Jr. convenes this week in Atlanta. 

The panel, called the Advisory Committee on Immunization Practices, or ACIP, is scheduled to vote on recommendations for Covid jabs and childhood immunizations for hepatitis B and measles, mumps, rubella, and varicella, or MMRV. Kennedy has gutted and restacked that committee with new members, some of whom are vaccine critics, raising concerns that they could soften, delay or fully eliminate recommendations for routine shots proven to be safe and effective. 

The panel is expected to vote on the hepatitis B and MMRV shot on Thursday, and Covid vaccines on Friday. The Centers for Disease Control and Prevention, whose latest director was ousted by the Trump administration earlier this month, typically adopts the panel’s recommendations. 

Some public health experts warn that weakening recommendations for Covid vaccines and other shots could make it harder for some people — especially healthy adults and children, along with those in rural areas — to access the jabs and have them covered by insurance. 

One major health insurance group on Wednesday said its member plans will cover all vaccines already recommended by ACIP, including updated Covid and flu shots, despite any changes the new slate of appointees makes this week.

Still, any further restrictions on shots by ACIP could have trickle-down effects, further depressing already declining immunization rates for vaccine-preventable diseases and raising the risk of outbreaks.

“There’s a pretty good likelihood that the decisions coming out of this meeting will further restrict vaccinations or at a minimum, limit or add confusion to the scope of vaccination coverage at a time when we really need to be doing everything possible to make them as widely available as possible,” Neil Maniar, a public health professor at Northeastern University, told CNBC. “There’s a lot of concern that we could see unnecessary outbreaks of diseases.”

Maniar said the votes are especially critical heading into the fall and winter season, when diseases, particularly respiratory viruses like Covid, spread more easily. 

The panel’s guidance determines which shots insurance plans and some government-run programs must cover at no cost to patients. In some states, pharmacists are also legally barred from administering vaccines that ACIP does not recommend. 

If ACIP votes to further restrict shot access, it could normalize policy decisions not grounded in science and further confuse Americans following Kennedy’s other recent moves to change U.S. vaccine policy. Those include the CDC’s decision to drop Covid shot recommendations for healthy kids and pregnant women, and the Food and Drug Administration’s approval of new Covid jabs with limits on who can get them. 

The FDA’s approval already created confusion leading up to the panel’s meeting this week, as some states are requiring that patients have prescriptions to receive a Covid vaccine. 

Numerous studies have demonstrated that shots using mRNA technology, including Covid vaccines from Pfizer and Moderna, are safe and effective, and serious side effects have happened in extremely rare cases. One paper in August estimates that Covid vaccines saved more than 2 million lives, mostly among older adults, worldwide between 2020 and October 2024. 

“To turn around and claim, well, after five years of all of us getting the vaccines and having them save millions of lives all over the world, the shots are no longer safe and effective – it does lead to confusion and uncertainty,” said Dr. Kawsar Talaat, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health. 

“People don’t know who to trust and who to listen to, and therefore people are less likely to feel comfortable getting the vaccines that could keep them healthy.” 

Kennedy has insisted that “anybody” who wants a Covid vaccine can get one, despite several reports and statements from lawmakers describing obstacles. Those hurdles cropped up after the FDA in August approved Covid shots for those 65 and up and younger adults with at least one underlying condition that puts them at higher risk of severe illness from the virus.

It was a break from U.S. vaccine policy in previous years, which recommended an annual Covid shot for all Americans 6 months and up.

The CDC panel could tailor its recommendations to the FDA’s approval, or further limit their use, given many members are hostile to mRNA shots and vaccines more broadly. One member, Retsef Levi, has pushed to stop giving mRNA vaccines, falsely claiming in a post on X that they cause “serious harm including death, especially among young people.”

It’s unclear what exact data will be presented at the meeting on Friday, but some health experts are concerned about whether the presentations will be based on concrete science. One presentation presented to the panel in June included a fabricated citation for a study that does not exist, according to multiple reports.

“I think it’s really important to see who is speaking at the meeting and what their agenda is,” Talaat said. “There were made-up studies and just falsehoods presented at the last ACIP meeting. I would not be surprised to see similar things at this one.” 

The Washington Post reported Friday that Trump administration health officials plan to link Covid vaccines to the deaths of 25 children in a presentation to ACIP. The claim is expected to be based on reports submitted to the FDA’s Vaccine Adverse Event Reporting System, or VAERS, which collects unverified side effects from shots.

Researchers have previously noted an elevated but rare risk of myocarditis, or inflamed heart muscle, in young men in particular. But there is no evidence that the vaccines in use now cause any other major safety risks, including pediatric deaths. 

Kennedy in September argued that “there’s no clinical data” supporting Covid vaccine recommendations for healthy individuals.

Talaat said healthy people are less likely to end up in the hospital from Covid. But she noted they could still develop long Covid or put high-risk people around them – whether that be elderly family members or immunocompromised coworkers – at risk of contracting the virus and developing severe illness. 

If ACIP moves to weaken Covid shot recommendations, access could vary by state, according to Talaat. 

On Wednesday, the governors of Oregon, Washington, California and Hawaii recommended that all adults and children concerned about the respiratory illness season can receive the Covid vaccine and other common immunizations. The updated guidelines in those states align with mainstream medical groups and aim to ensure access to shots even as the federal government changes guidelines.

Governors of several Democratic states, including Arizona, Illinois, Maine and North Carolina, have also signed orders intended to ensure most residents can receive Covid vaccines at pharmacies without individual prescriptions. 

Some states, particularly those led by Republicans, still require a doctor’s orders. 

Talaat said the people who are “going to suffer the most” are those who live in rural areas because they may not have easy access to a doctor who can provide a prescription or a pharmacy to receive a shot. 

But recommendations that further limit Covid shots could also force some children and adults to pay out of pocket for them. Talaat and some estimates said more than half of children in the U.S. are covered by the government-run Vaccines for Children program, which offers recommended shots for free. 

Medicare and Medicaid require that the recommended vaccines are free for patients, while the Affordable Care Act requires private insurers to cover all shots recommended by the panel and the CDC director. 

America’s Health Insurance Plans’ pledge on Wednesday to cover shots currently recommended by ACIP was significant because of the size of its member plans, which together provide coverage and services to over 200 million Americans. That includes more than a dozen Blue Cross Blue Shield plans, Centene, CVS‘s Aetna, Elevance Health, Humana, Kaiser Permanente, Molina, and Cigna.

But the group doesn’t cover everyone. For example, UnitedHealthcare, the country’s largest private health insurer, is not a member of the group.

ACIP on Thursday could reconsider a longstanding recommendation to give all newborns a dose of the hepatitis B vaccine within the first 24 hours of life, which the panel first recommended in 1991. Kennedy and anti-vaccine activists have repeatedly questioned that guidance. 

But the shot has been a life-saving public health intervention against the disease, which can lead to severe health problems, including liver cancer and failure, and death. Acute hepatitis B infections reported among children and teens dropped by 99% between 1990 and 2019, some studies said. 

The vaccines are estimated to prevented 38 million deaths among people born between 2000 and 2030 in 98 low and middle-income countries, according to the CDC. The agency said vaccination within the first day of birth, followed by two-to-three additional doses, protects children for life. 

The panel is expected to vote to recommend delaying the hepatitis B vaccine until age 4, two former senior CDC officials told KFF Health News. 

Talaat said global rates of hepatitis B in children have fallen thanks to the initial “birth dose” of the shot. While the U.S. now has low levels of the virus, skipping that dose carries risks: a mother can still pass the infection to her baby at birth, and newborns are far more likely to develop a lifelong, incurable infection.

Meanwhile, ACIP Chair Martin Kulldorff said at the panel’s June meeting that it may consider a proposal to advise against giving a product that combines the measles, mumps and rubella vaccine with the shot against varicella, or chicken pox, to children under 4.  

The CDC currently recommends getting those vaccines separately for those ages 1 to 2, but parents can opt to get them together for children age 4 and above.

Fever-induced seizures tied to the combination shot are common in young children – the CDC estimates the risk is at roughly 5% – but don’t cause permanent harm.

Significant changes made to the schedule or availability of MMRV shots could result in increased hesitancy among parents to get their children vaccinated. The U.S. already surpassed a milestone in reported measles cases in 2025, as it logged the most cases since the disease was declared eliminated in the U.S.