Changes in COVID-19 Vaccine Guidelines: Who Are Impacted?
On May 27, 2025, Health Secretary Robert F. Kennedy Jr. announced a significant change in the Centers for Disease Control and Prevention (CDC) recommendations for COVID-19 vaccination. Remarkably, the CDC is no longer advising vaccination for pregnant individuals or healthy children. The new guidelines now only recommend the shots for older adults and people at high risk of developing severe COVID-19 following an infection with SARS-CoV-2, the virus causing the disease.
The shift in recommendations came shortly after a statement published by Food and Drug Administration (FDA) officials in The New England Journal of Medicine (NEJM), suggesting that the focus of COVID-19 immunization programs should primarily target older adults and those at high risk.
These updates have stirred questions and concerns, particularly with the emergence of a new, more transmissible variant of SARS-CoV-2, called NB.1.8.1, in the U.S.
To address the most pressing concerns, Medical News Today spoke with Daniel Ganjian, MD, FAAP, a board-certified pediatrician at Providence Saint John's Health Center in Santa Monica, CA, and Monica Gandhi, MD, MPH, an infectious disease specialist at the University of California, San Francisco.
One key worry involves pregnant people. Ganjian noted, "If COVID-19 vaccines are no longer recommended for pregnant individuals, pregnant individuals would lose a key intervention that reduces their risk of severe COVID-19, ICU admission, preterm birth, and perinatal death." The American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, and previously recommended vaccination in pregnancy due to these risks.
Gandhi further highlighted that pregnant women are relatively immunocompromised and are at risk of severe COVID-19. Therefore, she expressed her preference for maintaining recommendations for vaccinating pregnant women. Similarly, in the context of children, vaccination could help prevent severe COVID-19, hospitalizations, and complications such as MIS-C, particularly among those with underlying medical conditions.
The new recommendations' implications for public health are multifaceted. Ganjian cautioned that rescinding broad recommendations might signal a shift in risk assessment, potentially leading to increased disease susceptibility among vulnerable populations. A more discerning approach could prioritize vaccine boosters for pregnant women, while children with prior immunity could likely be fine without further vaccination.
Healthcare professionals and public health experts continue to debate the shift in policy, with some arguing that previous recommendations helped protect these groups and maintain broader community immunity.
Gandhi additionally expressed some concern about the FDA's recent recommendations to conduct placebo-controlled trials for new COVID-19 vaccines. Comparing a new vaccine with a placebo could expose certain individuals, such as older people, to unnecessary risk.
Debates aside, it remains to be seen whether pregnant individuals and parents wishing to vaccinate their children may still access vaccines through private purchase or off-label use, depending on regulatory and healthcare provider policies. However, insurance coverage and public health supply may be limited if recommendations are withdrawn.
- The new CDC guidelines, which no longer recommend COVID-19 vaccination for healthy children and pregnant individuals, have raised concerns about the immune protection for these groups, particularly pregnant individuals who may now lose a key intervention for reducing their risk of severe COVID-19 and related complications.
- Pregnant women are relatively immunocompromised and at risk of severe COVID-19, and Dr. Monica Gandhi expressed her preference for maintaining recommendations for vaccinating pregnant women, citing the potential benefits in preventing severe COVID-19, hospitalizations, and complications.
- In the context of children, vaccination could help prevent severe COVID-19, hospitalizations, and complications such as MIS-C, particularly among those with underlying medical conditions. This may be an important factor to consider when evaluating the implications of the new recommendations on public health.
- The scientific and medical communities are engaged in ongoing debates about the shift in the CDC's COVID-19 vaccination policy, with some arguing that the previous recommendations helped protect vulnerable populations like pregnant women, children, and others at risk, while others advocate for a more targeted approach that prioritizes vaccine boosters for pregnant women and considerations for children with prior immunity.
