ACIP’s Sept 18–19 Meeting: The big decisions

By Victor Mejia

Published on September 19, 2025

The CDC’s Advisory Committee on Immunization Practices (ACIP) wrapped a two-day public meeting (Sept 18–19, 2025) with consequential votes on childhood vaccines and a closely watched debate over COVID-19 policy. Here are the outcomes, why they matter, and what to do next, with links to the primary sources.

1) Combo MMRV vaccine: No longer recommended for the first dose (<4 years)

ACIP voted 8–3 to stop recommending the combined measles-mumps-rubella-varicella (MMRV) shot as the first measles-series dose in children under 4. Families should expect providers to give separate MMR and varicella shots for that initial visit instead. Members cited seizure-risk trade-offs and program logistics in their discussion. In a related vote, the committee also removed MMRV from the Vaccines for Children (VFC) program, shifting publicly funded supply toward the separate MMR + varicella doses.

What this means for parents: If your child is due for their first measles-series dose (typically 12–15 months), you’ll likely be offered two shots (MMR + varicella) at the same visit rather than the 4-in-1 combo. Second-dose practices for older children were not changed by this vote.

2) Newborn hepatitis B shot: Proposed delay vote postponed; current policy stays

ACIP postponed (vote 11–1 to delay) a proposal that would have allowed some newborns to defer the birth-dose of hepatitis B vaccine. That means the status quo remains: the hepatitis B vaccine is still recommended within 24 hours of birth for all infants unless medically contraindicated. The committee indicated it will revisit the topic after further analysis and stakeholder input.

What this means for parents: Expect hospitals to continue offering the hep B birth dose before discharge, just as they do today.

3) COVID-19 (2025–26 season): Access maintained

After extensive debate about whether to narrow eligibility, ACIP voted to keep broad access to the 2025–26 COVID-19 vaccines rather than restricting shots only to older or high-risk groups. (Earlier coverage previewed the “risk-based vs. universal” debate; the final vote preserved access.) Details on implementation will follow from CDC once the director signs the recommendation.

What this means for families & clinicians: Providers can continue offering COVID-19 vaccination to the populations authorized on product labels this season while CDC finalizes the official wording.

ACIP also reviewed program and epidemiology updates (e.g., RSV immunization and routine schedule housekeeping) and posted all speaker decks publicly. If you want the line-by-line data, the official slide packets and livestream links are on CDC’s ACIP page.

Quick guidance by audience

Parents & caregivers

For 12–47-month-olds starting measles protection, expect MMR + varicella instead of MMRV at the first visit. That’s normal under the new guidance.
Newborns should still receive the hepatitis B birth dose before leaving the hospital.
COVID-19 shots remain available this season; talk with your clinician about timing alongside flu/RSV where appropriate.

Clinicians & vaccinators

Update standing orders and EHR decision support for MMRV first-dose changes and VFC formulary adjustments; ensure MMR + varicella inventory is adequate.
Maintain current hep B birth-dose protocols pending any future ACIP reconsideration.
Continue offering COVID-19 vaccination per product authorizations; watch for CDC’s final wording in the Federal Register/MMWR.

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