COVID-19: Who do the new vaccine guideline changes affect?

Medical News Today

6 days ago

Two experts answer key questions about the recent COVID-19 vaccine guideline changes. Image credit: MR.. Health Secretary Robert F. Kennedy Jr. recently announced more key changes to the Centers for Disease Control and Prevention (CDC) recommendations for COVID-19 vaccination.
Per these changes, the CDC no longer recommends COVID-19 vaccines to pregnant people or healthy children.
The only populations for whom the shots are still recommended are older adults and people at high risk of developing severe COVID-19 following infection with SARS-CoV-2, the virus that causes this illness.
These changes have caused some concern as a new, more transmissible variant of SARS-CoV-2 has emerged in the United States.
On May 27, 2025, the United States Health Secretary Robert F. Kennedy Jr. announced in a social media post that the Centers for Disease Control and Prevention (CDC) would no longer be recommending COVID-19 vaccination to pregnant individuals or healthy children.
The announcement came shortly after another statement published by Food and Drug Administration (FDA) officials in The New England Journal of Medicine (NEJM), which suggested that COVID-19 immunization programmes should, going forward, focus on older adults and those at high risk of developing severe disease, should they become infected with SARS-CoV-2, the virus that causes COVID-19.
These changes to the official immunization schedule have spurred questions and caused some concern, particularly as a new, more transmissible variant of SARS-CoV-2, called NB.1.8.1, has emerged in the U.S.
Medical News Today has spoken to Daniel Ganjian, MD, FAAP, 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, to answer the most pressing questions.
One concern when it comes to the potential impact on pregnant people is that a lack of access to COVID-19 vaccination might actually increase the risk of pregnancy complications.
'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 [intensive care unit] admission, preterm birth, and perinatal death,' Ganjian told MNT .
In a similar vein, Gandhi emphasized:
'Although I completely agree that the people most in need of booster COVID-19 shots ever year are those who are older (65 years or older) and those [who are] immunocompromise[d] or [have] multiple medical conditions, pregnant women are actually relatively immunocompromised and so are at risk of severe COVID-19.'
'So, I would have preferred that the guidance did not name healthy pregnant women as not needing the shot,' she told us.'
Insofar as children are concerned, while kids who are healthy overall may run a lower risk of developing severe COVID-19, infection with the coronavirus that causes it could nevertheless impact their health in unexpected ways.
It could, for instance, trigger long-term conditions that may lead to other complications.
'For children, removal of COVID-19 vaccine recommendations would increase the risk of severe COVID-19, hospitalization, and complications such as multisystem inflammatory syndrome in children (MIS-C), particularly among those with underlying medical conditions,' Ganjian said.
'The American Academy of Pediatrics recommends COVID-19 vaccination for all children 6 months of age [and older], as vaccine effectiveness against severe outcomes is well established,' he added.
Still, he did note that, even with the current changes to the vaccination recommendations, 'children with immunocompromising conditions or other high-risk comorbidities may still have access to vaccines under specific clinical indications,' although, he cautioned, 'this would depend on regulatory and public health policy decisions.'
Gandhi noted that while 'healthy children with previous immunity — either from vaccination or previous infection — do not need COVID-19 vaccinations,' those who have not had a chance to acquire that immunity could now be left exposed to health risks.
Thus, 'I would prefer children without previous immunity to get the COVID-19 vaccine,' she told us.
'From a public health perspective, rescinding broad recommendations would likely signal a shift in risk assessment, possibly due to changes in epidemiology, variant severity, or vaccine effectiveness, but would also risk increased morbidity [disease susceptibility] in vulnerable populations,' Ganjian cautioned.
Gandhi emphasized that a more discerning approach might prioritise the health and safety of pregnant people by offering them vaccine boosters, while reiterating that children who have already developed some immunity should be O.K. without further vaccination.
'I think pregnant women should get booster shots because they [are] relative[ly] immunocompromise[d]. Healthy children with prior immunity (either from natural infection or the vaccine) do not need COVID-19 boosters if we take a risk-based approach to vaccination.'
— Monica Gandhi, MD, MPH
On a related note, Gandhi also expressed some concern about the FDA's recent recommendation, also mentioning the NEJM statement from May 2025, to conduct plac ebo-controlled trials for new COVID-19 vaccines. This is because, at this point, participants receiving a placebo instead of a vaccine might be left unnecessarily exposed to severe disease.
'The original COVID-19 vaccine trials (such as with the Moderna or Pfizer vaccines) used a placebo-controlled design because there was no prior COVID-19 vaccine, so using a placebo as a comparison was ethical,' she explained.
'However, we now have COVID-19 vaccines, and it would not be ethical to compare a new COVID-19 vaccine with a placebo in a vulnerable individual (e.g. an older person) when their control could be a prior COVID-19 vaccine formulation,' Gandhi pointed out.
'For instance, I would never allow my 90-year-old father to be in a vaccine trial where he was either getting a new COVID-19 vaccine or a placebo, as being in the placebo arm would leave him unprotected, and he is in the category of individuals who need a yearly booster COVID-19 shot,' she admitted candidly.
One question that remains is whether, given the changes to recommended COVID-19 vaccination schedules, pregnant people and parents who may still wish to vaccinate their children might still be able to access the shots privately.
'Based on current knowledge, pregnant individuals or parents who wish to vaccinate their children may still be able to access COVID-19 vaccines through private purchase or off-label use if available, but this would depend on regulatory status and local healthcare provider policies.'
'However, insurance coverage and public health supply may be limited if recommendations are withdrawn,' he also cautioned.
Immune System / Vaccines
Infectious Diseases / Bacteria / Viruses
COVID-19