Addressing the Public Health Implications of Recent Changes to Federal Vaccine Recommendations
January 22, 2026
At the American College of Chest Physicians (CHEST), we believe that widespread vaccination and broad vaccine coverage are essential to protecting respiratory and critical care patients and central to improving public health. To this end, CHEST advocates for a national immunization policy grounded in rigorous scientific review, transparent expert deliberation, recommendations that prioritize patient welfare over ideology, and the placement of the highest qualified individuals in decision-making positions.
Shared responsibility for the protection of public health
When evidence-based vaccine guidance is weakened, misinformation spreads, and medical advancements, such as mRNA vaccines, are discontinued. Expected and established coverage for common diseases decreases, as does the ability to quickly develop and deploy lifesaving measures against future respiratory epidemics and pandemics.
The protection of public health has historically transcended politics. During the COVID-19 pandemic, the rapid development of safe and effective vaccines against SARS-CoV-2—supported by Operation Warp Speed in 2020—saved an estimated 3 million lives in the United States between December 2020 and November 2022. Unfortunately, recent federal actions weaken the systems that have enabled these successes and jeopardize decades of progress in disease prevention.
With the Vaccination Assistance Act of 1962 and the creation of the Advisory Committee on Immunization Practices (ACIP) in 1964, the Centers for Disease Control and Prevention (CDC) has provided rigorous, evidence-based guidance for clinicians and patients. This guidance has helped once-common diseases such as measles and varicella become rarities, while markedly reducing severe illness and death from invasive pneumococcal disease and influenza.
Changes to long-standing advisory processes raise serious public health concerns
On June 19, 2025, actions by the Department of Health and Human Services led to the dismissal of all 17 members of ACIP, disrupting a process that, for decades, has provided independent, evidence-based guidance to clinicians and the public. The committee was subsequently reconstituted with members whose professional backgrounds lie outside the immunology and public health expertise that has historically defined ACIP membership.
Initially, this change in ACIP makeup has led to narrower federal recommendations, increased reliance on “shared” or “individual” decision-making, greater skepticism toward mRNA COVID-19 vaccines, and a flawed, incomplete reassessment of the existing childhood vaccine schedule. In forming the revised childhood and adolescent vaccine schedule released to the CDC on January 5, 2026, the administration then anchored to a review of the immunization practices of other developing nations.
Impact of predictable downstream effects
The narrowing of vaccine recommendations—shifting from routine to risk-based or shared clinical decision-making guidance—has predictable downstream effects. The message conveyed is that routine preventive health measures are “optional” or “only for some people,” leading to lower uptake, widening immunity gaps, and increasing difficulty in achieving herd protection thresholds.
CDC vaccine recommendations serve as stopgaps; schedules, school and childcare requirements, standing orders, pharmacy protocols, and other mechanisms increase prevention and support earlier identification of emerging health issues. In the absence of these protocols, the burden shifts to the patient, requiring greater reliance on the person’s health literacy, health care access, and available local resources.
The widening of existing health inequities
These consequences are already visible. Reduced childhood measles, mumps, and rubella vaccination following the COVID-19 pandemic has contributed to more than 1,600 measles cases in the United States in 2025, including 203 hospitalizations and three deaths.
More recently, revisions to CDC vaccine safety communications have raised serious concern by implying risks unsupported by the prevailing scientific evidence, prompting public criticism from the National Academies of Sciences, Engineering, and Medicine. When scientific consensus is publicly undermined, public trust erodes.
In addition, narrowing universal recommendations and cutting investment in mRNA vaccine research don’t just affect today’s coverage—they undermine preparedness for emerging infectious threats and slow the pace of future vaccine development. In August 2025, the Biomedical Advanced Research and Development Authority began terminating or descoping 22 mRNA vaccine research and development projects, particularly for respiratory threats such as flu and avian influenza. The effect of this change is a reduction in clinical trials, trained implementation teams, and validated production factories—necessities for a timely response to a pandemic threat.
Restoring trust and continuity in a health care crisis
We recognize that vaccines, like all medications, can have side effects that vary in likelihood and severity from person to person. However, US vaccine programs have prevented severe illness and death since their development. History tells us that a sensible, scientific, and patient-focused approach to widespread vaccination—one not dependent on individual incomes or zip codes—is the only effective way to protect all US citizens.
As an organization dedicated to the health and well-being of all, CHEST urges federal health leaders to reaffirm the value of the scientifically rigorous processes that have saved the lives of millions of infants, children, and adults.
To accomplish this, the following steps are required:
- renew ACIP’s original charter—including its intended expertise, process, and scope—and appoint members who can thoughtfully and knowledgeably fulfill this mission;
- invest in funding for public health programs and the research necessary to keep them evidence-based and the pipeline for medical advancement moving;
- restore the evidence-based childhood vaccine schedule and reverse unilateral changes that further limit access to effective vaccines, including those for respiratory illnesses such as respiratory syncytial virus; and
- enable easy and equitable access to vaccines and other life-saving measures, ensuring coverage for our most vulnerable populations.
Without these steps, as a nation, we will fall short of the long-standing health protections all citizens have relied upon from their government.
Finally—and critically—CHEST calls on all physicians and health care professionals to be the advocates their patients require. With public health guidance increasingly unclear, the single most trusted source of information for patients and families must remain their clinicians. Reinforce the importance of evidence-based treatment, and engage your patients in clear, respectful conversations about the safety and effectiveness of vaccines. In addition, we strongly encourage clinicians to continue to:
- Conduct research and publish findings to strengthen the scientific foundation for treatment protocols.
- Ensure medical education and training thoroughly address the benefits and limitations of vaccination, particularly for higher-risk patients.
- Use institutional authority to protect equitable access to care and preserve strong community partnerships.
- Elevate and amplify awareness of concerns by sharing clinical experience and patient impact with decision-makers at local, state, and national levels.
CHEST commits to advocating for patients and the health needs they require to achieve the highest possible level of personal health. In moments of uncertainty, our responsibility is to be steady: to defend trusted processes, to champion prevention, and to keep faith with the public’s health.
CHEST will continue to speak out on behalf of our members and will not waver in our commitment to the patients and communities they serve. We call on local, state, and national leaders and clinicians alike to choose evidence over ideology and partnership over partisanship so that every person can share in the health and welfare that modern medicine makes possible.