“It’s a mess right now”: RFK’s sweeping changes put new vaccines in limbo | Trump administration

U.S. vaccine recommendations are in limbo, access to vaccines is suffering and some uncertainty could linger for years after the Trump administration’s immunization blows, experts say.

Robert F Kennedy Jr, Secretary of the US Department of Health and Human Services (HHS), made sweeping changes to immunization policy, reducing recommendations for childhood immunizations by a third and replacing experts on the Advisory Committee on Immunization Practices (ACIP) with his own hand-picked allies.

A judge’s order halted those changes because they weren’t done properly, but Kennedy did not appoint any new members to the ACIP — meaning there are no new vaccination recommendations coming from the committee, even if new vaccines are approved.

Ron Kroening, 63, suffers from asthma and severe allergies this time of year. So her doctor recommended the new Moderna mRNA flu vaccine, approved by the U.S. Food and Drug Administration (FDA) in August for those 50 and older. Trials suggest it provides even stronger protection than traditional flu vaccines.

It took some time to locate the only pharmacy in his area that stocked the vaccine — then Kroening was shocked to be charged a $40 copay.

“I thought it was a mistake because I’ve never had to pay for a flu shot in my life,” he said. But his insurance company told him that was because there was no ACIP recommendation, Kroening said: “The reason mRNA is not covered is because it is not listed as an ACIP vaccine. »

If ACIP doesn’t recommend the new vaccine by the end of the year — a likely scenario experts say — insurers won’t be required to cover it until January 2029 at the earliest.

“It’s really a barrier. And any barrier to vaccinations will prevent people from getting them,” said Kroening, a retired public health employee who worked on vaccination at the state level in Oklahoma. “A $40 co-pay is going to put people off,” he added, noting that his pharmacist also didn’t inform him that there were other flu vaccine options.

Insurers typically have at least a year after FDA approval to add coverage for a new vaccine to their plans, so a copay like Kroening’s is not unusual in the first year or so. But the difference is that it is not clear when the vaccine will be fully covered.

Typically, when a vaccine is approved for a new group of people — either because it’s new on the market or because approval has been expanded to include more people — insurers have one year from the recommendation to implement it by the next plan year, which typically begins in January. This means that if a vaccine is recommended by the ACIP in December 2026, insurers are required to cover it by January 2028. If it is recommended a month later, in January 2027, then the coverage requirement is pushed back to January 2029.

“The legal requirement doesn’t go into effect very quickly. The process takes time,” said Lindsay Wiley, a law professor and director of the Health Law and Policy Program at UCLA Law.

For the new flu vaccine, “it seems likely that at best we’ll get a recommendation next year,” Wiley said, “but there’s no reason to think” they will. “It just keeps delaying more and more,” she said.

The only exception to the coverage law is for Covid vaccines, as Congress amended the Affordable Care Act to specifically include coverage for Covid vaccinations within 15 days of ACIP’s recommendation.

The uncertainty around ACIP has other ripple effects. Some states do not allow pharmacists to administer vaccines without a recommendation from the ACIP. Some of the decisions the committee made before it dissolved have also been halted, including the September 2025 recommendation on new vaccines to prevent RSV – although insurers appear to cover them anyway. A now-canceled vote to end the universal birth dose of the hepatitis B vaccine is influencing potential laws at the state level.

Delays have also been reported for insurers covering new flu vaccines for seniors under Medicare, which is mandated by law even without an ACIP recommendation.

The U.S. government has appealed the part of the judge’s order that disbanded the vaccine committee, but nothing prevents Kennedy from going through the proper process to appoint new members, experts say. He didn’t do it.

“The White House and Department of Justice are making no serious attempt to revive the vaccine committee,” Aaron Siri, who served as Kennedy’s lawyer and has argued against vaccine makers, wrote Monday. Siri added: “It seems like the DOJ and the White House are doing everything they can to make sure there is no functioning vaccine committee. »

Dorit Reiss, a vaccine expert at UC Law San Francisco, agrees.

“The federal government is choosing not to implement a new ACIP,” she said. She also noted that Kennedy’s advisers were clearly “misinformed” about vaccine policy and that it was “embarrassing” even for anti-vaccine activists to watch the public meetings.

There are some advantages for Kennedy in not having a functioning ACIP, Reiss said. “Kennedy, in appointing his ACIP, wanted to change the timeline, and they haven’t been as quick as he would like. So getting around the ACIP is a plus,” she said. Delaying reconstituting the committee could allow it to make its own recommendations, she added.

Even after the conclusion of the lengthy trial, the path forward for ACIP remains fragile, because Kennedy “aggressively undermined” confidence in the committee’s independence, Reiss said.

“Without dramatic changes, the situation is unlikely to return to the way it was,” she said. “It showed that ACIP is politically vulnerable, and I think if we want ACIP to go back to what it was, we’re going to need a statute that gives it some protection.”

Ron Kroening’s insurer is a member of the AHIP insurance industry group, which has committed to continuing to cover all recommended vaccines starting in September 2025. And insurers can decide to cover vaccines before they are required to do so.

“Vaccines are more cost-effective than the flu,” Kroening said. He said he would still choose the new vaccine despite the co-payment. “I’m able to pay the $40 and I’m glad I did, but I’m still not happy that insurance doesn’t cover it,” he said.

He worries about what all this means for the future of vaccination in America. “They’re harder to get now,” Kroening said. “It’s a disaster right now, what they’re doing with our vaccines.”