New flu shots face coverage gaps after vaccine committee stalls

The United States has no functioning federal body to recommend new vaccines, leaving patients and insurers in a state of uncertainty. This gap has emerged after the Department of Health and Human Services dismantled the Advisory Committee on Immunization Practices, or ACIP, and has not replaced it with a new group.

Robert F. Kennedy Jr., the HHS secretary, cut childhood immunization recommendations by one third and replaced committee experts with his own allies. A federal judge halted these changes in a court order because the process was flawed. However, Kennedy has not nominated new members since the court ruling, leaving the committee without a quorum to issue new guidance.

Ron Kroening, 63, experienced the practical effects of this pause this autumn. He has asthma and seasonal allergies, so his doctor recommended a new mRNA flu vaccine from Moderna. The US Food and Drug Administration approved this shot in August for adults ages 50 and older. Trials indicated it offers stronger protection than traditional flu shots.

Kroening found the vaccine at one local pharmacy, but he was surprised by a $40 co-pay. He had never paid for a flu shot before. His insurance company explained that the charge was necessary because the vaccine is not listed as an ACIP recommendation. The insurer stated that coverage is not required until the committee formally endorses the shot.

Insurers generally have one year from an ACIP recommendation to add a vaccine to their plans for the next plan year, which typically begins in January. If the committee recommends a vaccine in December 2026, coverage must be in place by January 2028. If the recommendation slips to January 2027, coverage is delayed until January 2029. Experts say the committee is unlikely to issue a recommendation for the new flu shot before the end of this year.

Lindsay Wiley, a law professor at UCLA, noted that the legal timeline for coverage is slow by design. She observed that the delay means the new flu vaccine may not be fully covered until 2029 at the earliest. The only exception to this timeline is for coronavirus vaccines, which Congress mandated for coverage within 15 days of an ACIP recommendation.

The lack of a functional ACIP creates other problems. Some states require an ACIP recommendation before pharmacists can administer certain vaccines. Previous committee decisions, such as a September 2025 recommendation for respiratory syncytial virus shots, were also halted, although insurers continue to cover them. A voided vote to end the universal birth dose of the hepatitis B vaccine is influencing potential state laws.

Aaron Siri, a lawyer who has represented Kennedy, wrote on Monday that the administration is not making a serious attempt to revive the committee. He stated that the Department of Justice and the White House appear to be ensuring no functioning vaccine committee exists. Dorit Reiss, a vaccines expert at UC Law San Francisco, agreed that the federal government is choosing not to appoint a new ACIP.

Reiss said Kennedy likely prefers the current delay because the committee was not changing the vaccine schedule as quickly as he wanted. She noted that the committee is now politically vulnerable and may not return to its previous form without new legal protections. Kroening’s insurer, part of the AHIP group, promised to cover shots recommended as of September 2025, but Kroening said the new situation makes vaccines harder to get.

Kroening said he would still choose the new vaccine despite the cost. He noted that vaccines are more cost-effective than treating the flu. He concluded that the current state of immunizations is a mess, with access becoming more difficult for patients across the country.