Former AOA liaison to the Advisory Committee on Immunization Practices (ACIP) Dr. Stanley Grogg, DO, FACOP, FAAP, spoke at an ACOFP-sponsored session at the recent OMED conference about adult immunization updates for 2025.
The immunization landscape has seen significant changes in 2025. With new leadership at the Department of Health and Human Services (HHS), shifts within the Advisory Committee on Immunization Practices (ACIP), and updated recommendations from the Centers for Disease Control and Prevention (CDC), family physicians face both opportunities and challenges in the recommendations they make to patients and patient access to vaccines.
While federal recommendations have narrowed, clinicians should continue to consider individual risk factors when advising patients. Your state-level recommendations may differ from federal guidelines in either direction. For example, Illinois Governor J.B. Pritzker has directed the Illinois Department of Public Health (IDPH) to issue its own comprehensive COVID-19 vaccine recommendations for the 2025 respiratory virus season. The new statewide guidance is more expansive than the federal guidelines and includes a standing order to ensure Illinois residents have broad access to updated vaccines.
Changing Leadership, Shifting Priorities
Recent months brought a new Secretary of HHS, Robert F. Kennedy Jr., and a new CDC Director, Dr. Susan Monerez, the first non-physician to hold this role. These changes have influenced policy direction, including funding cuts to mRNA vaccine research and proposed overhauls to the Vaccine Injury Compensation Program (VICP). While some of these initiatives remain controversial, they are already impacting public confidence and fueling misinformation around vaccines.
Addressing Vaccine Hesitancy
Vaccine hesitancy continues to be a pressing issue. Patients are exposed daily to myths—such as claims that vaccines alter DNA or that flu shots cause influenza. In reality, vaccines are rigorously tested, safe, and highly effective. Dr. Grogg cautioned physicians not to mistake hesitancy for resistance. Past studies have found that hesitancy around vaccines is common, but true opposition is rare, although opposition may be growing. Dr. Grogg encouraged physicians to ask hesitant patients about their concerns, clarifying misconceptions, and providing evidence-based reassurance.
Key Updates in Adult Vaccination
Dr. Grogg reviewed individual vaccines and types of vaccines in some detail, addressing some misconceptions about various vaccines.
COVID-19
Current CDC guidance limits COVID-19 vaccination to adults 65 and older, as well as younger adults with high-risk conditions such as heart, lung, or kidney disease. While federal recommendations have narrowed, clinicians should continue to consider individual risk factors when advising patients.
RSV (Respiratory Syncytial Virus)
For the first time, RSV vaccines are broadly recommended for adults. All individuals aged 75 and older should receive one dose, while those aged 50–74 with chronic conditions may also benefit. Vaccination is best administered in late summer or early fall ahead of RSV season.
Influenza
All adults should continue to receive annual influenza vaccination. For patients over 65, high-dose or adjuvanted formulations are preferred to elicit a stronger immune response. A new option for the 2025–26 season is FDA-approved at-home administration of FluMist nasal spray for ages 2–49, increasing accessibility for families.
Shingles
Recombinant zoster vaccine remains a two-dose series for adults 50 and older. Immunocompromised patients may need an accelerated schedule.
Pneumococcal
Updated conjugate vaccines, PCV20 and PCV21, are now recommended for adults 50 and older. A single dose provides broad coverage without the need for follow-up polysaccharide vaccination.
HPV and Other Vaccines
Despite its proven cancer-prevention benefits, HPV vaccination remains underutilized. ACIP discussions have been delayed, leaving future recommendations uncertain. Physicians should continue to encourage vaccination through age 45 when appropriate.
Practical Tools for Clinicians
To simplify decision-making, the CDC offers a free Vaccine Schedule App for healthcare providers (available on iOS and Android). The app provides age-based and condition-based recommendations, contraindication guidance, and even coding tips for reimbursement. Dr. Grogg recommends this app highly. (This link was still active as of 10/2/2025.)
The current government shutdown may affect the accuracy and recency of government resources. One nongovernmental source of evidence-based vaccine recommendations that Dr. Grogg recommends is https://www.immunize.org/.
Bottom Line
"Vaccines remain one of the safest and most effective tools to protect adults from preventable disease," said Dr. Grogg. "Despite leadership changes and policy debates, the science is clear: staying up to date on immunizations safeguards not only individuals but also their communities." By engaging patients in open conversations and addressing hesitancy with compassion, physicians can play a pivotal role in maintaining high vaccination rates in 2025 and beyond.
ACOFP Supports Vaccination
ACOFP's advocacy priorities include improving outcomes and reducing costs through primary care and support for family physicians. Vaccination is an important aspect of primary care. Vaccines have been proven to be safe and effective and are critical to protect patients from life-threatening illnesses and diseases. Family physicians utilize vaccines in their practices to ensure their patients receive the highest level of care.
To this end, ACOFP and their advocacy partners support legislation and policies that:
- Recognize the significance of vaccination in primary care and their importance in ensuring patients receive the highest level of care from family physicians.
- Support access to vaccines as current evidence supports vaccine safety and efficacy.
We oppose efforts to limit access to vaccines. Instead, Congress and the Administration should take steps to ensure vaccines are accessible to all patients. ACOFP also supports measures to increase payments for vaccine reimbursement, as well as resources and regulatory flexibilities for providers administering vaccines—especially due to the costs associated with maintaining COVID-19 vaccines.
