The Advisory Committee on Immunization Practices (ACIP) has removed the COVID-19 vaccine mandate—a decision that, according to experts, puts vulnerable populations at risk and opens a broader debate on immunization in the country.
On September 19, the United States took a historic turn in its health policy. The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) announced that the COVID-19 vaccine would no longer be mandatory for everyone. From now on, it will be optional, with guaranteed coverage by both public and private insurance until 2026.
However, the measure does not consider the dangers it could pose for the most vulnerable populations in the United States, nor its implications for vaccination protocols and the institutional perception of immunization.
In a briefing held by American Community Media (ACoM), experts discussed the ACIP’s new recommendations. They analyzed the consequences of this decision and the controversies that have emerged in recent days regarding public health.
Vulnerabilities to COVID-19
Dr. Peter Chin-Hong analyzed the recommendations on COVID-19 vaccines. He noted that, despite the perception that the disease no longer poses a serious risk to most people, there are still highly vulnerable populations: adults over 65, pregnant women, young children, and immunocompromised individuals.
“In 2024, there were still around 50,000 COVID deaths in the United States, in what was supposed to be a year of recovery,” he stated.
Regarding the first group, he explained that people over 65 account for the highest rates of hospitalizations and deaths. The second group is pregnant women, even those without pre-existing health conditions, as the immune system becomes more vulnerable during pregnancy.
He also added a critical point: “Maternal antibodies cross the placenta to provide protection to the baby, but the baby cannot receive a vaccine before turning six months old.”
On young children, he warned: “The COVID-19 hospitalization rate in infants under two years old is comparable to that of older adults. In fact, over the past two seasons, ER readmissions due to this disease in children of that age even surpassed those recorded in people over 65.”
Finally, he stressed that immunocompromised individuals—those with comorbidities or weakened immune systems—require special attention: “The body may stop recognizing the virus despite having been exposed the year before, which is why reinforcing immune memory with booster doses is so important.”
Chin-Hong also warned about the lack of clarity in the official recommendations: “Strongly recommending vaccines and then saying they’re not mandatory is confusing. That message creates barriers that prevent those who need them most from accessing them.”
The Hepatitis B Debate
Dr. Maurizio Bonacini, president of Mission Gastroenterology and Hepatology and clinical professor at the University of California, San Francisco, presented his views on hepatitis B and strongly criticized President Donald Trump, who claimed that the disease is primarily transmitted sexually and that the vaccine should be administered at age 12 rather than at birth.
“The president’s statement that sexual transmission is the main route of contagion is incorrect, since in the United States the most frequent form of transmission occurs through injection drug use and potential medical or non-medical contamination,” he explained.
He added that delaying immunization until age 12 “is not supported by the data.” To back his position, he highlighted the case of Alaska, where after the introduction of the birth dose “there were no cases of liver cancer in young adults after 1993.”
Defending the MMRV
Dr. Yvonne “Bonnie” Maldonado, an expert in pediatrics and infectious diseases at Stanford, addressed the MMRV (combined vaccine against measles, mumps, rubella, and varicella). She defended its safety and effectiveness after decades of use: “Safe, effective, and time-tested tools like the MMRV prevent serious childhood diseases.”
She detailed the minimal risks of febrile seizures after the first dose: “About 8 out of every 10,000 children experience a febrile seizure with MMRV, compared to 4 out of every 10,000 with separate vaccines. That represents an additional risk of 0.04%.” She also clarified that these seizures are brief and leave no aftereffects.
“Outbreaks remind us of what’s at stake. Last year, measles outbreaks in the United States hospitalized dozens of children, most of them unvaccinated,” she pointed out. And she concluded: “Vaccines are one of the greatest achievements of modern medicine… Four diseases, one safe and effective shot, and millions of children protected.”