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January 21, 2026

Spotlight

This is a special edition of the GIH-TFAH Health Policy Update, focusing on vaccine and immunization policy. After years of heightened debate and scrutiny, the past year has been a critical moment for vaccine access and oversight. Changes to federal vaccine recommendations and communications are causing confusion, further eroding confidence in vaccines, and widening the divide between state approaches to vaccine policy. These developments carry significant implications for communities, health philanthropies, the public health system, and health care providers. In response to this evolving landscape, this special edition update takes a deeper look at recent vaccine policy and infrastructure changes, forecasts potential future developments, and discusses opportunities for philanthropy.
While the focus of this update is vaccine and immunization policy, we acknowledge other important public health changes that occurred in the first few weeks of the year and provide brief updates on recent developments related to SAMHSA grants and Dietary Guidelines for Americans.

Timeline of Administration Actions

February 13, 2025: U.S Secretary of Health and Human Services (HHS) Robert F. Kennedy, Jr. (hereafter referred to as Kennedy) is sworn in. After a contentious confirmation process, Senate Health, Labor, Education and Pensions (HELP) Committee Chairman Bill Cassidy agreed to support his nomination after receiving assurances that HHS would continue to protect the public health benefit of vaccination.
February 20, 2025: Kennedy postponed a meeting of the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), citing a need to “accommodate public comment in advance of the meeting.” The postponement delayed recommendations for fall respiratory virus vaccines.
March 25, 2025: Kennedy hired David Geier to study the link between vaccines and autism despite vast scientific research debunking this myth. Geier is a noted skeptic of vaccines and published papers on vaccines and autism that have been retracted.
May 27, 2025: Kennedy announced CDC will no longer recommend COVID-19 vaccines for healthy children and pregnant women. Many public health experts immediately questioned the change, given there was no new data or evidence to justify it.
June 9, 2025: Kennedy fired all 17 members of ACIP and then appointed eight new members, including many who have history as vaccine skeptics and have spread misinformation. In the past, the ACIP appointee process has been widely advertised and transparent. ACIP nominations have been solicited through the Federal Register and the ACIP website. Candidates must have an understanding of vaccination and immunization issues. Applicants would undergo a formal review by the ACIP Steering Committee, and the HHS Secretary would make the final selection(s). In 2025, there was no transparent process to fill the ACIP vacancies.
June 23, 2025: Kennedy appointed Lyn Redwood to the CDC’s Immunization Safety Office. She previously headed an anti-vaccine group, the World Mercury Project, which later became Children’s Health Defense.
June 25, 2025: Kennedy said the United States would stop funding GAVI (formerly the Global Alliance for Vaccines and Immunization), a global vaccine alliance with the goal of saving lives and protecting people’s health by increasing equitable and sustainable use of vaccines in low-income nations. The $1 billion previously pledged, he said, will not be delivered until GAVI starts “taking vaccine safety seriously,” although experts say this claim is unfounded.
June 25-26, 2025: The new ACIP met for the first time. The group voted to expand the recommendation for RSV antibody shots for infants to include new FDA-approved immunizations and for these shots to be covered by the Vaccines for Children Program. The Committee also voted to recommend the 2025-2026 flu vaccine to anyone 6 months and older without contraindications. Despite CDC evidence that thimerosal is safe for use in vaccines, the Committee voted to recommend only flu vaccines without thimerosal. While only a small percentage of flu vaccines on the market contain thimerosal, thus not having a major impact on vaccine access, the vote signaled that the new ACIP members will not always or consistently consider scientific data and evidence when making recommendations. Additionally, the Committee indicated its intent to explore other topics that have been of interest to vaccine critics such as the youth and adolescent vaccine schedules.
July 7, 2025: The American Academy of Pediatrics, American College of Physicians, American Public Health Association and the Infectious Diseases Society of America (IDSA), Massachusetts Public Health Alliance, and Society for Maternal-Fetal Medicine sued Kennedy, claiming he violated federal law by changing COVID-19 vaccine recommendations without scientific evidence for children and those who are pregnant.
August 27, 2025: CDC Director Dr. Susan Monarez was fired less than a month after her Senate confirmation to the post, testifying to Congress later that her dismissal was due to her refusal to preapprove Secretary Kennedy’s vaccine recommendations. Three CDC senior leaders, Dr. Debra Houry, Dr. Demetre Daskalakis, and Dr. Daniel Jernigan, resigned in protest.
September 15, 2025: Kennedy appointed five additional members to the ACIP. Like those appointed earlier in the year, several of the new appointees have a history of vaccine skepticism.
September 18, 2025: ACIP voted to recommend that children under age 4 get separate measles, mumps, rubella (MMR) and varicella vaccines (as opposed to having the choice of separate vaccines or the combined MMRV vaccine), and to further limit access to COVID-19 vaccines by recommending adults 65 and older receive the shots only after discussing the potential benefits and risks with a health care provider. The panel also said that everyone from 6 months to 64 years old could get the vaccine after consulting with a provider, with an emphasis on a risk-benefit analysis being most favorable for individuals at increased risk for severe COVID-19. Previously, a provider consultation was not a requirement for getting a vaccine.
November 19, 2025: Kennedy directed the CDC to update its website to say that the statement “vaccines do not cause autism” is not an evidence-based claim. HHS provided no new evidence to support the change, which was met with widespread alarm from medical and public health groups. TFAH released a corresponding statement, which highlighted how promoting harmful, false claims about vaccines is a violation of public trust that jeopardizes vaccine confidence, undermines prevention efforts, and puts communities at risk of vaccine-preventable outbreaks.
December 5, 2025: ACIP passed two new recommendations related to Hepatitis B (Hep B) vaccinations. First, the ACIP voted to replace the universal birth-dose of Hep B vaccine with a risk-based assessment. The recommendation for mothers who are Hep B-positive or whose Hep B status is unknown remained unchanged, while ACIP recommends shared clinical decision-making if the mother is Hep B-negative. For those who choose to delay the first dose of the vaccine, ACIP suggested delaying for at least two months. The second new recommendation is to offer parents the option of an antibody blood test to evaluate the need for the second and/or third doses of the Hep B vaccine. According to medical and public health experts, these votes will harm Americans’ health by hindering access to a vaccine that is proven safe and effective. The universal birth-dose vaccine recommendation is credited with reducing hepatitis B cases among children and adolescents by 99 percent and preventing an estimated 90,100 childhood deaths. The risk of developing chronic hepatitis B infection is highest in infancy, placing infected infants at increased risk for cirrhosis, liver cancer, liver failure, and premature death. You can read TFAH’s statement here and public comment here.
December 30, 2025: The Centers for Medicare & Medicaid Services (CMS) announced it will no longer require states to report childhood vaccination levels for patients covered by Medicaid and the Children’s Health Insurance Program. This information was previously collected as part of quality-of-care measures. States may continue to voluntarily report this data, which has been used to help researchers and policymakers identify trends and barriers to vaccine access. CMS is exploring new vaccine measures to capture data on whether patients and families are informed about vaccine choice, vaccine safety and side effects, and “alternative vaccine schedules.” If such changes are made, it could make it more difficult for researchers and policymakers to identify and address gaps in vaccine access and could further promote misinformation and confusion about vaccines.
January 5, 2026: HHS Deputy Secretary Jim O’Neill, in his role as Acting CDC Director, announced significant changes to U.S. childhood immunization practices, reducing the number of universal childhood vaccine recommendations and recategorizing some recommended vaccines as only recommended for high-risk groups or under shared clinical decision-making. These changes were made without a transparent, evidence-based process. TFAH, along with the National Association of County and City Health Officials and Big Cities Health Coalition, released a statement highlighting how these changes increase burden on parents and health providers to navigate an increasingly complex system and do not assure access to these life-saving vaccines.
January 13, 2026: Kennedy appointed two new members to the ACIP. Both are OB-GYNs who have questioned vaccinations during pregnancy.

The same day, it was reported that at least two members of the Advisory Commission on Childhood Vaccines were dismissed from the committee, with later reports indicating at least four of the nine committee members were removed. This advisory committee reports on the Vaccine Injury Compensation Program. No replacements have been named yet.

Timeline of Congressional Actions

On June 6, 2025, Representatives Frank Pallone, Jr. (D-NJ) and Kim Schrier, M.D. (D-WA) introduced the Family Vaccine Protection Act, which would codify ACIP and require that any new vaccination recommendations be supported by a preponderance of evidence. The bill was referred to the House Energy & Commerce Committee, who have not yet scheduled it for a mark-up, the next step in the legislative process.
On July 28, 2025, Senator Lisa Blunt-Rochester (D-DE) introduced a bill that would require that ACIP members can only be terminated for cause and would reinstate the ACIP members that Kennedy dismissed. No further action has been taken on the bill since introduction.
On September 4, 2025, Kennedy testified before the Senate Finance Committee on the agency’s health care agenda. Many of the Senators’ questions covered the dismissal of CDC Director Dr. Susan Monarez and the departure of other key agency leadership as well as recent changes at HHS that impact vaccine access. In the contentious hearing, Kennedy faced pushback from Senators on both sides of the aisle, with Senator Bill Cassidy (R-LA) stating “effectively, we’re denying people vaccine” as a result of HHS narrowing eligibility to receive the COVID-19 vaccine.
On September 18, 2025, former CDC Director Dr. Susan Monarez testified before the HELP Committee about the circumstances that led to her removal and the subsequent resignations of other top CDC officials. According to Dr. Monarez, Kennedy wanted “blanket approval from her” and she disagreed with the Secretary about the childhood vaccine schedule. Former CDC Chief Medical Officer Dr. Debra Houry also testified, stating she resigned “because Secretary Kennedy’s actions repeatedly censored CDC science, politicized our processes, and stripped agency leaders of the ability to protect the health of the American people.”
On September 18, 2025, Democratic Health Committee leadership in both the House and Senate introduced the Protecting Free Vaccines Act. The bill would require health insurance plans to continue to offer comprehensive coverage without cost-sharing for all vaccines approved by the ACIP as of October 2024, before Kennedy dismissed the previous membership.

State Actions

In response to changes at the federal level, some states have formed regional public health leadership collaboratives to better coordinate guidance, public health communications, and readiness.
- The Northeast Public Health Collaborative is a “voluntary regional coalition of public health agencies and leaders, brought together to share expertise, improve coordination, enhance capacity, strengthen regional readiness, and promote and protect evidence-based public health.”
- Health leaders in California, Oregon, and Washington announced the West Coast Health Alliance, aiming to ensure “that public health recommendations are guided by safety, efficacy, transparency, access, and trust.”
- Fifteen Governors came together to form The Governor’s Public Health Alliance. The coalition works to protect public health by helping states communicate across state lines, coordinate on pressing public health challenges, and support access to critical health care like vaccines.
Florida has proposed significantly rolled back school vaccination requirements, after Governor Ron DeSantis called on his state to become the first to remove all school vaccination requirements. Florida Surgeon General Dr. Joseph Ladapo has claimed vaccination requirements to be “immoral” intrusions on people’s rights that hamper parents’ ability to make health decisions for their children.
Following the overhaul of the childhood vaccine schedule earlier this month, 19 states have announced their intentions to follow the vaccine guidance of the American Academy of Pediatrics instead of the new schedule set forth by HHS. The states are: California, Colorado, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Vermont, Washington, and Wisconsin.
Earlier this month, Maryland Governor Wes Moore announced the Vax Act of 2026, which would allow the state’s Secretary of Health to take into account authoritative medical organizations that issue independent recommendations when deciding on vaccine policy. The proposed legislation ensures insurance coverage and pharmacist administration of vaccines.

Other Efforts and Actions

Vaccine Integrity Project: The group was launched in 2025 to promote the continued grounding of immunization policies and programs in the best available science and focused on optimizing protection of individuals, families, and communities against vaccine-preventable diseases.
American Academy of Pediatrics (AAP): Since the 1930s, AAP has developed vaccine guidance for pediatricians, which later led to the creation of vaccine schedules. AAP continues to develop a vaccine schedule for children and adolescents. In the past, their recommendations matched those from the CDC. In response to changes at the federal level, AAP’s recommended vaccine schedule differs from that published by CDC, and the AAP does not endorse the current CDC vaccine schedule.

AAP and six other medical organizations filed a lawsuit in July 2025 over changes to the vaccine schedule, asserting that they represent a pressing public health emergency. Following the January 5, 2026, updates to the childhood immunization recommendations, AAP and their co-litigants requested to file an amended complaint. The amended complaint adds an allegation that HHS’s January 5, 2026, updates to the childhood vaccination schedule were unlawful in that HHS failed to “examine the relevant data and articulate a satisfactory explanation for [their] action[s].” They also noted additional facts related to allegations that ACIP is unfairly balanced and inappropriately influenced in violation of the Federal Advisory Committee Act. In addition, they assert violations of the APA by ACIP’s votes to remove certain vaccinations from the childhood vaccine schedule and Secretary Kennedy’s May 19, 2025, directive to remove the COVID-19 vaccine from the childhood vaccine schedule. The plaintiffs have requested injunctions preventing further meetings of the ACIP and the implementation of the challenged changes to the childhood vaccine schedule, associated ACIP votes, and the May 19 directive.
Viral Truths: A project of Vaccinate Your Family, the initiative aims to provide easy-to-understand and factual information on vaccines.
Public Health Communications Collaborative: The Public Health Communications Collaborative (PHCC) serves as a learning and information hub for professionals who communicate about public health with a focus on messaging that is simple, clear, and accurate. The PHCC managing partners are the CDC Foundation, de Beaumont, Trust for America’s Health, The Kresge Foundation, and the Robert Wood Johnson Foundation.
Common Health Coalition: The Coalition is a cross-sector group of leading health care and public health organizations in support of better coordination between public health and health care systems. The Coalition has developed vaccine resources to prepare for and respond to the 2025-2026 respiratory virus season and to provide situational awareness around changes to childhood immunizations.

What Philanthropy Can Do

Given the recent changes in the immunization landscape, it is likely that geographic disparities will continue to grow in regard to accessing safe and affordable vaccines. Philanthropy has an opportunity to help bridge these gaps.

Philanthropic organizations can use their dissemination and convening power to share information on vaccine policy changes to their grantees and other community partners.
Philanthropic organizations can sponsor in-person or virtual gatherings to discuss the national, local, regional, or community impact of these changes and allowing those convened to identify potential solutions and take action.
Philanthropy can actively respond to changes in the federal vaccine landscape that are not evidenced-based. For example, groups can call for oversight of the overhaul of the vaccine schedule.
Philanthropic organizations can support education of state policymakers on how vaccine changes at the federal level impact their constituents, actions states can take to protect access, and accurate information sharing about vaccine safety and efficacy.
Philanthropic organizations can support groups actively working on vaccine policy, education, communications, and/or research.
Philanthropic organizations can support community-based organizations that conduct outreach to increase vaccine access and information in communities, particularly those with disparities in vaccine coverage.
Philanthropic organizations can partner with the state-level groups mentioned above to coordinate and plan strategy for the coming year.

To Learn More

New Vaccine Guidance: What Funders Should Know

Join us for a timely webinar exploring the Department of Health and Human Services’ recent changes to routine vaccinations. Experts will discuss the evolving pattern of vaccine recommendations, including the January 5 update to the Childhood Immunization Schedule, which reduces the number of routinely recommended vaccines and introduces new categories for highrisk groups and shared decisionmaking.

Our speakers will discuss what these changes mean for vaccine access, what to expect moving forward, and how crosssector partners are collaborating to ensure continued coverage. We will also highlight opportunities for philanthropy to get involved.

Featuring:
Katelyn Jetelina, Founder, Your Local Epidemiologist
Julia Spiegel, Founder & CEO, GovAct

When: Thursday, January 29, 2026, 2:30-3:30PM

Register Now

What We’re Watching

SAMHSA Grants
On January 13th, 2026, the Substance Abuse and Mental Health Services Administration (SAMHSA) distributed more than 2,000 grant termination notices, totaling an estimated $2 billion in grant funding. The grants included several of SAMHSA’s Programs of Regional and National Significance, which support overdose prevention, substance use disorder treatment, first responder training, youth suicide prevention, school-based mental health services, and more. However, following response from grant recipients, behavioral advocates, governors, and lawmakers, the Administration announced late Wednesday that the terminations would be reversed, and the grant funding would be restored. Stakeholders continue to monitor the situation to track any new actions and impacts.
Dietary Guidelines for Americans
Earlier this month, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture released the 2025-2030 Dietary Guidelines for Americans (DGAs) to mixed reactions from nutrition experts and the public health community. The DGAs have a significant impact on food and nutrition policy, including determining future standards for critical federal nutrition programs like the National School Lunch Program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Significantly, this edition of the Guidelines diverged from the recommendations of the Dietary Guidelines Advisory Committee’s Scientific Report, published in December of 2024. Historically, the Advisory Committee’s report has served as the scientific foundation for changes to the DGAs, adding transparency and clarity to the process.
Measles Outbreak Update
A measles outbreak in South Carolina is the largest ongoing measles outbreak in the country. As of January 20, the state is reporting 646 confirmed cases since the outbreak began last year. More than 500 people are in quarantine. The state’s Department of Public Health is encouraging vaccination to prevent infection and avoid quarantine. Vaccination is the best way to prevent the spread of measles.

January 20, 2026, also marked one year since a measles outbreak began in West Texas. The Pan American Health Organization (PAHO) and the Centers for Disease Control and Prevention are analyzing data and studying strains of measles to determine if the current outbreaks are related to the Texas outbreak. If they are connected, the U.S. stands to lose measles elimination status. Measles elimination status is the absence of endemic measles in a geographical area for one year. This was achieved in the United States in 2000. PAHO has invited the United States and Mexico to meet virtually on April 13 to review elimination status.
Emergency Funder Briefing: Southern Groups Launch Response to Voting Rights and Fair Representation Threat at SCOTUS
The Supreme Court's upcoming decision in Louisiana v. Callais could further weaken the Voting Rights Act, with devastating consequences for voting rights and fair representation – especially for communities of color across the South – and for community priorities like healthcare, housing, education, economic opportunity, climate, and more. State groups in Mississippi, Alabama, Louisiana, and beyond are mobilizing a coordinated emergency response. Join this funder-only emergency virtual briefing to learn how philanthropy can support this urgent effort.

Wednesday, January 28, 2026, 3:00 - 4:00pm ET

Please note that this is a closed briefing for funders and staff of philanthropy-serving organizations only

Hosted by Fair Representation in Redistricting (FRR) and State Infrastructure Fund (SIF). Co-sponsored by (list in formation): Bernard and Anne Spitzer Charitable Trust, Carnegie Corporation of New York, Democracy Fund, Grove Foundation, Louisiana Alliance, Mary Reynolds Babcock Foundation, Open Society Foundations, and Rockefeller Brothers Fund.

Register Now

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