Meeting Coverage

What Clinicians Need to Know About ACIP’s June 2025 Meeting

Miranda Manier, BA

Key Highlights

  • Clesrovimab approved for infants under 8 months to prevent respiratory syncytial virus during their first season, and added to the Vaccines for Children program for free access.
  • FluMist now allows self-administration for adults and caregiver administration for kids 2–17; Flublok expanded to ages 9 and older, offering more egg-free flu vaccine options.
  • Thimerosal-containing flu vaccines discouraged for children, pregnant women, and adults when single-dose, thimerosal-free options are available.

The Advisory Committee on Immunization Practices (ACIP) convened on June 25–26, 2025, to review and vote on several vaccine recommendations. Key decisions were made regarding respiratory syncytial virus (RSV) immunization in infants, influenza vaccine formulations, and the use of thimerosal-containing vaccines.1

RSV Immunization Recommendations

Clesrovimab for Infants

ACIP voted 5–2 to recommend the use of clesrovimab, a monoclonal antibody for infants under 8 months of age entering their first RSV season.2

Inclusion in Vaccines for Children Program

In a separate 7–0 vote, ACIP recommended including clesrovimab in the Vaccines for Children (VFC) program, ensuring access for eligible children without cost barriers.2

Clinical Implications

  • Clesrovimab may now be used as a preventive option for infants younger than 8 months who are entering their first RSV season and who are not protected by maternal RSV vaccination.
  • The monoclonal antibody is administered as a single intramuscular dose and can be given during the birth hospitalization or early infancy. 3,4
  • With inclusion in the VFC program, clesrovimab is now accessible at no cost to eligible infants, helping improve coverage for underinsured or Medicaid-enrolled families.5

Influenza Vaccine Recommendations

2025–2026 Season Updates

ACIP voted 6 in favor, with 1 abstention, to recommend continued annual influenza vaccination for individuals aged 6 months and older.2

The 2025–26 recommendations include the following updates:

  • FluMist is now approved for self-administration in adults and caregiver administration for children aged 2 to 17 years.6
  • Flublok can now be used in children as young as 9 years, expanding options for patients who need an egg-free or recombinant vaccine.6
  • All influenza vaccines for the 2025–26 season will be trivalent and will include an updated A(H3N2) strain.6

Thimerosal-Containing Vaccines

ACIP conducted three separate votes concerning thimerosal-containing influenza vaccines, each of which passed with 5 votes in favor, 1 against, and 1 abstention2:

  1. Pediatric use: Recommended against the use of thimerosal-containing influenza vaccines in children.2
  2. Pregnant women: Recommended against the use of thimerosal-containing influenza vaccines during pregnancy.2
  3. Adults: Recommended that adults receive thimerosal-free single-dose formulations when available.2

Most influenza vaccines in the United States are already thimerosal-free, but this recommendation reinforces preferential use of single-dose formulations across all age groups.7,8

Clinical Implications

  • FluMist (trivalent Live Attenuated Influenza Vaccine) may be administered by caregivers for children aged 2–17 years, or self-administered by adults, expanding access outside clinical settings.6
  • Flublok is now an option for children aged 9–17 years, giving clinicians an additional recombinant vaccine choice for patients who may not tolerate egg-based or live-attenuated vaccines.6
  • Clinicians should offer thimerosal-free, single-dose influenza vaccines whenever possible, especially when vaccinating children and pregnant women, in accordance with ACIP’s vote to recommend against thimerosal-containing formulations for these groups.7

Understanding ACIP's Role

ACIP is a group of medical and public health experts that develops evidence-based recommendations on how to use vaccines to prevent disease in the United States. Its guidance determines which vaccines should be used, at what ages, how many doses are needed, and what precautions or contraindications should be considered. These recommendations inform the national immunization schedules for children and adults and are used by clinicians across the country to guide vaccine administration.9

Once ACIP adopts a recommendation and it is approved by the CDC Director, it is published in the Morbidity and Mortality Weekly Report (MMWR). This publication marks the recommendation as official CDC policy. From that point, the guidance typically becomes the basis for vaccine coverage under public and private insurance plans, including the VFC program and preventive care mandates under the Affordable Care Act.9

Recent structural changes to ACIP prompted responses from professional medical organizations leading up to June’s meeting. An open letter published on June 25 from the American Medical Association and 77 other medical societies underscored the importance of vaccines for influenza, RSV, and COVID-19. The letter emphasized the collective commitment of the medical community to promote public understanding and confidence in vaccines to prevent severe respiratory illnesses.10

References:

  1. Centers for Disease Control and Prevention. ACIP meeting agenda, June 25–26, 2025. CDC. Accessed June 26, 2025. https://www.cdc.gov/acip/downloads/agendas/Final-posted-2025-06-24-508.pdf
  2. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) - day 2 of 2. YouTube. Published June 26, 2025. Accessed June 26, 2025. https://www.youtube.com/live/z-16fImZoEc
  3. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) - day 1 of 2. YouTube. Published June 25, 2025. Accessed June 26, 2025. https://www.youtube.com/live/2PnYYb_xj3U
  4. MacNeil A. Maternal/pediatric respiratory syncytial virus (RSV) session. CDC ACIP June 2025 meeting PowerPoint. CDC. Accessed June 26, 2025. https://www.cdc.gov/acip/downloads/slides-2025-06-25-26/01-MacNeil-Mat-Peds-RSV-508.pdf
  5. Peacock G. Implementation and uptake of nirsevimab and maternal vaccine for infant protection from RSV. CDC ACIP June 2025 meeting PowerPoint. CDC. Accessed June 26, 2025. https://www.cdc.gov/acip/downloads/slides-2025-06-25-26/02-Peacock-Mat-Peds-RSV-508.pdf
  6. Dugan V. 2024–25 influenza season update and seasonal influenza vaccine recommendations for the 2025–26 U.S. influenza season. CDC ACIP June 2025 meeting PowerPoint. CDC. Accessed June 26, 2025. https://www.cdc.gov/acip/downloads/slides-2025-06-25-26/04-dugan-influenza-508.pdf
  7. Redwood L. Thimerosal as a vaccine preservative. CDC ACIP June 2025 meeting PowerPoint. CDC. Accessed June 26, 2025. https://www.cdc.gov/acip/downloads/slides-2025-06-25-26/05-influenza-redwood-508.pdf
  8. CDC Vaccine Safety. Thimerosal and vaccines. CDC. Updated December 19, 2024. Accessed June 26, 2025. https://www.cdc.gov/vaccine-safety/about/thimerosal.html
  9. Centers for Disease Control and Prevention. Role of the Advisory Committee on Immunization Practices in CDC’s vaccine recommendations. CDC. Updated September 17, 2024. Accessed June 26, 2025. https://www.cdc.gov/acip/about/role-in-vaccine-recommendations.html
  10. American Medical Association. An open letter to the American public on respiratory virus vaccines. AMA. Published June 25, 2025. Accessed June 26, 2025. https://www.ama-assn.org/delivering-care/public-health/open-letter-american-public-respiratory-virus-vaccines