Impact of COVID-19 Vaccine Guideline Updates: Who Are Potentially Impacted?
The Centers for Disease Control and Prevention (CDC) has recently updated its guidance on COVID-19 vaccinations, leading to significant changes in recommendations for certain population groups.
On May 27, 2025, Health Secretary Robert F. Kennedy Jr. announced that the CDC would no longer recommend COVID-19 vaccines for pregnant people or healthy children. This shift in policy has raised concerns, particularly given the emergence of a more transmissible variant of SARS-CoV-2, the virus that causes COVID-19, within the United States.
The CDC's new guidelines follow a statement published in The New England Journal of Medicine (NEJM), suggesting that vaccination programs should primarily focus on older adults and those at high risk of severe COVID-19 infection.
The changes have sparked questions, particularly regarding the potential risks to pregnant individuals and children. For pregnant women, a lack of access to COVID-19 vaccination might increase the risk of pregnancy complications, according to board-certified pediatrician Daniel Ganjian, MD, FAAP. He noted that several organizations, including the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, have previously recommended vaccination during pregnancy due to the associated risks.
Dr. Monica Gandhi, MD, MPH, an infectious disease specialist at the University of California, San Francisco, echoed these concerns, emphasizing that pregnant women are relatively immunocompromised and at risk of severe COVID-19.
Regarding children, while they may have a lower risk of developing severe COVID-19, infection with the coronavirus could nevertheless impact their health in unexpected ways, potentially leading to long-term conditions and complications. Dr. Ganjian cautioned that removing COVID-19 vaccination recommendations for healthy children could increase the risk of severe disease, hospitalization, and complications, particularly for those with underlying medical conditions.
From a public health perspective, rescinding broad recommendations for COVID-19 vaccination might signal a shift in risk assessment, but it could also increase morbidity in vulnerable populations, such as pregnant women and children with underlying medical conditions.
While the changes to vaccination recommendations affect the public availability of COVID-19 vaccines for these groups, pregnant individuals or parents who wish to vaccinate their children may still be able to access the shots through private purchases or off-label use, depending on regulatory status and local healthcare provider policies. However, insurance coverage and public health supply may be limited if recommendations are withdrawn.
These changes come at a time when the CDC is still recommending routine COVID-19 vaccination for children based on prior vaccination status and age, while the focus of immunization efforts has shifted to older adults and individuals at high risk of severe COVID-19. For pregnant individuals and healthy children, formal strong recommendations for vaccination have been withdrawn, but the CDC continues to allow these groups to get vaccinated if they choose. Vaccination schedules for children under 65 years remain detailed in CDC resources for those who opt to vaccinate.
In conclusion, while the official COVID-19 vaccine recommendations have shifted primarily to older adults and individuals at high risk of severe COVID-19, vaccination remains an option for pregnant individuals and healthy children based on individual choice, even though strong recommendations have been withdrawn. The CDC continues to detail vaccination schedules for children under 65 years for those who choose to vaccinate.
- The CDC's new guidelines focus on older adults and those at high risk of severe COVID-19 infection, but they do not discourage vaccination for pregnant individuals and healthy children, leaving the decision up to individual choice.
- Board-certified pediatrician Daniel Ganjian expressed concern about the potential risks to pregnant women if they lack access to COVID-19 vaccination, as several organizations previously recommended vaccination during pregnancy.
- Dr. Monica Gandhi emphasized that pregnant women are relatively immunocompromised and at risk of severe COVID-19, suggesting that the removal of vaccine recommendations could increase the risk of pregnancy complications.
- Regarding children, while they may have a lower risk of developing severe COVID-19, infection with the coronavirus could lead to long-term conditions and complications, particularly for those with underlying medical conditions. Thus, removing COVID-19 vaccination recommendations for healthy children could increase the risk of severe disease for these vulnerable individuals.
