New ACIP Charter May Potentially Delay Vaccine Recommendations

The CDC published an updated charter for the Advisory Committee on Immunization Practices (ACIP), formally changing how the committee that shapes the United States vaccine schedule is governed.¹

This decision has been met with criticism from various medical organizations. The Infectious Diseases Society of America (IDSA), joined by the Pediatric Infectious Diseases Society (PIDS), the Society for Healthcare Epidemiology of America (SHEA), and the Society of Infectious Diseases Pharmacists (SIDP), responded that the new charter "changes the fundamental focus, membership structure, and governance of the committee" in ways that "will lead to confusion and delays that threaten public access to lifesaving vaccines and evidence-based, accurate information."²

What the New Charter Changes

Under the revised charter, ACIP continues to operate under Section 222 of the Public Health Service Act and the Federal Advisory Committee Act (FACA), advising the CDC director on vaccine use and immunization strategy for the civilian population. The committee retains its core duties, including reviewing scientific evidence, recommending updates to childhood, adolescent, and adult immunization schedules, and establishing the vaccine list used by the Vaccines for Children Program.¹

However, IDSA and its cosigning organizations point to several structural shifts they say weaken the committee's independence. The groups stated that governance of the committee "would be the responsibility of the CDC director instead of members with deep expertise on immunization, which would intensify politicization of the ACIP.”²

The charter itself specifies that meetings "will be held at the discretion of the ACIP DFO in consultation with the Chair," with no fixed number or frequency required, a departure the organizations said “contradicts the past practice of having regularly scheduled meetings open to the public."^1,2

The societies further warned that the charter "inappropriately emphasizes potential gaps or limitations in vaccine data, which could be used to delay, rescind, or refuse to make evidence-based vaccine recommendations," and that it "noticeably softens requirements regarding the publication of vaccine recommendations and their use for informing insurance coverage."²

However, according to the CDC website, the meetings will still be open to the public unless decided otherwise by the director, and meeting notice will still be given to the public.¹

The charter still ties ACIP recommendations to coverage requirements under the Affordable Care Act, noting that immunization recommendations adopted by the CDC director "must be covered by applicable health plans." It also sets the committee's membership at up to 19 voting members serving up to 4-year terms, selected by the Department of Health and Human Services (HHS) secretary, along with 33 non-voting liaison representatives from medical and public health organizations, including the American Pharmacists Association and IDSA itself.¹

Why Pharmacists Should Pay Attention

The warning over the new charter lands amid an already disrupted vaccine policy landscape that has directly affected pharmacy practice. HHS Secretary Robert F. Kennedy Jr asserted in June 2026 that ACIP could not meet ahead of flu season because a federal court ruling left it without a quorum, a claim the American Academy of Pediatrics (AAP) disputed. AAP President Andrew P. Racine, MD, PhD, FAAP, said in a news release that "the federal government has had and continues to have the power to restore a lawful ACIP and schedule a meeting at any time."³

That dispute traces back to a March 2026 preliminary injunction from US District Judge Brian Murphy, which found that Kennedy likely violated the Administrative Procedure Act by bypassing scientific review to cut the routine childhood vaccine schedule from 17 vaccines to 11 and that the committee's appointees failed to meet FACA's "fair and balanced" requirement, invalidating votes taken since June 2025.³

Pharmacists rely heavily on ACIP's output, as they often rely on ACIP recommendations to define their scope of practice, ensure provider liability protection, and facilitate insurance billing, and in many states, the authority to administer a given vaccine is tied directly to the federal schedule. When a vaccine shifts from "routine" to "shared clinical decision-making," it can create what Racine called real consequences: "Vaccination rates decline, measles continues to spread, and children suffer needlessly from other vaccine-preventable diseases like whooping cough and flu."³

Medical Societies Are Already Working Around ACIP

The new charter arrives after several major organizations had already begun distancing themselves from the ACIP. The American College of Obstetricians and Gynecologists (ACOG) withdrew as an ACIP liaison organization in February 2026, with ACOG president Steven J. Fleischman, MD, citing a "fundamental departure from the scientific rigor" that had defined the committee for 60 years. ACOG went on to release its own 2026 Maternal Immunization Schedule on June 10, 2026, covering tetanus-diphtheria-pertussis, influenza, COVID-19, and respiratory syncytial virus vaccination in pregnancy, a schedule endorsed by 13 organizations, including the American Pharmacists Association and AAP.⁴

Gretchen Garofoli, PharmD, BCACP, CTTS, FAPhA, a clinical professor at the West Virginia University School of Pharmacy, said state-level guidance is increasingly filling the gap left by federal uncertainty.

"It's very state specific, for whenever all the changes were going back and forth. Some of the states, for example, Pennsylvania—where I hold one of my licenses—they started to follow the American Academy of Pediatrics' (AAP) guidelines,” she said.⁴ “They followed the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Family Physicians guidelines."

With the new charter formalizing reduced meeting commitments and shifting authority toward the CDC director, pharmacists may face an extended period in which federal recommendations lag behind, or diverge from, the guidance of professional societies. Garofoli previously advised pharmacists to "stay up to date with where we are now and looking at those guidelines and recommendations," particularly for flu and COVID-19 vaccines, which have seen the most frequent changes. As insurance coverage and liability protections under many state laws remain anchored to ACIP action, pharmacists are advised to monitor both federal updates and parallel guidance from organizations such as ACOG and AAP to determine current scope of practice in their states.^3,4

REFERENCES

1. Centers for Disease Control and Prevention. ACIP Charter. April 8, 2026. Accessed June 30, 2026. https://www.cdc.gov/acip/about/acip-charter.html

2. Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Healthcare Epidemiology of America, Society of Infectious Diseases Pharmacists. New ACIP charter will delay vaccine access. News release. IDSA. June 26, 2026. Accessed June 30, 2026. https://www.idsociety.org/news--publications-new/articles/2026/new-acip-charter-will-delay-vaccine-access/

3. Gallagher A. HHS claims ACIP cannot meet for flu season due to ongoing legal battle. Drug Topics. June 25, 2026. Accessed June 30, 2026. https://www.drugtopics.com/view/hhs-claims-acip-cannot-meet-for-flu-season-due-to-ongoing-legal-battle

4. Gallagher A. ACOG releases maternal immunization schedule, differing from previous CDC schedule. Drug Topics. June 12, 2026. Accessed June 30, 2026. https://www.drugtopics.com/view/acog-releases-maternal-immunization-schedule-differing-from-previous-cdc-schedule