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The Advisory Committee on Immunization Practices (ACIP) plays a critical role in US immunization policy by issuing recommendations on the use of immunizations to control vaccine-preventable diseases. ACIP membership and decision making processes allow for the Committee to issue recommendations that respond to discovery and innovation in a timely manner, ensuring that target populations are reached with products newly approved or with expanded indications to protect against vaccine-preventable illness and death and safeguard population health.

Through its robust evidence-based review and recommendation development processes, the ACIP advises the Director of the Centers for Disease Control and Prevention (CDC) on the creation of the childhood/adolescent and adult immunization schedules, recommends immunizations for use in specialized situations (travel and occupational settings), and plays a statutory role in the establishment and maintenance of the list of immunizations for inclusion in the Vaccines for Children (VFC) program. Importantly, ACIP recommendations underpin statutory federal coverage requirements and patient no-fail compensation protections.

In recent months, the ACIP and CDC have undergone significant structural and personnel changes, leaving gaps in leadership and subject matter expertise within CDC divisions supporting the ACIP. Notably, in June 2025, the Secretary of the US Department of Health and Human Services (HHS) dismissed all 17 sitting members of the ACIP, ultimately replacing them with 12 new members. The ACIP Work Groups (WGs), which have historically been comprised of subject matter experts in a particular disease area, are also no longer operating according to precedent. For example, in some recent cases, the ACIP did not form or convene a WG for subject matter expert level discussion prior to issuing updated recommendations for the public, and there is no WG for other issues currently under deliberation (i.e., the measles, mumps, rubella, and varicella vaccine). In response to these changes, a variety of public health stakeholders, including professional medical societies and state health agencies, have taken steps to develop independent immunization guidance.

This paper provides an overview of the ACIP, its role in immunization policymaking that affects access, and the comprehensive processes and practices by which it has historically made recommendations. Further, this paper discusses how public health stakeholders have reacted to recent shifts in the federal immunization landscape.

Download the white paper here.