Sarah Bennett
The 2025 immunization schedule from the Centers for Disease Control and Prevention (CDC) includes new and updated recommendations for various vaccines, including COVID-19, influenza, pneumococcal conjugate, meningococcal serogroup B, and respiratory syncytial virus (RSV) vaccines. The CDC recommends the 2024-2025 COVID-19 vaccine for most adults aged 18 and older, with a focus on targeting the JN.1 lineage of the Omicron variant. Additionally, the CDC has updated the pneumococcal vaccination age recommendation from 65 to 50 years old. The 2025 schedule also includes changes to the influenza vaccine formulation, with a transition from quadrivalent to trivalent. Other notable updates involve the meningococcal B vaccine dosing and recommendations for RSV vaccination for infants and adults over 75.
| Characteristics | Values |
|---|---|
| COVID-19 | The 2024–2025 vaccine formula has been updated to target the JN.1 lineage of the Omicron variant. The CDC recommends this vaccine for most adults ages 18 and older, and for children ages 6 months and older to receive at least one dose. |
| Influenza | Vaccines for 2024–2025 are trivalent. High-dose inactivated and adjuvanted inactivated influenza vaccines are options for 18-year-old solid organ transplant recipients on immunosuppressive medications. |
| Measles, Mumps, Rubella | Children 12 months and older vaccinated with one dose should receive a second dose at least four weeks after the first if they are travelling internationally. |
| Meningococcal B | Bexsero dosing has changed to a two-dose series for healthy adolescents and a three-dose series for those at increased risk. |
| Pneumococcal Conjugate | The 2025 schedule lowers the age-based recommendation for pneumococcal vaccination from 65 to 50 years old. |
| Respiratory Syncytial Virus (RSV) | Updated notes clarify that for infants born between October and March, nirsevimab administration is ideal during birth hospitalization. |
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What You'll Learn
COVID-19 vaccines
The CDC recommends a COVID-19 vaccine for the 2024-2025 schedule for most adults aged 18 and older. This includes people who have previously received a COVID-19 vaccine, those who have had COVID-19, and those with long COVID. The CDC also recommends that parents of children aged 6 months to 17 years discuss the benefits of vaccination with a healthcare provider.
The COVID-19 vaccine helps protect against severe illness, hospitalization, and death. It is especially important for individuals aged 65 and older, those at high risk for severe COVID-19, and those who have never received a COVID-19 vaccine. Additionally, getting the 2024-2025 COVID-19 vaccine is crucial for pregnant, breastfeeding, or trying to conceive, as vaccine protection decreases over time.
The 2024-2025 COVID-19 vaccines are updated to provide better protection against the currently circulating strains, specifically targeting the JN.1 lineage of the Omicron variant. The FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) met on May 22, 2025, and recommended a monovalent JN.1-lineage vaccine composition for the 2025-2026 formula.
The CDC has not yet updated its official recommendation for the 2025-2026 COVID-19 vaccine. However, FDA leaders have indicated that the vaccine will likely be recommended for adults with at least one underlying health condition listed by the CDC that increases the risk for severe COVID-19. This includes pregnancy, as recommended by the American College of Obstetricians and Gynecologists (ACOG).
It is important to stay up-to-date with COVID-19 vaccine recommendations and discuss any concerns with a healthcare provider.
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Influenza vaccines
The FDA has made recommendations to vaccine manufacturers for the virus strains to be included in influenza (flu) vaccines for the 2025-2026 flu season in the US. The FDA anticipates an adequate and diverse supply of approved trivalent seasonal influenza vaccines for this season. Trivalent seasonal influenza vaccines include two influenza A subtype viruses (H1N1 and H3N2) and one influenza type B virus.
The FDA's recommendations are based on a thorough and comprehensive review of US and global surveillance data, with a focus on the epidemiology and antigenic characteristics of currently circulating flu viruses. The FDA does not anticipate any impact on the timing or availability of vaccines for the American public due to these recommendations.
The American Academy of Pediatrics (AAP) has also released its 2025-2026 flu vaccine recommendations, emphasizing the urgent need to increase vaccination rates. According to the AAP, the US Department of Health and Human Services (HHS) has recommended removing thimerosal from all influenza vaccines in the US, despite studies showing the preservative is safe. The AAP continues to support the World Health Organization's recommendations for the use of thimerosal as a preservative in multiuse vials globally.
The 2024-2025 influenza season was a "high-severity season" for all ages in terms of outpatient medical visits, hospitalizations, and deaths. The CDC reported 266 influenza-associated pediatric deaths during this season, the highest in a non-pandemic year since 2004. Less than 50% of eligible children in the US received a flu vaccine last season, contributing to the increase in influenza-related hospitalizations and deaths.
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Pneumococcal conjugate vaccines
There are several versions of the pneumococcal conjugate vaccine, each targeting different strains of the Streptococcus pneumoniae bacteria. The first version, Prevnar (PCV7), was a heptavalent vaccine that targeted seven strains of the bacteria. It was approved for use in the United States in February 2000 and was recommended for children under two and unvaccinated children between 24 and 59 months old who were at high risk for pneumococcal infection.
Prevnar 13 (PCV13), the second version, contained thirteen serotypes of pneumococcus and replaced Prevnar in February 2010. It is currently recommended for adults over 65. The third version, Prevnar 20 (PCV20), was approved by the FDA in April 2023 for the prevention of invasive disease caused by 20 different serotypes of S. pneumoniae. It is approved for individuals 6 weeks through 17 years of age.
Another pneumococcal conjugate vaccine is Pneumosil, a decavalent vaccine produced by the Serum Institute of India. It contains ten serotypes and was prequalified by the WHO in January 2020. Capvaxive, a pneumococcal 21-valent conjugate vaccine (PCV21) manufactured by Merck, was approved for medical use in the United States in June 2024 for individuals 18 years of age and older. It is indicated for the prevention of invasive disease and pneumonia caused by various serotypes of Streptococcus pneumoniae.
The pneumococcal conjugate vaccine is typically given in multiple doses, with infants and young children receiving four doses at 2, 4, 6, and 12–15 months of age. Children 24–59 months old who did not receive the recommended doses as infants may still receive the vaccine. Children and adolescents 6–18 years old with certain medical conditions may also need the vaccine if they did not receive the recommended doses.
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Meningococcal serogroup B vaccines
Meningococcal disease can cause meningitis (an infection of the brain and spinal cord) and blood infections. It is a rare but severe illness with a high risk of death or lasting disabilities, including hearing loss, brain damage, kidney damage, limb loss, nervous system problems, or severe skin scarring. The disease is caused by the bacteria Neisseria meningitidis, and the various serogroups of this bacterium are covered by different vaccines.
The Men B vaccines specifically protect against serogroup B of the meningococcus bacterium. In 2014 and 2015, two Men B vaccines were licensed: MenB-FHbp (Trumenba) and MenB-4C (Bexsero). Both vaccines are composed of novel protein or lipoprotein antigens. In June 2015, the U.S. Advisory Committee on Immunization Practices (ACIP) provided a category B recommendation for both Men B vaccines, indicating that they are appropriate for individual clinical decision-making. The ACIP recommends that Men B vaccines be routinely administered to certain individuals aged 10 years or older who are at increased risk for serogroup B meningococcal disease. This includes those with complement component deficiencies, anatomic or functional asplenia, microbiologists routinely exposed to isolates of Neisseria meningitidis, and those at increased risk due to a serogroup B meningococcal disease outbreak. The preferred age for Men B vaccination is 16 to 18 years, and the vaccines may also be given to individuals in this age range to provide short-term protection against most strains of serogroup B meningococcal disease.
Bexsero is a vaccine approved for 10- to 25-year-olds to prevent meningococcal group B disease. It can be administered in two or three doses. However, individuals with certain complement deficiencies and those receiving treatment that inhibits terminal complement activation (such as eculizumab) are at increased risk for invasive disease caused by Neisseria meningitidis group B even after being vaccinated with Bexsero. The most common side effects of the vaccine include pain, redness, or swelling at the injection site, fatigue, headache, nausea, and muscle pain. It is important to consult a healthcare provider to determine if Bexsero is suitable for an individual, and individuals with severe allergies to the vaccine's ingredients should not receive it. Additionally, vaccination should be postponed for pregnant women unless the benefits are considered to outweigh the potential risks.
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Respiratory syncytial virus (RSV) vaccines
Respiratory syncytial virus (RSV) usually causes mild, cold-like symptoms, but it can be severe in older people, babies, and those with underlying health conditions. RSV is a highly contagious virus that causes infections of the lungs and breathing passages in individuals of all age groups. It is the leading cause of infant hospitalization in the US. In children younger than five, there are approximately 2.1 million RSV-related outpatient visits a year, 58,000 to 80,000 hospitalizations, and 100 to 300 deaths.
The CDC has released guidance for healthcare providers on the use of RSV vaccines for older adults. The FDA has approved Arexvy, the first RSV vaccine for use in the US for individuals aged 60 and above. The safety and effectiveness of Arexvy are based on the FDA's analysis of data from an ongoing, randomized, placebo-controlled clinical study. Arexvy was found to be approximately 77% effective in preventing RSV-associated emergency department encounters and 83% effective in preventing hospitalizations in adults 60 and older. It also reduced the risk of developing severe RSV-associated LRTD by 94.1%.
GSK's Arexvy, Moderna's mResvia, and Pfizer's Abrysvo are the available RSV vaccines for older adults. These vaccines work by introducing an inactivated RSV protein into the body, where it fuses with host cells and stimulates the immune system to recognize the actual RSV virus. The best time to get an RSV vaccine is late summer or early fall, but it can be taken at any time.
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Frequently asked questions
The 2025 immunization schedule for children and adolescents includes updates to the COVID-19 vaccine, with at least one dose recommended for all individuals aged 6 months and older, and additional doses for immunocompromised individuals. The 2025 schedule also includes changes to the influenza vaccine, which has transitioned from a quadrivalent to a trivalent formulation, and updates to the respiratory syncytial virus (RSV) vaccine.
Yes, the Centers for Disease Control and Prevention (CDC) has issued changes to the 2025 immunization schedule for adults, which includes new and updated recommendations for COVID-19 vaccines, influenza vaccines, pneumococcal conjugate vaccines (PCV), and RSV vaccines. The 2025 schedule lowers the age-based recommendation for pneumococcal vaccination from 65 to 50 years old.
Yes, in addition to the changes mentioned above, the 2025 schedules also include updates to the measles, mumps, rubella, and varicella vaccines, with new contraindications for HIV-infected individuals. There are also changes to the meningococcal B vaccine dosing, with a two-dose series for healthy adolescents and a three-dose series for those at increased risk. Furthermore, the FDA has advised manufacturers to update the COVID-19 vaccines for use in the United States beginning in the fall of 2025 to more closely match currently circulating SARS-CoV-2 viruses, with a preference for the LP.8.1 strain.
