Issue 1816: June 4, 2025

On May 30, CDC posted updated versions of its recommended immunization schedules for children and adults, reflecting an update to its recommendations for use of COVID-19 vaccines in children and during pregnancy. In its email notice to immunization programs and public health partners, CDC described its changes, made in response to a recent HHS directive:

• The Child and Adolescent Immunization Schedule now calls for shared clinical decision-making regarding COVID-19 vaccination for all children and adolescents aged 6 months through 17 years, including those who are moderately or severely immunocompromised. Any of these children may be vaccinated after a shared clinical decision with their healthcare provider.
• Vaccines For Children (VFC)-eligible children are allowed to obtain COVID-19 vaccine at no charge through the VFC program after a shared clinical decision with their healthcare provider.
• Pregnancy is now shaded gray (indicating “no guidance”) in both the Adult and Child and Adolescent Immunization Schedules by Medical Indication.
• No changes were made to recommendations for COVID-19 vaccination of adults who are not pregnant and age 18 years and older.

For each schedule, check the revision date on page 1 on the bottom left of the PDF version and the upper left corner of the web version. Updates to the app version are ongoing.

Links to the updated schedules are below. Please note that the schedules’ addendum pages, where midyear updates to CDC schedules are typically itemized, are currently unavailable online. All changes listed above were made directly on the schedule tables.

Child and Adolescent Schedule

• CDC: Child and Adolescent Immunization Schedule by Age
• CDC: Child and Adolescent Immunization Schedule by Medical Indication
• CDC: Child Immunization Schedule Notes
• CDC: Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger; United States 2025 (PDF)

Adult Schedule

• CDC: Adult Immunization Schedule by Medical Condition and Other Indication
• CDC: Recommended Adult Immunization Schedule for ages 19 years or older; United States 2025 (PDF)

On May 29, CDC released updated VISs for pneumococcal polysaccharide vaccine (PPSV23) and pneumococcal conjugate vaccine (PCV). Changes incorporate recommendations for the routine use of PCV for adults age 50 years and older (previously 65 years) and the limited use of PPSV23. The updated VISs refer to PCVs generally and no longer reference specific PCV products.



The use of the updated VISs should begin immediately. If you use Immunize.org’s QR code reference resources linking directly to the English VISs on our website, you can keep using them. These QR code documents automatically link to the updated VISs and ensure you are always accessing the current official version.

Immunize.org will create and post translations of these updated VISs in coming weeks. CDC notes that translated VISs that are out of date following publication of an updated version may continue to be used. The official English VIS must also be provided when providing any translation.

Related Links

• Immunize.org: Vaccine Information Statements main page for VISs in 47 languages
• Immunize.org: Dates of Current Vaccine Information Statements (PDF)
• Immunize.org: You Must Provide Patients with Vaccine Information Statements (VISs) – It's Federal Law! (2 pages)
• Immunize.org: QR Code Links to All Vaccine Information Statements (VISs) (PDF)
• Immunize.org: VISs: Pneumococcal Vaccine page
• CDC: What's New with VISs web page
• CDC: Current VISs web page

On May 23, FDA licensed MenQuadfi (Sanofi) to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, W, and Y in children as young as age 6 weeks. Previously, the lower age limit was 2 years. This new age indication is the same as that for the other available MenACWY product, Menveo (GSK).

At its June 25–27 meeting, ACIP is expected to consider whether to recommend MenQuadfi as an option for MenACWY vaccination of infants and toddlers younger than age 2 years at high risk for meningococcal disease.

FDA posted the MenQuadfi package insert and approval letter.

Related Links

• Immunize.org: Vaccines A–Z: Meningococcal ACWY main page
• Immunize.org: Vaccines A–Z: Meningococcal B main page

Starting July 1, 2025, the Centers for Medicare and Medicaid Services (CMS) will allow rural health centers and federally qualified health centers to bill and be paid by Medicare Part B for covered vaccines (i.e., pneumococcal, influenza, hepatitis B and COVID-19) and corresponding administration fees.

For additional details, including billing codes and conditions, visit this CMS web page.

As of May 29, CDC reported 1,088 confirmed measles cases in 2025 in 32 states, including the first cases reported this year in Nebraska and Iowa. Nebraska’s case, an age-appropriately vaccinated child, had no history of out-of-state travel. Iowa’s case, an unvaccinated adult, was the first case in the state since 2019. Most (738 of 1,088, 67.8%) were reported by the Texas Department of State Health Services. Among confirmed cases, 12% were hospitalized and two out of three were younger than age 20 years.

CDC only requires reporting of laboratory-confirmed measles cases. Cases without laboratory testing for confirmation are not included in these numbers. Actual numbers of cases are, therefore, expected to be higher than confirmed case counts.

A map of 2025 measles cases in the contiguous United States, as of May 23, from the Johns Hopkins Center for Outbreak Response Innovation (CORI) appears below. The CORI Measles Outbreak Response website offers various ways to visualize the outbreak.

CDC offers a suite of resources for public health, healthcare professionals, and families in communities experiencing a measles outbreak. Resources include infographics for families, images to help clinic personnel identify cases, and a Be Ready for Measles communication toolkit. A quick reference for healthcare professionals provides guidance for caring for patients with measles. Find all these resources on the CDC Measles Cases and Outbreaks page.



Related Links

• CDC: Measles Cases and Outbreaks main page
• CDC: Be Ready for Measles Toolkit
• Center for Outbreak Response Innovation: Measles Outbreak Response main page
• CIDRAP: Iowa, Nebraska Announce First Measles Cases (5/27/25)
• Nebraska DHHS: First Confirmed Measles Case Reported in Nebraska (5/27/25)
• Immunize.org: Vaccines A–Z: Measles main page
• Immunize.org: Standing Orders for Administering Measles, Mumps, and Rubella Vaccine to Children and Teens (PDF)
• Immunize.org: Standing Orders for Administering Measles, Mumps, and Rubella Vaccine to Adults (PDF)
• Immunize.org: Ask the Experts: MMR (Measles, Mumps, and Rubella) web page

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

• NPR: Here’s the Science Behind the COVID Vaccine in Pregnancy (5/30/25)
• NPR: CDC Recommends Parents Talk to a Doctor About Getting COVID-19 Shots for Kids (5/30/25)

Immunize.org continues to expand its repository of VIS translations, all available in print-ready PDF format. Cerro Gordo County Health Department, based in Mason City, Iowa, generously donated 16 Pohnpeian VIS translations, shown below. Pohnpeian is primarily spoken in the Federated States of Micronesia in the South Pacific.

• COVID-19* (view in English)
• Hepatitis B* (view in English)
• Haemophilus influenza type b (Hib) (view in English)
• Influenza (inactivated or recombinant)* (view in English)
• MMR* (Measles, Mumps, and Rubella) (view in English)
• MMRV* (view in English)
• Meningococcal B* (view in English)
• Multi-vaccine pediatric (view in English)
• Polio* (view in English)
• Pneumococcal conjugate* (view in English)
• Rotavirus (view in English)
• RSV* (Respiratory Syncytial Virus) (view in English)
• Smallpox/Monkeypox (view in English)
• Td (Tetanus, Diphtheria) (view in English)
• Varicella (Chickenpox)* (view in English)
• Zoster (Shingles) (view in English)

*Indicates that translations are out of date. Other than PCV (see story above), they are out of date because they do not reflect the pronoun changes made in the January 31, 2025, versions of VISs that were altered to comply with a presidential executive order. As always, a copy of the current official VIS, in English, should be provided along with the translated VIS.

Power outages can create emergency conditions that damage your valuable vaccine inventory. For this reason, every site that stocks vaccines needs an emergency plan. Every VFC site is required to have one.

If your office does not have an up-to-date plan, follow CDC’s Vaccine Storage and Handling Toolkit to create one. Plans only work when staff are trained. This month is a good time to do that. Build redundancy, flexibility, and communication into your plan. Consider:

• Equipment backup options
• Alternate storage options
• Vaccine transport plans

Your plan should specify at least one facility where current staff are willing to receive and properly store your vaccine inventory if it must be relocated. CDC’s guide provides detailed instructions on monitoring temperatures during a power outage and what to do once proper storage conditions are restored. Keep a printed copy of your plan on or near your storage unit before the power goes out!

Prevent avoidable vaccine waste by training your staff on emergency procedures, including after-hours roles and responsibilities. Then run an exercise to check understanding.

Related Links

• CDC: Vaccine Storage and Handling Toolkit (31 pages, March 2024)
• CDC: Packing Vaccines for Transport During Emergencies (Aug 2015)
• Immunize.org: Clinic Tools: Storage and Handling main page
• Immunize.org: Vaccine Storage Emergency Response Worksheet (PDF)
• HHS: Technical Resources: Utility Failures web page

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Vaccinate adults! Order laminated 2025 U.S. adult immunization schedule booklets.

Laminated booklets of the 2025 U.S. adult immunization schedule are still available in the Immunize.org shop. The 2025 child and adolescent schedule booklets sold out.

The schedules are available online as PDFs from CDC at no cost. Immunize.org’s laminated booklets are ideal for use in any busy healthcare setting where vaccines are given.

Adult Booklets
1 copy: $10.00
2–4 copies: $9.50 each
5–19 copies: $8.50 each
20–99 copies: $7.50 each
100–499 copies: $6.00 each
500–999 copies: $5.00 each
1,000–1,999 copies: $4.00 each
2,000+ copies: $3.25 each

Visit the Shop Immunize.org: Laminated Schedules web page to view images and order today!

For additional information, call 651-647-9009 or email admininfo@immunize.org.

Related Links

• Immunize.org: Laminated Adult Immunization Schedules (19 and older) web page
• Immunize.org: Shop Immunize.org main page

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Explore the www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations

Immunize.org's www.Give2MenACWY.org website promotes the importance of adolescent vaccination, including the recommended MenACWY vaccine booster dose at age 16. Many teens are behind on vaccines because of the pandemic, so vaccine outreach is more important than ever.

Materials on this colorful website for healthcare professionals incorporate the 2020 ACIP meningococcal vaccine recommendations and coverage statistics from CDC’s National Immunization Survey–Teen (NIS–Teen). One particularly popular resource on the site is the Algorithm for MenACWY Immunization in Adolescents 11 Through 18 Years of Age.

The website is divided into five easy-to-access sections:

• Vaccinate Teens: teen vaccination schedules and tips for improving vaccination rates
• Give 2 Doses: tools to help improve second dose coverage of MenACWY vaccine
• 16-Year-Old Visit: resources to help providers and patients remember the important vaccines recommended for 16-year-olds
• Tools for Providers: tools to explain meningococcal ACWY vaccine recommendations and improve coverage for all adolescent vaccines
• Resources: links to print materials, organizations involved in adolescent vaccination, personal stories about the importance of vaccination, and other resources of interest

The site also categorizes materials according to whether they are primarily of interest to providers, to adolescents, or to parents.

Visit Give2MenACWY.org and enjoy browsing (and deploying) its bountiful resources.

Related Links

• Give2MenACWY.org website
• Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age
• MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection
• Recommending MenACWY: What to Say and How to Say It
• Top 10 Ways to Improve Adolescent Immunization Rates
• Developing an Immunization Culture in Your Office
• Know Your Rates: Measuring Immunization Success in Your Practice
• You're 16: We Recommend These Vaccines for You
• Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations, signed by six medical societies
• Ask the Experts: Meningococcal ACWY
• CDC: ACIP Meningococcal Vaccine Recommendations
• CDC: Vaccination Coverage Among Adolescents Aged 13–17 Years—National Immunization Survey–Teen, United States, 2023