The Vaccine Intelligence Report: May 28-June 2

The Vaccine Intelligence Report—brought to you by Vaccinate Your Family—provides clear, fact-based updates on vaccine policy, research, and public health each week. This report is part of Viral Truths, a resource designed to cut through the noise, offering concise information to help navigate the evolving immunization landscape.

THIS WEEK AT A GLANCE

  • Trump signed an EO directing the CDC and ACIP to align the recommended childhood immunization schedule with an HHS assessment of “peer, developed countries,” though ongoing litigation limits any immediate effect
  • VRBPAC recommended updating the 2026-2027 Covid vaccines to target XFG, signaling continuity in the strain-selection process despite broader vaccine policy disruption
  • Illinois, Iowa, and West Virginia are seeing diverging vaccine policy debates, with new limits on minors’ vaccine access in Iowa, a vaccine access bill awaiting signature in Illinois, and ongoing litigation over school immunization requirements in West Virginia
  • Measles continues to spread across the U.S., while the CDC’s new analysis of the 2025 West Texas outbreak underscores the potential severity of measles infection among unvaccinated children

NEED TO KNOW

Trump EO Signals Continued Push to Narrow Childhood Immunization Schedule

  • President Donald Trump signed an Executive Order (EO) last week (May 29) directing the Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices (ACIP) to align the recommended childhood immunization schedule with a Health and Human Services (HHS) assessment comparing U.S. recommendations to those of “peer, developed countries.”
  • The move formally endorses HHS Secretary Robert F. Kennedy Jr.’s broader effort to narrow the childhood schedule, though the EO does not appear to have an immediate operational effect.
    • The HHS assessment—authored by Dr. Tracy Beth Høeg, former HHS employee, and Martin Kulldorff, current Chief Science Officer in the Office of the Assistant Secretary for Planning and Evaluation (ASPE)—evaluated childhood immunization schedules in 20 countries, including several Western European countries, Australia, Canada, Japan, and New Zealand.
  • The assessment recommends that all children be routinely vaccinated against 11 diseases—a significant reduction from the 17 diseases included in the current CDC schedule and the 18 included in the American Academy of Pediatrics’ (AAP) schedule.
    • Immunizations no longer recommended for all children under the assessment include hepatitis A, hepatitis B, influenza (flu), meningococcal disease, respiratory syncytial virus (RSV), and rotavirus. The assessment also recommends reducing the number of routine human papillomavirus (HPV) vaccine doses.
    • See graphic below for a full breakdown of the changes recommended by the HHS assessment.
  • The EO comes after Kennedy previously used the same assessment to reshape the CDC’s recommended childhood immunization schedule in January 2026. That move was later halted by a preliminary injunction in AAP’s lawsuit against HHS.
    • The court stayed the pared-back schedule, and the CDC has since reverted to the previous July 2025 schedule.
    • Separately, Kennedy removed the broad Covid vaccine recommendation for healthy children and pregnant women in May 2025. The CDC continues to recommend this vaccine under shared clinical decision-making (SCDM), while the AAP and other medical societies recommend the vaccine for all children.
  • In practice, Trump’s EO directs the CDC and ACIP to pursue a policy shift that is already constrained by the ongoing litigation. Vaccine law expert Dorit Reiss said the order has “no immediate operational effect,” because ACIP’s ability to act remains limited by the court order.
    • The federal judge overseeing the AAP case also found that Kennedy’s reconstitution of ACIP likely violated federal law. Given the suspended appointments, ACIP’s scheduled March meeting was canceled, and the committee currently lacks a clear path to advancing new recommendations unless the committee is reformed using legal processes.
  • The Administration has framed the proposed changes as bringing the U.S. in line with peer countries, but that comparison is incomplete.
    • A review of childhood immunization schedules across 30 European countries found that most recommend vaccines protecting against 15 or more diseases.
    • More broadly, immunization schedules are tailored to each country’s disease risks, healthcare infrastructure, vaccine access systems, and public health priorities. Differences across countries do not necessarily indicate that one schedule is safer or more evidence-based than another.
  • Efforts to narrow the childhood immunization schedule have been widely criticized by public health experts and medical professional organizations, including AAP, which released its own childhood immunization schedule after the CDC’s earlier changes.
  • The EO also states that “most peer nations maintain high childhood vaccination rates through public trust and education.” That framing is notable given declining trust in federal vaccine guidance in the U.S.
    • U.S. public trust in federal childhood immunization recommendations dropped by 11 points (from 71% to 60%) from June 2025 to March 2026. Further, more than half of U.S. adults (56%) report having “little” to “no confidence” in federal health agencies to make recommendations about the childhood immunization schedule.
  • While the EO may not immediately change vaccine access or recommendations, it signals that the Administration is continuing to pursue a narrower federal childhood schedule despite ongoing litigation, state-level divergence from federal guidance, and concerns from medical organizations that further changes could deepen confusion for families, clinicians, schools, and insurers.

     

    Comparison of Immunizations Recommended for Children

VIR Chart 6.3.png

Sources: CDC, HHS, AAP

VRBPAC Recommends Updated Covid Vaccine Target for 2026-2027 Season

  • Last week (May 28), the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted 8-0, with one abstention, to recommend updating the 2026-2027 Covid vaccines to better match currently circulating variants.
    • The committee recommended that updated vaccines target XFG, the currently dominant Covid variant in the U.S. and part of the broader JN.1 family of variants.
  • Committee members discussed uncertainty around emerging variants and whether future Covid vaccines may need to target multiple strains. However, most agreed that XFG offered the best balance of currently available evidence, protection against circulating variants, and feasibility for manufacturers preparing vaccines ahead of the fall respiratory virus season.
    • Discussions also touched on concerns about reduced disease surveillance, with committee members warning that reduced data and visibility into emerging variants has made it increasingly difficult to assess Covid’s evolution and could make future strain-selection decisions more challenging.
  • Notably, the meeting largely followed the traditional strain-selection process: VRBPAC convened on schedule, reviewed surveillance and manufacturer data, and made a recommendation for the upcoming season.
    • That continuity stands out amid broader disruption across the federal vaccine policy and regulatory landscape, including recent changes to vaccine recommendations, advisory committee membership, and public health leadership.
  • The FDA still needs to make an official determination based on VRBPAC’s recommendation before manufacturers move forward with updated vaccine formulations for the 2026-2027 season.

STATE POLICY SPOTLIGHT

Illinois, Iowa, and West Virginia Show Diverging State Vaccine Policy Fights

  • In Illinois, a bill (SB 3487) passed both chambers that would support vaccine access by requiring hospitals to identify eligible patients and offer flu and pneumococcal vaccines in line with ACIP or state public health guidance. It now awaits Governor JB Pritzker’s signature.
  • Iowa Governor Kim Reynolds signed a bill (SF 304) on May 19 that limits minors’ ability to receive HPV and hepatitis B vaccines without parental permission. The law takes effect July 1.
    • Health advocates warn that restricting access to the HPV vaccine could increase rates of preventable HPV-related cancers, including cervical, anal, penile, vaginal, vulvar, and oropharyngeal cancers.
  • In West Virginia, the state Supreme Court has yet to rule in the ongoing case over whether to allow religious exemptions to school vaccine requirements. The school board has not yet filed a reply to Governor Patrick Morrisey’s amicus brief, which was due June 1.
    • The case remains a key test of whether West Virginia can maintain its longstanding medical-exemption-only school vaccine policy.

OUTBREAK OUTLOOK

News on respiratory virus season, measles, pertussis, and other vaccine-preventable and infectious disease outbreaks.

Measles Spread Continues Across U.S. as CDC Highlights Severity of 2025 Texas Outbreak

  • As of May 23, the U.S. has reported 2,077 measles cases in 2026—an increase of 44 cases in the last week.
    • Colorado and New Mexico each reported one new measles case in the last week, bringing the states’ totals to 23 and 16, respectively.
    • Oregon has reported 23 measles cases in 2026.
      • New state data show that nonmedical exemptions for kindergarten immunization requirements have risen to a record high of 10.9% during the 2025-2026 school year—an increase of 4.0% since the 2021-2022 school year.
      • Nonmedical exemption rates in the state are highest for the second dose of the measles, mumps, and rubella (MMR) vaccine at 9.4%—an increase from 4.9% 10 years ago, and more than one third of schools are at risk of a measles outbreak.
    • Pennsylvania officials confirmed one new measles case on May 29, bringing the state’s total to 40 this year.
    • Utah recorded two new measles cases in the past week, bringing its 2026 total to 478 cases as of June 2.
    • Virginia officials reported nine measles cases in the last week, bringing the state’s 2026 total to 77 as of June 2.
    • States continuing to report high numbers of cases in 2026 include Arizona (95), Florida (154, as of May 23), and Texas (182).
  • In its May 28 edition of the Morbidity and Mortality Weekly Report (MMWR), the CDC reported findings from its analysis of the 2025 West Texas measles outbreak, underscoring the potential severity of measles infection.
    • The analysis found that of the 325 cases reported between January and March 2025, 60 (18.5%) required hospitalization.
      • Most hospitalized patients were children with no underlying medical conditions. All were unvaccinated or had unknown vaccination status.
    • Many hospitalized patients experienced serious complications, including pneumonia, dehydration, and hypoxia requiring supplemental oxygen. Four patients required intensive care, two required mechanical ventilation, and one patient died.
    • The CDC emphasized that vaccination remains the most effective tool for preventing infection and severe disease.

2026 Pertussis Cases Exceed Last Year’s Totals in Some Areas; Officials Monitoring Small Uptick in Mpox Cases

  • Pertussis (whooping cough) remains endemic in the U.S., with 28,783 cases reported last year. While the current 2026 total of 4,598 cases (as of May 16) remains below case counts at this time last year, some states have already exceeded their totals for all of 2025.
    • This year, West Virginia has reported 44 cases, and Nevada has reported 93 cases—already surpassing each state’s full year 2025 total.
    • Several other states have already reported more than half of their 2025 totals, including California (690 cases), New York (241 cases), South Carolina (87 cases), and Utah (108 cases).
    • Pertussis is a highly contagious respiratory disease that can be particularly dangerous for infants. The CDC and the AAP recommend that everyone be vaccinated against whooping cough. Children 6 and under should receive the diphtheria, tetanus, and pertussis (DTaP) vaccine series, and adults should receive tetanus, diphtheria, and pertussis (Tdap) booster doses and vaccination during pregnancy to protect newborns.
    • Declining childhood vaccination rates are a likely contributor to continued pertussis transmission. Public health experts caution that trust in vaccines is critical in preventing future outbreaks.
  • Public health officials are reporting recent small upticks in mpox cases, reflecting a broader national uptick in infections. The U.S. has recorded 535 cases this year, as of May 3.
    • Wisconsin confirmed five cases as of May 26, while Boston health officials have issued alerts encouraging at-risk individuals to get vaccinated.
    • Mpox is a viral disease that spreads primarily through close physical contact. While overall risk to the general population remains low, health officials encourage people at higher risk of exposure to receive the mpox vaccine.

REALITY CHECK

These fact checks respond to several recent claims made by different groups and individuals.

CLAIM: The U.S. should align its childhood immunization schedule with those of peer countries.

  • REALITY: This is misleading. Childhood immunization schedules are not interchangeable across countries—they are designed around each country’s disease risks, healthcare system, vaccine delivery infrastructure, and ability to maintain high vaccination coverage.
  • Looking at another country’s schedule in isolation leaves out the systems that make those recommendations work.
    • Many peer countries have universal or near-universal health coverage, centralized immunization systems, national registries, and school- or community-based vaccination programs that help keep coverage high.
  • The U.S. has a more fragmented system, meaning federal recommendations play an especially important role in guiding providers, insurers, state programs, schools, and families.
  • Shifting from a broad, routine vaccine recommendation to a narrower, risk-based recommendation can have broader consequences than an international comparison suggests.
  • The comparison also overlooks differences in disease burden, outbreak risk, vaccine delivery systems, and broader socioeconomic factors. Vaccine schedules are tailored not only to when children are most vulnerable and how diseases spread, but also to country-specific contexts such as parental leave policies, childcare entry, and well-child visit patterns.
    • U.S. recommendations reflect domestic data on disease burden and population-level risk, as well as healthcare access patterns, outbreak history, and real-world opportunities to reach children before exposure risk increases. For example, the U.S. schedule accounts for risks tied to early-life hepatitis B infection, seasonal flu, and rotavirus hospitalizations among infants and young children.
  • Importantly, peer countries do not follow one single model. Some countries recommend fewer doses of certain vaccines, while others recommend protection against a similar or greater number of diseases than the U.S.
    • For example, South Korea and Brazil recommend vaccination against 18 diseases, while Greece recommends protection against 17 diseases.
  • The U.S. childhood immunization schedule was developed for the U.S. context and has long been reviewed by medical and public health experts using evidence on disease risk, vaccine safety and effectiveness, timing of protection, and implementation.
  • Reducing the schedule primarily because other countries do things differently ignores the broader systems and safeguards needed to maintain protection against vaccine-preventable diseases.

CLAIM: Routine childhood vaccines have been associated with sudden infant death syndrome (SIDS), and there are reports that confirm a causal link. 

  • REALITY: Extensive research has found no evidence that routine childhood vaccines cause SIDS, and major scientific reviews have repeatedly refuted claims that vaccines increase an infant’s risk of sudden death.
  • Misleading claims linking vaccines to SIDS often stem from the fact that SIDS occurs most frequently between two and four months of age—the same period when infants receive several routine vaccinations—but events occurring around the same time do not necessarily mean they are related.
    • Timing alone cannot establish causation, and researchers have long cautioned against assuming that because one event follows another, the first event definitively caused the second.
  • Notably, a frequently cited study from 2021 claiming a link between vaccination and SIDS was retracted by its publisher just last month (May 2026) after reviewers identified serious methodological flaws including misuse of Vaccine Adverse Event Reporting System (VAERS) data and unsupported conclusions about causation.
  • The now-retracted study relied heavily on VAERS—a passive federal vaccine safety surveillance system designed to identify potential safety signals for further investigation, not to determine whether a vaccine caused a reported event.
    • Because anyone can submit a report about nearly any medical event that occurs after vaccination, VAERS reports alone cannot establish causation.
    • In instances where a potential safety signal is identified through VAERS, it is investigated through additional epidemiological studies, clinical review, and regulatory assessment to determine whether a true causal relationship exists.
  • Large epidemiological studies directly examining this claim have consistently failed to find a causal relationship between routine childhood vaccination and SIDS.
    • In fact, some research has found that vaccinated infants are less likely to die from SIDS than unvaccinated infants – although, importantly, this is a finding that researchers generally attribute to differences in healthcare utilization and other factors, rather than a direct protective effect from vaccination itself.

WHAT TO WATCH

Key HHS Leadership Roles Remain Unfilled

  • Several key federal health leadership roles remain vacant or filled on an interim basis, adding to uncertainty across agencies central to vaccine policy, recommendations, and regulation.
  • President Trump has nominated Dr. Erica Schwartz to serve as CDC Director and Dr. Nicole Saphier to serve as Surgeon General, though the timeline for Senate confirmation remains unclear.
  • The FDA remains without a permanent Commissioner, and no nominee has been announced. Within the FDA, the Centers for Biologics Evaluation and Research (CBER) and Drug Evaluation and Research (CDER) also lack permanent Directors.

HHS Announces New Plan to Combat Lyme Disease

  • On May 29, RFK announced a series of initiatives aimed to address Lyme disease, a bacterial disease spread by ticks. The announcement includes funding for educational campaigns, identification of existing medicines that can be repurposed, and AI for healthcare support.
  • Notably absent from the announcement was any mention of vaccines as a means of disease prevention.
  • While there is not an approved human vaccine currently available, Pfizer and Valneva recently released data on their phase-3 vaccine candidate, demonstrating 70% efficacy in preventing Lyme disease.

State Departments Announces Plans to Re-Engage Gavi, the Global Vaccine Alliance

  • On Tuesday (Jun. 2), Secretary of State Marco Rubio told the Senate Foreign Relations Committee the U.S. has decided to re-engage with Gavi amid the ongoing Ebola outbreak.
  • These statements come amidst delays in congressionally appropriated funding to the alliance from FY2025 and FY2026.

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