The Vaccine Intelligence Report: February 19-24

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

  • ACIP’s scheduled Feb. 25-27 meeting was postponed to Mar. 18-19 amid ongoing CDC turmoil, including the sudden departure of the agency’s top official and legal challenges
  • AAP has urged a swift decision on its motion to pause ACIP proceedings, and 15 states filed a separate lawsuit challenging changes to the federal immunization guidance and policy
  • ACOG announced its withdrawal from ACIP due to concerns with recent changes and released updated maternal immunization guidance, reaffirming the importance of vaccination during pregnancy
  • Virginia joined the majority of U.S. states in opting to follow evidence-based vaccine guidance instead of the new CDC childhood immunization schedule, and Maine is considering similar action
  • Wisconsin became the fourth state to independently join the WHO’s public health network
  • New Hampshire rejected a bill that would eliminate all childhood immunization requirements, but a similar proposal remains under consideration in Iowa
  • The U.S. has surpassed 1,000 measles cases in 2026, outpacing last year’s spread of the disease and drawing concerns about broader vaccine-preventable disease risk
  • 71 children have died from the flu this season, with five new deaths reported in the past week

NEED TO KNOW

ACIP Meeting Postponed Amid CDC Turmoil & Legal Challenges

  • On Thursday (Feb. 19), the Centers for Disease Control and Prevention (CDC) postponed the Advisory Committee on Immunization Practices (ACIP) meeting scheduled for Feb. 25-27. It is now set for Mar. 18-19.
    • The ACIP develops recommendations on the use of vaccines, which serve as the basis for the CDC’s adult and childhood immunization schedules. The committee typically holds three meetings each year to vote on vaccine recommendations.
  • The planned February meeting agenda was not released, but sources indicated Covid vaccines and other mRNA-based immunizations would have likely been discussed.
    • Recent comments from ACIP Chair Dr. Kirk Milhoan and Vice Chair Dr. Robert Malone suggest a focus on Covid vaccines. Milhoan has also said that ACIP will be more of a “safety committee” going forward, focusing its attention on potential harms of vaccination and considering vaccine efficacy as “secondary.”
  • The postponement is the latest development for ACIP, which has undergone significant change over the last several months.
    • In June 2025, HHS Secretary Robert F. Kennedy Jr. overhauled the committee, firing all 17 sitting members—who usually serve a 4-year term—and replacing them with his own appointees. He most recently added two obstetrician-gynecologists (OB-GYNs) to the panel, which House Democrats have opposed, with over 40 Representatives calling for their removal.
  • Health and Human Services (HHS) spokesperson Andrew Nixon did not provide a reason for the delay. However, the move comes amidst ongoing agency turmoil, both within leadership and in court. See following stories on CDC leadership and the lawsuits against HHS for more.

Litigation Mounts Over CDC Immunization Schedule and ACIP Restructuring

  • The postponement of the upcoming ACIP meeting may impact the ongoing lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organizations against HHS and Secretary Kennedy.
    • The plaintiffs are seeking to restore the CDC’s recommended childhood immunization schedule to its prior version and to pause further ACIP proceedings while litigation is pending.
  • Massachusetts federal judge Brian E. Murphy had previously indicated he would rule ahead of the originally scheduled Feb. 25 ACIP meeting, but the meeting’s postponement may alter the immediacy of the court’s decision-making.
    • However, AAP urged a swift decision on its motion for a preliminary injunction that would halt the next scheduled ACIP session in March. The plaintiffs argue that continued delays and changes “inject more confusion, uncertainty, and dysfunction into the American healthcare system.”
  • The case has grown more complex in recent days. Children’s Health Defense (CHD)—the anti-vaccine advocacy organization co-founded by Kennedy—has recently moved to participate in the litigation.
    • On Feb. 18, CHD filed a motion to intervene in the case, and on Monday (Feb. 23), they responded to the plaintiffs’ motion for injunction. AAP has opposed CHD’s intervention, which they argue is without merit. AAP’s formal response to CHD’s filing is due by 6:00pm ET Thursday.
    • Separately, CHD filed its own lawsuit against the AAP in January, alleging violations of the Racketeer Influenced and Corrupt Organizations (RICO) Act related to AAP’s public statements on vaccine safety. Legal analysts note that civil RICO claims are often dismissed at early stages; however, even unsuccessful claims can require defendants to devote time and resources to litigation.
  • Adding another dimension to the legal fight, 15 states announced Tuesday (Feb. 24) that they will sue HHS over the CDC’s revised childhood immunization schedule and the “unlawful replacement” of ACIP members.
    • Filed by 14 Attorneys General and one Governor, the complaint names HHS, Secretary Kennedy, the CDC, and Acting CDC Director Dr. Jay Bhattacharya as defendants. The states argue that the revised schedule was not grounded in scientific evidence.
  • With multiple lawsuits pending, intervention efforts underway, and a court ruling still forthcoming, the outcome of this litigation could influence both the near-term trajectory of ACIP proceedings and the broader direction of federal vaccine policy.

CDC’s Second-In-Command Abruptly Departs, Marking Latest in Ongoing Leadership Churn

  • The CDC’s most senior official, Principal Deputy Director Dr. Ralph Abraham, abruptly stepped down on Monday (Feb. 23), marking the most recent leadership change for the agency.
    • National Institutes of Health (NIH) Director Dr. Jay Bhattacharya recently assumed the role of Acting CDC Director following the departure of Deputy Secretary Jim O’Neill, who exited HHS earlier this month as part of White House-directed leadership changes.
    • HHS had recently indicated that Abraham would be staying on to support Bhattacharya and cited “unforeseen family obligations” as the reason for his departure.
  • Abraham, who previously served as Louisiana Surgeon General, was appointed to the role just three months ago. Abraham has advocated for the end of “mass vaccination” in Louisiana and criticized Covid vaccines.
  • Abraham’s departure is the latest in a string of senior leadership exits and reorganizations at CDC and across HHS in recent weeks and months, reinforcing concerns about ongoing instability at the highest levels of the nation’s top health agencies.

ACOG Withdraws from ACIP, Reaffirms Maternal Vaccine Guidance

  • The American College of Obstetricians and Gynecologists (ACOG) announced yesterday (Feb. 24) its withdrawal from participation in the CDC’s ACIP, citing concerns about recent changes to the committee’s membership and direction.
    • ACOG has raised questions about the integrity and transparency of the vaccine policymaking process, stating that “ACIP has ignored peer-reviewed reports on vaccine safety; shared presentations containing cherry-picked data without appropriate scientific context; and unilaterally changed the childhood and adolescent vaccine schedule without regard to expert input, eroding the evidence-based framework that has guided ACIP and vaccine policy for decades.”
    • The organization emphasized that it will continue issuing independent, evidence-based vaccine recommendations for obstetric clinicians and pregnant patients.
  • The withdrawal follows ACOG’s release of updated maternal immunization guidance (Feb. 18), reaffirming that vaccination during pregnancy is a core component of prenatal care and is critical to protecting both pregnant women and their infants from vaccine-preventable diseases.
    • ACOG continues to recommend annual influenza and Covid vaccines during respiratory virus season; tetanus, diphtheria, and pertussis (Tdap) vaccination during each pregnancy (27–36 weeks’ gestation); and respiratory syncytial virus (RSV) vaccination for eligible patients who are 32–36 weeks pregnant between September and January to protect newborns in their first months of life.
  • While overall guidance remains the same, ACOG has described the update as a way to put maternal immunization guidance in one place and make it easier to integrate older recommendations with newer respiratory season prevention tools like RSV and Covid vaccines.
    • The updated guidance also outlines ongoing barriers to vaccine uptake including mis- and disinformation, limited awareness of recommendations, and distrust in the medical system and notes that changing national guidance has contributed to confusion among patients and clinicians alike.
  • These recent moves come amid broader federal vaccine policy upheaval, including recent changes to the childhood schedule, raising questions about whether evidence-based maternal immunization guidance could face similar scrutiny.

VYF Publishes Annual State of the ImmUnion®

  • Each year, Vaccinate Your Family publishes our State of the ImmUnion® brief outlining specific actions policymakers can take to protect communities from vaccine-preventable disease outbreaks. Each week in the Vaccine Intelligence Report, we highlight the policy challenges and vaccine-preventable diseases our nation is facing. To act on those challenges and strengthen our ability to prevent disease, read our brief here.

STATE POLICY SPOTLIGHT

Wisconsin Joins WHO Public Health Network and Multi-State Health Alliance

  • Wisconsin is the most recent state to independently join the World Health Organization’s (WHO) Global Outbreak Alert and Response Network (GOARN), following the lead of California, Illinois, and New York.
    • GOARN is a global partnership of over 360 institutions that provides international public health resources to help prevent and control infectious disease outbreaks and public health emergencies.
    • The move follows the United States’ formal withdrawal from the WHO in January, which means the country will have less access to data from other countries that can provide early warnings of outbreaks or potential pandemics.
  • Additionally, Governor Tony Evers announced that the state will join the Governor’s Public Health Alliance—a coalition of governors representing a third of Americans—to improve state public health preparedness and response and to support access to healthcare including vaccines.

State-Level Divergence on Vaccine Guidance Continues as Virginia Backs AAP

  • The Virginia Department of Health (VDH) announced Thursday (Feb. 19) it will follow the AAP’s recommended childhood immunization schedule rather than federal vaccine guidance.
    • VDH said AAP’s schedule “best reflects the existing science” to protect children and adolescents against 18 vaccine-preventable diseases.
    • The agency also confirmed that Virginia’s school- and daycare-entry immunization requirements remain unchanged and reaffirmed the importance of vaccination in protecting public health.
  • Virginia is the 28th state (including D.C.) to reject the new CDC childhood immunization schedule and instead rely on evidence-based guidance. See map below. 
  • Relatedly, a Maine legislative committee advanced a bill (LD 2071) to decouple state vaccine policy from federal guidance and instead align with AAP, ACOG, and the American Academy of Family Physicians (AAFP).
    • LD 2071 would also prohibit co-pays for recommended vaccines under state-regulated insurance plans. The full House and Senate will vote on the bill in the coming weeks.

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Pink states will not rely on federal guidance for any vaccines: CA, CO, CT, DC, DE, HI, IL, KS, KY, MA, MD, ME, MN, MS, NC, NH, NJ, NM, NY, OR, PA, RI, VA, VT, WA, WI

Striped states will not rely on federal guidance for only Covid and/or hepatitis B vaccines: AK, AZ, MI

School Immunization Requirements Under Pressure Across Multiple States

  • The New Hampshire House of Representatives voted Thursday (Feb. 19) to reject a bill (HB 1811) to end all school and daycare immunization requirements.
  • However, the state still has other bills under consideration that would roll back immunization requirements.
    • Earlier this month, Representatives approved a bill (HB 1719) that would remove the hepatitis B childhood vaccine requirement. It is now under consideration by the Senate.
    • Two other proposals (HB 1584 and 1022) aim to simplify the process for parents to obtain religious exemptions for their children. HB 1584 has also been approved by the House, and Representatives are set to vote on HB 1022 in the coming weeks.
  • Other states are still considering legislation that would largely or entirely eliminate immunization requirements.
    • In Iowa, House lawmakers advanced HF 2171 earlier this month, which would end school immunization requirements. The bill still requires Senate approval.
    • The Arizona House is considering a bill (HCR 2056) that would make it illegal for the government to require any medical products or treatments, including vaccines, as a condition of education, employment, or entry to a public space.

OUTBREAK OUTLOOK

Measles Outpaces 2025 Spread, Raising Broader Concerns About Vaccine-Preventable Disease Risk

  • As of Feb. 25, the U.S. has reported 1,099 measles cases in 2026—a threshold not reached until late April last year—signaling a faster pace of spread. Several states remain key areas to watch:
    • South Carolina‘s ongoing upstate outbreak added 17 cases from Feb. 17 to Feb. 24, bringing total case numbers to 979 since last October, and to nearly 700 in 2026.
      • At least 20 measles-related hospitalizations have been reported; however, because hospitals are not required to report admissions, experts believe the true number may be much higher.
      • The state health department is receiving support from the CDC Foundation to assist with case investigation and contact tracing.
    • Florida has recorded 92 measles cases from Jan. 1 through Feb. 14, over 70% of which have occurred in Collier County, where the Ave Maria University outbreak is ongoing.
    • Arizona (55 cases) and Utah (123 cases) have also reported elevated activity this year.
    • Oregon has declared a measles outbreak after five cases were confirmed this year, though officials believe there are more unreported infections occurring statewide.
    • Additional cases have been confirmed in Washington (26), North Dakota (11), Pennsylvania (10), Maine (5), Georgia (2), and Illinois (2).
  • Disease experts warn that the current resurgence of measles signals future potential outbreaks of other vaccine-preventable infectious diseases.
    • Measles is a highly contagious disease, meaning that when vaccination rates drop, outbreaks occur quickly. Experts explain that vaccination rates are also declining for other infectious diseases, indicating more outbreaks are likely on the horizon.
    • Diseases that could follow include pertussis (whooping cough), meningitis, polio, rotavirus, RSV, tetanus, rubella, hepatitis B, and diphtheria.

CDC Reports Slight Uptick in Flu and Five Additional Pediatric Deaths

  • CDC data for the week ending Feb. 14 show that flu activity remains elevated. Positive test rates have increased compared to the previous week, but hospitalizations continue to decrease.
    • 26 states are currently reporting high or very high flu activity, up slightly from 24 states the week prior.
    • Five pediatric flu deaths were reported in the past week, increasing this season’s total to 71. Recent flu-related deaths were reported in several states including Georgia (the state’s first pediatric flu death this season).
    • The proportion of influenza B cases continues to increase nationwide, accounting for over 45% of positive flu tests for the week ending Feb.14.
  • More broadly, national respiratory illness activity remains moderate as of Feb. 20.
    • RSV activity is elevated and growing in some parts of the U.S., and hospitalizations remain elevated and increasing.
    • Covid activity is elevated in some areas of the U.S. but decreasing overall, and hospitalizations continue to decline.

REALITY CHECK

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

CLAIM: The risks of vaccination during pregnancy outweigh the potential health benefits for the mother or infant.

  • REALITY: Extensive scientific evidence shows that vaccination during pregnancy is safe and provides significant health benefits to both mother and baby. In contrast, infection with vaccine-preventable diseases during pregnancy poses well-documented risks of serious complications.
  • Vaccines recommended during pregnancy by ACOG—such as Covid, flu, Tdap, and RSV vaccines—have been rigorously studied and shown to be safe for both pregnant women and their infants.
  • Vaccination protects the mother from severe disease and enables the transfer of protective antibodies across the placenta, helping safeguard infants during the first months of life, when they are too young to receive many vaccines themselves.
  • By contrast, infection during pregnancy can result in serious adverse outcomes.
    • For example, Covid infection during pregnancy increases the risk of stillbirth as well as severe maternal illness, hospitalization, and death.
    • Emerging evidence suggests that maternal Covid infection—not vaccination—may be associated with a small increase in early childhood neurodevelopmental diagnoses such as autism.
    • Pregnant women vaccinated against Covid are 62% less likely to require hospital admission and 90% less likely to need critical care. Vaccination during pregnancy significantly reduces the risk of hospitalization in infants under 6 months, who are not yet eligible for Covid vaccination.
  • Multiple large, well-designed studies and safety surveillance systems have found no increased risk of miscarriage, birth defects, preterm birth, stillbirth, or developmental disorders—including autism—following recommended maternal vaccination.

CLAIM: We do not have sufficient evidence that RSV monoclonal antibodies (mAbs) are safe for newborns, and there are concerns that they may be linked to serious adverse events, including seizures or infant deaths.

  • REALITY: High quality clinical trials and ongoing safety monitoring show that RSV mAbs provide strong protection against severe RSV in infants and do not increase risk of serious adverse events.
  • RSV is the leading cause of hospitalization among infants in the U.S. and poses the greatest risk in the first months of life when immune protection is limited.
  • Because RSV is especially dangerous to newborns, prevention measures are recommended during peak RSV season (fall and winter):
    • Pregnant women who are 32-36 weeks pregnant during RSV season should receive the maternal RSV vaccine at least two weeks before delivery so protective antibodies can pass to the baby.
    • For babies born during RSV season to mothers who did not receive the RSV vaccine, a mAb is recommended within the first week of life.
  • A mAb is a form of immunization that provides immediate, ready-made immune protection against RSV—unlike a vaccine it does not require the infant’s immune system to build its own response.
  • Robust evidence and post-authorization safety data demonstrate that RSV mAbs provide critical protection and do so safely:
    • In a large randomized clinical trial published in the New England Journal of Medicine, a single dose of the mAb nirsevimab reduced medically attended RSV infection by 70 to 75% and RSV-related hospitalization by more than 75% in babies’ first RSV season.
    • Randomized trials involving thousands of infants found no increased risk of adverse events among infants who received mAbs compared to those that did not and ongoing FDA and CDC safety monitoring has not identified any safety signals indicating increased risk of serious outcomes.
  • More specifically, claims that mAbs are associated with increased rates of febrile seizures and infant deaths are unfounded and not supported by evidence:
    • A large-scale safety monitoring review presented to ACIP last June, found no increased risk of febrile seizures and no seizure-related safety signal was identified in post-authorization data.
    • Deaths observed in studies were rare, occurred in both treatment and comparison groups, and were determined by investigators to be unrelated to the intervention. Further, FDA and the CDC monitoring has not identified any increased risk of mortality associated with these products.
  • Choosing not to protect infants against RSV is not a risk-free alternative. RSV infection itself carries a clear, well-documented risk of hospitalization and serious illness in early infancy, and preventive immunization substantially reduces severe outcomes and maintains a strong and consistently monitored safety profile.

WHAT TO WATCH

Senate Panel to Question Surgeon General Nominee Means

  • The U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a confirmation hearing for Casey Means, MD, President Trump’s nominee for U.S. Surgeon General, on Wednesday (Feb. 25).
    • Means has raised concerns about the safety of childhood vaccines, arguing more research is needed on their “cumulative effects.”
  • President Trump previously withdrew his first surgeon general nominee, Dr. Janette Nesheiwat, and said he selected Means based on Kennedy’s recommendation.

WHO Convenes Meeting on Flu Vaccine Strain Selection for 2026-2027 Season

  • The WHO is holding its biannual information meeting on Mar. 12 to review global surveillance data and recommend the influenza virus strains to be included in vaccines for the 2026–2027 northern hemisphere flu season.

FDA Signals Potential Scrutiny of RSV Immunizations for Infants

  • In her first address to staff as director of the FDA’s Center for Drug Evaluation and Research (CDER), Dr. Tracy Beth Høeg said the agency will more closely examine the safety of RSV monoclonal antibodies—an immunization given to infants born during RSV season to prevent severe disease, if their mother did not receive the RSV vaccine during pregnancy.
    • Høeg pointed to infant deaths reported in RSV monoclonal clinical trials, despite FDA reviewers and study investigators determining that these deaths were unrelated to the products.
    • She also said the agency would be investigating a potential increased risk of febrile seizures, even though the CDC already carried out a study—published in June—that found no elevated seizure risk associated with RSV monoclonal antibodies.
  • It remains unclear whether this scrutiny will result in formal FDA action, labeling changes, or advisory committee review, but the comments signal possible increased regulatory attention on the products.

Rand Paul, Mike Lee Move to Repeal Vaccine Injury Compensation Framework

  • Republican Senators Rand Paul and Mike Lee introduced the End the Vaccine Carveout Act, which would reform the 1986 law that created the Vaccine Injury Compensation Program (VICP).
    • The VICP allows families to seek compensation for rare vaccine injuries through a specialized federal claims system that is typically faster and less burdensome than traditional litigation, requires a lower standard of proof, and covers legal fees.
  • While sponsors of the bill argue that it would increase transparency by allowing claims to proceed through the traditional court system, changing the 1986 law would effectively dismantle the established compensation pathway for those believed to be injured by a vaccine and would also destabilize the vaccine market.
    • While public health experts and leading advocacy organizations have acknowledged that there is room for reforms to the VICP, they warn that dismantling the program threatens the nation’s vaccine supply and accessibility.
  • The VICP has historically had bipartisan support, and therefore, the bill may face opposition and be unlikely to advance. However, its introduction reflects broader skepticism and ongoing political scrutiny about vaccine safety oversight.

Vaccinate Your Family is a nonpartisan organization dedicated to protecting people of all ages from vaccine-preventable diseases. To learn more, visit us at: vaccinateyourfamily.org

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