The Vaccine Intelligence Report: September 23-29

The Vaccine Intelligence Report

September 23-29, 2026

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: 

• During her confirmation hearing last week, FDA Commissioner nominee Dr. Heidi Overton told senators the MMR vaccine is safe and effective, while HHS Deputy Secretary nominee Chris Klomp advanced out of the Senate Finance Committee (Sep. 24) and Surgeon General nominee Dr. Nicole Saphier advanced out of the HELP Committee (Sep. 30)
• CDC named Dr. David Sugerman as the new Acting Director of its immunization and respiratory disease center following a recent reorganization that merged the agency’s flu and Covid divisions
• CDC issued updated 2026-2027 Covid vaccine guidance and opened ordering through the VFC program, ending a nearly month-long delay in access for eligible children
• In response to the recent HHS request for information, major medical and public health groups and state attorneys general broadly urged the agency to preserve an evidence-based vaccine recommendation process and warned that changes to recommendation categories could affect access, coverage, and patient understanding
• CDC changed how it counts measles deaths during the ongoing outbreak, creating a gap between federal and Pennsylvania counts that could delay reporting of outbreak severity
• The U.S. declined to support a U.N. declaration on pandemic prevention, preparedness, and response, citing concerns about portions of the agreement and ongoing negotiations over pathogen access and benefit sharing
• The U.S. has reported more than 3,700 measles cases this year, with Pennsylvania reaching more than 900 cases as it continues to drive much of the recent increase 

NEED TO KNOW

Key HHS Nominees Move Through Confirmation Process as Vaccine Policy Draws Scrutiny

• Several nominees for senior federal health positions moved through the Senate confirmation process last week, with vaccine policy continuing to draw significant attention from lawmakers.
• Heidi Overton, President Trump’s nominee to lead the Food and Drug Administration (FDA), appeared before the Senate Health, Education, Labor, and Pensions (HELP) Committee for her confirmation hearing (Sep. 24).
  • During questioning, Overton affirmed that the measles, mumps, and rubella (MMR) vaccine is “safe and effective” and said people should currently receive it. Her comments came after President Trump’s unsubstantiated August claim that the combined MMR vaccine is “lethal” and his call for the shots to be separated.
  • Overton generally declined to say how she would approach potential future changes to vaccine policy or other controversial FDA issues, repeatedly emphasizing that she would review available evidence and follow agency processes.
  • The Committee will revisit her nomination after the October recess.
• Separately, the Senate Finance Committee advanced Chris Klomp’s nomination to serve as Deputy Secretary of Health and Human Services (HHS) in a 15-12 vote (Sep. 24), sending his nomination to the full Senate.
  • If confirmed, Klomp would formally become HHS Secretary Robert F. Kennedy Jr.’s second-in-command. He already serves as a senior adviser to Kennedy and has played a significant role in department policy and operations.
• The HELP Committee advanced Nicole Saphier’s nomination for Surgeon General on Wednesday (Sep. 30), also sending her nomination to the full Senate for consideration.
• The advances come as the Administration continues to fill key health leadership positions amid ongoing debate over federal vaccine policy and the roles of HHS and its agencies in developing immunization guidance.

Leadership Change at CDC Immunization Center Follows Recent Reorganization

• The Centers for Disease Control and Prevention (CDC) has replaced the acting director of the National Center for Immunization and Respiratory Diseases (NCIRD), which oversees the agency’s work on vaccine-preventable diseases, immunization programs, and respiratory viruses.
  • David Sugerman, a career CDC official, will assume the role of acting director starting October 5. He replaces Rebecca Greco Koné, who began her tenure in June after Brandi Limbago rotated out of the position.
  • The center’s last permanent director, Dr. Demetre Daskalakis, resigned in August 2025 due to concerns about “political interference and scientific integrity.”
• The leadership change follows a reorganization of NCIRD that took effect earlier this month, consolidating offices and merging the agency’s influenza and coronavirus divisions into a single Influenza and Respiratory Viruses Division.
  • The change comes amid broader concerns about staffing and scientific capacity at the CDC. Recent reporting found that workforce reductions have affected the agency’s ability to provide guidance, conduct surveillance, and support state and local health departments.
• NCIRD plays a central role in monitoring and responding to diseases including measles, influenza (flu), Covid, and respiratory syncytial virus (RSV), as well as supporting immunization programs and outbreak response.

CDC Issues 2026-2027 Covid Vaccine Guidance as VFC Ordering Opens

• The CDC released updated interim clinical guidance for the 2026-2027 Covid vaccination season (Sep. 23), while also opening ordering of updated doses through the federal Vaccines for Children (VFC) program.
  • Based on the July 2025 immunization schedule, the guidance recommends an updated 2026-2027 dose for all adults, all immunocompromised children ages 6 months to 17 years, and all other children through shared clinical decision-making.
• VFC ordering ends a nearly month-long delay that had limited access for eligible children, even as updated Covid vaccines were already available through the commercial market for children with private insurance.
  • The VFC program provides vaccines at no cost to eligible children, including those who are Medicaid-eligible, uninsured, underinsured, American Indian, or Alaska Native. Availability may still vary by state depending on how quickly states place and distribute orders to participating providers.
• The CDC’s new Covid vaccine landing page also notes that the July 2025 immunization schedule remains in effect due to legal “uncertainties and inquiries,” likely reflecting the March 16 preliminary injunction that stayed federal vaccine policy changes, including narrower Covid vaccine recommendations.

Health, Patient, and Business Groups Urge Caution on Changes to Federal Vaccine Recommendations

• In response to HHS’s request for information (RFI) on federal vaccine recommendation categories and shared clinical decision-making (SCDM), major medical, patient, public health, and business groups broadly urged the Department to preserve an evidence-based recommendation process, and cautioned that changes could create confusion or disrupt vaccine access and coverage.
  • The RFI was issued in support of the Administration’s August Executive Order on childhood vaccine recommendations and the Task Force on Safer Childhood Vaccines.
• Medical groups including the American Academy of Family Physicians (AAFP), American College of Physicians (ACP), American Nurses Association (ANA), and Infectious Diseases Society of America (IDSA) opposed adding new recommendation categories. These groups and the National Foundation for Infectious Diseases (NFID) emphasized continued reliance on established scientific review processes.
  • IDSA cautioned that “any changes to vaccine categories should decrease confusion, not increase it.”
  • Several also urged HHS to use SCDM selectively, rather than broadly expanding it to vaccines for which evidence supports routine or risk-based recommendations.
• Patient and public health groups, including American Cancer Society (ACS), Families USA, Georgetown University Center for Children and Families, National Health Law Program (NHeLP), and a coalition of five public health organizations and 14 health law and policy scholars warned that changing recommendation categories could have downstream effects on insurance coverage, pharmacy access, Medicaid and the Children’s Health Insurance Program (CHIP), and the VFC program.
  • A coalition of 22 state attorneys general and Pennsylvania Governor Josh Shapiro raised similar concerns about state laws and programs that rely on federal vaccine recommendations.
• The U.S. Chamber of Commerce highlighted potential uncertainty for employers and health plans, while Covered California and the California Public Employees’ Retirement System (CalPERS) urged HHS to retain the current framework and clarify that vaccines recommended through SCDM remain recommended and covered.
• Taken together, the comments reflect concern that changes to federal recommendation categories could reach well beyond clinical guidance, affecting how patients understand recommendations, how providers administer vaccines, and whether vaccines remain readily accessible and covered.

CDC Changes How It Counts Measles Deaths, Creating Gap with State Data

• The CDC has changed how it reports measles deaths during the ongoing U.S. outbreak, creating a discrepancy between federal and state counts and raising concerns among former federal health officials about delays in tracking outbreak severity.
  • Pennsylvania has reported four measles-associated deaths this year, while the CDC currently reports two deaths nationally. The federal agency is now counting a death only after the National Center for Health Statistics (NCHS) determines that measles was the underlying cause from death certificate data.
• This marks a shift from the CDC’s historical approach during active outbreaks, when the agency relied on more timely reports from state health departments to track measles-associated deaths while final mortality data were still being processed. Former senior NCHS officials warn the change could delay federal reporting by weeks or months and provide an incomplete picture of an active outbreak.
  • Death certificates identify the chain of events leading to death—not simply whether someone died “with” or “from” a disease. If measles causes pneumonia that leads to respiratory failure, for example, measles can still be recorded as the underlying cause.
  • Also, testing positive for measles at the time of death does not automatically make it a measles death; the certifier must determine that the disease caused or contributed to the death.
• The differing approaches to tracking highlight a broader challenge: finalized death-certificate data provide standardized mortality statistics, while state surveillance can provide more timely information about the severity of an evolving outbreak. Former NCHS officials caution that relying only on the former could create confusion about the severity of the current measles outbreak.

U.S. Declines to Support U.N. Pandemic Preparedness Declaration

• The U.S. declined to support a proposed United Nations declaration on pandemic prevention, preparedness, and response during a high-level meeting of the U.N. General Assembly (Sep. 25).
• The nonbinding declaration was intended to strengthen international cooperation ahead of future pandemics, including efforts related to disease surveillance, health-system capacity, financing, and equitable access to vaccines, treatments, and other health products.
• Representing the U.S., CDC Director Dr. Erica Schwartz said the Administration could not support the full text, citing unresolved concerns about what she described as ‘divisive ideologies’ as well as an unfinished international negotiation over pathogen access and benefit sharing.
• The decision comes as the U.S. continues to pull back from some multilateral health partnerships, including its withdrawal from the World Health Organization (WHO), raising questions about the country’s role in international pandemic preparedness and coordination.

OUTBREAK OUTLOOK 

Measles: 3,782 cases have been reported nationally in 2026, including an increase of 416 cases over the past two weeks (Sep. 25).

• Pennsylvania continues to be a hotspot for measles activity with 903 total cases in 2026 and 114 new confirmed cases in the last seven days (Sep. 28).
• For more on other states driving recent measles activity, see here.

Covid: Infections are growing or likely growing in 14 states (Sep. 25). National Covid activity is low and steady(Sep. 25), with overall acute respiratory illness remaining very low.

Flu: Seasonal flu activity remains low nationally (Sep. 19) but is beginning to grow, which demonstrates an earlier rise in confirmed cases than expected.

WHAT TO WATCH

New Initiative Aims to Provide Clearer Respiratory Vaccine Guidance

• The NFID launched the National Respiratory Communications Initiative (NRCI), a coalition aimed at providing clear, consistent, evidence-based information on flu, Covid, RSV, and pneumococcal disease. Vaccinate Your Family is among the initiative’s partner organizations.
  • The launch comes as a new nationally representative NFID survey found that while 77% of U.S. adults view vaccines as among the best ways to prevent serious infectious disease, only 48% tried to get at least one respiratory vaccine in the past year. Of those who tried, 22% reported issues such as long waits or vaccine unavailability. Many respondents also reported uncertainty about which vaccines are recommended for them.
• NRCI will bring together immunization, infectious disease, patient advocacy, and public health organizations to align and amplify respiratory disease prevention messaging, with resources designed for both the public and healthcare professionals.

WHO Selects Flu Vaccine Strains for 2027 Southern Hemisphere Season

• The WHO selected the flu strains recommended for vaccines used during the 2027 Southern Hemisphere flu season.
  • WHO experts meet twice each year to review global surveillance data and recommend vaccine strains for upcoming flu seasons in the Southern and Northern Hemispheres. The latest recommendations were based on flu activity from February through August.
• The Southern Hemisphere season provides an early signal of which flu viruses may be important during the next Northern Hemisphere season. WHO will meet again in February to recommend strains for the 2027-2028 Northern Hemisphere flu vaccine.

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