There are concerns about the lack of transparency in the decision process that led to this Agency Action. There is also a lack of foundation for the recommendations concerning thimerosal-free influence vaccines as no peer-reviewed studies (link: https://pubmed.ncbi.nlm.nih.gov/24814559/) have found that the preservative is dangerous (link: https://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html) or is in any way linked to autism (link: https://nap.nationalacademies.org/catalog/10997/immunization-safety-review-vaccines-and-autism). For those that have demonstrated prior vaccine hesitancy these new recommendations may soothe their concerns even though they are not evidence-based. However, it will limit the availability of multi-dose, lower-cost flu vaccines negatively impact safety-net clinics and rural health centers.
An internal instruction issued by a government agency outlining policies, procedures, or actions to be followed by agency employees. While not legally binding outside the agency, these directives guide agency operations and decision-making.
Who It Impacts: Employees and divisions within the issuing federal agency. These directives guide how staff enforce regulations, allocate resources, and interpret laws. They may also affect industries regulated by the agency.
Who Is Not Impacted: The general public and businesses are not directly bound by agency directives, though these policies may indirectly influence enforcement practices that affect them.
Summary
The Agency Action summarizes the main takeaways for the CDC’s Advisory Committee on Immunization Practice (ACIP) meeting held in late June 2025. In this meeting, the committee voted to: (1) approve a one dose respiratory syncytial virus (RSV) vaccine for vulnerable infants. (2) approve an updated Vaccines for Children Program resolution for prevention of RSV, (3) reaffirm recommendation for annual influence vaccines that are thimerosal free, and (4) recommend seasonal thimerosal free influenza vaccine for all those over 6 months of age (e.g., school-aged children, pregnant women, adults).
Impact Analysis
Legal Challenges
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Take Institutional Action
- Promote independent guidance from the American Medical Association, American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Geriatric Society, American Osteopathic Association, Infectious Diseases Society of America, and National Medical Association. Many reputable, independent, science-driven, and evidence-based associations continue to provide guidance for immunization schedules.
- As ACIP leadership changes, look to professional medical and public health associations for evidence-based guidance, talking points, communication strategies, and advocacy materials.
- Educate patients about thimerosal, debunk mis- and disinformation designed to reduce vaccine uptake and increase refusal rates.
Read the Public Health Communication Collaborative’s Guide on Vaccine Development, Safety, and Effectiveness and share with consumers in medical and community-based settings: Vaccine Development, Safety, and Effectiveness - Public Health Communications Collaborative
Associated or Derivative Policies
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Policy Prior to 2025
Thimerosal had previously been largely phased out of vaccines in the U.S. save for multi-dose, low-cost influenza vaccines. For over two decades, thimerosal has repeatedly been investigated and has demonstrated no negative impact at current levels used in a small proportion of influenza vaccines.
Additional Resources
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