April 2025 ACIP Meeting: Autoimmune and Immunocompromised Key Updates
The Advisory Committee on Immunization Practices (ACIP) met on April 15–16, 2025, to review new data and discuss potential changes to U.S. vaccine policy. This summary covers the presentations from day 1 (April 15) and includes updates most relevant to people with autoimmune conditions or compromised immune systems.
Day 2 Summary:
Lyme Disease: Planning for a Future Vaccine
A new ACIP workgroup has been announced to prepare for a Lyme disease vaccine, which is currently in late-stage trials. This workgroup plans to present at the June 2025 ACIP meeting.
While Lyme disease is not formally classified as an autoimmune disease, it can trigger autoimmune responses and mimic autoimmune conditions, and is the most common vector-borne disease in the U.S., with an estimated 476,000 people in the U.S. diagnosed and treated for Lyme disease each year.
ACIP Lyme Disease Vaccines Work Group Objectives
- Review epidemiology and burden of Lyme disease
- Review data about risk for Lyme disease
- Review safety, immunogenicity, and efficacy data for Lyme disease vaccine candidates
- Review economic analyses related to Lyme disease vaccination
- Develop Lyme disease vaccination policy options
- Identify areas where additional data are needed
COVID-19: Risk-Based Guidance May Be Coming
Find a detailed summary on the Epidemiology and risk factors for COVID-19 hospitalizations presentation here:
ACIP discussed possible changes to the COVID-19 vaccine schedule for the 2025–2026 season. A shift toward risk-based recommendations, rather than universal annual boosters, is being considered.
Proposed guidance includes:
- Immunocompromised individuals would still be recommended to receive multiple doses per year.
- Patients with autoimmune conditions (e.g., lupus, MS, autoimmune hepatitis) are explicitly listed among the groups at higher risk of severe COVID-19 and eligible for continued protection.
A formal vote is expected at a future meeting.
Pneumococcal Vaccine: Guidance Under Review for Special Populations
The ACIP’s pneumococcal vaccine workgroup is reviewing data to update guidance for hematopoietic stem cell transplant (HSCT) recipients — a group that significantly overlaps with autoimmune and immunodeficient patients.
FluMist: Easier Access for Caregivers
The nasal spray flu vaccine, FluMist, is now approved for self-administration in adults and caregiver administration to children. This may improve vaccination access in households managing chronic illness or mobility challenges.
Mpox: Adolescent Vaccine Recommendation in Progress
ACIP previewed a possible new recommendation for routine mpox vaccination in adolescents at increased risk, such as those with immune deficiencies or underlying conditions. Early data indicate that the JYNNEOS vaccine is safe and elicits robust immune responses in this age group. A vote is expected in June.
CMV: A Promising Vaccine in Development
Moderna’s mRNA-1647 vaccine for cytomegalovirus (CMV) is now in a Phase 3 trial targeting non-pregnant women ages 16–40. CMV can cause life-threatening disease in immunocompromised individuals and birth defects in newborns. Though current trials focus on maternal protection, future studies may explore uses for transplant recipients and other high-risk populations.
Measles: Resurgence Highlights Need for Community Protection
The CDC reported a significant spike in U.S. measles cases—712 as of April 10, including a large outbreak in Texas. Nearly all cases were among unvaccinated individuals. Hospitalization and severe complications remain a concern, especially for immunocompromised individuals. ACIP emphasized the importance of maintaining high MMR coverage to protect those who cannot rely on their own immune response.
Watch the whole day one meeting here: