Amesh Adalja, MD, Breaks Down 2025 Vaccine Policy Shifts for Primary Care

Infectious disease physician Amesh Adalja, MD, from the Johns Hopkins Center for Health Security, outlines the most significant changes to US vaccine policy in 2025 that affect primary care practice. Dr Adalja highlights the shift away from universal COVID-19 vaccination toward a risk-based approach and discusses the new recommendation to eliminate thimerosal from all influenza vaccines in the US. He also flags potential access and logistics concerns these changes may raise for clinicians and patients. Watch the video above for Dr Adalja’s breakdown of what’s new and what’s still uncertain as vaccine policy continues to evolve.

The following transcript has been edited for clarity, flow, and style.

Patient Care: What are the most important changes in US vaccine policy this year that primary care physicians need to be aware of?

Dr Adalja: The most important changes are that new COVID-19 vaccines are going to be recommended for those that have high risk conditions or are of older age groups. That is a change from the prior universal recommendation, which may pose some problems for insurance coverage in some of the lower risk patients who still want to get COVID vaccines. There also will be a change with respect to influenza vaccines. This is probably not a major change, only about 4% of influenza vaccines in the US are going to be impacted, but there is a recommendation to not use vaccines that contain thimerosal. Those are the multidose vials. So that may pose some logistical issues for people who are maybe doing vaccination drives or vaccinating in nursing homes, where they use those multidose vials. Otherwise, everything seems to be the same for now, but it's obviously still all up in the air with ACIP in the state that it is in.

Amesh Adalja, MD, is an adjunct assistant professor at the Johns Hopkins Bloomberg School of Public Health and founder of Tracking Zebra, an infectious disease-related project management, consulting, media, and strategy firm.