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Director's Letters – Friday, June 6, 2025
Director Vohra Statement on COVID-19 Vaccine Recommendations
Dear Colleagues,
The Illinois Department of Public Health (IDPH) remains committed to open and transparent communication on public health developments.
Background
On May 27, 2025, Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. announced that the Department would be adjusting its recommendations for COVID-19 vaccination. According to media reports, this decision was made independent of existing processes dating back to the mid-1960s that rely on scientifically informed debate and discussion at the Food and Drug Administration’s (FDA) Vaccines and Related Biological Projects Advisory Committee (VRBPAC) and the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP).
This departure from existing vaccination consultation and consideration processes has introduced uncertainty for Illinois health care providers and residents. Based on these reasons, I write to you all today to share IDPH’s review and actions in response to this recently updated federal COVID-19 guidance. A quick summary of the recent changes include:
- FDA will only approve COVID-19 vaccines for non-high risk individuals under age 65 if randomized, placebo-controlled trial data proves vaccine prevention of symptomatic COVID-19 rather prevention of severe disease.
- CDC updated their child and adolescent immunization schedule for children with no underlying risk conditions to include shared clinical decision-making between parents/guardians and their children’s health care providers. In addition, they note “no guidance” for vaccination during pregnancy in their immunization schedule by medical indication.
To ensure providers and residents in Illinois receive guidance informed by the best available evidence, IDPH is reviewing data and consulting with subject matter experts to provide recommendations that are grounded in the most up to date clinical science. Our initial findings are outlined below.
COVID-19 in Children
IDPH reviewed national and state data as well as convened subject matter experts in the field of pediatric infectious diseases and population health. Our findings demonstrate a benefit to shared clinical decision making for COVID-19 vaccination for children with no underlying risk factors. We advise providers to note that even in this endemic stage of COVID-19, a significant portion of U.S. children ages 6 months to 17 years hospitalized with COVID-19 in 2022-2024 (41%) had no underlying conditions.
At this time, IDPH concurs with the position of the American Academy of Pediatrics (AAP) to maintain access to vaccination and advises providers to use shared clinical decision making for children with no underlying risk factors.
COVID-19 in Pregnancy
The ACIP vaccination schedule now cites “No Guidance/Not Applicable” for COVID-19 vaccination during pregnancy. However, CDC still lists pregnancy as a risk factor for severe disease in COVID-19. Most recent data continues to show that COVID-19 infection during pregnancy increases the risk of severe COVID-19 and adverse pregnancy outcomes. Additionally, infants were hospitalized in Illinois between 2023-2025 more than any other pediatric age group, with more than two-thirds of them being under 6 months old, underscoring the role of maternal vaccination.
At this time, IDPH is aligned with the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommendations that all pregnant people continue to receive COVID-19 vaccines.
Vaccine Access and Insurance Coverage
As of the date of this letter, under the CDC recommendations and immunization schedule, health insurance coverage includes vaccines administered under shared clinical decision-making recommendations.
We strongly urge clinicians and pharmacy providers to be familiar with all underlying conditions eligible for COVID-19 vaccine regardless of age or pregnancy status including lesser-known ones such as physical inactivity, former smoking, or mood disorders.
IDPH’s Process to Determine Evidence Based Best Practices for Immunizations
These recent federal actions have raised the need for IDPH to establish an independent review process to ensure that we make the most scientifically sound recommendations for our healthcare providers and residents. Towards that end, we intend to convene subject matter experts as necessary, including leaders on our Illinois Immunization Advisory Committee, to determine if future federal guidelines are in alignment with the latest scientific and epidemiological evidence.
IDPH also plans to issue a detailed health advisory regarding COVID-19 vaccination recommendations, after reviewing findings from the ACIP meetings scheduled June 25-27, 2025.
During this time of rapidly changing federal recommendations, IDPH remains committed to being a transparent and credible source of information for our providers and maintaining a focus on the most up-to-date public health evidence to protect and promote the health of Illinois’s residents.
Yours in good health,
Sameer Vohra, MD, JD, MA
Director
Illinois Department of Public Health
