It's an anniversary no one wants to celebrate, but an anniversary nonetheless.
Thursday, March 19, marked six years since the first COVID-19 lockdown was implemented in the United States. And while it is undeniable that the impact of the global pandemic is still felt worldwide, one place Americans see its lingering effects the most is in vaccine policy.
Vaccine hesitancysurgedafter the FDA approved the first COVID vaccine in August 2021. Since then, it has only bolstered following the appointment of Health and Human Services SecretaryRobert F. Kennedy Jr., a known vaccine skeptic, early in Trump's second administration.
The Trump administration's ensuing actions around vaccination have beenadmonished by major medical institutionsand public health experts,with some warningthat more Americans, especially children, may die from preventable diseases as a result. Kennedy hassaid the vaccines will remain availableto anyone who wants them, andsupporters have praisedwhat they say is a move toward a more individual rights-based approach to public health.
Even more confusingly, a complicated set of rules and changes around the COVID-19 shotwas overturned earlier this weekby a federal judge, rendering some hotly-contested decision moot - at least for now.
Here's a refresher on the back-and-forth regarding the COVID vaccine, so far.
What did the judge rule about COVID and other vaccine changes?
On March 16,a Massachusetts federal judge blocked parts of HHS's reshaping of federal vaccine policy, siding with the American Academy of Pediatrics (AAP) and other medical groups that sued to stop what they called Kennedy's agenda of upending immunization policies.
The judge also blocked Kennedy's 13 appointees from serving on the Advisory Committee on Immunization Practices (ACIP), finding the panel unlawfully constituted.
Kennedy had firedall 17 original membersof the ACIP, which is a committee of health experts that guides vaccine use for the Centers for Disease Control and Prevention,replacing them with memberswhom critics have called unqualified. Some of the members, like Kennedy, have a history of anti-vaccine advocacy and involvement in anti-vaccine groups.
The judge said that because it was unlawfully constituted, the earlier panel's votes to downgrade recommendations for hepatitis B vaccines for newborns and COVID-19 shots broadly were also invalid
Federal ruling:Judge blocks parts of Robert F. Kennedy Jr.'s vaccine policy changes
RFK Jr., Trump admin butt heads with medical societies over COVID vaccine
In May 2025, Kennedy announced that the COVID-19 vaccine wouldno longer be includedin the CDC's recommended immunization schedule for healthy children and pregnant women, a move breaking with expert guidance.
This drew the ire of the AAP, which went as far as torelease its own schedulein August 2025, saying the federal process was no longer credible. Others, including the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Family Physicians (AAFP), backed AAP's recommendations.
It is recommended that all children aged 6 months to 23 months receive the latest COVID-19 vaccine to reduce the chances of serious illness. Children and adolescents ages 2 to 18 without other high-risk factors, such as immunosuppression, can receive and should be offered the vaccine if they were not immunized before, according to the guidance.
In a response posted to social media,Kennedy hit back at the pediatrics academy's criticism, implying that corporate pharmaceutical funders influenced the organization's views.
What changed about who could get the COVID vaccine?
In August 2025, the FDA approved an updatedround of COVID vaccines, but only for individuals 65 years of age or older. Additionally, people aged 6 months or older with existing health conditions were eligible for the COVID-19 vaccine without a prescription or doctor's order.
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The ACIP voted in September 2025to recommend COVID-19 vaccinations for everyone 6 months or older, based on individual decision-making after they consult with a healthcare provider, known as "shared clinical decision-making." The CDC officially accepted these recommendations on Oct. 6.
In some cases, physicians, registered nurses and pharmacists are considered healthcare providers,according to the CDC, and therefore could administer vaccines after discussing them with the patient.
People could also self-declare that they are moderately or severely immunocompromised and qualify for the vaccine without third-party confirmation,according to CDC guidelines.In some cases, you could be asked to sign a paper confirming that you have an underlying condition or provide verbal confirmation.
What to know right now:RFK Jr., the CDC and confusing vaccine recommendations
Which COVID shots were approved by the FDA?
On Aug. 27,Kennedyannounced that emergency-use authorizations for COVID-19 vaccineshad been terminated. The FDA approved the following vaccines:
Moderna, Pfizer and Novavax immunizations were approved only for "those at high risk" and people over 65.
Moderna vaccine was approved for children 6 months and older with an underlying condition and people over 65.
Pfizer was approved for those 5 and older with an underlying condition and people over 65.
Novavax was approved for those 12 and older with an underlying condition and people over 65.
When announcing the restrictions, Kennedy did not specify which conditions are considered as putting people at "high risk." However, theCDC lists a bevy of health conditionsthat make someone "higher risk," including common health issues like asthma, cancer, kidney disease, diabetes, obesity, mood disorders and a history of smoking.
In response,several states passed their own regulationsto protect access to COVID-19 vaccines. A handful of states formed groups to address vaccine availability, including theWest Coast Health Allianceand theNortheast Public Health Collaborative.
What other changes did RFK's HHS make to vaccines?
Kennedy has spearheaded several other changes to U.S. vaccine schedules and recommendations, includingremoving four from the childhood listand splitting the MMR vaccine ‒ a combination shot protecting against measles, mumps, and rubella ‒ into two separate vaccines. Kennedy, withPresident Donald Trump'sbacking, said cutting the number of vaccinationsaligns the United Stateswith other developed nations.
The updated recommendations maintain immunizations for 11 diseases, including measles, mumps, and varicella, while categorizing others as either targeted for high-risk groups or subject to parents' discretion with their doctors, according to HHS.
The ACIPalso changed recommendationsregarding the first of three hepatitis B shots normally given at birth, a practice long used to protect babies highly susceptible to infection and transmission. In December, it declared that only babies born to moms who test positive for hepatitis B should receive the shot at birth, advice that experts said would lead to many babies not receiving a full course of immunization.
What happens now?
Because Kennedy's ACIP appointees were blocked via the recent court ruling, the meeting scheduled for March 18 to March 19 was postponed. Future meetings are yet to be determined.
Changes to the hepatitis B vaccines for newborns and COVID-19 shots made via earlier ACIP votes were deemed invalid. This theoretically means that the recommendations would revert to what they were before the current committee was formed.
These recommendations match theschedules currently followed by the AAP.For the Hep B shot, this means the previous recommendation applies: One dose is given within 24 hours of birth, the second is given one to two months after and the third dose is given between 6 and 18 months of age.
Other changes, such as splitting the MMR vaccine, remain in place.
The Trump administration has promised to appeal the case and take it up to SCOTUS, if necessary.
Contributing: James Powel, Adrianna Rodriguez, Sudiksha Kochi,USA TODAY
This article originally appeared on USA TODAY:COVID vaccine guidance today: What to know 6 years since lockdown.