ACIP in Limbo, a New mRNA Flu Shot, and Your Cat Could Be a Bird Flu Risk

The 2025–26 flu season has effectively ended — but the decisions made in the next six weeks will determine whether your family can easily access flu and COVID vaccines this fall. Three converging stories this week make that unusually concrete.

The season closes: what 166 deaths actually means for next fall

CDC's Week 18 FluView report shows the season is winding down. ILI (influenza-like illness) visits fell to 1.8% of outpatient care nationally, well below the 3.1% baseline1, and every jurisdiction is now at minimal activity. The cumulative hospitalization rate reached 86.3 per 100,000 people — driven almost entirely by H3N2, which made up 87.6% of subtyped influenza A hospitalizations.1

The pediatric death toll held at 166 — the same number reported last week, meaning no additional deaths were reported in the final accounting. Among eligible children whose vaccination status was known, 85% of those who died had not been fully vaccinated.1

That 85% figure deserves more attention than it usually gets. It doesn't mean a flu shot is a guarantee — the 2025–26 vaccine had a known H3N2 mismatch problem. But the current season vaccine still offered 53–55% protection against flu-related hospitalization in adults 50 and older, measured September through December 2025.2 Partial protection at scale still prevents a meaningful share of deaths and hospitalizations.

What strain should you expect next fall? Influenza B flipped to dominate in late season (82.3% of clinical lab positives in Week 18), all B/Victoria lineage.1 A(H3N2) led the full season. Manufacturers are already selecting strains for fall 2026 formulations, but they can't finalize until ACIP approves — and that's where the problem starts.

The bigger issue: ACIP is stuck, and fall vaccine coverage may be collateral damage

The Advisory Committee on Immunization Practices — the CDC expert panel whose votes trigger insurance coverage requirements and state immunization policies — cannot currently hold a meeting. A federal judge in March blocked HHS Secretary Kennedy's January 2026 overhaul of the childhood vaccination schedule and ruled that most of his ACIP appointees were improperly installed.3 HHS is appealing. ACIP has been unable to convene since.

Kennedy signed a new ACIP charter in late April that expands committee eligibility to include people who have personally experienced "severe vaccine injury." Public health experts suspect the charter rewrite is designed to let Kennedy rebuild the committee from scratch while circumventing the court ruling.3 The NAIIS summit (May 19–21 in Atlanta) — a major annual gathering of adult immunization specialists — may produce statements calling for ACIP to be reconstituted, but as of this writing, no concrete appointments have been announced.

Why does this matter for your family right now?

ACIP normally reviews and votes on fall respiratory virus vaccines in June. If the committee cannot meet and vote before fall, the downstream consequences are real:

Insurers are required to cover vaccines at zero cost-sharing only when ACIP formally recommends them. No ACIP vote = potentially no mandatory free coverage.
Many states tie pharmacists' legal authority to administer vaccines to ACIP-listed recommendations. A gap there limits access points.
CDC guidance on formulation specifics for the fall flu and COVID vaccine relies on a functioning ACIP.

Knowingly, Politico reported this week that White House and HHS officials have privately indicated they intend to reconstitute ACIP in coming weeks. HHS declined to comment publicly, citing pending litigation.3

What this means for your family: Do not wait until September to decide on fall vaccines. If ACIP does reconvene in June, fall flu shots may be available at pharmacies on the usual September–October timeline with standard insurance coverage. If it doesn't, expect coverage gaps and potential access friction. Getting vaccinated before the season rather than during it may matter more this year than usual.

Moderna's NEJM result: a better flu shot exists, but it can't be approved right now

This week brought the peer-reviewed Phase 3 data everyone in vaccine circles has been watching. The Fluent trial, published in The New England Journal of Medicine, enrolled more than 40,000 adults aged 50 and older across multiple countries and compared Moderna's mRNA-based flu vaccine (mRNA-1010) against standard-dose licensed flu shots.4

The result: mRNA-1010 was 26.6% more effective at preventing lab-confirmed influenza compared to standard-dose vaccines in this age group. In absolute terms, 2% of mRNA-1010 recipients developed confirmed flu versus 2.8% in the standard-vaccine group.4

The caveats are important:

The trial compared mRNA-1010 to standard-dose vaccines, not to higher-dose options like Fluzone High-Dose or Fluad (the adjuvanted vaccine). Both of those are already preferred for adults 65 and older. It's unclear whether mRNA-1010 would outperform those enhanced options.
Reactogenicity was higher with mRNA-1010 — arm soreness, fatigue, and fever were more common compared to the standard-shot arm.5
FDA's PDUFA review deadline is August 5, 2026. FDA was initially set to reject Moderna's application before the White House intervened; the review is now proceeding. Kennedy, who has said mRNA technology is dangerous, will have to either approve or block it.3

What this means for your family: mRNA-1010 is not available yet. If the FDA approves it by August, it could be on pharmacy shelves in time for fall 2026 — but expect limited supply in year one. Adults 50+ who currently get a standard-dose shot and want stronger coverage have existing options right now: ask for Fluzone High-Dose or Fluad (both are ACIP-recommended for 65+, and many providers use them for the 50–64 group as well). The mRNA data is the strongest argument yet for why mRNA flu vaccines could matter long-term, but the decision point for fall 2026 is whether the FDA clears it on schedule.

Federal court blocks the Kennedy childhood schedule overhaul

A separate but related story closed this week. A federal court halted the January 2026 childhood vaccination schedule overhaul that Kennedy's HHS had ordered — the one that reduced the number of recommended childhood vaccines and removed several from the standard schedule.6 Pediatricians and public health experts praised the ruling; HHS is appealing.

For parents with children under 18: continue following the pre-January 2026 schedule. The American Academy of Pediatrics' schedule remains the operative clinical guidance, and most pediatricians are following it. The court ruling reinforces that position. Check your child's immunization records against the AAP schedule before summer camps and back-to-school enrollment.

States are moving to fill the federal gap

New York Gov. Hochul signed two vaccine bills on May 15 that directly respond to federal policy uncertainty.7

The first requires health insurers to cover vaccines recommended by the state health commissioner, even when those vaccines fall off federal recommendation lists. The second expands pharmacist authority to administer the full range of routine childhood vaccines to children ages 3–18 — previously limited to flu and COVID only.

If you're in New York, this means your neighborhood pharmacy can now administer the full childhood schedule. In the current regulatory environment, where federal coverage requirements are in flux, state-level insurance mandates provide a meaningful backstop. Watch for similar legislation in California, Massachusetts, and Illinois.

H5N1 alert: a Washington state case and confirmed cat-to-human spread

Two bird flu developments this week are relevant to families with pets or poultry.

First: A Washington state resident tested positive for H5N1, the first confirmed human case in the United States in nine months.8 The total US human case count since March 2024 now stands at 71, with at least two fatal cases among backyard flock owners.9

Second, and more unusual: CDC published evidence this week confirming cat-to-human H5N1 transmission — the first documented case of H5N1 spreading from a domestic cat to a person.10 The mechanism appears to be raw pet food contaminated with H5N1. CDC's recommendation: do not feed cats raw poultry or animal products.

Human-to-human H5N1 transmission has not been detected in the current US outbreak. The risk to the general public from casual contact remains low. But if your household includes:

Backyard chickens or ducks
A cat fed raw meat or raw poultry-based food
Direct exposure to wild birds

...the risk calculus is different from zero. No H5N1 vaccine is currently available for the general public in the US; stockpiles exist for emergency use. If you handle live poultry, use gloves and eye protection, and report any ill birds to your state agriculture department.

What to do this week

Check your child's vaccine record against the pre-January 2026 AAP schedule while the court stay holds. Catch-up appointments before summer travel are the right move.
Adults 50+: if you got a standard-dose flu shot this past season, ask your provider about Fluzone High-Dose or Fluad for fall 2026. mRNA-1010 may also be an option by September if FDA acts on schedule.
Track ACIP reconstitution. If HHS does not announce new committee appointments by early June, contact your insurer's member services line to confirm coverage status for fall vaccines before the August–September window.
Pet owners: stop feeding cats raw poultry. This is the cleanest single action families can take to reduce an emerging H5N1 exposure pathway.
Backyard flock owners: register your flock with your state agriculture department; wear PPE when handling birds; wash hands immediately after contact.

Sources and notes: All flu surveillance data from CDC FluView Week 18 (ending May 9, 2026). Vaccine effectiveness estimate (53–55%) is from a NEJM-published observational study covering September–December 2025, in non-immunocompromised adults 50+; it does not reflect the full-season average. The Moderna Fluent trial result was published May 2026 in NEJM. ACIP and FDA timeline reporting from Politico, May 13, 2026.