Issue 1869: April 15, 2026

On April 3, Blue Cross and Blue Shield (BCBS) companies released a statement regarding their insurance coverage of ACIP-recommended vaccines. Their commitment to investing in ongoing coverage of recommended vaccines with no out-of-pocket expense to patients makes it clear that they value and support vaccination. Importantly, healthcare professionals are reassured they can continue to purchase, offer, and administer recommended vaccines with the confidence that BCBS will continue to pay for vaccination services. The statement is reprinted below.

Blue Cross and Blue Shield (BCBS) companies consistently hear that members want continued access to vaccines, and that health care providers value clear guidance on coverage and payment.

To provide certainty, continuity and peace of mind, BCBS companies will continue the commitment we made in 2025, to cover all ACIP-recommended (Advisory Committee on Immunization Practices) immunizations with no cost sharing through 2027, while operating within federal and state laws and meeting program and customer requirements.

As always, decisions regarding vaccinations are made between patients and their health care providers, and BCBS companies will continue to apply rigorous, evidence-based processes when evaluating coverage policies.

Influenza activity continues to wane nationally, with most of the remaining circulating influenza virus identified as Type B. COVID-19 levels are very low across the country. RSV is the remaining preventable winter respiratory virus with significant activity nationally.

RSV preventive antibody products, nirsevimab (Beyfortus, Sanofi) and clesrovimab (Enflonsia, Merck), are routinely recommended from October through March in most of the contiguous United States. This season, the National Respiratory and Enteric Viruses Surveillance System continues to show RSV activity persisting later in the year than usual, with ongoing elevated RSV risk to infants in some regions where this is not typical. Individual public health jurisdictions are responsible for directing recommendations to extend RSV preventive antibody product administration beyond March, particularly for newborns, based upon local RSV epidemiology. 

Only one dose of Beyfortus or Enflonsia is recommended for most infants. Infants with certain risk factors for severe RSV disease are the only ones recommended to receive a preventive antibody product as they enter their second RSV season. This means that most infants who receive RSV preventive antibody now, during this unusually late season, will not be due for RSV immunization at the beginning of the next RSV season in October.

The Association of Immunization Managers (AIM) collects information on this season’s changes in recommendations for use of RSV preventive antibody products from the 66 federally funded immunization program jurisdictions (including states, certain cities or counties, and territories). On April 2, AIM posted a map showing current RSV preventive antibody guidance, based on available information. As of April 1, 48 jurisdictions extended their RSV preventive antibody administration season through April 30. Rhode Island and Philadelphia extended through April 15 and will reassess the situation. Two jurisdictions were undecided and four did not recommend extending use of RSV antibody products, although Virginia and Missouri will consider requests by VFC program participants to extend administration dates for their patients on a case-by-case basis. Ten jurisdictions already maintain year-round RSV preventive antibody administration policies due to the year-round circulation of the virus in their areas.

Visit the color-coded map and supporting documentation for each jurisdiction's status on AIM's website for details on your jurisdiction. 

Nationwide RSV activity and vaccination rates reported by CDC are highlighted below.

• Respiratory Illnesses Data Channel:
  • RSV activity started later than expected in most regions of the United States, though illness is not more severe compared with recent seasons. This unusual timing means higher levels of RSV activity may continue through April in many regions. Emergency department visits and hospitalizations for RSV are highest among infants and children less than age 4 years.
• RSVVaxView:
  • Among the reporting eight state and city IIS jurisdictions, preventive antibody coverage among infants younger than age 8 months (born since April 1, 2025) ranged from 34.2% to 52.5%.  Among five U.S. territorial and affiliated island jurisdictions, coverage ranged from 0% to 31.1%.
  • As of February 2026, among females with an infant born since April 2025, 65.1% of infants were reported to be protected against RSV through either maternal RSV vaccination with Abrysvo (Pfizer) only (9.4%) or through a preventive antibody product (55.7%).
  • As of February 22, 2026, 43.2% of adults age 75 years and older and 32.8% of adults age 50–74 years with a high-risk condition for RSV reported having ever received an RSV vaccine.

Related Links

• AAP: RSV Immunization Administration Frequently Asked Questions web page
• Immunize.org: Standing Orders for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants and High-Risk Young Children (PDF)
• Immunize.org: Standing Orders for Administering Clesrovimab RSV Preventive Antibody (Enflonsia, by Merck) to Infants (PDF)
• Immunize.org: Vaccines A–Z: RSV (Respiratory Syncytial Virus) main page
• Association of Immunization Managers: Immunization Program Directory web page

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As of April 9, CDC reported 1,714 confirmed measles cases for 2026, 75% of the number of cases reported in all of 2025. So far, 32 states have reported measles cases in 2026. Notable updates include:

• The outbreak in Utah is currently the fastest growing outbreak in the United States. Utah Department of Health and Human Services confirmed 583 cases since the beginning of 2026, with 121 cases reported in the past 3 weeks.
• The South Carolina Department of Public Health confirmed 997 cases of measles since October 2025: no new cases have been reported since March 17. A measles outbreak may be declared over once there are no new outbreak-associated cases identified for two incubation periods (42 days).
• Arizona’s outbreak is on the border with Utah and connected to the larger Utah outbreak. Arizona Department of Health and Human Services confirmed 292 cases in 2026, with 15 new cases in March.

CDC only requires reporting of laboratory-confirmed measles cases. Cases without laboratory testing for confirmation are not included in these numbers. Actual numbers of cases are, therefore, higher than confirmed case counts.

The chart below shows the age distribution of U.S. measles cases since January 1, 2025, from the Johns Hopkins International Vaccine Access Center measles tracker. At least 56% of cases occurred in children younger than age 18 years. All of these children have access to two doses of MMR vaccine with no out-of-pocket expense, either through private insurance or the federal VFC program.

• VaccineInformation.org: Measles web page
• LetsGetRealAboutVaccines.org: Measles web page
• Immunize.org: Vaccines A–Z: Measles main page

Related Links

• AAP: Fact Checked: The MMR (Measles, Mumps and Rubella) Vaccine Is Safe and Effective web page
• CDC: Measles Cases and Outbreaks main page
• Common Health Coalition: More Illness, Greater Cost: Spotlight Brief; Childhood Immunizations (PDF)
• Johns Hopkins International Vaccine Access Center: U.S. Measles Tracker web page
• PopHIVE (Yale School of Public Health): Infectious Diseases Dashboard: Measles web page
• Health Canada: Measles and Rubella Weekly Monitoring Report

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Our newest video in the Ask the Experts Video Series is titled Why Is It Important to Vaccinate Babies Against Rotavirus? This video briefly describes the importance of vaccination against rotavirus, the most common vaccine-preventable cause of severe gastroenteritis in infants and young children in the United States and worldwide.

The 1-minute video is available on our YouTube channel along with our full collection of quick video answers to popular Ask the Experts questions.

Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise.

• Facebook at ImmunizeOrg
• Instagram at ImmunizeOrg
• LinkedIn at ImmunizeOrg
• YouTube at ImmunizeOrg

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These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

• Washington Post: CDC Delays Publishing Report Showing COVID Vaccine Benefits (4/9/26)
• The Guardian: As RFK Jr Allies Hailed Mississippi’s Rollback of Strict School Vaccine Rules, Whooping Cough Surged and a Baby Died (4/9/26)
• KFF Health Policy: The HPV Vaccine: Access and Use in the U.S. (4/08/2026)
• Medscape: As HHS Renews ACIP Charter, Questions Swirl About Its Direction (4/7/26)
• The 19th: As Parents Seek Out ‘Vaccine Friendly’ Clinics, Pediatricians Worry About Eroding Trust (4/7/26)
• HealthBeat: Michigan Measles Outbreak Shows High Cost of Stopping Even a Small Number of Infections from Spreading (4/3/26)
• New York Times: C.D.C. Pauses Testing for Rabies and Pox Viruses (4/1/26)

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