Vaccine oversight and policy have entered a period of significant transition. The FDA and NIH issued a consensus glossary to harmonize real-world evidence terminology, aiming for consistency across clinical studies. The CDC’s Advisory Committee on Immunization Practices (ACIP) underwent an abrupt comprehensive member replacement by HHS Secretary Robert F. Kennedy Jr., sparking controversy and leading to delays in RSV antibody vaccine votes and re-evaluation of all childhood vaccination schedules. The American Academy of Pediatrics publicly criticized these changes, raising alarms about potential impacts on vaccine science and public health guidance integrity.