Vaccine Panel

CDC vaccine advisers voted last week to change childhood vaccine recommendations.

Context

Health Secretary RFK Jr., who has been vocal in his criticism of vaccines, restructured the CDC’s vaccine advisory system after taking office. In June, Kennedy fired all existing members of the Advisory Committee on Immunization Practices (ACIP) and appointed replacements, many of whom have previously criticized coronavirus vaccine policies.

Former CDC Director Susan Monarez said she was fired after refusing to rubber-stamp recommendations from the reformulated committee, and several top vaccine leaders resigned in protest. The CDC has been embroiled in tensions over vaccine policy since these changes.

Changes to MMRV

The committee voted 8-3 last week, with one abstention, to recommend against using the combined measles, mumps, rubella, and varicella (MMRV) vaccine for children under age 4. Instead, the panel recommended that young children receive separate shots – one MMR vaccine for measles, mumps, and rubella, and another for varicella (chickenpox). The combined MMRV vaccine is currently given to about 15% of children receiving their first dose of these immunizations, typically administered between 12 and 15 months of age, and was approved by the FDA in 2005. The majority of children already receive two separate shots for MMR and varicella.

The two-day meeting was marked by chaos and confusion, with members repeatedly uncertain about what they were voting on. On Thursday, committee members misunderstood the wording and voted to keep the combined MMRV vaccine available for low-income children, but then reversed that vote on Friday once the information was made clear.

Covid Updates

The committee also voted unanimously to change Covid vaccine access, recommending that adults 65 and older receive vaccines only after consulting a healthcare provider – including a pharmacist – about benefits and risks. Everyone 6 months to 64 years old could also get the vaccine after a provider consultation, though this seemed to contradict FDA authorization, which limited shots to adults 65 and older or those with certain medical conditions. The restrictions will complicate pharmacy distribution, which provided two-thirds of the Covid vaccines that Americans received last year.

Next Steps

Committee members gave conflicting reasons for the changes – the committee’s chairman cited adverse events and seizure risks from the combined MMRV vaccine, while member Robert Malone said the review aimed to regain public trust. The recommendations need approval from the CDC's acting director to become official policy.

Some insurance companies announced they would continue covering vaccines recommended before September 1; meanwhile, four Democratic-led states formed an alliance to issue their own vaccine recommendations. ACIP plans to review vaccines given during pregnancy, childhood, and adolescence, indicating more changes could follow.