Introduction to Vaccine Advisory Panel Recommendations
U.S. Health Secretary Robert F. Kennedy Jr.’s hand-picked vaccine advisory committee on Thursday recommended the Centers for Disease Control and Prevention adopt new restrictions on a combination shot that protects against chickenpox as well as measles, mumps and rubella.
The panel advised that the vaccine known as MMRV not be given before age 4 and that children in this age group instead get separate vaccines — one against MMR and another for varicella, or chickenpox. The vote was 8-3, with one member abstaining.
The Advisory Committee on Immunization Practices
The Advisory Committee on Immunization Practices put off an expected vote on hepatitis B shots given to infants on the day they are born. On Friday, it’s expected to decide whether to recommend that some babies can wait a month for those shots, and to also take up COVID-19 shots.
The committee makes recommendations to the CDC director on how already-approved vaccines should be used. CDC directors have almost always accepted those recommendations, which are widely heeded by doctors and guide vaccination programs. Committee Chairman Martin Kulldorff said committee members aim to reassure the public and remove unnecessary risks and harms.
Concerns from Doctors and Public Health Experts
But many doctors and public health experts say the committee is creating fear and mistrust around vaccines at a time when U.S. vaccination rates are already falling. Kennedy, a leading anti-vaccine activist before becoming the nation’s top health official, has made or proposed numerous changes to the nation’s vaccine system, including firing the entire 17-member panel earlier this year and replacing it with a group that includes several anti-vaccine voices.
Thursday’s meeting “promoted false claims and misguided information about vaccines as part of an unprecedented effort to limit access to routine childhood immunizations and sow fear and mistrust in vaccines,” Dr. Susan Kressly, president of the American Academy of Pediatrics, said in a statement. “Instead of emerging with clear guidance about vaccines that we know protect against serious illnesses, families are left with confusion, chaos and false information.”
Panel’s Actions and Access to Vaccines
Experts are also concerned the panel’s actions could narrow access to the vaccines. The group voted 8-1, with three abstentions, to keep MMRV covered for kids as young as 12 months under the Vaccines for Children program, which pays for about half the shots given to kids in the U.S.
Several committee members expressed confusion during that follow-up vote on whether to align payments under the program with the more restrictive vaccine guidance they had just passed. Another federal official noted that there are other government insurance programs, including Medicaid, that will need to stop paying for that early combo dose because they have to follow CDC recommendations.
Panelists Focus on Rare Seizures
Discussions on the MMRV vaccine focused largely on rare instances of feverish seizures associated with the first dose, given to kids between ages 1 and 2.
Committee member Dr. Cody Meissner said such seizures may be “a very frightening experience” for families, but medical experts agree they’re not linked to brain function or school problems.
The panel last dealt with the issue in 2009, when it said either the combination shot or separate MMR and chickenpox shots were acceptable for the first dose, but that separate doses were generally preferred. Today, 85% of kids receive separate doses for the first round, according to information presented at the meeting.
The MMR Vaccine and Protection
Dr. Diego Hijano, a pediatric infectious disease expert from St. Jude Children’s Research Hospital, answers your questions on how the MMR vaccine can protect your kids from the measles.
Some doctors and public health experts say they are not aware of any new safety data that would explain the revisiting of those vaccination recommendations — and, in fact, many of the studies discussed Thursday were more than a decade old.
The Vaccine Panel and Hepatitis B Shot
As many as 2.4 million people in U.S. are estimated to have hepatitis B, which can cause serious liver infections, and half are unaware of infection, a CDC presenter told the panel.
In adults, the virus is spread through sex or through sharing needles during injection-drug use. But it can also be passed to a baby from an infected mother, and as many as 90% of infected infants go on to have chronic infections. The virus can also live on surfaces for more then seven days at room temperature, and unvaccinated children living with anyone with a chronic infection are at risk.
A hepatitis B vaccine was first licensed in the U.S. in 1981. In 2005, the ACIP recommended a dose within 24 hours of birth for all medically stable infants who weigh at least 4.4 pounds (2 kilograms). The infant shots are 85% to 95% effective in preventing chronic hepatitis B infections, studies have shown.
Following the 2005 recommendation, hepatitis B cases among infants fell from 5,494 cases per year in 2005 to 2,214 cases in 2023.
Debate on Hepatitis B Vaccine
During Thursday’s discussion, some committee members questioned whether babies born to moms who test positive for hepatitis B are the only ones who truly need a vaccine in the first day of life.
By giving virtually all babies the hepatitis B right after birth, “Are we asking our babies to solve an adult problem?” asked committee member Dr. Evelyn Griffin.
But Meissner expressed bewilderment at some of this discussion.
Sen. Bill Cassidy, R-La., who is a liver disease doctor, explained why he supported the CDC guidance that infants should receive the hepatitis B vaccine, as he raised concerns that the ACIP will vote to change the recommendation.
“This an absolutely safe vaccine,” he said. “I’m not sure what we’re gaining by avoiding that first dose within 12 to 24 hours after birth.”
Conclusion
The vaccine advisory panel’s recommendations have sparked concerns among doctors and public health experts, who fear that the changes could lead to a decline in vaccination rates and an increase in vaccine-preventable diseases. The panel’s actions have also been criticized for promoting fear and mistrust around vaccines. As the nation grapples with declining vaccination rates, it is essential to prioritize evidence-based recommendations and ensure that vaccines are accessible to all who need them.
FAQs
Q: What is the MMRV vaccine?
A: The MMRV vaccine is a combination shot that protects against chickenpox, measles, mumps, and rubella.
Q: What are the new restrictions on the MMRV vaccine?
A: The vaccine advisory panel recommended that the MMRV vaccine not be given before age 4 and that children in this age group instead get separate vaccines — one against MMR and another for varicella, or chickenpox.
Q: What is the hepatitis B vaccine?
A: The hepatitis B vaccine is a vaccine that protects against hepatitis B, a virus that can cause serious liver infections.
Q: Why are some committee members questioning the hepatitis B vaccine?
A: Some committee members are questioning whether babies born to moms who test positive for hepatitis B are the only ones who truly need a vaccine in the first day of life.
Q: What are the concerns about the vaccine advisory panel’s recommendations?
A: The concerns include the potential decline in vaccination rates, increase in vaccine-preventable diseases, and promotion of fear and mistrust around vaccines.
