U.S. vaccine advisers voted on Thursday to revise the use of one of two key childhood vaccines under review, another step in U.S. Health Secretary Robert F. Kennedy’s push to rewrite U.S. immunization policy.
The group, which advises the Centers for Disease Control and Prevention on U.S. vaccination schedules, recommended against allowing parents to choose the combined measles-mumps-rubella-varicella vaccine before age 4.
Instead, separate vaccine shots will be given for measles-mumps-rubella and varicella.
The votes are the first from Kennedy’s 12-member Advisory Committee on Immunization Practices, many of whom have advocated against vaccine use. Five of those members were named this week.
Kennedy, a longtime anti-vaccine activist, is moving at breakneck speed to push through changes to the nation’s vaccine policies, including restricting eligibility to COVID-19 shots, ousting the country’s top public health official, and amplifying federal support for state vaccine exemptions.
He says these moves are needed to restore trust in U.S. public health agencies.
The panel delayed to Friday a vote on a recommendation to wait to give the hepatitis B vaccine until infants reach 1 month of age, rather than at birth, unless the mother tests positive for the virus.
A spokesperson for Merck, which makes the combination MMRV shot, said the recent advisory committee vote and discussion “occurred in the absence of new scientific data and in contrast to years of evidence affirming the current immunization schedule.”
The panel reviewed the change to the combined MMRV shot recommendation based on studies showing a higher risk of seizures in children under 4 compared with those who received separate measles-mumps-rubella and varicella shots.
The CDC had already recommended separate MMR and varicella vaccines for children younger than 4 unless parents express a preference for the combined shot.
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The day-long meeting was marked by points of confusion as an entirely new roster of members asked about procedures and the impact of their decisions on health insurance coverage.
The panel repeatedly asked for clarification on the vote for coverage under the Vaccines for Children program, forcing one panel member to abstain because it was not clear what he was voting on.
The split vote appeared to allow children covered under the Vaccines for Children to continue to have free access to the combination shot, but the new recommendations could limit access to the combination shot for other children.
The Merck spokesperson described the vote on the children’s vaccine program as unprecedented and said it was still working to figure out the implications to access.
“It’s confusing. They’re going to need to clarify this,” said Dr. Norman Baylor, former director of the FDA’s Office of Vaccines Research and Review who has served as a liaison to the vaccine panel.
“I’m just amazed that nobody stepped up to say, take a step back,” Dr. Bruce Gellin, former HHS deputy assistant secretary for Health and director of the National Vaccine Program Office, said. “If this is going to invoke trust, we’ve got a long way to go.”
During the meeting, several committee members objected to the absence of representatives of physician groups and experts who administer vaccines and changes in standard protocols for reviewing and ranking evidence before taking votes.
Such representatives were removed from work group participation, where such discussions typically occur, and no such work groups were convened to consider the data on either the MMRV or hepatitis B shot.
Dr. Aaron Milstone, pediatric director of Infection Prevention at Johns Hopkins Children’s Center, said afterwards the move would reduce access to vaccines and remove the ability of parents to decide to give the child fewer shots.
The committee is expected to vote on Friday on recommendations on who should get the COVID-19 vaccine.