Health Secretary Robert F. Kennedy Jr.’s intentions to overhaul the childhood vaccination schedule became strikingly clear today. A federal advisory panel, meeting this Thursday, is expected to vote against recommending the combined measles, mumps, rubella, and chickenpox (MMRV) vaccine for children under four years old.
While this decision by the Kennedy-appointed committee might not immediately cause widespread changes, as the recommendations for separately administered MMR and varicella shots remain, it highlights a significant philosophical shift.
This vote, however, is likely just the beginning of a broader reassessment of official immunization guidelines. According to Martin Kulldorff, the panel’s chair, the Advisory Committee on Immunization Practices (ACIP) will form two new work groups: one dedicated to scrutinizing vaccine use during pregnancy, and another tasked with comprehensively reviewing childhood and adolescent vaccination schedules.
This planned overhaul has deeply concerned many public health experts, who fear that restricting access to established vaccines could lead to a dangerous resurgence of diseases previously considered vanquished.
In addition to the MMRV discussion, the committee is also poised to vote on limiting the use of the hepatitis B vaccine. Their proposal suggests administering this vaccine only to newborns whose mothers are known carriers of the disease, and to other infants after they reach four weeks of age. Currently, universal newborn hepatitis B vaccination is standard practice to prevent this liver-damaging infection.
Dr. Sean O’Leary, who chairs the infectious disease committee for the American Academy of Pediatrics, voiced strong concerns: “If individuals lose access to vital vaccines, we risk seeing a return of severe childhood diseases that we’ve largely controlled for decades.”
He added, “These diseases are almost entirely preventable today. As a pediatrician, it would be heartbreaking to witness children and families suffer from illnesses that could have been avoided.”
Introduced in 2005, the MMRV vaccine offers a single-shot alternative to the separate measles, mumps, and rubella (MMR) vaccine and the varicella (chickenpox) vaccine.
Panel members had already hinted in June that the MMRV shot would face close examination. During Thursday’s meeting, scientists from the Centers for Disease Control and Prevention (CDC) presented data indicating a slight increase in the risk of fever-induced seizures with the combination vaccine. While such seizures are generally harmless and can occur with many common childhood illnesses, this data seems to be driving the committee’s decision.
Historically, the CDC has advised giving the MMR and chickenpox vaccines separately to children under four precisely because of this acknowledged, albeit small, risk of febrile seizures.
However, many pediatricians and parents often chose the combined MMRV vaccine to reduce the number of clinic visits and injections required. The panel’s anticipated vote aims to remove this option for parents.
Leading medical organizations have expressed strong opposition to the committee’s proposal to recommend against the MMRV vaccine.
Dr. Amy Middleman, head of pediatrics and adolescent medicine at Case Western Reserve University and a liaison to the committee from the Society for Adolescent Health and Medicine, pointed out that Thursday’s MMRV discussion lacked the customary detailed presentations on feasibility, acceptability, cost-benefit analysis, or equity considerations.
A recommendation against the MMRV vaccine would have significant implications, as it would cease to be covered by essential programs like the Vaccines for Children Program, which serves nearly half of the nation’s children, and the Children’s Health Insurance Program, designed for low-income families.
“I strongly urge the committee to adhere to a methodical, evidence-based process before casting votes on matters that impact public health to such an extent,” Dr. Middleman emphasized.
Earlier, Susan Monarez, recently removed as CDC director after less than a month, testified to lawmakers that Secretary Kennedy intended to revise the entire childhood immunization schedule.
Monarez claimed Kennedy instructed her to approve all panel recommendations “regardless of the scientific evidence presented.”
Traditionally, ACIP’s decisions have served as the foundation for state vaccine mandates and health insurance coverage requirements. However, the panel’s recent actions seem to have significantly undermined its credibility.
Following the panel’s initial June meeting, several prominent medical organizations ended their decades-long collaboration with the committee, choosing instead to issue their own independent vaccination recommendations.
Adding to the dissent, most major insurers announced Tuesday that they would continue covering routine vaccinations through 2026, irrespective of any restrictive votes by the panel. Senator Bill Cassidy, a Republican from Louisiana and chair of the Senate health committee, further advised Americans on Wednesday not to trust the panel’s efforts to alter childhood vaccine guidelines.
The MMRV vaccine discussion notably highlighted palpable tensions among the newly appointed panelists.
“What we’re effectively saying is that we don’t trust parents to make an informed decision,” stated Dr. Cody Meissner, a pediatrician from the Dartmouth Geisel School of Medicine, widely recognized as one of the most qualified members on vaccine science.
He clarified that if the panel votes against the combination vaccine, it “simply won’t be an option” for parents.
It’s important to note that most of the current panelists are new appointments. In June, Secretary Kennedy controversially dismissed all 17 previous committee members, replacing them with seven new individuals who largely align with his skeptical views on vaccines. Another five members were announced just this week. Historically, ACIP members undergo a rigorous vetting process spanning months to years before their appointment.
During their first meeting in June, the initial seven panelists declared their intent to re-examine all recommended childhood and adolescent vaccinations. They also voted to revoke a long-standing recommendation for a specific type of flu shot containing thimerosal, a preservative that anti-vaccine advocates have falsely linked to autism.
The committee is also set to revise recommendations for the hepatitis B vaccine this Thursday. The initial dose is typically given to newborns within 24 hours of birth. Public health experts credit this vaccine with dramatically reducing maternal transmission of hepatitis B in the U.S., lowering incidence from approximately 20,000 cases annually before 1991 to fewer than 20 per year.
If left untreated, hepatitis B can cause severe liver damage, including cirrhosis, liver failure, and liver cancer. Infants infected at birth face a 90% risk of developing chronic hepatitis B, with one in four experiencing severe complications or death from the disease.
Secretary Kennedy and his supporters have previously contended that hepatitis B transmission is limited to sexual contact or shared needles, suggesting that only infants born to infected mothers require immunization at birth.
Dr. Noele Nelson, a senior author of the existing hepatitis B vaccine guidelines and former leader of the CDC’s hepatitis vaccines work group, highlighted that a pregnant woman’s hepatitis B status isn’t always definitively known.
Dr. Nelson added that infections could also be missed due to inaccurate test results or issues with reporting or interpreting them.
She further explained, “Universal hepatitis B vaccination at birth acts as a crucial safety net, protecting infants born to mothers whose infection status is unknown or inaccurately recorded.” Dr. Nelson resigned from the CDC in July.
Dr. James Campbell, vice chair of the American Academy of Pediatrics’ infectious disease committee, emphasized that hepatitis B, a highly contagious virus, can spread through various non-sexual routes, including shared household items like toothbrushes, razors, or combs.
He recalled, “In the past, we had risk-based hepatitis B vaccination recommendations, targeting only infants of infected mothers, but these did not sufficiently reduce the overall disease burden. That’s precisely why a universal recommendation is now in place.”
Secretary Kennedy has publicly questioned the safety of the hepatitis B vaccine, incorrectly asserting that it lacked proper testing. During his January confirmation hearing, he notably declined to affirm that the vaccine does not cause autism, a fact broadly accepted by the scientific community.
Conversely, Dr. Claudia Hawkins, a specialist in hepatitis B and C at Northwestern University Feinberg School of Medicine, affirmed the vaccine’s safety: “Hepatitis B vaccines are exceptionally safe, with no reports of serious side effects in infants, children, or adults since their inception. There is absolutely no medical reason to delay the hepatitis B vaccine.”
A separate, critical vote regarding Covid-19 vaccines is slated for Friday.