An influential federal committee, responsible for recommending vaccine policies in the U.S., is preparing for a crucial two-day meeting to re-evaluate long-established immunizations. This panel, known as the Advisory Committee on Immunization Practices (ACIP), will be voting on recommendations for Covid-19 and hepatitis B vaccines – the latter being a highly contagious disease that severely impacts the liver. They will also consider the M.M.R.V. combination vaccine, which protects against measles, mumps, rubella, and chickenpox. Health Secretary Robert F. Kennedy Jr. has frequently expressed doubts about vaccine safety. Former CDC director Susan Monarez, who was recently dismissed, informed lawmakers that Mr. Kennedy intends to modify the standard childhood immunization schedule. She stated that he “directed me to commit in advance to approving every ACIP recommendation regardless of the scientific evidence.”
Pictured above: A hepatitis B shot being prepared for a 1-month-old patient. This vaccine is among those scheduled for discussion this week.
During Thursday’s session, the committee is expected to propose restricting the hepatitis B vaccine, suggesting it only be administered to newborns whose mothers are confirmed carriers of the virus. There is also a possibility the M.M.R.V. vaccine could be fully withdrawn. Friday’s agenda includes a potential vote to narrow the criteria for Covid-19 vaccine recipients. Historically, ACIP’s recommendations have significantly influenced insurance coverage. While insurers are mandated to cover all committee-endorsed vaccines, they retain the option to cover additional ones. However, AHIP, the national trade association for the health insurance industry, announced Wednesday that health plans would continue to cover all immunizations recommended as of September 1st – including new Covid-19 and flu vaccine formulations – at no patient cost through 2026. The association emphasized that their “evidence-based approach to coverage of immunizations will remain consistent.” Nevertheless, the committee’s decisions this week could signal significant, widespread changes to the established childhood immunization schedule.
Mr. Kennedy controversially appointed all 12 current committee members after dismissing the previous 17 in June. Seven new members were named shortly after, with the remaining five announced just recently.
An interactive graphic provides a visual overview of the current childhood vaccination schedule, highlighting three key recommendations currently under review by the CDC’s immunization advisory panel: Hepatitis B (1st and 3rd doses), Covid-19 (at 6 months for high-risk children), and MMRV (1st and 2nd doses, an alternative to separate MMR and Chickenpox shots).
In June, the initial seven panelists declared their intention to thoroughly examine all recommended vaccinations for children and adolescents. They also voted to revoke a long-standing recommendation for certain flu shots containing thimerosal, a preservative inaccurately linked to autism by many anti-vaccine groups. Dr. Robert Malone, a committee member, stated in a recent interview that the committee’s goal is to re-evaluate the “entire pediatric schedule,” demanding data on vaccine-vaccine interactions. Mr. Kennedy has consistently argued that the current number of childhood vaccinations is unsafe, a claim that medical experts widely refute as fundamentally incorrect. Dr. Malone has publicly embraced the “anti-vaxer” label, considering it “high praise.” He further noted that the committee would assess the “appropriateness of immediate afterbirth vaccination with hepatitis B vaccines.”
This refers to the initial dose of the hepatitis B vaccine, administered to newborns within 24 hours of birth. Public health experts credit this vaccine with significantly reducing maternal transmission in the U.S., cutting incidence from approximately 20,000 cases annually before 1991 to fewer than 20 cases per year. Dr. Richard Besser, former acting director of the CDC and CEO of the Robert Wood Johnson Foundation, warned that a likely limitation of hepatitis B shots for infants could trigger a resurgence of the disease in children. He expressed concern that “each meeting takes us closer to a time where vaccine-preventable diseases become a norm in our society.”
Robert Malone, a member of the Advisory Committee on Immunization Practices, speaking during a meeting at the CDC in Atlanta.
Untreated hepatitis B can cause severe liver damage, including cirrhosis, liver failure, and cancer. Over 90% of infants infected with the virus will develop chronic, lifelong hepatitis B. Mr. Kennedy and his supporters have asserted that hepatitis B is exclusively transmitted via sexual contact or shared needles, suggesting that only babies born to infected mothers should receive the vaccine at birth. However, Dr. James Campbell, vice chair of the American Academy of Pediatrics’ infectious disease committee, clarified that this highly contagious virus can also spread through everyday household items used by an infected individual, such as toothbrushes or razors. Dr. Campbell explained, “We’ve had, in the past, risk-based hepatitis B vaccination recommendations and they did not reduce the overall burden. That’s why we have universal recommendation now,” referencing previous attempts to vaccinate only at-risk newborns. The hepatitis B vote is slated for Thursday. Panelists will also address the M.M.R.V. shot, available since 2005. The panel’s chair, Martin Kulldorff, presented data in June indicating a slight increase in fever-induced seizures with the combination vaccine, though these seizures are generally harmless and can occur with any childhood illness. It’s worth noting that the M.M.R.V. combination vaccine is not universally administered. The CDC already advises separate administrations of the M.M.R. and chickenpox vaccines, particularly for the first dose given to children under two, due to seizure risks. A distinct vote concerning Covid-19 vaccines is planned for Friday.