How ACIP recommendations could impact how you get COVID, childhood vaccines

By HPN Staff

The newly constituted Advisory Committee on Immunization Practices (ACIP) met shortly after five additional members were appointed, voting to change recommendations on COVID-19 and childhood immunizations. 

During what observers characterized as an at times chaotic meeting, the 12-member committee backed by Health and Human Services Secretary Robert F. Kennedy Jr., voted 8-3, with one abstention, to no longer recommend a single combination MMRV —  measles, mumps, rubella, and varicella (more commonly known as chicken pox) —  vaccine shot for children under the age of 4. Instead, they recommended separate MMR and varicella shots, citing concerns over the risk of febrile seizures in children who had received the combination shot. 

The committee also unanimously voted to drop recommendations for the COVID-19 vaccine for anyone over the age of 6 months, saying instead that the decision to receive the vaccine should be an individual one. This greatly expands an earlier decision by the CDC to drop the recommendation of the COVID vaccine for children and pregnant women.  

A decision to require COVID vaccines to be available only with a prescription failed on a tie vote — the measure failed since the committee chairman, Dr. Martin Kulldorff, voted on the ”no” side. 

Why it matters

The ACIP makes recommendations concerning vaccines and vaccine policy to the Centers for Disease Prevention and Control (CDC). Those recommendations traditionally inform state and local public health authorities and insurance companies. 

Some have claimed dropping COVID immunization recommendations could make it more difficult for some to access the vaccine, as insurance companies will no longer be required to cover it free of charge. However, health insurance companies have generally said they will still cover the immunization. Some employers, such as Walmart, will still cover them for workers as well.

The COVID vaccine can cost up to $250 without insurance coverage.

The controversy surrounding perceived vaccine skepticism among the new ACIP members has spurred four Democratic-governed states — California, Oregon, Washington and Hawaii — to break with the CDC and make their own immunization recommendations. Other states are considering alliances as well.

Further context

The panel made its MMRV recommendation, citing long-standing concerns over the small but present risk of febrile seizures in children aged 12-23 months within a week of receiving the combination dose. In 2008, the ACIP reviewed the evidence and decided to drop its existing preference for the single combination MMRV over the separate shots. 

Other decisions made by the new committee include voting to reverse a prior decision to continue coverage for the combination MMRV shot under the Vaccines for Children program, which provides free vaccinations for roughly one-half of American children. The decision to remove MMRV from coverage aligns with the previous ACIP policy of only providing coverage under the program for vaccines that are recommended by the committee. 

The committee also tabled a vote over the timing of the Hepatitis-B vaccine, commonly administered within 24 hours of birth, despite pressure from some committee members, amid presentations from CDC staffers of the vaccine's safety and efficacy.