Committee takes unexpected turn on COVID vaccine for pregnant women Image Key Points The CDC’s Advisory Committee on Immunization Practices (ACIP) quietly reinstated COVID vaccine eligibility for pregnant women under a “shared clinical decision making” model, reversing Robert F. Kennedy Jr.’s earlier directive against recommending it. The change allows pharmacies to once again administer COVID vaccines to pregnant women and requires most insurance plans to cover the shots. Despite being appointed by Kennedy, the panel showed unexpected autonomy—voting down a proposed prescription requirement for COVID vaccines and making other split decisions, signaling it may not fully align with Kennedy’s vaccine skepticism. By HPN Staff The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) quietly reversed an earlier decision by Health and Human Services Secretary Robert F. Kennedy Jr. concerning COVID vaccine recommendations for pregnant women. An update to the CDC’s vaccine schedule issued Oct. 7 confirms that pregnant women fall under the “shared clinical decision making” column, an unexpected turn away from Kennedy's earlier decision against any recommendation. Why it matters The updated recommendation means that pharmacies can again administer the COVID vaccine to pregnant women, and that most insurance plans must cover it. It also indicates the influential ACIP panel, which is tasked with reviewing scientific research on vaccines and immunology and making recommendations to the CDC regarding vaccine use, may not be as critical of vaccination as some have expected. The panel, whose hand-picked appointees had been generally considered to be sympathetic to RFK’s vaccine skepticism, showed early signs of independence in the inaugural September meeting. While the decision to recommend shared clinical decision making for COVID shots for those 6 months and older was unanimous, a decision to require a prescription for the COVID vaccine failed on a tie vote, with the new chair, Dr. Martin Kulldorff, among the “no” votes. Another provision, concerning replacing the recommendation of a single combination MMRV vaccine shot for children under the age of 4 with two separate shots, passed on a split vote of 8-3, with one abstention. The fact that the change in recommendations for pregnant women was made with no fanfare has raised questions in some circles. Dorit Reiss, a vaccine law expert at the University of California’s law school in San Francisco, was quoted in a Politico article saying, “Under these circumstances, if they were going to change the decision about pregnancy, I would have expected them to address it expressly, since it was changed expressly [by Kennedy].” The bigger picture Kennedy issued a decision last May ordering the CDC to no longer recommend that healthy children and women who are pregnant women receive the shot. Kennedy soon after dismissed all 17 sitting ACIP members and subsequently appointed new members whom he determined to be more amenable to his policy directions. At the ACIP meeting in September, the panel adjusted CDC COVID vaccine guidance to recommend that individuals 6 months and older receive the shot after consultation with their healthcare provider. As the ACIP decision did not directly address or mention pregnant women, his decision in that regard held. SUGGESTED STORIES How ACIP recommendations could impact how you get COVID, childhood vaccines 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 m Read more Flu shot still recommended despite recent vaccine skepticism The United States is entering flu season and September and October are the best times to get vaccinated, medical experts say. But those recommendations come amid vaccine controversy as the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Contr Read more FDA’s top vaccine official returns to post after controversial resignation Dr. Vinay Prasad, who resigned from his role as a top official at the U.S. Food and Drug Administration (FDA) after only three months with the agency, has returned to his post. Prasad, a California-based hematologist-oncologist and frequent publ Read more
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