Hepatitis B vaccine recommendation left in limbo by CDC panel, following revisions to MMRV guidance
In a contentious meeting this week, the Advisory Committee on Immunization Practices (ACIP) voted to change the recommendations for the MMRV vaccine, a combination shot for measles, mumps, rubella, and chickenpox. The vote comes after a heated Senate hearing involving the recently-ousted CDC director Susan Monarez, who testified that she was fired after clashing with Robert Kennedy Jr. over demands regarding vaccine policies.
The change in recommendations allows children under 4 to receive the MMRV vaccine, a move that some argue could lead to more children being vaccinated. However, concerns have been raised about evidence showing a slightly increased risk of fever-related seizures in children ages 12-23 months after receiving the MMRV shot compared to the MMR. Dr. Cody Meissner, a pediatrician at Dartmouth College and ACIP member, noted that while fever-related seizures can be frightening, they are not uncommon and occur in 3% to 5% of all children.
In a separate debate, the ACIP also considered changes to the current recommendations for the hepatitis B vaccine. The proposed changes could mark a major departure and reverse decades of progress in lowering rates of illness in the U.S. The existing policy is to give the hepatitis B vaccine to all babies at birth regardless of the mother's hepatitis B status. However, the new recommendations would guide doctors to screen all mothers and offer the vaccine only to those who do not test negative in an initial screening.
Dr. Evelyn Griffin, an OB-GYN and ACIP member, expressed concern about the new recommendations, asking if the committee is asking babies to solve an adult problem. Dr. Adam Langer, a CDC scientist, responded that there are potential harms to infants of waiting and no benefits to waiting a month. Despite these concerns, a small revolt against tackling this issue occurred.
The American Academy of Pediatrics (AAP) had decided to boycott the meetings, arguing that federal vaccine policymaking is no longer a 'credible process.' Robert F. Kennedy Jr. has barred professional medical groups such as the AAP from serving in their traditional roles as expert liaisons to workgroups of the advisory committee.
The panel's decisions could have significant implications for children's health insurance programs. Coverage by the Children's Health Insurance Program and Medicaid will be affected by the vote and may not cover these shots anymore.
Later on Friday, the panel will vote on recommendations on who should be eligible for the latest COVID-19 vaccines. The meeting has been marked by tension between the committee and the medical establishment, with Robert F. Kennedy Jr.'s leadership and the proposed changes to vaccine policies being a point of contention. Dr. Kulldorff, an epidemiologist, acknowledged the controversy and challenged his critics to an open public debate.
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