US Federal Committee Meets To Talk COVID-19, MMRV, And HepB Vaccines: Latest Updates

On Thursday, September 18, the Advisory Committee on Immunization Practices (ACIP) met to vote on possible changes to its recommendations to the US Centers for Disease Control and Prevention (CDC) with respect to three different vaccines: MMRV (measles, mumps, rubella, and varicella), hepatitis B, and COVID-19. After Thursday's meeting ended in confusion, with some key votes being pushed to the following day, here's everything that went down on day two.

The rest of this article is behind a paywall. Please sign in or subscribe to access the full content.

Key takeaways

• MMRV shot no longer recommended for children under 4 years of age. Separate MMR and varicella shots are recommended instead. 
• Thursday's decision that MMRV will still be covered by the federal Vaccines for Children program was reversed. The combined shot will no longer be covered by that program for under-4s.
• No vote was taken on the hepatitis B vaccine, so the recommendations remain unchanged.
• COVID-19 vaccines no longer recommended for all Americans aged 6 months and over. Decision to vaccinate should now come down to "individual decision-making" for each patient.

When it met on Friday, September 19, the ACIP held a second vote on the question of whether the Vaccines for Children program would cover MMRV shots for under-4s. The committee reversed its decision of the previous day and now recommends that the program not cover the MMRV combined vaccine for this age group. The recommendation for children aged 12 months to 4 years is that they receive separate MMR and varicella vaccines.

Friday also saw a decision not to have a vote on changing the recommendations for hepatitis B vaccination, though a statement from the Department of Health and Human Services (HHS) announced a blanket recommendation for testing for the virus in pregnancy, “covered across all insurance programs.”

The major decision to come out of Friday’s meeting was that COVID-19 vaccines will no longer be recommended across the board to US residents. Previously, the CDC guidelines said all people aged 6 months and over should be immunized against the disease. Now, HHS says that vaccination should be “determined by individual decision-making,” stressing that the benefits of the shots are greatest for over-65s and those with increased susceptibility to serious disease.

Far from bringing much-needed clarity, American Academy of Pediatrics infectious disease specialist Sean O’Leary told a press conference that the new recommendations were “extraordinarily vague”, as reported by Nature News. NPR described the meeting overall as “chaotic”. 

While the ACIP stopped short of recommending that COVID-19 vaccines only be available on prescription, something that had been on the table, it still remains to be seen whether all Americans who want a COVID shot this season will be able to get one. Prior to this year, access was relatively straightforward via a pharmacy or primary care provider. Now, that is likely to change – possibly significantly.