As many Americans supporting the “Make America Healthy Again” agenda had hoped, a vaccine advisory panel appointed by the Department of Health and Human Services Secretary Robert F. Kennedy, Jr., has begun reviewing childhood vaccine recommendations.
This week, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) voted 8-3 against recommending the combined measles, mumps, rubella, and varicella (MMRV) vaccine for children under age 4, advising instead that children in this age group receive separate shots for MMR and varicella (chickenpox).
The decision is driven, in part, to avoid injecting children with several different vaccines all at the same time.
The new guidance from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) suggests the vaccine, called MMRV, shouldn’t be recommended for children under age 4 because of a small risk for febrile seizures in that age group. The seizures can be prompted by fevers associated with viruses or, sometimes, vaccines. They usually last for a few minutes and, while they are scary for parents to witness, are generally harmless, doctors say.The panelists voted 8-3 in favor of the change. One member, Dr. Robert Malone, abstained because of a conflict of interest.Doctors have known about the increased risk of febrile seizures in young children for years. It’s why the CDC already suggests that younger kids get the varicella vaccine separately, unless a parent or a caregiver prefers the MMRV shot.The combination shot was developed to cut down on the number of vaccines babies receive at age 1 and to increase the chances kids will get all of their vaccinations. But about 85% of parents opt to give their children the stand-alone measles, mumps and rubella vaccine and a separate varicella shot, according to data presented at Thursday’s meeting.
The panel also indefinitely postponed a vote on a Hepatitis B vaccine they had already deferred once. Hepatitis B (HBV) is a bloodborne pathogen that can be transmitted sexually or if there is contact with infected bodily fluids via needles, surfaces, or other contaminated items.
And the panelists said they felt unready to decide whether to limit the use of a vaccine for hepatitis B that is typically given to all newborns. Some said they still had questions about the vaccine’s safety, while others seemed relieved that the panel did not make what they saw as a rash decision that might harm children.“We are more prudent when we are cautious,” Dr. Joseph Hibbeln, a neuroscientist formerly at the National Institutes of Health, said as he voted to table the vote.
It must be noted that 90% of newborns who acquire hepatitis B (usually from infected mothers at birth) will become chronically infected if not given immediate prophylaxis (i.e., the vaccine). This means those children have immune systems that will not be able to kill the virus, but will eventually have adverse effects on their liver.
How many children does this impact? In the U.S., about 17,800 infants were born to hepatitis B-positive mothers in 2021, representing nearly 0.5% of all births.
I would simply argue that parents of infants should be fully informed of the risks and health consequences of Hepatitis B, then they can decide if the vaccine is appropriate for their child. There should be no mandate for this particular shot.
However, a few of the experts on the panel argued otherwise.
Public health experts acknowledge that a baby’s risk of contracting hepatitis B is low if the mother is negative for the virus. But they say the broad recommendation should be maintained because of the original reason it was put in place: Many babies slipped through the cracks.The ACIP originally recommended the vaccine be given only to infants of mothers who tested positive. But when uptake of the vaccine remained low due to a lack of prenatal testing, the panel broadened the recommendation to include any infant within 24 hours of birth. About 12 to 16 percent of pregnant women do not receive prenatal screening for the infection, according to the CDC.“The birth dose is the safety net that catches a baby who would otherwise fall ill,” said Kelly Moore, president of Immunize.org, a vaccine advocacy organization, and a former ACIP member who voted for the recommendation.
Again, I would argue that a one-size-fits-all approach to healthcare is senseless. Ensure the parents have all the information they need, including risks and outcomes, and allow them to select the schedule appropriate for their child.
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