A key committee of the US disease control and prevention centers.
After an 8-3 vote with an abstention, the CDC Immunization Advisory Committee will no longer recommend that children under 4 years receive a single shot for papers, measles, rubella and chickenpox (better known as chickenpox).
On the other hand, the CDCs will recommend that children from 12 to 15 months receive two separate shots at the same time: one for papers, measles and rubella, or MMR, and another for chickenpox.
The first vote of the two -day meeting of the committee represents a relatively small change to current immunization practices. The Committee will vote on Friday about the changes proposed to the hepatitis B vaccines of childhood and COVID-19.
But doctors said that lack of experience and skepticism of display vaccines during much of the discussion would only further dilute public confidence in the guidance of science and public health.
“I think the main objective of this meeting has already happened, and that was to sow distrust and instill fear between parents and families,” Dr. Sean O'Leary, president of the Infectious Diseases Committee of the American Academy of Pediatrics, said Thursday during a press conference on Zoom.
“What we saw today at the meeting was not really an effort in good faith to create an immunization policy in the best interest of Americans. It was, frankly, an alarming attempt to undermine one of the most successful public health systems in the world,” O'Leary said. “This idea that our current vaccine policies are broken or need a radical review is simply false.”
Giving MMR vaccines and chickenpox in the same shot has been associated with a higher relative risk of brief seizures of high fevers in the days after vaccination for children under 4 years – 8 out of 10,000 children generally have febrile seizures after receiving the combination of shooting, compared to 4 in 10,000 that receive separate mmr and chicken shooting at the same time.
By anguish that are for family members, seizures are a relatively common side effect for high fevers in young children and have not associated with any long-term consequence, said Dr. Cody Meissner, a former head of pediatric infectious diseases in Tufts-New England Medical Center that is serving in ACIP for the second time (previously served under presidents George W. Bush and Obama).
The problem with the division of vaccines in multiple shots is that it generally leads to less compliance with the vaccine, Meissner said. And the risks of not vaccinating are real.
“We are seeing a risk benefit of febrile seizures … compared to falling below a 95% coverage rate for the immunity of the flock, and the consequences of that are devastating, with pregnant women who lose their babies, newborns dying and with congenital rubella syndromes,” said Dr. Joseph Hibbel, a psychiatrist and a psychiatrist neurescientist and another member of ACIP ACIP.
Meissner, Hibbeln and Hilary Blackburn were the only three members to vote against change.
The meeting ended with a vote with respect to the continuous coverage of the MMRV fired under the CDC Children's Vaccine ProgramA publicly financed service that provides immunizations to almost half of the children of the nation. The program currently only covers the shots that Acip recommends.
As President Martin Kullldorff described the vote, several members of the committee complained that they did not understand the proposal as written. Three refrained from the vote completely.
As the meeting broke, the members could be heard trying to clarify with each other for what they had just voted.
The Committee also spent several hours debating if it delayed the first dose of the hepatitis B vaccine, a typically given shot at birth, until the child has 1 month. They will vote on the proposal on Friday.
The medical reason to alter the schedule of hepatitis B was less clear.
“What is the problem we are addressing with the discussion of hepatitis B? As far as I know, there has not been a series of adverse results,” said Pediatrician Dr. Amy Middleman, one of several people to raise the point during the discussion and the period of public comments.
The committee member, Dr. Robert Malone, replied that changing the recommendation of when children should be vaccinated by hepatitis B would improve the confidence of Americans in public health messaging.
“A significant population of the United States has significant concerns about vaccine policy and vaccine mandates, [particularly] The immediate disposition of this vaccine at the time of birth, “Malone said. The problem, he said,” is not security, but of trust. “
Hepatitis B is often asymptomatic, and half of infected people do not know that they have it, according to CDC. Up to 85% of babies born to infected mothers infected, and the risk of long -term risk of the disease is greater as soon as the infection is acquired.
Babies infected with the hepatitis B virus in the first year of life have a 90% chance of developing chronic diseases, and 25% of those who make it die of According to the American Academy of Pediatrics.
Since the vaccine was introduced in 1991, Infections of hepatitis B infections They have fallen into 95% in the US. Almost 14,000 children Hepatitis B infections acquired from 1990 to 2002, according to CDC; Today, the new annual infections in children are near zero.
The two -day meeting this week is the second time that the committee has met from Kennedy He said goodbye to Acip's previous members In June, in what he described Like a “clean sweep [that] It is necessary to restore public confidence in the science of vaccines. “
The next day, he appointed seven new members to the committee and added the last five earlier this week. The new members include doctors with relevant experience in pediatrics, immunology and public health, as well as several people who have been open vaccine skeptics or have been criticized for disseminating medical misinformation.
They include Vicky Pebsworth, a nurse who works as a research director of the National Vaccine Information Center, an organization with A long history to share inaccurate and mislead false and discredited statements About the flu and the COVID-19 shots.
In some cases, new members of ACIP also lack medical or public health experience of any kind. Resef Levi, for example, is a professor of operations management at the MIT without biomedical or clinical title that, however, has been an open critic of vaccines.
“Appointing members of antivacamic groups for the policy establishment committees in the CDCs and the FDA from the strip to the mainstream. They are not alone at the table, which would be quite bad; they are in charge,” said Seth Kalichman, a psychologist from the University of Connecticut who has study The vaccine information center role In the propagation of erroneous information of the vaccine. “It is the worst case.”
Although ACIP celebrates three public meetings per year, it usually works throughout the year, he said Dr. Paul offitDirector of the Vaccine Education Center in Children's Hospital of Philadelphia and former member of ACIP in the early 2000s.
The new recommendations to vaccine schedule are generally written before ACIP meetings in consultation with expert work groups that advise the members of the committee throughout the year, Offit said. But in August, medical groups such as American Medical Assn., The American Academy of Pediatrics and the Society of Infectious Diseases of America were told that they were no longer invited Check scientific evidence and advise the committee before the meeting.
That same month, Kennedy dismissed the director of the CDC, Susan Monarch, who had been designated for the position by President Trump and confirmed by the Senate. On Wednesday, monarch He said to a Senate committee That Kennedy dismissed her in part because she refused to sign the changes she planned to make in the vaccine schedule this month without seeing scientific evidence for them.
She did not specify during the audience what these changes would be.
Acip's recommendations become officers only after the CDC director approves them. With Monaz outside, that responsibility now goes to the Undersecretary of Health and Human Services Jim O'Neill, who serves as an interim director of the CDC.
Asked by reporters Wednesday, if the US public must trust any change that the ACIP recommends to the childhood immunization program, Senator Bill Cassidy (R – La) was overwhelming: “No”.
Cassidy chair el Senate Committee which supervises the Department of Health and Human Services, and issue the decisive vote for the Kennedy nomination. Before running for consumption, Cassidy, a specialist in doctor and liver, created a public-private association that provides Hepatitis B vaccines at no cost For 36,000 children from Louisiana.
He cast his vote after Kennedy undertook Cassidy that he would maintain the CDC immunization program.
As public confidence in the integrity of CDC guidelines, alternative sources for information have increased. Earlier this year, the American Academy of Pediatrics announced which would publish its own vaccination program based on the evidence that differs from the CDC on the flu and covid shots. And Wednesday, Governor Gavin Newsom He signed a law Giving California the power to establish its own immunization program, the same day that the State associated with Oregon and Washington to Issue joint recommendations For COVID-19, flu vaccines and RSV.
On Tuesday, an association that represents many health insurers of the United States announced that its members would continue to cover all the vaccines recommended by the previous ACIP, regardless of what happened at the meeting on Thursday, until the end of 2026.
“While health plans continue to operate in an environment made up of federal and state laws, as well as the requirements of the program and the client, the evidence -based approach for the coverage of immunizations will continue to be consistent,” the United States Health Insurance Plans said in a statement. The group includes the main insurers Aetna, Human, Kaiser permanent, Cigna and several Blue Cross and Blue Shield groups. United United, the largest insurer in the country, is not a member.
It is not clear what will be covered after 2026.
