Federal Vaccine Advisory Committee's Controversial Vote on MMRV Vaccine

I. Background and Composition of the Committee

A federal vaccine advisory committee, known as the Advisory Committee on Immunization Practices (ACIP), which is composed of members personally selected by Health and Human Services secretary Robert F. Kennedy Jr., made a significant decision. This committee is tasked with providing recommendations regarding vaccine usage to the US Centers for Disease Control and Prevention (CDC). These recommendations typically hold sway over state vaccine requirements for schools, insurance coverage of vaccines, and pharmacy access.

II. The Vote on MMRV Vaccine

On Thursday, in an 8 - 3 vote, the committee recommended that the combined measles, mumps, rubella, and varicella (MMRV) vaccine should not be administered before the age of 4. This decision was based on long - established evidence indicating a slightly elevated risk of febrile seizures in this age group. Currently, parents have two options for vaccinating their children against these diseases: the combined MMRV shot or two separate shots (one for MMR and another for chickenpox), with approximately 85 percent of children receiving the separate shots.

III. Expert Opinions on Febrile Seizures and Immunization Rates

Experts assert that while febrile seizures can be alarming, they are generally short - lived and harmless. Moreover, removing the option of the combined MMRV vaccine for parents could potentially lead to a decline in immunization rates against measles, mumps, and rubella, which are some of the most perilous childhood diseases.

IV. Policy Shift under Kennedy's Leadership

This vote is part of a new vaccine policy shift led by Kennedy, a long - time anti - vaccine activist. Since taking office as HHS secretary, Kennedy has imposed restrictions on Covid - 19 vaccine recipients and dismissed all 17 sitting members of ACIP, replacing them with 12 new members, some of whom were appointed just this week. Several of the new advisers have a history of criticizing vaccines or denouncing public health measures implemented during the Covid - 19 pandemic. Kennedy contends that a "clean sweep" of ACIP was necessary to restore public confidence in vaccine science.

V. Other Vaccine - Related Topics under Consideration

During the meeting, committee members were also asked to assess whether to recommend against the combined MMRV vaccine before age 4 and whether to delay the first dose of the hepatitis B vaccine until the child is at least one month old. In the US, the hepatitis B vaccine is typically administered in the hospital shortly after birth due to the risk of mother - to - child transmission during delivery. The World Health Organization advocates for a universal birth dose of the hepatitis B vaccine.

VI. Discussion and Explanation of the Vote

The topics discussed at the meeting were not based on new data or evidence. Two ACIP members, Joseph Hibbeln and Cody Meissner, along with representatives from professional medical organizations present, questioned the need for these changes. Robert Malone, a controversial new ACIP member, explained that a significant portion of the US population has substantial concerns about vaccine policy and mandates. Malone, a former mRNA researcher who spread false information during the Covid - 19 pandemic, abstained from Thursday's vote as he had previously served as an expert witness in a lawsuit related to the mumps vaccine.

CDC scientists presented hours of data on the well - established safety and efficacy of the hepatitis B and MMRV vaccines. The vote to remove the recommendation for the combined shot for children under 4 was ultimately based on the long - acknowledged fact that the MMRV vaccine is associated with a higher risk of fever and febrile seizures 5 to 12 days after the first dose among children aged 12 to 23 months. Approximately one febrile seizure occurs for every 2,300 to 2,600 MMRV vaccine doses, as per the CDC. There is no increased risk of febrile seizures after vaccination with the MMRV vaccine in children aged 4 through 6 years when the second dose is given.

VII. Dissenting Views

Meissner, one of the three dissenting votes and a professor of pediatrics at Dartmouth College, argued that recommending against the combined MMRV vaccine for children under 4 restricts parental freedom. Hibbeln, who also voted no, expressed concerns that removing an option for measles, mumps, and rubella vaccination could further lower already declining childhood vaccination rates.

Medical experts, such as Melissa Stockwell, a pediatrician and professor at Columbia University, and Ari Brown, a pediatrician in Texas and a spokesperson for the American Academy of Pediatrics, were also perplexed by the new recommendation. They emphasized that while febrile seizures can be concerning for parents, they are benign and relatively common in young children with a rising fever, and the slightly higher incidence in the combination vaccine should not be a reason to remove access to it.

VIII. Decision on Vaccine Coverage and Future Votes

Despite recommending against giving the MMRV vaccine to children under 4, the advisory committee voted 8 to 1, with three members abstaining, to maintain coverage of the vaccine as part of the Vaccines for Children program, which provides free vaccines to low - income children and those without insurance. However, the committee's recommendation could still impact private insurance coverage and pharmacy access to the MMRV vaccine.

On Friday, the CDC advisers are set to vote on whether to delay the hepatitis B vaccination to one month after birth and will also discuss Covid - 19 vaccines.

Update: As of 9 - 19 - 2025 1:30 pm BST, the number of abstentions in the vote to maintain coverage of the MMRV vaccine as part of the Vaccines for Children program was corrected.