A new group of CDC advisors voted last month to separate the chickenpox vaccine from the measles, mumps, rubella components of the MMRV shot due to concerns over febrile seizures, while recommending a more risk-based approach to COVID-19 immunizations that mirrors recent FDA approvals.
Last month, the CDC’s recently revamped advisory committee voted to separate the “V”—or the vaccine for varicella, also known as chickenpox—from the combined MMR—measles, mumps and rubella—shot for children under four years of age. Monday, the CDC adopted that guidance, along with the panel’s recommendation for individual-based decision making on COVID-19 vaccination.
The Sept. 18 meeting was heralded as the first test for the new members of the Advisory Committee on Immunization Practices (ACIP), seven of whom were appointed in June after Health Secretary Robert F. Kennedy Jr.’s ousting of the previous 17 members. Five new members were also added in September just ahead of the meeting.
Experts and other industry watchers agreed that it did not go well, creating confusion and demonstrating a “lack of knowledge” among the new advisors. Nevertheless, the ACIP’s recommended new immunization schedules were approved last week by acting CDC Director and Deputy Health and Human Services Secretary Jim O’Neill.
With regard to the change in the MMRV schedule, ACIP members had focused on the risk of febrile seizures, a rare complication of the vaccine. The CDC’s new recommendation of a standalone chickenpox vaccination for toddlers “follows evidence presented to ACIP by the CDC Immunization Safety Office’s that healthy 12–23 months old toddlers have increased risk of febrile seizure seven to 10 days after vaccination for the combined measles, mumps, rubella, and varicella vaccine compared to those given immunization for chickenpox separately,” according to the agency’s announcement on Monday.
The CDC has also accepted ACIP’s recommendation that anyone over age 65 and anyone aged six months to 64 with an underlying condition get a COVID-19 vaccine booster—guidance that mirrored the FDA approvals granted to Moderna, Pfizer/BioNTech, and Novavax for their respective vaccines in August. For the rest of the population, the CDC has moved from a universal recommendation to a risk-based one, with the ultimate decision being left up to patients (or their parents, in the case of minors) and healthcare providers. This formalized guidance issued by Health Secretary Robert F. Kennedy Jr. in May via a video posted to social media and apparently without the knowledge of CDC staffers.
