Cdc Endorses Rfk Jr. Vaccine Panel Recommendations

The Centers for Disease Control and Prevention signed off Monday on an outside panel’s decision to downgrade Covid-19 vaccine recommendations for Americans and to effectively eliminate the option for parents to choose a combination measles and chickenpox vaccine for young children.

The move formalizes the position of CDC’s Advisory Committee on Immunization Practices, which voted Sept. 19 to remove the blanket recommendation that adults 65 and older get vaccinated for Covid-19. Instead, the 12-member panel changed the recommendation to “shared clinical decisionmaking,” a public health concept that means vaccination isn’t the default for a given population but remains an option.

The panel also recommended that people from 6 months to 64 years confer with their doctors when deciding whether to get vaccinated but emphasized that the benefits are greater for those with underlying health conditions.

The decision solidifies guidance for providers and insurers, though some people may face obstacles to Covid shots depending on where they live. Kennedy critics have warned that some states and state-regulated plans may interpret the softer recommendation to not widely offer or cover the vaccines.

O’Neill also adopted ACIP’s recommendation that young toddlers receive separate vaccines for chickenpox and for measles, mumps and rubella, a decision that will limit the ability of parents to choose a combination vaccine for all four illnesses for kids between 12 and 15 months old.

The CDC has for years had a preference for those children to receive the MMR and chickenpox shots separately for the first doses, though the previous recommendation allowed parents the option of what’s known as the MMRV shot to cut down on the number of jabs at a child’s checkup. But ACIP made the change due to concerns about a rare but heightened risk of febrile seizures in that age group after the MMRV shot, and the new recommendation limits its use to older children.

“Informed consent is back,” Deputy Secretary Jim O’Neill said in a statement. “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred health care providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today.”

Private health plans and federal entitlement programs must cover vaccines recommended with shared clinical decisionmaking with no cost sharing under federal law.

The CDC’s action should unlock its ability to ship vaccines provided under the Vaccines for Children program, which provides free pediatric immunizations to children who are Medicaid-eligible and un- or underinsured. Public health experts expressed alarm last week that those shots couldn’t be shipped without agency action on the recommendations, noting that the lack of action was putting low-income Americans at a disadvantage to privately insured families.

O’Neill’s statement was silent on the hepatitis B vaccine, the schedule for which ACIP had been slated to reconsider last month before tabling the vote. O’Neill or Kennedy could technically make changes to the hepatitis B birth dose recommendation — a longtime target of the anti-vaccine movement — before the ACIP revisits the vote, but such a move would be highly unusual. The CDC currently recommends that every infant get their first hepatitis B shot shortly after birth, but the ACIP had considered recommending that infants whose mothers test negative for the infection get their first shot after they are at least one month old.

Why it matters: Kennedy or O’Neill also could have chosen to further narrow the Covid-19 vaccine recommendation, but the decision to endorse the ACIP’s guidance appears to show that he still trusts the panel’s guidance. The move comes after Kennedy fired all of the ACIP members in June and replaced them with his own, more vaccine-skeptical picks.

Kennedy also, in May, downgraded the Covid shot recommendation for healthy children to shared clinical decision making, and removed the recommendation that pregnant women get the vaccine. That move came without a vote from ACIP.