The Centers for Disease Control and Prevention’s vaccine advisory panel greenlighted a more limited COVID-19 vaccine recommendation Friday, concluding a two-day meeting that was a far cry from the panel’s meetings of years past.
The CDC’s Advisory Committee on Immunization Practices, often known as ACIP, voted 12-0 to recommend that all people ages 65 and older and people ages 6 months to 64 with underlying conditions receive an updated COVID-19 shot for the fall and winter season in consultation with their health care provider.
The vote concluded an unusually eventful meeting that included a revote, punting a vote on the hepatitis B vaccine, and spirited debate over whether to require a prescription to receive a COVID-19 vaccine.
Health and Human Services Secretary Robert F. Kennedy Jr. completely remade the usually nonpartisan vaccine advisory committee in his image, firing old vaccine experts and replacing them with vaccine skeptics.
Throughout the two-day meeting, scientists and leading medical organizations questioned the committee’s new processes and the data or lack thereof that they took into consideration. Some worried the committee’s new recommendations could lead to fewer vaccinations and unnecessary disease spread or death.
“I would encourage the committee to make decisions based on the data, rather than theoretical concerns that are raised,” liaison member Grant Paulsen of the Pediatric Infectious Diseases Society told the voting members during presentations. Liaison members are nonvoting ACIP members that can participate in discussion.
The panel’s decision falls in line with the Food and Drug Administration’s actions on vaccines ahead of the fall respiratory virus season. The FDA in August approved updated COVID-19 shots for those age groups, moving away from a broad recommendation for vaccination.
The decision could mean that insurers will likely maintain broad coverage for the vaccine. However, it’s unclear what coverage could look like for some groups, for example young people with no underlying conditions. Under the 2010 health care law, most health insurance plans must cover ACIP/CDC-recommended vaccines, even with shared clinical decision-making.
AHIP, the main lobby group representing health insurers, announced earlier this week that it would continue to cover all immunizations that were recommended as of Sept. 1, 2025, and coverage would be available through the end of 2026.
COVID-19 vaccines
The committee narrowly shot down a recommendation that people must have a prescription to receive a COVID-19 vaccine moving forward. The committee voted 6-6, with the chair, Martin Kulldorff, breaking the tie.
Several members of the committee agreed that requiring a prescription would present a barrier to implementing the new COVID-19 vaccine schedule, with some voting “strongly” against the proposal.
“It is the sense of the committee that state and local jurisdictions should require a prescription for the administration of the Covid-19 vaccine,” the voting language read.
But others threw their support behind the recommendation, arguing that vaccines are given too freely and there should be more discernment for each individual patient when determining whether to get vaccinated.
“That individual patient is making an affirmative decision together with their health care provider as a consultant, that this is the best path forward for them,” committee member Robert Malone said. “As opposed to somebody who is subjected to propaganda, marketing and other activities that are not based in an actual, real world assessment of their risks and benefits.”
The panel also voted 11-1 to recommend that the CDC promote a more thorough informed consent process, including at least six of the vaccine risks and uncertainties that were presented during the meeting Friday.
The committee also voted 12-0 to recommend that health care providers discuss the risks and benefits of vaccination with patients before making a decision on whether to get vaccinated.
MMRV, hep B discussion
In an unusual move, the committee reconsidered a resolution it voted on Thursday regarding the measles, mumps, rubella and varicella vaccine.
The committee initially voted Thursday to split up the MMRV vaccine and instead administer just two shots — one for MMR and one varicella for kids under age 4. But it notably did not make the same recommendation for the Vaccines for Children program, which provides vaccines to low-income children.
The committee corrected itself Friday, voting 9-3 that it does not recommend the combined MMRV shot for kids under age 4 in the Vaccines for Children Program. The decision brings the Vaccines for Children recommendation in line with the committee’s general recommendation for that age group.
Energy and Commerce ranking member Frank Pallone Jr., D-N.J., warned the committee’s decision will lead to more vaccine hesitancy for the MMRV vaccine, which could worsen the ongoing measles outbreak.
“Let me be clear, children will die due to the return of vaccine-preventable diseases as a result of ACIP’s action,” Pallone said in a statement.
The American Medical Association said the committee’s recommendation splitting up the MMR and varicella — commonly known as chickenpox — shots will cause confusion for families and physicians, and the committee only used selective data in its former guidance.
The committee also tabled a vote on whether to change the recommendation for the hepatitis B vaccine after the panel was not in agreement on whether to delay the shot for newborns. Only ACIP Chair Kulldorff voted against tabling the issue.
The committee voted 12-0 to recommend that all pregnant people be tested for hepatitis B, which is already the standard of care for pregnant people.
Senate Health, Education, Labor and Pensions Chair Bill Cassidy, R-La., warned the committee against making future changes to the hepatitis B vaccine recommendation in a statement following the meeting. Cassidy is a physician who has spent much of his career treating hepatitis patients.
“If a mom wants to get a lifesaving hepatitis B vaccine to protect her newborn, she should be able to get it,” Cassidy said in a statement.
“The proposed ACIP recommendation could have put that access at risk, making it harder for that mom or that parent to protect their child against hepatitis B. Postponing the vote was the right call,” he added.
Some liaison members at the meeting were skeptical of how the newly formed committee arrived at its recommendations and asked for ACIP to produce a framework for how it will assess vaccines moving forward.
Former CDC officials watched in shock. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and a former acting CDC director, said the committee has long been nonpartisan and free of political theater or gamesmanship. Now, he worries that the committee is unreliable.
“If the committee continues down this path, the health repercussions for our nation will be severe. I urge the ACIP chair and its members to approach their work with the seriousness of purpose and commitment to science that this responsibility demands. Lives are at stake,” Besser said in a statement.
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