No more "one size fits all" vaccine guidances from the CDC's Advisory Committee on Immunization Practices (ACIP):
https://thehill.com/policy/healthcare/5512906-covid-19-vaccine-guidance-update/
CDC vaccine panel votes to change COVID-19 vaccine guidance
By Joseph Choi - September 19, 2025A federal vaccine advisory panel voted on Friday to recommend people talk with a clinician before getting a Covid vaccine, while voting against a motion to require prescriptions for the shot.
All 12 members of the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) voted unanimously to update COVID-19 guidance so coronavirus vaccinations for all people should be based on “individual-based decision making.”
For people between six months and 64 years old, the recommendation advised that vaccinations be based on individual-based decisionmaking along “with an emphasis that the risk-benefit of vaccination is most favorable for individuals who are at an increased risk for severe COVID-19 disease and lowest for individuals who are not at an increased risk, according to the CDC list of COVID-19 risk factors.”
ACIP Chair Martin Kulldorff said it was his understanding that this recommendation they voted on would mean that SARS-CoV-2 vaccines would still be covered by insurance. Insurers look to the board’s recommendations to inform their coverage.
The ACIP voted against a motion which recommended that states and local jurisdictions require prescriptions for COVID-19 vaccines. The panel does not have the purview over whether to require prescriptions. States and local jurisdictions make those rules, not the CDC.
The vote was split evenly 6-6. With Kulldorff voting ‘no’ to break the tie, the motion failed.
The questions they were to vote on were not publicly disclosed until the very end of the meeting.
ACIP member Retsef Levi, professor of operations management at the Massachusetts Institute of Technology’s Sloan School of Management, led the panel’s discussion on the COVID-19 vaccines.
Levi, a known COVID-19 vaccine opponent and skeptic, was selected to lead the CDC’s COVID-19 working group in August. During the pandemic, Levi called for all COVID-19 programs to be stopped immediately, claiming there was no proof of efficacy and that the vaccines were behind the deaths of children and young people.
Levi presented four questions for the committee to vote on: to recommend the CDC promote six risks and uncertainties he cited in his presentation on Friday; to recommend requiring prescriptions for COVID-19 vaccines; that patients should be informed of the risks of COVID-19 and its vaccination before receiving the shot; and to update the current guidance so that coronavirus vaccinations for all people should be based on “individual-based decision making.”
All questions except for the one recommending a prescription for COVID-19 vaccine were passed by the committee.
Members of the working group that Levi leads gave a presentation strongly supporting the continued availability of COVID-19 vaccines, especially for pregnant women, children and seniors.
“In summary, Covid-19 vaccination matters for pregnant women, pediatric patients — especially those less than two years of age — people 65 years and older, those of any age with a weakened immune system or chronic medical conditions and anyone who feels they want protection for themselves or their families,” said Henry Bernstein, a member of the COVID-19 working group, on behalf of himself and two other members of the working group who he described as being in the “minority.”
During the committee’s discussion on Friday, ACIP members spent time speculating on whether the COVID-19 vaccine rewrote human DNA after being administered, whether it could cause lung cancer; of it could cause birth defects.
The debate over requiring a prescription, though outside the powers of the committee, was prolonged as several members strongly believed that requiring a prescription was creating a barrier to access. Members noted that people who are uninsured or underinsured don’t have the ability to easily go to a healthcare provider to receive a prescription.
Prescriptions aren’t normally required for seasonal vaccines like the flu shot and COVID-19, being available to the demographics for whom they are recommended. Still, Levi argued that COVID-19 vaccines were being treated essentially like over-the-counter drugs, adding that he believed they offered “questionable benefits for a lot of people.”
Fellow ACIP member Hillary Blackburn, pharmacist and director of medication access and affordability at Ascension Rx, who was appointed just this week, spoke out strongly against a prescription requirement.
“Well historically, at least 19 states have required pharmacist authorization to be tied to ACIP recommendations,” Blackburn noted. “And so, a lot of the states have been making their own recommendations to help clarify some of the confusion, which has been limiting some of the access, as we’ve seen with CVS and Walgreens pulling their COVID-19 vaccines for the season.”
Kelly Goode, president of the American Pharmacists Association, added on to this argument, telling the committee, “Pharmacists are the most successful healthcare providers who embrace the relationships with patients, and are well equipped to determine risk based on medications and health histories.”
“Furthermore, pharmacists are the healthcare providers who have the most experience with covid 19 vaccines. Claims data show that 90 percent of COVID-19 vaccines have been given in pharmacies,” she added.
ACIP voted to postpone a decision on the Hepatitis B vaccine for infants and very young children. This has become an issue in the case of Dr. Susan Monarez:
CDC vaccine advisers delay controversial vote on hepatitis B vaccine
By Nathaniel Weixel - September 19, 2025Key vaccine advisers to the Centers for Disease Control and Prevention voted 11-1 Friday morning to delay a recommendation on changes to the hepatitis B vaccine administered to newborns, a surprise development greeted with relief by infectious disease experts.
The vote came after a lengthy and tense discussion Thursday about the necessity of giving newborn babies the vaccine, rather than waiting until they are at least a month old.
Members of the Advisory Committee on Immunization Practices (ACIP) had been considering eliminating the current recommendation that all newborns receive the vaccine, which has been credited with a dramatic decrease in the infection rate over the past 30 years.
Several liaison members of the panel questioned the need for a policy change, given that there was no new evidence showing that there was a problem, or evidence to support delaying the vaccine by a month.
Cody Meissner, a member of the committee, also warned against changing the recommendation during the discussion Thursday.
“We will increase the risk of harm based on no evidence of benefit, because there will be fewer children who will get the full hepatitis B vaccine series,” Meissner said.
The vote was previously scheduled to take place Thursday but was pushed back to Friday.
On Friday morning, ACIP members decided there was too much confusion in the wording of their recommendation.
“I believe that there’s enough ambiguity here and enough remaining discussion about safety, effectiveness, and timing that I believe that a vote today is premature,” panel member Robert Malone said.
“I applaud the committee for getting this one vote right by tabling to allow it to have further discussion,” said Jason Goldman, a liaison representative and president of the American College of Physicians.
Separately Friday, the panel decided to vote again on whether the combined measles, mumps, rubella and varicella (MMRV) vaccine should be covered under the Vaccines for Children (VFC) program, which provides low-cost or free vaccines for about half of the children in the country who are uninsured or on Medicaid.
ACIP members voted Thursday to recommend against using the combined vaccine for kids under 4 years old. But in a confusing addition, they then voted against aligning their recommendation with the VFC program.
The new vote Friday brought the VFC program in line with that new recommendation, meaning the combination shot will no longer be covered. Separate MMR and varicella shots will be.
“Please provide to the public so they can have trust, faith and confidence in vaccination as to what process we are going to be using to properly vet and discuss all future vaccines,” Goldman said. “That is why the evidence to recommend framework was created so we would have the standard to be able to vet all vaccines, but that is not being used.”
ACIP voted unanimously to delay the administration of the vaccine for measles, mumps, rubella and varicella (chickenpox), commonly called the MMRV:
https://thehill.com/policy/healthcare/5511387-mmrv-vaccine-delay-acip/
CDC panel votes to push back MMRV vaccine recommendation to 4 years old
By Joseph Choi - September 18, 2025The vaccine advisory panel for the Centers for Disease Control and Prevention (CDC) voted Thursday in favor of delaying the administration of the vaccine for measles, mumps, rubella and varicella (chickenpox), commonly called the MMRV.
The CDC’s Advisory Committee on Immunization Practices (ACIP) is scheduled to vote on three questions during Thursday’s meeting. Five of the members were appointed to the committee just this week.
First, the panel was asked to consider whether the MMRV vaccine should not be recommended for children younger than 4. The panel voted 8-3 to approve the change, with one member abstaining.
This vote would have meant that children who receive their vaccinations through the Vaccines For Children federal program will not be able to receive the MMRV shot until they’re 4 years old. The committee voted, however, in a follow-up motion against aligning the VFC with the recommendation, changing nothing in terms of what the program covers for the time being.
Children can normally get the MMRV vaccine beginning at 12 months of age.
ACIP members Hillary Blackburn, Cody Meissner and Joseph Hibbeln were the three members to vote no on the recommendation.
The panel decided to delay the votes on hepatitis B vaccine guidance until Friday, when they will also vote on COVID-19 vaccine guidance.
The meeting Thursday was tense, with panel members very aware of the heightened attention on their vote following the firing and resignation of top CDC officials and the growing scrutiny of Health and Human Services Secretary Robert F. Kennedy Jr. on Capitol Hill.
“We are currently experiencing heated controversies about vaccines. And a key question is, who can you trust? Here’s my advice, when there are different scientific views, only trust scientists who are willing to engage with and publicly debate the scientists with other views,” ACIP Chair Martin Kulldorff said at the start of the meeting.
The core argument against allowing MMRV vaccinations under the age of 4 appeared to be the slightly increased risk of febrile seizures linked to the injections. Febrile seizures are caused by fevers of all types.
Febrile seizures are common and generally don’t cause any long-lasting effects, though members of the panel noted they can be traumatic for families to experience. The risk is lower when vaccines are administered when a child is older.
Kulldorff argued the risk of seizures could scare parents away from getting the MMRV vaccination.
Members of the committee who opposed the motion argued that changing the recommendation took away parents’ right to choose when and how to vaccinate their children.
Jason Goldman, president of the American College of Physicians, lambasted the motion as lacking supporting evidence and causing more confusion than benefits.
“When you make this recommendation, you now give license to insurance companies and the Vaccine For Children Program not to cover this vaccine. And finally, you are taking away the choice of parents to have informed consent and discussion with their physician on what they want to do for the health and benefit of their children,” Goldman told the committee during public comments.
Others warned this motion will cause a drop in vaccination rates.
“The disadvantage of giving two doses — or, as was suggested, separating the two doses — is that we know compliance falls. And the advantage of combination vaccines is that children and adults are more likely to complete the vaccine requirements if it’s given as a single dose,” Meissner said.
According to Andy Pavia, professor and pediatric infectious disease expert at the University of Utah, the immunization practices considered Thursday are “settled science.”
“This new handpicked ACIP has chosen to address issues that were relatively settled science for which there’s no new information that really suggests a need to do a detailed review,” Pavia said shortly before the vote. “And has already proposed votes that would change things even before hearing the data, and it suggests a great deal of prejudgment of the issues.”
Former CDC Chief Medical Officer Debra Houry told the Senate Committee on Health, Education, Labor, and Pensions the day before the meeting that the agenda and questions discussed by the ACIP were developed almost exclusively by political appointees, with little input from scientific staffers from her agency.
According to Houry, CDC scientists had no input on the first questions the committee voted for Thursday, only being asked for contributions on the COVID-19 vaccine vote scheduled for Friday.
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