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Kennedy’s Vaccine Panel Tweaks Measles Shot Guidance. More Changes Could Come.

Sep 18, 2025 12:09:00 -0400 by Josh Nathan-Kazis | #Healthcare

HHS Secretary Robert F. Kennedy Jr. could dramatically change CDC guidance on key childhood vaccinations. (Saul Loeb / AFP / Getty Images)

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Robert F. Kennedy Jr.’s handpicked vaccines advisory committee on Thursday voted to recommend a change to the childhood vaccine schedule, advancing Kennedy’s plans to dramatically change how vaccines are used in the U.S.

The committee voted in favor of a minor tweak to the Centers for Disease Control and Prevention’s recommendations for use of the measles, mumps, rubella, and varicella vaccine. A vote on a more significant change to the use of the hepatitis B vaccine was delayed until Friday.

The meeting comes a day after former Centers for Disease Control and Prevention director Dr. Susan Monarez, whom Department of Health and Human Services Secretary Kennedy fired late last month, said in a Senate hearing that Kennedy had told her the CDC’s childhood vaccine guidance “would be changing in September,” and that Monarez “needed to be on board with it.” Monarez said that Kennedy told her that he “spoke to the president every day about changing the childhood vaccine schedule.”

The committee, called the Advisory Committee on Immunization Practices, gathered at 10 a.m. Thursday for the first of two daylong meetings. The committee recommends guidelines for how doctors and patients in the U.S. should use vaccines. Its decisions determine which vaccines insurers are legally required to cover without a copay.

Discussions on Thursday focused on childhood vaccines. On Friday, the committee will turn to the updated Covid-19 shots.

As the meeting began, committee chair Martin Kulldorff waded into the political debate over Kennedy’s firing of Monarez, and the subsequent resignation of three top CDC officials. Kulldorff criticized Monarez for not being in touch with him during her tenure, and defended the committee’s controversial decision in June to recommend against using flu vaccines that contain the preservative thimerosal.

Kulldorff also challenged Monarez and a group of former CDC directors to “have a live public debate with me concerning vaccines.”

Kennedy replaced all of ACIP’s members earlier this year. The committee’s recommendations must generally be approved by the CDC director, but since Kennedy fired Monarez in August, any recommendations from this month’s meeting need only be approved by Kennedy himself.

Kennedy, a prominent vaccine skeptic before President Donald Trump appointed him secretary of the Department of Health and Human Services, has long been critical of the CDC’s childhood vaccine schedule, which advises doctors and parents which immunizations children should receive at what point in their lives.

At the Wednesday Senate committee hearing, the CDC’s former chief medical officer, Dr. Debra Houry, who resigned immediately after Kennedy fired Dr. Monarez, said that HHS political appointees had worked with CDC officials to propose items for the agenda for this week’s ACIP meetings.

“Does normally the cabinet secretary or political staff set the agenda for a scientific meeting?” the committee’s chair, the Louisiana Republican Sen. Bill Cassidy, asked Houry.

“Not for the past decade I was at CDC,” Dr. Houry said.

The committee voted to change the recommendations for the measles, mumps, rubella, and varicella vaccine (MMRV). It delayed a proposed vote on the hepatitis B vaccine. Those two shots are the keystones of the childhood vaccination schedule; the CDC has recommended the hepatitis B vaccine for virtually all newborns since 1991.

The most-watched Thursday debate centered on a proposed new recommendation that the babies of women who test negative for hepatitis B not be vaccinated against hepatitis B until they are at least one month old. The recommendation would allow earlier vaccination if the mother and doctor agree.

Dr. Paul Offit, a vaccines expert and director of the Vaccines Education Center at the Children’s Hospital of Philadelphia, told Barron’s that a negative test on the mother wouldn’t necessarily remove the risk that an infant could be infected with hepatitis B. The tests are imperfect, Offit says, and mothers could be infected during pregnancy after they test negative. “It adds an additional level of risk without any benefit,” Offit says of the proposed delay. “The vaccine is safe.”

CDC scientists on Thursday afternoon presented ACIP members with a summary of published studies on the hepatitis B vaccine showing that administration of the shot at birth didn’t increase the risk of allergic reaction, mortality, sudden instant death syndrome, or seizures.

A CDC official, Dr. Adam Langer, said during a presentation that dropping the recommendation for all infants to receive a hepatitis B vaccine could increase the number of cases of babies who contract hepatitis B during birth, lead to “disproportionate harm” for patients without insurance, and create higher lifetime healthcare costs from “missed opportunities” to prevent hepatitis B.

The potential benefit of changing the policy, he said, is a “potential reduction in the already-rare cases of birth-dose vaccination adverse effects,” though said those adverse events, when they occur, “tend to be mild.”

The committee delayed its vote on the hepatitis B vaccine proposal until Friday.

As for the MMRV vaccine, the committee voted 8-to-3, with one abstention, in favor of not administering a combined MMRV vaccine for patients under age 4. Instead, it will recommend children in that age group receive two separate shots, an MMR vaccine and a separate varicella, or chicken pox, vaccine.

The CDC currently advises that parents can choose between the combined MMRV vaccine or the separate MMR and varicella shots for their child’s first dose, given before the age of four, though it recommends separate shots. For the second dose, the agency says that the combined MMRV shot is generally preferred.

Today, only 15% of patients under the age of 4 get the combined MMRV shot, according to the CDC. “I don’t think this is a big change at all,” Offit said.

In addition to guiding the clinical practice of doctors, a decision by ACIP not to recommend a shot for a certain group could mean that the shot will no longer be paid for by insurers. In a statement on Tuesday, however, the insurance industry trade group AHIP said that health plans will continue to pay in full for all vaccines that ACIP recommended as of Sept. 1, including updated Covid-19 vaccines, through the end of 2026.

“While health plans continue to operate in an environment shaped by federal and state laws, as well as program and customer requirements, the evidence-based approach to coverage of immunizations will remain consistent,” the group said in a statement.

Kennedy purged ACIP in June, firing all 17 of its members, all of whom had been appointed to overlapping four-year terms. He appointed eight new members shortly thereafter, and five new members on Monday. The committee, as reconstituted, bears little resemblance to its traditional membership. Once made up of leading infectious-disease specialists, epidemiologists, and other relevant experts, many of the committee’s current members are known largely for their opposition to various aspects of the federal government’s response to the Covid-19 pandemic.

Plans for the meeting have caused deep concern among medical professionals and elected officials. In late August, Cassidy, the Republican chair of the Senate health committee, said that this week’s meeting “should not occur until significant oversight has been conducted,” and that, “if the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership.”

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com