Retsef Levi, a member of the CDC’s Advisory Committee on Immunization Practices and professor of operations management at the Massachusetts Institute of Technology, signaled that the committee could revisit other vaccine recommendations in future meetings. Maya Homan/Georgia Recorder
ATLANTA — A key vaccine advisory panel at the Centers for Disease Control and Prevention has indefinitely postponed a controversial change to guidelines on administering hepatitis B vaccines to newborn babies, and altered long-standing recommendations around COVID-19 vaccine access for children and adults, though a proposal to require prescriptions for all individuals seeking the shot narrowly failed.
The panel also voted to reverse a decision they made only Thursday that would have prevented updated guidelines on the MMRV vaccine, which protects against measles, mumps, rubella and varicella, from applying to children enrolled in the Vaccines for Children program.
CDC vaccine panel votes to limit use of a childhood vaccine as COVID, hepatitis B decisions loom
Vaccines for Children is a federal program which covers the cost of vaccines for more than half of American children. The decision to implement different standards for children enrolled in VFC caused confusion among top health officials as well as some committee members when it was introduced Thursday.
Jason Goldman, the president of the American College of Physicians who also serves as a liaison to the committee, criticized Thursday’s vote, arguing that the changes were not backed by scientific evidence.
“Would you consider that the second vote actually revealed the truth, that you do not have the data or evidence to challenge the current standing and that there is no associated harm?” Goldman asked the committee.
The committee’s reversal on Friday standardizes the updated MMRV vaccine recommendations for all children. If ACIP’s recommendations are approved by CDC officials, doctors will be required to administer separate MMR and varicella vaccines for all children under 4 years of age.
ACIP tables a rule delaying Hepatitis B vaccine for newborns
In what appeared to be another reversal, the panel shelved a resolution that sought to alter current CDC recommendations around hepatitis B vaccines for newborn children.
The current three-dose series for hepatitis B, an incurable viral infection that attacks the liver, includes one vaccine administered to infants within 24 hours of birth, and subsequent booster shots given a month and six months after the initial dose. ACIP has been recommending a hepatitis B vaccine for all babies within a day of being born since 1991, which resulted in a 99% drop in serious infections between 1990 and 2019.
CDC panel opts against requiring COVID shot prescription, but wants greater emphasis on its risks
If ACIP members choose to implement the changes at a later meeting, official CDC guidelines will recommend that pediatricians delay administering the first dose of the hepatitis B vaccine until 30 days after birth for all children whose mothers test negative for the disease.
The panel did not provide any evidence indicating that delaying the vaccine improved children’s health, or that there were any widespread or serious instances of harm caused by administering hepatitis B vaccines to newborns. However, some ACIP members also cast doubt on the accuracy of data showing the shot is safe.
“I think that there are gaps in what we know and understand about the effects of hepatitis B, particularly on very young infants,” said Vicky Pebsworth, a committee member who is a registered nurse and who sits on the board of the National Vaccine Information Center, which advocates for vaccine exemptions. “I think that the conclusion that we know that it is safe is, perhaps, premature.”
Dr. Adam Langer, who serves as the principal deputy director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, urged the panel to reconsider narrowing the recommendations.
“One of the primary reasons for recommending universal birth dose in the U.S. is to serve as a safety net for infants born to mothers with unknown test results,” Langer said during his presentation to the committee on Thursday.
“To date, no country in the world has reverted from universal to selective birth dose recommendations,” he added.
The meeting, which was held at the CDC’s Chamblee campus, also inspired a demonstration organized by a group of former CDC workers, who dressed up as preventable diseases and waved signs to the passing cars while the meeting was underway.
Cindy Weinbaum, who spent about a decade of her career at the CDC in the division of viral hepatitis, said she commended the committee for deciding to table a vote that would have changed the recommendations for hepatitis B vaccinations.
“I think it’s really commendable, actually, that they delayed this vote because they do not know the implications of not recommending a birth dose of hepatitis B,” Weinbaum said.
“So that was a nod to their lack of understanding of vaccine programs, vaccine science and the importance of certain vaccinations for kids,” she added.
Weinbaum said the proposal’s appearance on the committee’s agenda reflects the “vaccine nihilism that the current administration is supporting.” She said the shot given to newborns within the first day of their life has found itself in the “cross hairs of the anti-vax movement.”
“It’s because here’s this newborn baby and you’re very vulnerable, and sticking it with a needle is kind of a scary thing,” she said. “They just don’t understand that it’s even more scary to get liver cancer, and that’s really what we want to prevent.”
ACIP moves to center vaccine harm
Though the committee did not implement some of its more controversial proposals, ACIP’s new members have signaled that they would like to place a greater focus on examples of vaccine harm and adverse outcomes in future policy proposals.
They have also rejected widely embraced data on vaccine safety, choosing instead to focus on isolated cases and dubious studies, including one paper claiming that rats exposed to the COVID-19 vaccine exhibited “autism-like behaviors” that was eventually retracted by the journal that published it.
Some ACIP members, including Robert Malone, also pushed back against guidelines that advise vaccinating young children and pregnant women, arguing that there is a lack of data proving definitively that vaccines are safe.
“The default should be the assumption that there is no intervention in the infant and the pregnant woman with the vaccine unless there is definitive evidence of safety,” Malone said.
But Dr. Cody Meissner, a professor of pediatrics and medicine at Dartmouth College who has served as a past committee member, pushed back against the argument that any medical intervention should be entirely risk-free.
“I just want to point out that it’s very, very difficult to prove the absence of harm, it’s simply not a practical objective,” Meissner said.
“I think it’s important for everyone to understand that no vaccine is 100% safe and no vaccine is 100% effective,” he added. “What’s important for the provider before administering a vaccine is to think about that particular patient and does the benefit of protection exceed any possible side effect from the vaccine.”
But in a conversation with reporters after the meeting, Retsef Levi, an ACIP member and professor of operations management at the Massachusetts Institute of Technology, signaled that the committee could revisit other vaccine recommendations in future meetings.
“I think we need to review vaccines, in general, from time to time,” Levi said. “It’s part of a good process. I don’t think that I need now to single out one vaccine or another. I think that, in general, it’s actually in the mission of ACIP. . . to actually review every vaccine.”
Georgia Recorder editor-in-chief Jill Nolin contributed to this report.
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