Recommendation for Tightened Regulations on MMRV Immunizations by Kennedy's Consultative Body
In a series of recent developments, the Advisory Committee on Immunization Practices (ACIP) in the U.S. has been revisiting vaccination recommendations for both the MMRV (Measles, Mumps, Rubella, and Varicella or chickenpox) vaccine and the hepatitis B shot.
The panel has advised that the MMRV vaccine should not be given before age 4, and children in this age group should instead receive separate vaccines for MMR and varicella. This decision was not based on new safety data, as some doctors and public health experts have noted. The slight increase in feverish seizures after the first dose of the MMRV vaccine, as observed through clinical trials and post-approval studies, has led to the current Centers for Disease Control and Prevention (CDC) recommendations.
Regarding hepatitis B, the ACIP put off a vote on hepatitis B shots given to infants on the day they are born. Approximately 2.4 million people in the U.S. are estimated to have hepatitis B, a virus that can also be passed to a baby from an infected mother. Shockingly, 90% of infected infants go on to have chronic infections. However, the CDC and its ACIP currently recommend administering the first dose within 24 hours after birth to prevent mother-to-child transmission, a guideline that has remained unchanged despite ongoing debates about vaccine safety and necessity.
The infant shots are 85% to 95% effective in preventing chronic hepatitis B infections. Despite discussions about delaying the hepatitis B vaccination for newborns, the ACIP is expected to decide on Friday whether to recommend that some babies can wait a month for hepatitis B shots and take up COVID-19 shots instead. Some committee members have questioned whether babies born to moms who test positive for hepatitis B are the only ones who truly need a vaccine in the first day of life.
The panel's actions could potentially narrow access to vaccines, particularly the MMRV vaccine, under the Vaccines for Children program, which pays for about half the shots given to kids in the U.S. The U.S. Health Secretary Robert F. Kennedy Jr.'s hand-picked vaccine advisory committee recommended new restrictions on the MMRV vaccine. The committee makes recommendations to the CDC director on how already-approved vaccines should be used.
The hepatitis B vaccine was first licensed in the U.S. in 1981. Since then, cases among infants have fallen significantly. Following the 2005 recommendation, hepatitis B cases among infants fell from 5,494 cases per year in 2005 to 2,214 cases in 2023. Half of the people with hepatitis B are unaware of their infection, underscoring the importance of vaccination.
Discussions on the MMRV vaccine focused largely on rare instances of feverish seizures associated with the first dose. In adults, hepatitis B is primarily spread through sex or sharing needles during injection-drug use. The vote on the recommendation was 8-3, with one member abstaining.
The concern is that debating these issues could lead to fewer people getting vaccinated, potentially resulting in the return of diseases that were largely conquered. It is crucial to maintain the momentum of vaccination programs and protect public health.
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