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Changes affect access to MMRV shots

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Hepatitis B, COVID-19 vaccine votes expected on Friday

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Vote raises questions about vaccine coverage

By Michael Erman, Julie Steenhuysen and Mariam Sunny

ATLANTA, Sept 18 (Reuters) - U.S. vaccine advisers voted

on Thursday to revise the use of one of two key childhood

vaccines under review, another step in U.S. Health Secretary

Robert F. Kennedy's push to rewrite U.S. immunization policy.

The group, which advises the Centers for Disease Control and

Prevention on U.S. vaccination schedules, recommended against

allowing parents to choose the combined

measles-mumps-rubella-varicella vaccine before age 4.

Instead, separate vaccine shots will be given for

measles-mumps-rubella and varicella.

The votes are the first from Kennedy's 12-member Advisory

Committee on Immunization Practices, many of whom have advocated

against vaccine use. Five of those members were named this week.

Kennedy, a longtime anti-vaccine activist, is moving at

breakneck speed to push through changes to the nation's vaccine

policies, including restricting eligibility to COVID-19 shots,

ousting the country's top public health official, and amplifying

federal support for state vaccine exemptions.

He says these moves are needed to restore trust in U.S.

public health agencies.

The panel delayed to Friday a vote on a recommendation to wait

to give the hepatitis B vaccine until infants reach 1 month of

age, rather than at birth, unless the mother tests positive for

the virus.

A spokesperson for Merck ( MRK ), which makes the combination MMRV

shot, said the recent advisory committee vote and discussion

"occurred in the absence of new scientific data and in contrast

to years of evidence affirming the current immunization

schedule."

PANEL SAYS MOVE ADDRESSES FEBRILE SEIZURE RISK

The panel reviewed the change to the combined MMRV shot

recommendation based on studies showing a higher risk of

seizures in children under 4 compared with those who received

separate measles-mumps-rubella and varicella shots.

The CDC had already recommended separate MMR and varicella

vaccines for children younger than 4 unless parents express a

preference for the combined shot.

The day-long meeting was marked by points of confusion as

an entirely new roster of members asked about procedures and the

impact of their decisions on health insurance coverage.

The panel repeatedly asked for clarification on the vote

for coverage under the Vaccines for Children program, forcing

one panel member to abstain because it was not clear what he was

voting on.

The split vote appeared to allow children covered under the

Vaccines for Children to continue to have free access to the

combination shot, but the new recommendations could limit access

to the combination shot for other children.

The Merck ( MRK ) spokesperson described the vote on the children's

vaccine program as unprecedented and said it was still working

to figure out the implications to access.

"It's confusing. They're going to need to clarify this,"

said Dr. Norman Baylor, former director of the FDA's Office of

Vaccines Research and Review who has served as a liaison to the

vaccine panel.

"I'm just amazed that nobody stepped up to say, take a step

back," Dr. Bruce Gellin, former HHS deputy assistant secretary

for Health and director of the National Vaccine Program Office,

said. "If this is going to invoke trust, we've got a long way to

go."

During the meeting, several committee members objected to

the absence of representatives of physician groups and experts

who administer vaccines and changes in standard protocols for

reviewing and ranking evidence before taking votes.

Such representatives were removed from work group

participation, where such discussions typically occur, and no

such work groups were convened to consider the data on either

the MMRV or hepatitis B shot.

Dr. Aaron Milstone, pediatric director of Infection

Prevention at Johns Hopkins Children's Center, said afterwards

the move would reduce access to vaccines and remove the ability

of parents to decide to give the child fewer shots.

The committee is expected to vote on Friday on

recommendations on who should get the COVID-19 vaccine.