A federal vaccine advisory panel has voted to stop recommending the combined MMRV vaccine — measles, mumps, rubella, and varicella — for children under age 4.
The vaccine advisory panel — the Advisory Committee on Immunization Practices (ACIP) — voted 8–3 to recommend that the combined MMRV vaccine (measles, mumps, rubella, varicella) not be given to children under age 4.
The recommendation: children under 4 should receive MMR and varicella (chickenpox) shots separately, rather than combined.
The reason given is a slightly higher risk of febrile seizures when the combined MMRV vaccine is used in this younger age group compared to separate administration. Febrile seizures are generally short and do not lead to long-term harm.
The panel’s vote is a recommendation; it does not immediately change the official CDC vaccination policy until adopted by the CDC director and incorporated into official schedules.
It remains unclear exactly how private insurers will respond, or whether vaccine access might be affected in some settings. Reports raise concerns about potential confusion or reduced uptake, but the impacts are speculative at this point.
The Vaccines for Children (VFC) program will still cover the MMRV vaccine for children as young as 12 months despite the recommendation against it for under-4s.
However, as Politico reports, a growing number of doctors fear the move could confuse parents and providers — from which vaccine version to give, to when to give it, to what the change even signals.
There’s also concern that some may misread the decision as casting doubt on the safety of MMR or varicella vaccines overall — especially amid ongoing vaccine misinformation:
Doctors say the MMRV change and the proposed recommendation for hepatitis B vaccine — to delay giving the first dose to most infants until at least 1 month of age — aren’t backed by scientific evidence, will hamper access, possibly limit insurance coverage and are likely to foment vaccine hesitancy among parents at a time when the country just underwent a historic measles outbreak.
“I think the primary goal of this meeting has already happened, and that was to sow distrust and instill fear among parents and families. So that’s done. They’ve already done that,” Dr. Sean O’Leary of the American Academy of Pediatrics told reporters. “Hopefully, that doesn’t gain much traction.”
The votes by panel members handpicked by Kennedy come amid a tumultuous three weeks at the Centers for Disease Control and Prevention that saw Kennedy oust its director with the White House’s blessing. The day before the gathering in Atlanta, Susan Monarez, the fired CDC head, warned in congressional testimony that the secretary is endangering public health.
On Friday, the Advisory Committee on Immunization Practices is slated to vote on Covid-19 vaccine recommendations following a major change to their labels by the FDA. Commissioner Marty Makary has indicated the agency will release a report linking pediatric deaths to the shot, and anti-vaccine allies of Kennedy are pushing him to pull messenger RNA vaccines from the market.
While the added risk of febrile seizures with the MMRV shot is small — about 1 extra febrile seizure per 2,300–2,600 MMRV doses compared with separate shots — separating the doses reduces that risk. Still, health officials emphasize that both MMR and varicella vaccines are safe and essential. The benefit of vaccination — preventing measles, mumps, rubella, and chickenpox (which can have serious complications) — far outweighs the small seizure risk.
Maintaining high vaccination rates remains critical for preventing outbreaks of diseases that can have serious consequences, especially in young children.
READ NEXT: Congress Explodes Into Shouting Match After Squad Member’s Allegation
Hello Patrick! Thank you for this article re: the new ACIP guidelines for giving the MMR vaccine separately from the Varicella vaccine. As a recently retired RN & Childbirth Educator who formerly worked in both obstetrics & pediatric clinics, I’ve kept up with the vaccine issue for decades. When I did clinic work in the early 70’s in a Chicago inner city clinic, I was alarmed that several vaccines were given at each visit rather than at a slower pace which was the norm in private medical practices at that time.
I was told by my supervisor and one of the pediatricians that they feared that if they didn’t give multiple vaccines/visit, the young mothers might miss upcoming appointments, therefore, there babies would be under immunized. That was not the case for my clients, which I realize is anecdotal. The teen moms I served usually did not miss appointments.
Following those years & certification in childbirth ed, I began teaching expectant couples in my own community of mostly middle class people. In those early years, there were also many teens in my classes. Since I always taught about vaccines, I kept up with updates via conferences, medical literature, etc. As more & more vaccines became required, I became alarmed for many reasons for which I won’t elaborate here. Interestingly, it was now physicians serving my mostly middle class community who rationalized this practice with the same excuse. My perspective about young parents was exactly the opposite; they are very responsible.
Of course, there are a few who are not, but they are the exceptions.
Dr. Robert Sears published “The Vaccine Book” in 2010 in which I found that he, too, was very alarmed at the number of vaccines administered to young children before attending kindergarten. In his book, he suggested 2 alternative Vaccine Schedules: one for parents who wanted to simply slow down the number of immunizations given/visit & possibly separate out trivalent or quadravalent substances & one which included only the most important for parents who were extremely vaccine hesitant.
I gave out copies of the official state vaccine schedule (16 pages which included side effects) and Dr. Sears’ 2 alternative schedules. I usually taught about this topic in Class 7 of a 7 week series & opened the discussion by asking my students what they knew about & or thought about vaccines. Several had concerns about the number but admitted they knew very little about them other than the requirement for attending school. I would ask those with concerns to explain which began a discussion about the pro’s & con’s of vaccines.
At the end of the discussion, I explained my own middle-of-the-road position that vaccines save lives but do have side effects. Mercury which had been shown to have a correlation, not causation with autism had already been removed from pediatric immunizations years before, but aluminum was now used in them. It was unknown if there was a threshold for this metal above which neurological damage may occur, so perhaps slowing down the number of shots/visit would be helpful. Also since fever was a side effect of many, perhaps decreasing the quantity would also decrease the chance of high fevers which could lead to febrile seizures.
At the end of this discussion, I encouraged them to read the material and consider what they’d like to do and also to make a prenatal visit to their family doc or pediatrician to discuss this issue. On this and several other issues, I reminded them that they were the parents and would know their baby better than any health professional; they needed to be a part of every decision.
As a recently retired healthcare professional, I’d encourage others in this field to ask hard questions about this issue, to do your own research, & most importantly listen to your patients, really hear them.
Thank you!