The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) is scheduled to meet to review the established childhood vaccination schedule and policies. Potential changes include revisions to the hepatitis B immunization protocol for infants and examinations of current practices for other infectious diseases, such as measles, mumps, pertussis, and polio. This review has drawn attention from various groups and medical professionals.
Committee Composition and Trust
Established in 1964, ACIP's recommendations inform medical practice and insurance coverage for vaccinations. Secretary of Health and Human Services Robert F. Kennedy Jr. replaced committee members in June. This change, along with the discontinuation of collaborations with some medical groups, has led to expressions of concern from organizations such as the American Academy of Pediatrics. The committee's September meeting involved procedural difficulties, leading to a tabled vote on the hepatitis B vaccine recommendation and a change in chairmanship. The current chair, Dr. Kirk Milhoan, is a pediatric cardiologist and a fellow with the Independent Medical Alliance, a group that has recommended treating COVID-19 with ivermectin, despite studies indicating its ineffectiveness.
Separately, the CDC recently updated its position on the potential link between vaccines and autism, a theory that has been widely refuted by scientific research. In response, several independent medical organizations, including the American Academy of Pediatrics, the American Academy of Family Physicians, and the Vaccine Integrity Project at the University of Minnesota, have begun issuing their own independent vaccination recommendations.
Review of the Childhood Vaccine Schedule
ACIP will receive the initial report from a new working group tasked with scrutinizing the childhood vaccine schedule. This schedule outlines over 30 doses protecting against more than a dozen diseases. This review occurs amidst an increase in outbreaks of vaccine-preventable diseases, attributed to declining immunization rates. Dr. Raynard Washington, director of the Mecklenburg County Public Health Department, noted an increase in measles and pertussis cases in his area and expressed concern about any potential barriers to vaccination.
Proponents of the existing schedule emphasize that each vaccine is rigorously evaluated for safety and effectiveness before inclusion and is continuously monitored post-implementation. They state that the timing of vaccine administration considers a child's immune system optimal response and periods of highest disease risk. Dr. Sean O'Leary, chair of the American Academy of Pediatrics's committee on infectious diseases, stated that delaying or spacing out vaccines introduces unnecessary risk. While some express concern about the number of antigens in vaccines, supporters note that children are exposed to a greater number of immune stimuli from naturally occurring microbes than from vaccines. Vaccines have also undergone refinement to reduce ingredient counts over decades.
Proposed Changes to Hepatitis B Vaccine
The committee is expected to vote on a potential change to the recommendation for universal hepatitis B vaccination for all newborns within 24 hours of birth. The exact nature of the change is unclear, but possibilities include delaying the shot or requiring a detailed parental discussion.
Arguments supporting a change include that hepatitis B is often transmitted through sexual contact and drug use, suggesting that increased screening of pregnant women and vaccinating only infants of positive mothers could be sufficient. Some other countries also do not administer the dose universally at birth. Conversely, arguments against changing the recommendation highlight that the virus can spread through other means, such as contact with infected bodily fluids or contaminated household objects. Over 90% of infants infected with the virus develop chronic infections, increasing risks for liver disease, failure, and cancer. An analysis presented at past ACIP meetings indicated that delaying hepatitis B vaccination by even a few months could result in over $222 million in additional healthcare costs and hundreds of preventable deaths annually. Eric Hall, assistant professor of epidemiology at Oregon Health and Science University, underscored the role of universal vaccination in hepatitis B elimination efforts. Universal vaccination has significantly decreased hepatitis B infections. Dr. O'Leary affirmed the hepatitis B vaccine's safety record and its role in protecting infants from chronic illness and liver cancer.
Discussions on MMR Vaccine and Aluminum Adjuvants
ACIP is also reportedly investigating the option of separating the Measles, Mumps, and Rubella (MMR) vaccine into three individual shots. Concerns have been raised that this change could lead to increased doctor visits, more injections, and potentially lower overall vaccination rates.
The committee is also examining the safety of aluminum-containing adjuvants, which are used in several important vaccines, including those for diphtheria, tetanus, hepatitis, and influenza. These aluminum salts enhance the immune system's response to the vaccine. A working group's mandate includes evaluating whether specific aluminum adjuvants increase the risk of asthma. Most public health experts indicate a lack of evidence supporting safety concerns regarding aluminum adjuvants, and a recent large Danish study found no associated danger. Daily exposure to aluminum from food, consumer products, and the environment is generally higher than from vaccines. Critics of aluminum adjuvants assert potential links to health issues such as autism and attention deficit hyperactivity disorder. However, Dr. Frank Virant, president of the American Academy of Allergy, Asthma & Immunology, stated there is no evidence that vaccines cause allergies or autoimmune disorders. Removing aluminum from vaccines would compromise their effectiveness, and no immediate substitute vaccines are currently available.