COVID-19 vaccine support reined back by ACIP

On the second day of its latest meeting, the CDC's vaccine committee reduced some support for COVID-19 vaccines, but did not go as far as some might have feared in limiting access.

The Advisory Committee on Immunization Practices (ACIP) voted unanimously against recommending the vaccines for all adults, instead leaving it up to individuals in consultation with their healthcare provider, but also came down 11 to one in favour of recommending that the discussion must have a greater emphasis on potential risks.

Crucially, the rider on shared clinical decision-making should mean that insurance coverage for the vaccines is maintained.

Meanwhile, in another vote, the panel stopped short of requiring a prescription for the shots, with a six-all vote that failed as chair Martin Kulldorf voted against the motion and followed an impassioned discussion on whether it would restrict access between panellists and strong criticism from liaison organisations, including the American Medical Association (AMA).

The ACIP also deferred a vote on the use of the vaccines during pregnancy in order to look further at the data.

Currently, the CDC recommends a COVID-19 vaccine for most adults ages 18 and older, with use in children aged six months to 17 years at the discretion of patients and their healthcare provider.

That said, there was a sense that the panel could have gone a lot further in restricting access, given that many of those appointed to it by Health and Human Services (HHS) Secretary Robert F Kennedy Jr have criticised the federal response to the COVID-19 pandemic.

Kennedy fired all 17 former members of the ACIP in June, replacing them with a new roster of his own choosing. He was also instrumental in getting former CDC director Dr Susan Monarez fired after a month in the job, a move that Monarez has claimed was because she refused to rubber-stamp ACIP recommendations and fire CDC staffers without cause.

The American Academy of Paediatrics (AAP) recommended in August that all infants and toddlers aged six to 23 months receive the COVID-19 vaccine, after HHS rescinded its recommendation in this age group, as well as for pregnant women.

As the meeting came to a close, the AMA issued a statement saying that ACIP's "new process and recommendations leave parents confused about how best to protect their kids, and unable to choose the combined MMRV vaccine for children under 4 years old. The AMA is concerned that this change not only reduces parental choice, but also reflects ACIP's reliance on selective data in forming its guidance."