The Advisory Committee on Immunization Practices voted last week to restrict access to the combined measles, mumps, rubella, and varicella (MMRV) vaccine for low-income children under the age of four. Vaccines for Children, a program that provides low-cost or free vaccines for children who are uninsured or on Medicaid, will no longer provide the MMRV vaccine.
JAKE SCOTT; [email protected]
Scott is a board-certified infectious disease specialist.
Scott told the Institute for Public Accuracy: “A lot of people assume that this change is not going to make a big difference, but it will. The current recommendation, as it stood before the ACIP vote, allowed families to either receive the combined shot or separate shots over time. This is a solution in search of a problem. Practically, what this means is that kids are going to need an extra injection––an extra needle. Only about 15 percent of parents were opting for the combination shot over the extra needle, but those are families who were choosing to minimize the pain, stress, and complexity of another shot. That combination shot was improving vaccination completion rates for those 15 percent of families. We’re disrupting this successful vaccination program that has protected millions of kids.”
Scott added: “Kids who are covered through the Vaccines for Children program won’t have the option of the combo shot anymore. So [MAHA] is taking away medical freedom that they have been pretending to champion. The whole thing is fraught with irony.”
The rationale for the change is that the MMRV vaccine is associated with a known but small risk of one additional febrile seizure per 2,300 one-year-olds who receive the combined shot. “The overall risk is still quite low: 4.3 per 10,000. This is an uncommon occurrence,” said Scott. “Seizures can be scary; I have young kids and I wouldn’t want them seizing and I’m a doctor. But they’re brief and don’t leave any lasting effects. We have known about this very small and manageable extra risk of the MMRV shot since 2008, and we have successfully managed it with informed consent––which is what [MAHA] is supposedly all about!… The question is not about the small seizure risk. It’s about whether this change improves health outcomes, and I don’t see evidence that it does. It just removes choice for that 15 percent of families that prefer the combo shot.
“Going backward on this, without new safety data, is concerning to me. It sends a message about vaccine safety. When parents see a vaccine is being not recommended, it undermines confidence––and potentially undermines confidence in the entire immunization program. We’re already dealing with so much hesitancy. It has gotten more mainstream to spout fringe theories. At a press conference this week, Trump claimed that kids are getting 80 vaccines, that they’re being treated like ‘horses.’ Trump is complaining that kids get too many shots, but it’s hypocritical because now they are making kids get more shots [by eliminating the availability of this combo shot]. They are actually eliminating medical freedom. Parents won’t have the choice to reduce injections.
“This change, coming from a reconstituted committee that is acting independent of pediatric organizations, will fuel more mistrust. It’s rushed, predetermined, and not evidence-based. And it puts pediatricians and general practitioners in a difficult position.”