The CDC’s Advisory Committee on Immunization Practices is meeting to review childhood vaccine recommendations in the US.
The committee has already voted to change current guidance on combined measles, mumps, rubella and varicella (MMRV) vaccines for children under 4.
Votes on Hepatitis B immunisation and COVID-19 vaccinations for children are expected overnight.
The advisory committee members were all recently appointed by US Secretary of Health, Robert F Kennedy Jr., after he fired the previous committee.
The SMC asked local experts to comment on the recommendations and what this means for NZ.
Dr Helen Petousis-Harris, Associate Professor, University of Auckland, comments:
Note: Dr Petousis-Harris has written a blog post on this topic, available here.
“What we have just seen at ACIP is frankly extraordinary — and not in a good way. As of this writing, after protracted confusion, the committee has voted in a contradictory way on the combined measles-mumps-rubella-
“For context: MMRV is not used here in Aotearoa New Zealand, but internationally it is considered a very safe and effective vaccine, with the advantage of fewer injections improving uptake. The only additional risk identified has been a slightly higher rate of febrile seizures in the youngest age group — a risk outweighed in many settings by the benefits of higher coverage. In New Zealand, we use separate MMR and varicella vaccines, but both approaches are supported by robust science.
“COVID-19 vaccines are among the most closely studied medical products in history, with billions of doses administered worldwide and an unparalleled level of safety monitoring. We now have a clear picture of the risks: rare side effects such as myocarditis can occur, but they are generally mild and far less common than heart inflammation or other complications following COVID-19 infection itself. The weight of evidence from international studies, including work in New Zealand, consistently shows that the benefits of vaccination in preventing severe illness, hospitalisation, and death vastly outweigh these uncommon risks.
“The bigger issue is what this means for global vaccine confidence. ACIP has historically been a gold-standard advisory body that other countries, including ours, look to when weighing evidence. Under RFK Jr., the committee has been repopulated with individuals critical of vaccination, and the result is what we are seeing now – a Keystone Cops routine, where confusion, ideology, and procedural chaos replace clarity, evidence, and consistency.
“This matters because diseases like measles, mumps, rubella, varicella, and hepatitis B are not trivial. They can cause serious illness, lifelong complications, and death when vaccination falters. And while the U.S. may be able to tolerate some policy confusion, the ripple effects will be felt globally. Misinformation spreads fast, and mixed messages from ACIP give it oxygen.
“For New Zealand, the practical impact on our vaccine schedule is limited — but the reputational damage to one of the world’s most trusted advisory bodies is not. The science hasn’t changed: vaccines remain very safe, effective, and lifesaving. What has changed is ACIP’s ability to communicate that science with authority. Policy-making by pantomime should concern all of us.”
Conflict of interest statement: “HPH has received research funding from industry for investigator led projects, served on expert advisory boards for industry, WHO, NZ government, and on clinical trial DSMBs. She is co-director of the Global Vaccine Data network who are conducting safety studies on COVID-19 vaccines across over 30 countries.”
Professor Tony Walls, Head of Department Paediatrics and Child Health University of Otago, Christchurch, comments:
On the differences between childhood immunisations in NZ and the US:
“We do not give a Hepatitis B vaccine at birth in NZ unless it is known that mum has Hepatitis B. It is used to prevent transmission of Hepatitis B from mum to infant. If infants get Hepatitis B in this way there is a high chance they will have Hepatitis B for life.
“MMRV is not available in New Zealand – it is very expensive and so we give the MMR and the V vaccines separately. There are also fewer adverse events if we do it this way.
“The COVID vaccine is not recommended or funded for children in NZ unless they have an underlying condition that might put them at risk of severe COVID.”
Conflict of interest statement: No conflicts of interest. Prof. Walls is on the PHARMAC immunisation subcommittee of PTAC.
Our colleagues at the Aus SMC and the UK SMC have also gathered comments. A small selection follows – see the full AusSMC expert reaction on Scimex and the UK SMC roundup on their website.
Professor Paul Griffin, Director of Infectious Diseases and Professor of Medicine, Mater and the University of Queensland, comments:
Note: This comment has been abridged. See the full comment here.
What do we know about vaccine safety?
“COVID-19 has been a global health event of unprecedented impact with recorded cases now estimated to exceed 700 million and deaths exceeding 7 million. While the public health emergency of international concern was declared over on the 5th of May 2023, the impact of COVID-19 continues. The ability to rapidly develop a number of vaccines that were approved by regulatory bodies and deployed around the world has undoubtedly had a tremendous impact, with estimates suggesting cases averted as a result of vaccination likely to be at least in the 10s of millions and deaths in the 100s of thousands, if not millions.
“Vaccines for COVID-19 were able to be developed rapidly due to many important innovations and based on many years of research, preparing to be able to more rapidly respond to a novel emerging pathogen such as that responsible for COVID-19.
“All the usual phases of clinical trials (including with placebo controls) were completed with numbers of participants exceeding that usually seen in other similar clinical trials. To achieve regulatory approval, these vaccines (as with all vaccines that are approved by our and other similarly rigorous regulators) demonstrated both high levels of efficacy as well as safety. Once approved, safety as well as effectiveness was continued to be carefully observed, and while it is clear that vaccines for COVID-19 are associated with adverse events (as with essentially any intervention), for the majority of vaccines approved, the rate of related adverse events was such that the benefits outweighed these risks hence these regulatory approvals and associated recommendations have remained in place. The raw number of adverse events may seem high, especially if compared to other vaccines, however, the denominator, or number of doses given in such a short space of time, which is now over 13.5 billion doses of COVID-19 vaccines, does need to be taken into account.
“The distinction between correlation and causation also needs to be considered given the majority of the world’s population has now been vaccinated. This does not mean that anything bad that happens to anyone is a direct result of having received a COVID-19 vaccine.”
Conflicts of interest: Paul is director and scientific advisory board member of the Immunisation Coalition and Director of the AMA Queensland. Paul has received speaker honoraria from companies including Seqirus, Novartis, Gilead, Sanofi and Janssen. His Medical Advisory Board Memberships have included Sanofi, AstraZeneca, GSK, MSD, Seqirus, Moderna, Ferring and Pfizer. He is a Clinical Trial Principal Investigator, including on trials of 8 COVID-19 vaccines.
Prof Adam Finn, Professor of Paediatrics, University of Bristol, said:
Note: This comment has been abridged. See the full comment here.
“It is important, in science, to draw a clear distinction between association and causality. In other words, if 2 things seem to happen together, it might mean that one caused the other, but it isn’t necessarily so. It’s a good idea to look out for things that happen together, but once you spot them, there’s more work to be done to figure out what, if any, relationship exists between them. Jumping to conclusions, which may be false, is just as bad a failing as not bothering to look out for problems. Above all, it’s critical to approach evidence with an open mind. If you already have decided the answer to your question, you won’t be able to assess the evidence objectively. If you want to identify whether someone is a scientist, ask them for an example of a time they changed their mind about something when they saw the evidence. As regards vaccine safety, we collect information about anything that happens and then, very carefully, assess whether there is a causal link of not. When there is, we generally find out pretty quickly and take action without delay.”
Conflicts of interest: AF advises the U.K. government and the WHO on vaccination policy and undertakes paid consultancy for many vaccine developers and manufacturers including GSK and Merck who make MMR vaccines.