Kennedy's vaccine advisers change COVID shot guidance, calling them an individual choice

A federal panel tasked with helping craft vaccine policy decided Friday against providing specific recommendations for the updated COVID-19 shot, instead leaving it to "individual-based decision making" for those 6 months and older, which could require discussions with a health care provider in some states.

The board also narrowly defeated a proposal that would have recommended states require anyone who wants the vaccine to get a prescription.

New Yorkers aren’t expected to be directly impacted by the decisions from the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices — appointed by U.S. Health and Human Services Secretary Robert F. Kennedy Jr. after he dismissed the previous members — since state health officials released guidelines on Thursday making the vaccine accessible to everyone, as well as other actions by Gov. Kathy Hochul.

But the highly anticipated meeting did little to clarify how people can get the vaccine if they want it and potentially sowed confusion among the public between federal and state health recommendations. The vote specified that a COVID vaccination for people 65 and older, as well as those 6 months to 64 years, should be guided by individual-based decision making, also known as shared clinical decision making. The CDC defines shared clinical decision making as a process between patients and their health care providers.

In previous years, the CDC, acting on the advisory panel's recommendation, recommended the shot for all Americans 6 months and up.

"Since we are not talking about an emergency situation, we think it’s appropriate that this is something to be discussed between patient and provider," advisory board member Retsef Levi, a health care analytics specialist, said during the meeting. 

After the vote, HHS officials said adding shared clinical decision-making "allows for immunization coverage through all payment mechanisms." It's unclear how that will impact a person's ability to access the vaccine in other states.

"The collective effect of the deliberation and the vote today is to scale back routine access that people have had to the COVID-19 vaccine," Jennifer Kates, senior vice president and director of the Global Health & HIV Policy Program at KFF, a nonprofit health policy organization, said in an interview. "It will still be available but in a more restrictive way. Access will likely vary depending on where you live."

The votes came at the end of two lengthy days of hearings that were marked by confusion by board members, several of whom had only been appointed a few days earlier. Kennedy fired all the previous members in June. Some medical association and infectious disease experts have expressed concern that he replaced them with members who share his skeptical views on vaccines.

Members of the panel sparred with each other and outside experts over the quality of the data used to discuss possible adverse effects from the vaccine. Others said previous studies showing the vaccine is safe were being ignored.

On Friday morning, the board had to take another vote to clarify that kids younger than 4 who are part of the federal Vaccines for Children program should not get the combined measles, mumps, rubella and varicella (MMRV) vaccine. Late Thursday, the board voted the opposite way, even after previously agreeing all children  younger than 4 are better off getting inoculated against these diseases in two separate shots. 

The panel also voted to add more discussion of adverse effects to the updated COVID-19 vaccination information sheet and urge clinicians to discuss all the pros and cons with patients.

Levi said the CDC should "find the right language to communicate these risks and uncertainty to patients and medical providers so we can actually have the appropriate informed consent."

The CDC director must adopt any ACIP recommendations before they are officially part of the agency's immunization schedule.

The panel also tabled a vote to change the schedule for the Hepatitis B vaccine so that newborns of mothers who are not positive for the virus will get it at 1 month  old rather than at birth.

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.