Tag: CDC ACIP

Public Comments on Upcoming CDC ACIP Meeting Posted

I have just noticed that there are over 5,000 comments posted on the comments section of regulations.gov in the section entitled Meeting of the Advisory Committee on Immunization Practices-September 2025.

The link to the comment section is on the CDC ACIP meeting announcement web page, “Written Public Comments.”

This is the first time I’ve seen a written comment section like this for the meetings. I think it gives people a sense of what health care professionals and others think about how things are going with the current approach to preventive medicine at the CDC.

CDC ACIP Meeting Agenda Posted

I just noticed that the CDC ACIP draft agenda for upcoming meeting on September 18th and 19th has been posted. There will be votes on the MMRV, Hepatitis B, and Covid-19 vaccines.

Upcoming CDC Advisory Committee Meeting in September 2025-Or Not?

I’ve been checking the Centers for Advisory Committee schedule on their website for weeks and the only way I found out there is an upcoming meeting is on the Federal Register schedule. Sena found it in a news outlet story. As of this morning around 9 a.m., there was no announcement on the CDC website yet. That may change later today.

According to the Federal Register, the CDC ACIP will hold a meeting on September 18, 2025, from 10 a.m. to 5 p.m., EDT, and September 19, 2025, from 8 a.m. to 4 p.m., EDT.

Under Supplementary Information:

“The agenda will include discussions on COVID-19 vaccines; Hepatitis B vaccine; measles, mumps, rubella, varicella (MMRV) vaccine; and Respiratory Syncytial Virus (RSV). The agenda will include updates on ACIP Workgroups. Recommendation votes may be scheduled for COVID-19 vaccines, Hepatitis B vaccine, MMRV vaccine, and RSV. Vaccines for Children (VFC) may be scheduled for COVID-19 vaccines, Hepatitis B vaccine, MMRV vaccine, and RSV. Agenda items are subject to change as priorities dictate. For more information on the meeting agenda, visit https://www.cdc.gov/​acip/​meetings/​index.html.”

However, I also noticed a news article posted by the Center for Infectious Disease Research and Policy (CIDRAP) indicating that the meeting might be postponed because of the recent upheaval around vaccine policy and personnel.

This meeting’s actual timing and schedule items could be moving targets.

University of Minnesota CIDRAP Story on CDC ACIP Meeting Next Week

The University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) posted a news report about the upcoming CDC ACIP meeting next Wednesday. Apparently, so far the new advisory committee draft agenda does not include a vote on the Covid-19 vaccine.

Center for Infectious Disease Research and Policy Outlook on Covid Data and New CDC ACIP Committee

I have a lot more faith in the infectious disease news from the University of Minnesota Center for Infectious Disease Research and Policy Outlook (CIDRAP) than most other news outlets. Their review of the so far 8 newly appointed CDC ACIP committee members is interesting. I plan to watch the upcoming June 25-27 CDC ACIP meeting.

They also provide updates on the CDC Covid-19 variant tracking data. While the LP.8.1 has been in the spotlight lately as the upcoming variant of note, the Nowcast estimates of the proportion of NB.1.8.1 are currently almost equal to LP.8.1. They report the NB.1.8.1 is minimally more immune evasive than LP.8.1. They are both descended from the JN.1 lineage. Overall, Covid-19 activity is low.

Dept of Health & Human Services to Reconstitute CDC Advisory Committee on Immunization Practices

HHS announced the removal and replacement of the current members of the CDC Advisory Committee on Immunization Practices in a press release today. The CDC ACIP meeting for vaccine recommendations is still scheduled for June 25-27. According to the Federal Register announcement under Supplementary Information:

“SUPPLEMENTARY INFORMATION:

Purpose: The Advisory Committee on Immunization Practices is charged with advising the Director, Centers for Disease Control and Prevention (CDC), on the use of immunizing agents. In addition, under 42 U.S.C. 1396s, the Committee is mandated to establish and periodically review and, as appropriate, revise the list of vaccines for administration to vaccine-eligible children through the Vaccines for Children program, along with schedules regarding dosing interval, dosage, and contraindications to administration of vaccines. Further, under applicable provisions of the Affordable Care Act and section 2713 of the Public Health Service Act, immunization recommendations of ACIP that have been adopted by the Director, CDC, and appear on CDC immunization schedules generally must be covered by applicable health plans.

Matters To Be Considered: The agenda will include discussions on anthrax vaccines, chikungunya vaccines, COVID-19 vaccines, cytomegalovirus (CMV) vaccine, Human papillomavirus (HPV) vaccine, influenza vaccines, Lyme disease vaccine, meningococcal vaccines, pneumococcal vaccines, Respiratory Syncytial Virus (RSV) vaccines for adults, and RSV vaccines for maternal and pediatric populations. Recommendation votes are scheduled for COVID-19 vaccines, HPV vaccine, influenza vaccines, meningococcal vaccine, RSV vaccines for adults, and RSV vaccine for maternal and pediatric populations. Vaccines for Children (VFC) votes are scheduled for COVID-19 vaccines, HPV vaccine, influenza vaccines, and RSV vaccines. Agenda items are subject to change as priorities dictate. For more information on the meeting agenda, visit https://www.cdc.gov/​acip/​meetings/​index.html.

Meeting Information: The meeting will be webcast live via the World Wide Web. For more information on ACIP, please visit the ACIP website: https://www.cdc.gov/​acip.“

CDC ACIP Meeting on the RSV Vaccine and Some Dad Jokes

We watched the section of the CDC ACIP meeting about RSV vaccines on February 29, 2024. There was a lot of discussion on the safety of the vaccine. It looks like it will still have a requirement that you have a shared clinical decision-making meeting with your physician. I think that still implies you’d need a prescription. However, there are only a handful of states which would require a prescription from your doctor. Iowa is one of them.

That made the comment by one of the committee participants thought provoking. I believe she got the RSV vaccine from a pharmacist, who asked no questions. There was no shared clinical decision-making discussion with that pharmacist.

But there was a discussion during the meeting with a pharmacist who was in the room. She made it clear that pharmacists had plenty of training (“20 hours” along with additional learning) and could handle the shared clinical decision-making piece with patients.

Sena and I have had all of our vaccines including the Covid-19 shots administered by pharmacy techs. I hardly know what the pharmacists look like because they are a blur, managing the drive-up window and all other customers. It’s clear that a large proportion of vaccines are available at most pharmacies and the techs give the shots. They are pleasant and happy to apply the Band-Aid.

You can’t even telephone the pharmacy and talk to a live person. Sometimes you’ll get a recording which replies to most of your questions with “Sorry, I didn’t get that. Did you say you want a vaccine or a cheeseburger with fries?” Scheduling vaccine appointments are generally done on line. Scheduling a visit with the pharmacist is probably not easier than scheduling one with your doctor, who might confuse you with “the colonoscopy” in room 5.

I’ve looked at the health care professional section on the CDC website pertaining to the age and medical conditions necessary to qualify for getting the RSV vaccine. I’m pretty sure I’m in the right age category, although I stopped keeping track after the evolution of asparagus. I don’t have any chronic medical conditions, unless you count dad jokes. I exercise, juggle, take only a multivitamin a day, meditate, and regularly leap tall buildings in a single bound. I’m pretty sure I don’t need the RSV vaccine, but what do I know? I’m a retired psychiatrist.

It looks like the risk of getting Guillain-Barre Syndrome (pronounced “GBS”) is not zero and may or may not be associated with the RSV vaccine. It’s pretty clear that 2 of the 3 major manufacturers of the vaccine who attended the meeting were pretty sensitive to any hints their product might have anything to do with GBS and might challenge you to a no holds barred thumb wrestling match if you say otherwise.

We think there’s a long way to go before everybody’s clear on who gets the RSV vaccine and when, and also where. But you can’t get it at the pharmacy drive up window.

CDC ACIP Meeting on Covid 19 Vaccine Additional Dose

The CDC ACIP meeting on February 28, 2024 on the proposal of a Spring booster of the Covid 19 vaccine was interesting and confusing. Initially right after the morning presentations, we were a little confused about whether the committee was targeting only those who got the vaccine booster last fall or everybody. That didn’t make much sense given the concern about low overall uptake of the vaccine.

The presenters also mentioned that getting the Spring Covid booster would be part of a shared clinical decision-making discussion with your doctor, similar to that recommended for the RSV vaccine. That was bewildering because we think that’s part of the reason some people might skip the RSV vaccine, given the news reports last year pointing out you had to have a prescription from a medical provider in some states to get it.

I was pretty interested in learning more about T-cell immunity given the concern about waning which of immunity from vaccines over a few months, which I think was based on neutralizing antibodies from B cells. I thought the CDC web site link to an article about the T-cell immune response suggested that cell mediated immune responses might mean that our immunity might not be waning that quickly. However, one of the presentations, “Evidence to Recommendation” showed a slide indicating that your T-cell immunity gets weaker with age (ref. de Candia P, Prattichizzo F, Garavelli S, Matarese G. T Cells: Warriors of SARS-CoV-2 Infection. Trends Immunol. 2021 Jan;42(1):18-30. doi: 10.1016/j.it.2020.11.002. Epub 2020 Nov 13. PMID: 33277181; PMCID: PMC7664351.)

I’ve read other articles, one of them on the CDC website, which says you may have more durable immunity provided by T-cells, but if I read it carefully, the authors hedge and say that T-cell adaptive immunity may not be as strong when you’re older. (Moss, P. The T cell immune response against SARS-CoV-2. Nat Immunol 23, 186–193 (2022). https://doi.org/10.1038/s41590-021-01122-w).

Later in the afternoon, the committee voted that those who are 65 years old and older should get the spring dose. There was no further discussion of limiting it to only those who got the Covid vaccine in the fall of 2023. There was also no discussion of the shared clinical decision-making detail. The committee upvoted the resolution with a majority.

And yet, the voting question did say: ACIP recommends that persons greater than or equal to 65 years of age “should” (which was changed from “may”) receive an additional dose of 2023-2024 Formula COVID-19 vaccine. The “additional dose” means in addition to the vaccine (monovalent XBB.1.5) given last fall. That’s a relatively select group, when you take the subset of those who are 65 and older.

However, the slides in the “Evidence to Recommendation” had recommended there should be shared clinical decision-making, meaning that you should discuss getting the vaccine with your doctor. However, according to the STAT NEWS article summary of this meeting, substituting the word “should” for “may” would make the conversation with a doctor unnecessary.

Finally, there was no discussion at all of changing the 5-day isolation precaution for those testing positive for Covid-19. If the committee were planning to drop that, as many news agencies recently reported, I would think they’d have discussed it at length at the meeting.

The CDC Director will have to sign off on the additional Covid-19 shot before it’s official.

2/29/2024 Update: CDC Director endorsed the additional dose yesterday.