, 2025-04-17 17:24:00
At its first meeting under the new administration, the US Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted on recommendations for several vaccines but did not vote on the influenza vaccine, as had previously been scheduled.
ACIP was due to meet in February, as it does annually, but the meeting was postponed for unexplained reasons. Some advocates, professional societies, and public health experts expressed concern that the delay might have been due to statements reportedly made by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. that ACIP’s members were corrupt and would be replaced. HHS then unveiled a page on its website that lists panelists’ disclosures, but no panelists have been removed.
At the rescheduled 2-day meeting, April 15 and 16, ACIP members — as required by HHS — stated conflicts at the outset and before every vote.
The delayed influenza vote was not unusual. The panel typically does not vote on its influenza or COVID-19 vaccine recommendations until its June meeting and said it will do the same this year.
The panel’s recommendations help guide clinician decisions and are also used by payers when deciding whether to cover a vaccination.
The ACIP voted 15-0 to recommend that Penmenvy (MenABCWY), GSK’s newly-approved pentavalent meningococcal vaccine, can be used when vaccines for the A, C, W, and Y strains and B strains are indicated at the same visit for healthy persons aged 16-23 years, when shared clinical decision-making favors administration of the B vaccine, and for individuals aged 10 or older who are at increased risk for meningococcal disease.
The recommendation is the same as for Pfizer’s Penbraya pentavalent vaccine.
Marianna Rodriguez, communications director of the American Society for Meningitis Prevention, said during the public comment portion of the meeting that the recommendations were not clear enough. Almost half of clinicians “report the meningitis vaccination guidance is too complex compared to other childhood vaccines, leaving providers confused and kids unprotected,” said Rodriguez.
Some of the panelists agreed that the decision-making seemed a bit confusing and that it could be a burden for physicians to determine which vaccine to stock. “I am very concerned about having three meningitis vaccines in a fridge,” said chair Helen Keip Talbot, MD, professor of medicine and health policy, at Vanderbilt University, Nashville.
She and others suggested that the recommended schedule should be monitored and perhaps revisited.
The panel also voted 14-0, with one abstention, to recommend one dose of the respiratory syncytial virus (RSV) vaccine to individuals aged 50-59 at increased risk due to underlying conditions such as cardiovascular disease, diabetes, asthma, and chronic obstructive pulmonary disease, or who are immunocompromised.
Some 15,000-20,000 Americans in that age group are hospitalized each year due to RSV, said Michael Melgar, MD, of the CDC’s Adult RSV Vaccine Work Group. Underlying health conditions increase the risk of more severe disease, he said.
The US Food and Drug Administration (FDA) has approved the monovalent Arexvy (GSK), Pfizer’s bivalent Abrysvo, and Moderna’s monovalent mRNA vaccine, mResvia, for adults over age 60. The FDA also approved Arexvy and Abrysvo for adults aged 50-59 at increased risk for severe disease. Moderna is currently seeking FDA approval for a wider group — adults aged 18-to-59 at increased risk — and expects a decision by June 12.
The National Alliance for Aging Research applauded the recommendation to extend RSV eligibility. That will “offer earlier, broader protection for reducing disease burden and healthcare costs,” said Katron Werner-Perez, of the Alliance, during public comments.
The panel also voted 14-0, with one abstention, to recommend Vimkunya (Bavarian Nordic), a newly-approved virus-like particle chikungunya vaccine for persons aged 12 or over who are traveling to an area where there is an outbreak. The vaccine can also be considered for anyone over 12 who is traveling or taking up residence in an area that is at elevated risk for an outbreak or if someone will be staying for more than 6 months.
Chikungunya is a mosquito-borne viral illness that generally occurs in the tropics and infects some 600,000 or more individuals each year.
The panel also voted 14-0, with one abstention, to recommend Vimkunya for lab workers at risk of exposure.
June Votes on Hot-Button Topics
At its next meeting, the ACIP will vote on whether to recommend use of Jynneos (Bavarian Nordic), the mPox vaccine in 12-17-year-olds at risk for the virus, and on recommendations for the influenza vaccine, including a new version of FluMist (AstraZeneca). That live attenuated nasal vaccine will be available for the first time for self-administration or administration by a caregiver.
The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) cancelled its initial meeting to discuss recommendations for the 2025-26 influenza vaccine make-up and then made the selection of strains behind closed doors in March.
The VRBPAC is holding a public meeting on June 5 to discuss the strains to include in updated COVID-19 boosters, which the ACIP panel will discuss at its June gathering.
The ACIP will also vote in June on whether to modify the language for HPV vaccination to allow for the shot to be given to children as young as 9 and whether one dose — instead of the current two — might offer sufficient protection.
Survey data indicates that only about 61% of adolescents had received two doses of the HPV vaccine in 2023, Cassandra Pingali, MPH, MS, an epidemiologist with the CDC told the ACIP members. The CDC reported in February that HPV vaccination decreased cervical precancer incidence by 79% and cut higher-grade precancer incidence 80% among 20-24-year-old women.
Kennedy had been involved in litigation against HPV vaccine maker Merck. During his confirmation hearings, he pledged to stop receiving referral fees from plaintiffs if he became HHS Secretary.
Now, as Secretary, he may be ultimately tasked with rejecting or approving the ACIP recommendations, including for the HPV vaccine. Normally, that decision is up to the CDC director. Currently, Susan Monarez, MD, is the acting CDC director, and she has been nominated to be the permanent director.
It is not clear whether she can make decisions about the ACIP recommendations in her capacity as acting director.
Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.