In Brief

A U.S. vaccine advisory panel has voted to advise against giving the combined MMRV vaccine to children under age 4, recommending instead separate MMR and varicella shots. The change reflects concerns over a slightly higher risk of fever-related seizures in the youngest age group.

Key Points

  • ACIP voted 8-3 to recommend that children under 4 years old receive separate MMR and varicella vaccines instead of the combined MMRV vaccine.
  • The recommendation aims to reduce risk of febrile seizures in younger children associated with the combined vaccine.
  • The Vaccines for Children program will continue to cover the combined MMRV vaccine if parents choose it.
  • Pending votes include changes to the hepatitis B vaccine schedule at birth and updated recommendations for COVID-19 vaccines.
  • Formal adoption by the CDC Director is required before changes become policy, and effects on vaccine uptake and coverage remain to be seen.

Atlanta, September 19, 2025— In a significant shift for childhood immunization policy, the Centers for Disease Control and Prevention’s (CDC) vaccine advisory committee voted Thursday to change its guidance on the combined MMRV vaccine (measles, mumps, rubella, and varicella) for children under the age of 4. Reuters+2AP News+2

Background & Context

The Advisory Committee on Immunization Practices (ACIP), which advises the CDC on vaccination schedules, held an 8–3 vote (with one abstention) recommending that children younger than 4 years should not receive a combined MMRV shot for their first dose. Instead, children in that age group should get separate injections: one vaccine for measles-mumps-rubella (MMR) and another for varicella (chickenpox). boisestatepublicradio.org+4AP News+4Reuters+4

The rationale for the change centers on concerns about a modestly increased risk of febrile seizures (seizures triggered by fever) in younger children who receive the combined vaccine. While such seizures are generally not harmful in the long term, they are distressing and can lead to additional medical visits. boisestatepublicradio.org+3CDC+3WIRED+3

Under the current guidance prior to this vote, parents/caregivers could choose between the combined MMRV vaccine or the separate MMR + varicella shots when children are between 12 and 47 months. boisestatepublicradio.org+3CDC+3CDC+3

What Was Decided & What’s Still Pending

  • Decision made: Children under 4 should receive separate vaccines (MMR + varicella) rather than the combined MMRV vaccine as the first dose. Reuters+2The Guardian+2

  • What remains unchanged: The Vaccines for Children (VFC) program will still cover the MMRV vaccine if parents/caregivers choose it. AP News+1

  • Pending votes/changes: The panel also considered recommendations around the hepatitis B vaccine given at birth and new COVID-19 vaccine eligibility guidelines, with those votes to follow. Reuters+1

    • Voices from the Debate

    During the meeting, experts raised both support and concerns. One pediatric infectious disease specialist, Dr. Flor Muñoz, questioned:

    “A question I’ve had all along through these discussions is why? Why are we addressing this hepatitis B vaccine recommendation? Is there really a reason?” boisestatepublicradio.org

    Other medical professionals expressed worry that the change may lead to mixed messaging or reduced uptake of vaccines, especially since vaccine hesitancy is a growing concern. The Guardian+1

    On the other side, committee members argued that even a small elevated risk of febrile seizures in young children justifies adjusting recommendations to reduce that risk. WIRED+1

    What’s Confirmed vs. Unconfirmed

    Confirmed:

  • The vote has passed at the advisory panel level (ACIP) to recommend separate MMR and varicella vaccinations for children under 4 instead of the MMRV combined shot. Reuters+1

  • The CDC’s Vaccines for Children program will still provide coverage for MMRV under current policies. AP News+1

    • Alleged / Under Discussion:

  • Whether insurers, Medicaid, or state programs beyond VFC will alter their coverage policies in response to the change. boisestatepublicradio.org+1

  • The broader impact on vaccine compliance: if separating shots might discourage parents from completing schedules. The Guardian+1

  • Whether the recommendation will be formally adopted by the CDC Director and how quickly the shift in published policy and practice will occur. boisestatepublicradio.org+1

    • What’s Next & Implications

    The recommendations still need to be formally approved by the acting CDC Director before they become official policy. Once adopted, healthcare providers will need to adjust their vaccine-scheduling practices and inform parents accordingly. State health departments, insurers, and public health programs may also need to revise their policies and coverage rules. boisestatepublicradio.org+1

    There is likely to be public discussion and possibly concern from parents, pediatricians, and medical organizations about the changes — especially around balancing risk-benefit trade-offs and maintaining trust in vaccination programs. Experts may issue guidance to help healthcare providers explain the change. Monitoring will be important to see whether vaccine rates are affected.

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