ACIP voted to change its recommendations for the first dose of measles, mumps, rubella, and varicella vaccine for children. (Photo: Joe Radle via Getty Images)
A leading committee at the Centers for Disease Control and Prevention (CDC) has announced new recommendations for the combined measles, mumps, rubella, and varicella (MMRV) vaccine.
The composition of the committee, called the Advisory Committee on Immunization Practices (ACIP), recently changed under the leadership of Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. All 17 previous members were dismissed and then replaced by a new group, which included several prominent anti-vaccine advocates.
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As of 5:30 PM ET Thursday, CBS reports, the committee voted only on the MMRV vaccine. By a vote of 8 to 3, with one abstention, the committee decided that the combination MMRV vaccine is not recommended for children under four years of age. Instead, they recommend that children in this age group receive the MMR vaccine, which protects against measles, mumps, and rubella, and the varicella vaccine, which protects against chickenpox, in two separate injections.
The latter option, sometimes abbreviated as MMR+V, was already recommended for children under 4 years of age. ACIP is simply considering removing the MMRV option from its recommendations for many children.
Previously, the Centers for Disease Control and Prevention (CDC) recommended that children aged 12 to 15 months receive either a single dose of the measles-resistant vaccine (MMRV) or a single dose of the measles-resistant vaccine (MMR) along with the varicella vaccine. MMRV vaccination is associated with a slightly higher risk of febrile seizures in children aged 12 to 15 months compared to separate doses of the measles-resistant vaccine (MMR) and varicella vaccines, so the latter option is preferred and recommended for this age group.
However, previous recommendations allowed caregivers to vaccinate their children with the measles-modifying vaccine (MMRV). They could do this, for example, if they wanted to reduce the overall number of vaccinations a child received in a single visit. Doctors helped caregivers weigh the risks and benefits of both options. Although febrile seizures are frightening for children and their caregivers, they are relatively rare, usually harmless, and resolve quickly, while the measles-modifying vaccine (MMRV) slightly increases the risk of these events.
After the first dose of MMRV or MMR+V vaccine, children receive the second dose between the ages of 4 and 6. At this age, both options are equally recommended, so the choice depends on preference and availability.
At the ACIP meeting on Thursday, some experts argued that recommending only the MMR+V vaccine option for children aged 12 to 15 months deprives caregivers of choice and could impact coverage by public insurers, CBS reports. Others noted that the increased risk of seizures is small, has been known for nearly 20 years, and is discussed with caregivers as a standard of care. Speakers at the meeting also noted that currently, 85% of caregivers choose individual vaccines for their children, while 15% choose the combination MMRV vaccine, according to independent medical journalist Liz Sabo.
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The ACIP recommendations are important in part because they determine which vaccinations are included in the Vaccines for Children (VFC) program, for which approximately half of children in the United States are eligible. The program covers children who are uninsured or underinsured, children receiving or eligible for Medicaid, and children who are American Indian or Alaska Native.
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According to Medscape, there is apparent confusion among ACIP members regarding the VFC program.
On Thursday, the ACIP committee voted to remove children under 4 from the MMRV program to bring it in line with the new recommendation. Committee members rejected any changes, and some abstained, stating they were unsure what they were voting for. However, on Friday, the vote resumed, and committee members voted to amend the VCP program, removing MMRV from this age group, CNN reports.
For the committee's recommendations to become official guidelines, they must be reviewed and approved by the CDC director, but most often the director approves the recommendations.
Meanwhile, America's Health Insurance Plans (AHIP), an industry group representing private insurers, announced in a statement on September 16 that insurers will continue to cover vaccines recommended as of September 1, 2025, until at least the end of 2026.
On Thursday, ACIP also discussed the hepatitis B vaccine but decided to postpone a vote on it. The committee plans to discuss and vote on its COVID-19 vaccine recommendations on Friday.
Following changes in leadership at HHS and the CDC, the American Academy of Pediatrics published its own recommended immunization schedule for children and adolescents and said it would not endorse the CDC's recommendations.
Editor's note: This story was updated on September 19, 2025, at 10:50 a.m. ET to note that ACIP voted twice on its recommendations to the VFC, thereby reversing its decision.
Disclaimer
This article is for informational purposes only and does not contain medical advice.
Nicoletta Lanese. Social media navigation. Editor of the “Health” channel.
Nicoletta Lanez is the health editor for Live Science and previously served as a news editor and staff writer for this website. She holds a certificate in science communication from the University of California, Santa Cruz, and degrees in neuroscience and dance from the University of Florida. Her work has appeared in The Scientist, Science News, Mercury News, Mongabay, and Stanford Medicine Magazine, among other publications. Based in New York City, she is also an avid dancer and performs in productions by local choreographers.
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