US measles deaths mount while dismantled vaccine panel leaves CDC guidance unchanged
The United States reported three measles-associated deaths last week, among them an unvaccinated seven-month-old baby in New York and a postpartum woman in Pennsylvania. Officials also announced that another infant died in Wisconsin’s outbreak. Both New York and Wisconsin recorded their first measles-linked deaths in three decades. Despite a historic rise in cases and deaths, US vaccine recommendations have not changed.
Four former members of the Advisory Committee on Immunization Practices say the committee’s dismantling has slowed the response. Months after Robert F Kennedy Jr, secretary of the Department of Health and Human Services, replaced vaccine advisers with his own appointees, a federal judge halted the panel’s work, finding that the Trump administration had failed to constitute it properly. The CDC is taking nominations for a new committee, but appointments can take months or years. Former member Noel Brewer of the UNC Gillings School of Global Public Health said it typically took 12 to 18 months from considering new recommendations to adopting them. Yvonne “Bonnie” Maldonado of Stanford Medicine, another former member, said a functioning ACIP would “definitely” discuss updating advice as measles spreads, and that the absence of the committee will affect disease and deaths.
In ordinary times, US infants receive the first measles, mumps and rubella shot at age one; during outbreaks, babies at risk can be vaccinated from six months. The second dose is usually given between ages four and six, but in an outbreak it can follow the first by as little as four weeks. Former member Edwin Asturias of the University of Colorado said that delay helps create a pool of unprotected children, fewer of whom still see a doctor after age two. A working ACIP would likely weigh earlier MMR timing in stricken areas, campaigns aimed at unvaccinated adults, and geographically targeted vaccination, while existing CDC outbreak advice receives less attention than it would in normal times. Childhood vaccine mandates remain a state and local matter, tied to daycare and school.
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