COVID, MMRV Vaccine Guidelines Have Changed (Updated)

Editor’s note: This is an updated version of a story originally published on Sept. 18. It was updated again on Sept. 19 at 5:30 p.m.

Federal vaccine recommendations for inoculation against COVID-19, measles, chickenpox, and other viruses have changed.

The new guidelines adjust who is advised to get vaccinated against these diseases—which can have serious health implications for pregnant people, fetuses, and newborns—under what conditions, and at what age.

The U.S. Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), which is responsible for creating national vaccination guidelines for children and adults, convened in a raucous and occasionally chaotic meeting from Sept. 18-19 to review its current guidance.

The panel voted unanimously on Sept. 19 that decisions about whether patients should get a COVID-19 vaccine should be made on an individual basis, moving away from previous guidance that broadly recommended endorsed the vaccine’s use.

The day before, its members voted 8-3 to recommend against children under 4 receiving a combined measles, mumps, rubella, and varicella vaccine. (Varicella is the virus that can cause chickenpox and shingles.) A vote on hepatitis B was put off until a later date, following confusion and heated debate over proposed changes to guidance.

Rewire News Group spoke with two doctors about how changes to vaccine recommendations could affect the health of millions of reproductive-age people in the U.S.

Can pregnant people get the COVID vaccine?

Altering vaccination guidelines that had been in place following the outbreak of the coronavirus pandemic in 2020, the ACIP panel no longer broadly recommends the COVID-19 vaccine to multiple specific groups, including pregnant people and young children. Instead, it voted to leave the decision up to individuals and their health-care providers, in what’s often called “shared clinical decision making.” It also recommended that the CDC emphasize the vaccine’s drawbacks, but stopped short of outlining specific risks.

COVID-19 can have mild symptoms mimicking a cold or the flu—or it can cause pneumonia, organ failure, and even death. Contracting COVID-19 during pregnancy increases the risk of severe illness, and death, according to the American College of Obstetricians and Gynecologists (ACOG), the leading professional organization for U.S. OB-GYNs. COVID-19 during pregnancy is also linked to miscarriage, stillbirth, and other pregnancy complications.

ACOG began recommending the COVID-19 vaccine for most pregnant people in 2021, the same year it became widely available. Vaccination reduces the risk of severe illness and pregnancy complications, and some protection against the virus is passed along to newborns, who are not eligible for a COVID-19 vaccine until they reach 6 months of age.

Dr. Georges Benjamin, executive director of the American Public Health Association said, “Women of reproductive age … certainly are at risk of COVID and, in my view, should be vaccinated.”

When can kids get the MMRV vaccine?

The MMR and varicella vaccines are available in two separate shots or in a single, combined shot. The panel decided the combined vaccine shot should not be given to children under 4, after concerns were raised about an increased risk of febrile seizures associated with combining shots; evidence shows the risk of this complication is minor.

If contracted, these viruses can cause rash, fever, and swelling. Though rare, they can cause severe complications and death—sometimes years after recovering from the virus.

Previously, the CDC recommended children get two doses of MMR and varicella vaccines—one between 12 and 15 months of age, and a second between 4 and 6 years of age. And the recommendation schedule allowed parents and providers to decide whether a combined or a two-shot regimen was most appropriate for the child.

Measles was declared eliminated in the U.S. in 2000. But a recent measles outbreak in Texas that has infected more than 700 people since January 2025 led to about 100 hospitalizations; two children died. Declining vaccination rates are believed to have played a role in the outbreak.

Should newborns get the hepatitis B vaccine?

Current guidelines for the hepatitis B vaccine remain in place. The first dose is currently recommended to be given to infants shortly after birth.

Inoculation right after birth “maximizes the effectiveness of the vaccine in preventing newborn infection,” according to the American Academy of Pediatrics (AAP).

Hepatitis B is transmitted through blood and sexual fluids, and can spread from a pregnant person to their infant both in utero and during childbirth. If untreated, the inflammation caused by chronic hepatitis B infection can lead to scarring of the liver that causes the organ to fail.

People infected at birth with chronic hepatitis B who never received treatment face up to a 25 percent lifetime risk of developing liver cancer, according to the Hepatitis B Foundation. Those infected with hepatitis B face up to a 4 percent annual risk of liver cancer, depending on whether they have cirrhosis.

After the newborn dose of the hepatitis B vaccine, CDC guidelines currently recommend a second dose between one and two months of age, and a final dose between 6-18 months of age.

Before 1991, when the U.S. launched a vaccination program designed to stamp out hepatitis B infections acquired during pregnancy and childbirth, roughly 18,000 to 20,000 babies were diagnosed each year, said Dr. James Campbell, the vice chair of the American Academy of Pediatrics’ committee on infectious diseases. Today, only 20 to 30 are.

Most hepatitis B infections can be linked to a specific risk factor, like intravenous drug use, sex with an infected person, or being born to a hepatitis B-positive individual. But up to one-third can’t be, Campbell said.

“We don’t know where everybody gets it from,” Campbell added. “Giving all babies the vaccine protects them from both known and unknown risks for getting hepatitis B.”

Changes will have consequences, advocates warn

The ACIP meeting came amid a deliberate dismantling of the nation’s public health infrastructure under the Trump administration. Health and Human Services Secretary Robert F. Kennedy Jr. has long espoused anti-vaccine views that don’t comport with available scientific evidence.

In June 2025, Kennedy fired all 17 existing ACIP members citing “persistent conflicts of interest.” He’s since selected 12 new people to sit on the panel—many of whom have demonstrated vaccine skepticism or other fringe scientific views. The panel had already signaled an interest in relitigating its previous vaccine recommendations and schedules, especially for children.

Experts and advocates warn that the chaos, confusion, and disinformation surrounding vaccine recommendations under Kennedy’s leadership will further undermine public trust in vaccines. A recent Washington Post/KFF poll found that more than 15 percent of parents have delayed or skipped getting their kid a recommended childhood vaccine.

Changing regulations could also make it harder for patients who still want or need protection against these diseases to get inoculated.

Some leading health organizations will likely stick with their own vaccine guidance following the ACIP changes.

After Kennedy’s comments about pregnancy and the COVID-19 vaccine, ACOG in August 2025 reaffirmed its recommendation that pregnant and lactating people receive the COVID-19 vaccine and boosters.

“The full body of data clearly shows that the COVID-19 vaccines are not only completely safe for use during pregnancy but also protective both during pregnancy and after the infant is born,” Dr. Mark Turrentine, an OB-GYN who helped author ACOG’s guidance, said in a statement.

Likewise, there is ample scientific evidence to back up the current hepatitis B vaccination schedule.

“We’re very close to eliminating perinatal hepatitis B,” Campbell told Rewire News Group. “It will be a step backwards if we decide to undo all that’s been done over the years for no reason.”

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