The recent meetings of the Advisory Committee on Immunization Practices change almost nothing about early childhood vaccination. For now.

T he decisions made during the September 18 and 19 meetings of the Advisory Committee on Immunization Practices (ACIP) change almost nothing about how pediatricians working in the real world approach early childhood vaccination. And for this, I am, as a practicing pediatrician, quite grateful.

These meetings were described as “controversial.” They were so only because RFK Jr.’s dismantling of the prior advisory board and re-creation with well-known vaccine skeptics meant that anyone with an actual scientific foundation in this matter was very doubtful that anything of substance could or would come forth from the meetings. After weeks of speculation about what might emerge, the announced changes signify a meaningless outcome that only highlights how ill-prepared this group is to make children healthier.

The first decision announced was that the ACIP is officially recommending against the combined MMRV (measles, mumps, rubella, and varicella) vaccine for one-year-olds in favor of dividing the vaccine into two separate ones — an MMR and a varicella (chicken pox). The reality is that the vast majority of practicing pediatricians have been separating the MMR and the varicella vaccines at the one-year visit for years already, as the very slight increased risk of febrile seizure (one febrile seizure for every 2,300 doses of MMRV compared with separate doses) following the combined MMRV vaccine at that age has been known about since 2007. And the ACIP (the very same committee that voted on September 18) issued updated guidelines in 2008 on this issue, stating that it was up to the physician and the family in question to decide whether the slight increased risk of a febrile seizure with the MMRV vaccine was worth decreasing the number of shots a baby received from two to one. Since that time, most pediatricians, including me, have separated the two, as a febrile seizure, while clinically insignificant for the majority of children, is terrifying for parents to watch.

So the vote on September 18 basically did nothing other than codify that one-year-olds must get two shots instead of one to be vaccinated against these diseases. This is ironic, as one of the biggest complaints of the vaccine-skeptic crowd is how many shots we give to young babies and toddlers, and it takes the autonomy of making individualized decisions out of the hands of parents (which also seems to fly in the face of the anti-vaccine movement).

The following day the committee made the wise decision to delay a vote regarding potential changes to the hepatitis B vaccine schedule. While it is certainly understandable that parents might question the need for their newborns to receive such a vaccine before leaving the hospital, physicians and public health scientists should understand the value of the current schedule (birth, two and six months) and recognize that any delay in that schedule (as was initially proposed to be debated at this meeting) will only lead to increased cases of preventable hepatitis B in infants. Similar to the debate over the MMRV vaccine, the fact that the ACIP is even questioning the newborn hepatitis B vaccine reveals a shocking lack of historical and scientific knowledge. When the hepatitis B vaccine was first introduced in the early 1980s, it was given only to those individuals who were identified at high risk of contracting the illness, such as health care workers, IV drug users, and patients on dialysis. For almost ten years, the public health community watched, expecting to see a significant drop in infantile and childhood Hep B cases.

This never happened, as every year about 18,000 infants were infected, half of whom had no obvious exposure risk. So in 1991, the decision was made by that year’s ACIP members to recommend universal hepatitis B vaccinations for newborns, regardless of known risk. Within ten years, rates of Hep B in the pediatric population had plummeted, and now cases of hepatitis B in individuals younger than 19 years of age are almost unheard of. Clearly, history tells us, there is a large proportion of infants at risk for this infection who are not easily identified as such. Delaying the first hepatitis B vaccine until one month of age will only reverse an enormous public health victory, and I am relieved that the members of the current committee had the wisdom to avoid such a mistake for now.

These ACIP decisions make no one happy — except for those, like me, who are at least relieved that protection against these diseases is still available. For those who understand how critical childhood vaccination is for both individual and public health, the unhappiness stems from the fact that this will undoubtedly reinforce the factitious narrative that “big bad science” has been hiding data and potential harm from vaccines from the public for years (as pointed out above, anyone who cared to find out this information could get it from a simple Google search for the last two decades).

And for those who have concerns about vaccine safety and have placed all their hopes in this Wild West group of scientific advisers who currently make up the ACIP, this decision may signal to them the reality that despite all of the noise generated by RFK Jr., there really is no smoking gun or Great Big Pharma conspiracy to be unearthed in the matter of childhood vaccines.

For now, I will choose to focus on the positive: My patients can still be protected against measles, mumps, rubella, and chicken pox, as well as hepatitis B, in exactly the same way as I have been practicing for the past 15 years. Long may this last.