NEW YORK (AP) — Health Secretary Robert F. Kennedy Jr.'s new vaccine advisory committee meets this week, with votes expected on whether to change recommendations on shots against COVID-19, hepatitis B and chickenpox.

The exact questions to be voted on Thursday and Friday in Atlanta are unclear. Officials at the Department of Health and Human Services did not immediately respond to questions seeking details on the newly posted agenda.

However, some public health experts express concern that the votes will at the very least raise unwarranted questions about vaccines among parents.

Even more consequential is the potential vote that could restrict a government program from funding vaccines for low-income families.

Dr. William Schaffner, a vaccines expert from Vanderbilt University, stated, “I’m tightening my seat belt.”

The Advisory Committee on Immunization Practices (ACIP) makes recommendations to the director of the Centers for Disease Control and Prevention (CDC) regarding the use of approved vaccines. Historically, CDC directors have accepted these recommendations, which significantly influence doctors and vaccination programs.

Kennedy, initially a prominent anti-vaccine activist, previously dismissed the 17-member panel and replaced it with a new group including several anti-vaccine proponents.

Here’s an overview of the three vaccines currently under review:

COVID-19

Before Kennedy's appointment, ACIP typically reaffirmed flu vaccine recommendations each June without hesitation. However, this past June, under Kennedy, the ACIP remained silent on COVID-19 vaccines.

Kennedy once announced the removal of COVID-19 shots from CDC recommendations for healthy children and pregnant women, a move condemned by medical professionals and instigating legal action from the American Academy of Pediatrics and others.

Subsequently, CDC officials announced that families could still receive the 2024-2025 version of COVID-19 shots for their children through consultations with healthcare providers, indicating these vaccines would still be covered under the federal Vaccines For Children program, critical for uninsured families.

Yet, with each season introducing new COVID-19 formulations, the committee has yet to determine whether this year’s vaccinations will be recommended or funded by the program.

Further complicating matters, the FDA recently restricted the use of this fall's COVID-19 vaccines for healthy young adults and children.

If ACIP adheres to this and provides no alternative guidance from the CDC, “that would take away access for roughly half of America’s kids,” according to Dr. Sean O’Leary from the AAP. The pediatricians advocate for continued vaccinations for all children aged 6 months to 2 years.

Hepatitis B

Hepatitis B is known for causing severe liver infections, spread primarily through sexual contact or shared needles, and can be transmitted from an infected mother to her baby. A significant proportion of infected infants can develop chronic infections if not vaccinated promptly.

The hepatitis B vaccine has been available in the U.S. since 1981, with recommendations in place since 1991 for infants to receive doses within 24 hours of birth. Research highlights that these shots are 85% to 95% effective in preventing chronic infections.

However, there are renewed discussions about revisiting this guidance, as incomplete screening processes for mothers prior to birth have led to ongoing transmissions.

MMRV

Chickenpox, historically a common childhood illness, can lead to severe complications. The vaccine's recommendation came in 1995, significantly decreasing cases and fatalities. In 2006, the combination MMRV vaccine was licensed, though subsequent findings led the ACIP to no longer preferentially recommend it over separate measles, mumps, rubella, and varicella doses.

Despite this, pediatricians typically recommend separate doses for initial vaccinations, although the combination shot is preferred for subsequent doses. Concerns persist about revisiting this vaccine's guidance amidst efforts to foster distrust towards vaccinations.

The upcoming ACIP meeting could have far-reaching effects on public health and vaccination access, particularly for vulnerable populations.