If Americans hoped to get some clarity from Health Secretary Robert F. Kennedy Jr.’s vaccine panel on who should be getting a COVID-19 shot this fall, they may be disappointed.

The Advisory Committee of Immunization Practices spent Sept. 19 in a heated debate over safety and efficacy data but fell short of voting on clear recommendations on eligibility.

Instead, panel members voted to “to promote more consistent and comprehensive informed consent processes” and encourage discussion between patients and providers about the risks and benefits of vaccination.

“The idea here is to send a very strong message," said panel member Retsef Levi, who presented the voting recommendations and emphasized the need for more communication between patients and medical providers about vaccine risks and uncertainties. “We don’t intend to prescribe to the CDC exactly what language to use.”

The panel also said vaccination decisions for children and adults should be based on “individual-based decision-making – with an emphasis that the risk-benefit of vaccination is most favorable for individuals who are at an increased risk for severe COVID-19 disease.”

Although it’s not an explicit recommendation, the voting language does fall in line with actions in August from the Food and Drug Administration, which approved updated COVID-19 shots for those over 65 and people with existing health problems.

The agency also revoked emergency use authorizations, making it more difficult for children younger than 5 to access the shots.

Despite the approval, several states have issued their own guidance about COVID-19 vaccines. California, Oregon and Washington have created their own advisory council that will release its own vaccine recommendations for the West Coast. States like Colorado, Pennsylvania, New York and Minnesota, among others, also have issued guidance or signed executive orders on vaccines.

Health insurance companies have also vowed to cover the COVID-19 vaccines "with no cost-sharing for patients through the end of 2026," according to America's Health Insurance Plans.

Meanwhile, wastewater surveillance data shows "high" levels of COVID-19 virus throughout the nation, according to WastewaterSCAN, a network run by Stanford and Emory University that monitors sewage for signs of diseases. That suggests a summer surge has spilled into September.

The COVID-19 vaccine votes marked the end of a chaotic two-day meeting of the 12-member panel that included changes to the childhood immunization schedule, delays, revotes and many heated discussions.

On Sept. 18, Kennedy's immunizations committee, ACIP, voted to no longer recommend a combination vaccine that targets measles, mumps, rubella and varicella (chicken pox) to children younger than 4. Although the decision does not affect guidance for the separate MMR and varicella vaccines, health experts worry that the change will sow confusion and mistrust.

Despite changes to MMRV recommendations, the panel voted to continue covering the vaccines for children under 4 under the Vaccines for Children program, which provides vaccines to children whose parents or guardians may not be able to afford them. The panel reversed that decision the next day.

Members also decided to push back a pivotal vote to recommend delaying the hepatitis B vaccine for babies because of a "discrepancy" in language before tabling the vote "indefinitely" during the Sept. 19 session.

In a nail-biting moment, the committee nearly voted to recommend that states and local jurisdictions require prescriptions for COVID-19 vaccines. The vote ended in a tie that was broken by the ACIP chair, Martin Kulldorff, who rejected the recommendation.

“ACIP should not be reduced to political theater or gamesmanship," said Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention. "If the committee continues down this path, the health repercussions for our nation will be severe. I urge the ACIP chair and its members to approach their work with the seriousness of purpose and commitment to science that this responsibility demands. Lives are at stake."

Recommendations made by ACIP have wide-ranging implications, guiding vaccine requirements for schools and impacting a government program offering free vaccinations for about half of America's kids.

Under Kennedy's leadership, the Department of Health and Human Services has made several sweeping changes to the COVID-19 vaccine policy. HHS dropped routine shots for children and pregnant women, focusing instead on older and high-risk groups. Kennedy also has halted nearly $500 million in mRNA projects.

Contributing: Mrinalika Roy, Reuters

Adrianna Rodriguez can be reached at adrodriguez@usatoday.com.

This article originally appeared on USA TODAY: RFK Jr. vaccine panel avoids further COVID shot restrictions after chaotic meeting

Reporting by Adrianna Rodriguez, USA TODAY / USA TODAY

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