Updated ACIP Recommendations and MMRV Vaccine

Updated ACIP Recommendations and MMRV Vaccine

On September 18-19, 2025, CDC’s Advisory Committee on Immunization Practices (ACIP) voted to recommend:

  • MMRV (combined MMR + varicella) vaccine should not be given to children under 4 years old.
    • It is recommended to administer MMR and varicella vaccines separately.

Clinical Background: MMRV Vaccine

The MMRV vaccine is a combination vaccine against measles, mumps, rubella, and varicella. The ACIP made this decision on the basis that the MMRV vaccine is linked to a twofold increased risk of febrile seizures in children under 2. According to national data, MMRV vaccine accounts for about 15% of first dose measles, mumps, and rubella vaccination. In Philadelphia, MMRV as first dose accounts for even less than the national average.

Implications for Vaccine Access 

  • Vaccines for Children (VFC) coverage: MMRV vaccine will no longer be covered for children under 4 years old through the VFC program. MMRV vaccine will continue to be covered for children 4 to 12 years of age.
  • Clinical guidance: Immunization decisions should continue to be made by clinicians and families based on the most current eligibility criteria.
    • Children should still receive two doses of measles, mumps and rubella (MMR) and varicella vaccines — once at 12 to 15 months and again at 4 to 6 years as per the childhood vaccination schedule.
    • MMR and varicella vaccines can be given at the same visit.
    • Children aged 4 years and older can still get MMRV. There is no evidence of an increased risk of febrile seizure in this older age group. 

Questions?

The Philadelphia Immunization Program remains committed to protecting children and families from vaccine-preventable diseases. We will continue to keep you informed on vaccine availability, product coverage, and resources to support your practice and patients.