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.

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

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