A federal vaccine advisory committee made up of members hand-picked by Health and Human Services secretary Robert F. Kennedy Jr. recommended in an 8-3 vote on Thursday that the combined measles, mumps, rubella, and varicella (MMRV) vaccine should not be given before age 4, citing long-known evidence that shows a slightly increased risk for febrile seizures in that age group.

Experts say that while frightening, febrile seizures—which are uncommon after vaccination—are usually short-lived and harmless, and removing the option for parents could cause a decline in immunization rates against measles, mumps, and rubella, some of the most dangerous childhood diseases.

Known as the Advisory Committee on Immunization Practices, or ACIP, the group provides recommendations to the US Centers for Disease Control and Prevention on vaccine usage. These recommendations are typically adopted by CDC and have an impact on state vaccine requirements for school, insurance coverage of vaccines, and pharmacy access—something at least one member of the panel seemed to be unaware of.

Thursday’s vote is part of a new shift in vaccine policy being spearheaded by Kennedy, a longtime anti-vaccine activist. In his short time as HHS secretary, Kennedy has implemented restrictions on who can receive Covid-19 vaccines and dismissed all 17 sitting members of ACIP, replacing them with 12 new members—some of whom were installed just this week. Several of the new advisers have a history of criticizing vaccines or denouncing public health measures taken during the Covid-19 pandemic. Kennedy said a “clean sweep” of ACIP was necessary to build back public confidence in vaccine science.

On Thursday, committee members were asked to evaluate whether to recommend against the combined MMRV vaccine before age 4, as well as whether to delay the first dose of the hepatitis B vaccine until the child is at least one month old.

Currently, parents have two options for vaccinating their children against measles, mumps, rubella, and varicella, also known as chickenpox. They can choose the combined shot, known as MMRV, or two separate shots—one for MMR and another for chickenpox. About 85 percent of children get separate shots.

In the US, the hepatitis B vaccine is given in the hospital shortly after birth, because the virus can be transmitted to children during delivery. A serious liver infection, hepatitis B can lead to cirrhosis and cancer. Each year in the US, an estimated 25,000 infants are born to women diagnosed with the hepatitis B virus. Without vaccination, up to 90 percent of them would develop chronic infections. The World Health Organization advises a universal birth dose of the hepatitis B vaccine.

The topics of discussion at Tuesday’s meeting were not based on new data or evidence, and in fact, two ACIP members, Joseph Hibbeln and Cody Meissner, as well as several representatives from professional medical organizations who were in attendance, questioned why these changes were up for consideration.

Robert Malone, one of the more controversial new ACIP members, offered an explanation: “It’s clear that a significant population of the United States has significant concerns about vaccine policy and about vaccine mandates.” Malone is a former mRNA researcher who rose to prominence during the Covid-19 pandemic by spreading falsehoods about the disease and the vaccines; he abstained from Thursday’s vote because he previously served as an expert witness in a lawsuit over the mumps vaccine.

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To Genevieve Lakier, a professor of law at the University of Chicago whose research focuses on free speech, Carr’s threats against ABC appear to be “a pretty clear cut case of jawboning.” Jawboning refers to a type of informal coercion where government officials try to pressure private entities into suppressing or changing speech without using any actual formal legal action. Since jawboning is typically done in letters and private meetings, it rarely leaves a paper trail, making it notoriously difficult to challenge in court.

This Kimmel suspension is a little different, Lakier says. During the podcast appearance, Carr explicitly named his target, threatened regulatory action, and within a matter of hours the companies complied.

“The Supreme Court has made clear that that’s unconstitutional in all circumstances,” says Lakier. “You’re just not allowed to do that. There’s no balancing. There’s no justification. Absolutely no, no way may the government do that.”

Even if Carr’s threats amount to unconstitutional jawboning, though, stopping him could still prove difficult. If ABC sued, it would need to prove coercion—and however a suit went, filing one could risk additional regulatory retaliation down the line. If Kimmel were to sue, there’s no promise that he would get anything out of the suit even if he won, says Lakier, making it less likely for him to pursue legal action in the first place.

“There’s not much there for him except to establish that his rights were violated. But there is a lot of benefit for everyone else,” says Lakier. “This has received so much attention that it would be good if there could be, from now on, some mechanism for more oversight from the courts over what Carr is doing.”

Organizations like the FPF have sought novel means of limiting Carr’s power. In July, the FPF submitted a formal disciplinary complaint to the DC Bar’s Office of Disciplinary Counsel arguing that Carr violated its ethical rules, misrepresenting the law by suggesting the FCC has the ability to regulate editorial viewpoints. Without formal rulings, companies affected by Carr’s threats would be some of the only organizations with grounding to sue. At the same time, they have proven to be some of the least likely groups to pursue legal action over the last eight months.

In a statement on Thursday, House Democratic leadership wrote that Carr had “disgraced the office he holds by bullying ABC” and called on him to resign. They said they plan to “make sure the American people learn the truth, even if that requires the relentless unleashing of congressional subpoena power,” but did not outline any tangible ways to rein in Carr’s power.

“People need to get creative,” says Stern. “The old playbook is not built for this moment and the law only exists on paper when you’ve got someone like Brendan Carr in charge of enforcing it.”

This vacuum has left Carr free to push as far as he likes and it has spooked experts over how far this precedent will travel. Established in the 1930s, the FCC was designed to operate as a neutral referee, but years of media consolidation have dramatically limited the number of companies controlling programming over broadcast, cable, and now, streaming networks. Spectrum is a limited resource the FCC controls, giving the agency more direct control over the broadcast companies that rely on it than it has over cable or streaming services. This concentration makes them infinitely easier to pressure, benefitting the Trump administration, Carr, but also whoever might come next.

“If political tides turn, I don’t have confidence that the Democrats won’t also use them in an unconstitutional and improper matter,” says Stern. “[The Trump administration is] really setting up this world where every election cycle, assuming we still have elections in this country, the content of broadcast news might drastically shift depending on which political party controls the censorship office.”