Robert F. Kennedy Jr.’s revamped Advisory Committee on Immunization Practices (ACIP) held its first meetings this week, and major medical organizations are sounding the alarm, saying the advisors' decisions undermine established science and aim to sow distrust in immunizations.
The ACIP, which helps guide the Centers for Disease Control and Prevention (CDC) on how best to implement approved vaccines, struck its first blow against vaccines, recommending against the use of flu shots that contain a preservative that has been used in vaccines for decades, Fierce Pharma reported. The panel came down hard on flu vaccines that contain thimerosal, which is used in multidose vials to prevent contamination after one dose has been drawn.
Earlier this month, RFK Jr., the new Secretary of the Department of Health and Human Services (HHS), who has long been an anti-vaccine activist, dismissed all 17 members of the ACIP and replaced them with a group of eight advisors, including one who has already stepped down and others who have expressed their anti-vaccine views.
Comments from the panel’s new chair also signaled that changes could be coming for U.S. vaccine policy, especially as it pertains to kids.
The ACIP will create two new work groups to examine the cumulative effect of childhood vaccine schedules and assess shots that haven’t been subject to review in more than seven years, the committee’s newly appointed chair, Martin Kulldorff, Ph.D., said at the top of a two-day ACIP meeting that started Wednesday.
Medical groups say the newly appointed CDC vaccine advisory committee has deviated away from the longstanding evidence-based process that has historically guided ACIP deliberations. That process includes input from CDC experts, working groups and trusted scientific and medical organizations.
The American Academy of Pediatrics (AAP), which typically attends ACIP meetings as one of 30 liaison members, is now boycotting the ACIP. The pediatrics group said it will continue to publish its own evidence-based immunization recommendations and schedules, which it has done for its entire 95-year history, the organization said.
"For decades, the AAP and other organizations have worked to shape immunization policy through the ACIP. But now, with the committee dismissals, it is no longer a credible process," AAP President Susan J. Kressly, M.D., said in a video message released Wednesday.
"We won't lend our name or our expertise to a system that is being politicized at the expense of children's health. But we're not stepping back. We're stepping up. The AAP will continue to publish our own immunization schedule, just as we always have," Kressly said.
“What we heard in this meeting was really a false narrative that the current vaccine policies are flawed and that they need fixing,” Sean T. O’Leary, M.D., chair of the AAP Committee on Infectious Diseases, said in a press conference Wednesday. “That's completely false. These policies have saved millions of lives, trillions of dollars.”
"In the first 30 minutes of the meeting, it became clear that there is an intent to dismantle our country’s vaccine program – one that other countries have looked to replicate because of its success," O'Leary said. "These changes are being framed as efforts to 'increase vaccine confidence,' but many of the individuals involved have a history of sowing distrust."
Jason Goldman, M.D., president of the American College of Physicians (ACP), also a liaison member of the ACIP, said the organization was "deeply alarmed" by the proceedings of this week’s ACIP meeting.
"What should have been a rigorous, evidence-based discussion on the national vaccine schedule instead appeared to be a predetermined exercise orchestrated to undermine the well-established safety and efficacy of vaccines and fundamental basics of science. Our concerns have been confirmed: a committee and process that was once grounded in science and the best available evidence has become politicized," Goldman said.
The ACP said the newly reconstituted ACIP made recommendations without following the evidence to recommend framework or involving the work groups to vet and thoroughly examine the questions. "It makes it very difficult to trust any of these recommendations when they have not been appropriately discussed in an open, transparent, and evidence-based manner," Goldman said.
The ACP said will continue to participate as a liaison at the ACIP meetings, "as it is important to make sure our voices are heard and to continue to point out when there is a questionable presentation or misinformation being put forth."
Goldman said liaisons were not allowed to all have full access to the discussion or be able to participate fully, which was "deeply concerning.".
Regarding the two new work groups, Goldman said if the work groups follow "appropriate, recognized, evidence-based and peer reviewed processes and data to answer these questions," then the organization "welcomes the opportunity to once again prove the safety, efficacy, and benefit of this great public health service."
Tina Tan, M.D., president of the Infectious Diseases Society of America, also a liaison member, said the ACIP meeting this week was "politicized, chaotic and not transparent."
“Agenda items were added last minute, limiting the ability of members to review data. Disclosures about potential conflicts of interest of the newly appointed ACIP members have not been made public," Tan said. “Re-examining the childhood vaccine schedule and the use of thimerosal are both politically motivated actions that are not based on science. Raising questions without adequate data casts doubt on vaccination, which can further drive down confidence in vaccines. More than any other medications, vaccines are extensively and constantly reviewed and evaluated. Vaccination saves lives."
In a statement, another liaison member of the ACIP, the American Academy of Family Physicians (AAFP), said the organization will continue to participate in the vaccine advisory committee meetings "in an effort to promote evidence-based medicine and urge data-driven recommendations when it comes to vaccines."
"As we have always done, the AAFP will thoroughly review all ACIP and CDC recommendations to determine whether they adequately address threats to public health and make alternate recommendations when necessary. The health of our patients and communities are on the line, and the AAFP will continue to strongly advocate for continued access to vaccines that we know are safe, effective and save lives," the AAFP said in a statement.
Medical groups are concerned that false comments about vaccine safety made by current committee members will sow seeds of fear, doubt and distrust in medicine among patients and contribute to the spread of medical mis- and disinformation.
"This is a dangerous and reckless path that will leave our patients vulnerable to preventable illnesses. With this erosion of trust, physicians and the public will be forced to seek scientifically sound vaccine guidance and recommendations that are based on the best available evidence to protect the public health in our country elsewhere," Goldman said.
The National Foundation for Infectious Diseases (NFID) also slammed what it called a "flawed process."
“Vaccines are among the greatest public health accomplishments,” said NFID Medical Director Robert H. Hopkins Jr., M.D. “The process we witnessed instills doubt rather than builds confidence and calls into question the legitimacy of the votes taken, including the vote on thimerosal in influenza (flu) vaccines.”
The virtually nonexistent risks of thimerosal in flu vaccines pale in comparison to the real risks posed by flu each year in the U.S., Hopkins said in a statement. There were 250 U.S. pediatric flu deaths during the 2024-25 season, the deadliest non-pandemic flu season on record for U.S. children. CDC preliminary estimates show that during the 2024-25 season, flu vaccination prevented 12.5 million flu-related illnesses, 5.7 million medical visits and 240,000 hospitalizations, Hopkins said.
Last month, the CDC changed COVID vaccine recommendations with the COVID shots no longer on the list of immunizations recommended by the agency for pregnant women and "healthy" children.
The American College of Obstetricians and Gynecologists (ACOG) pushed back on that decision. Steven J. Fleischman, M.D., president of the ACOG, said the decision to rescind the COVID-19 vaccine recommendation for pregnant women "was not made based on any new research or latest scientific evidence."
The HHS misused studies and risks sowing more doubt about the safety of the COVID-19 vaccines, Fleischman said.
More than two dozen major medical groups are urging payers to continue covering COVID-19 vaccinations for pregnant patients without undue utilization management or cost-sharing requirements.
In a statement, AHIP, a trade group representing health insurers, said the organization is "committed to ongoing coverage of vaccines to ensure access and affordability for this respiratory virus season."
Controversy about the newly remade ACIP and its vaccine recommendations could make insurers' decisions about which vaccines to cover more complicated.
The Affordable Care Act requires health insurers to cover vaccines recommended by the CDC. Some insurers may look to independent bodies and medical associations for expert advice, Reuters reported, citing multiple insurance industry insiders and experts.
As medical groups look for alternative sources for unbiased information, there is ongoing discussion about forming an independent vaccine panel, according to multiple media sources.
One initiative, called the Vaccine Integrity Project, was launched out of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. According to its website, the Vaccine Integrity Project is dedicated to safeguarding vaccine use in the U.S. so that it remains grounded in the best available science and free from external influence.
"Over the coming months, facilitated sessions will be held to gather critical feedback to understand what may be needed to ensure the integrity of the U.S. vaccine system, including vaccine evaluations and clinical guidelines based on rigorous and timely reviews," the organization said.
Michael Osterholm, Ph.D., director of the CIDRAP, told Reuters that the group has been meeting with insurers.