Bring back former ACIP members, vaccine advocates say

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Former members should be brought back to a national panel that reviews vaccine safety and efficacy, said some public health experts and physicians.

However, new members of the Advisory Committee on Immunization Practices (ACIP) got support in their work. Another commenter proposed banning vaccines altogether.

The new members of ACIP convened June 25 for the first day of the board’s two-day meeting with new members appointed by Health and Human Services Secretary Robert F. Kennedy Jr. The board advises the U.S. Centers for Disease Control and Prevention (CDC), which sets the nation’s adult and childhood immunization schedules.

In recent weeks, health care advocates and medical organizations blasted Kennedy’s action to dissolve the 17-member ACIP and appoint new members without public vetting of their backgrounds. The former members themselves published a joint editorial claiming his actions “critically weakened” the nation’s vaccine program.

Along with review of studies on inoculations against various illnesses, they opened the floor for 10 members of the public to comment.

Abusing ACIP guidelines

Many states, including large ones like California and New York, are misusing ACIP guidelines to restrict medical exemptions for school vaccine requirements, said Kim Mack Rosenberg, Esq., general counsel for Children’s Health Defense. That organization was founded by Kennedy and has become a public voice in questioning whether childhood vaccines have harmful, not healthy, effects.

ACIP has acknowledged its guidelines are not exhaustive and the board cannot define all reasons why a child may need a medical exemption, Rosenberg said. However, many states and schools are overriding treating physicians’ clinical judgments and limited exemptions based on ACIP recommendations. They are ignoring other serious risks or reasons why a vaccine may need to be deferred, she said.

“I urge you to amend the best practices guidelines on this or issue a clear public statement on your website affirming the CDC is not authorized to give medical advice about what an individual child may need to stay safe, that the guidelines are not exhaustive and cannot define every reason for a medical exemptions, and only treating physicians using CDC guidance, other evidence, patient and family history, their clinical judgment, and any other information relevant to an individual child's health, should determine if an exemption is warranted,” Rosenberg said. “Without your action, misapplication of the ACIP guidelines will continue to have devastating consequences.”

Rosenberg offered an example of a teen in New York who had physicians agreeing a third hepatitis B vaccine could endanger her life. She wanted to attend school and even tried to get the shot at walk-in clinic, but was excluded from classes because she did not have the required shot, Rosenberg said.

Meanwhile, states are using the ACIP guidelines to threaten doctors’ licenses, she said.

“Your timely action is needed this summer to Safeguard vulnerable students,” Rosenberg said.

Public health advocates disappointed

Kennedy’s actions to dismiss 17 ACIP members and reappoint his own selection were disappointing to members of the Big Cities Health Coalition (BCHC), a group of 35 of the nation’s largest metropolitan health departments, said BCHC Executive Director Chrissie Juliano.

People around the country go to local health departments for vaccines and to get information from people they know and trust. Those departments in turn look to ACIP for vaccine recommendations.

“But with all due respect to the new committee members, there's genuine worry about whether that will remain the case,” Juliano said. “For more than 60 years, ACIP has provided independent, science-based, nonpartisan, and objective vaccine recommendations. Clinicians, health departments, and families across the country rely on these recommendations. At a time when trust in public health is already low, the sudden dismissal of an entire committee will only cause additional confusion and distrust.”

Vaccines are one of public health’s greatest accomplishments, preventing disease and saving lives, Juliano said. ACIP members must follow the science and make decisions based on public health, she said.

“The Big Cities Health Coalition is deeply concerned that many routine vaccines may soon become inaccessible or unaffordable for millions of Americans if ACIP makes changes based on ideology rather than science,” Juliano said. “The stakes are simply too high to let that happen.”

Preserving access

The former members of ACIP had the expertise to design vaccine studies, but it is clear the new members do not, said Mary Koslap-Petraco, DNP, PNP-BC, CPNP. Koslap-Petraco also is chair of Vaccinate Your Family, a pro-immunization advocacy group.

Citing her own experience, Koslap-Petraco said she has patients with long COVID who were not vaccinated. Parents are being misled by myths and disinformation on the Internet, losing faith in their primary care providers, she said.

In her vicinity, the churchyards on Long Island, New York, have headstones of children with their causes of death — measles, polio, tetanus, whooping cough, Koslap-Petraco said. Years ago, her mother had polio and her sister’s immune system was permanently damaged from measles.

“Do we really want to witness this again? I will leave it to all of you to explain to the parents why their children did not have access to life-saving vaccines,” Koslap-Petraco said.

‘Fear-mongering and pseudoscience’

Caroline Brown, MD, FAAP, IBCIC, described her experience as a pediatrician in North Carolina.

“I've cared for children in this community for nearly two decades, and I've seen what vaccine preventable diseases do to otherwise healthy kids,” she said. “I've treated infants with blue faces gasping for breath from RSV and pertussis, children in the ICU paralyzed, brain damaged or missing limbs from illnesses we now have vaccines to prevent.”

Older colleagues who treated children in the 1980s and 1990s are haunted by experiences seeing children ravaged and suffering from disease, she said. The same day as the meeting, her home state confirmed its first case of measles in her county.

“So I've spent the past 24 hours responding to panicked parents worrying about their young children,” Brown said. “We must acknowledge that measles spread throughout our country is our reality today, only because of the fear-mongering and pseudoscience that has overtaken our country. Remember, measles was completely eradicated from the United States 25 years ago and is back now because of declining vaccine rates fueled by misinformation that is not only allowed but amplified by voices of some of you sitting on this very committee.

“The parents of the children I care for are frightened, watching health policies shift from evidence to ideology and from science to self-interest,” she said.

Safeguarding American children

Amy J. Hardin, MD, a Georgia pediatrician, described her medical training at Emory University near the CDC headquarters. She described the time before flu and pneumococcal vaccines, with feverish children admitted and undergoing numerous tests for meningitis, sepsis, and other illnesses. Those infections did not discriminate by income, and children from all walks of life died or survived with disabilities, deafness, cerebral palsy or severe learning challenges, she said.

Hardin said she sleeps better on call and remembers the year 1999 — the time of the last funeral she attended for a patient who died of a vaccine-preventable disease. That 2-year-old boy missed his shot because his mother got sick and forgot to reschedule the checkup.

“You are now the decision makers in your new role of the ACIP to safeguard American children,” Hardin said. “They are your responsibility and mine too. Please don't let us go backwards. Don't make my job a more difficult one.”

‘A bioweapon mechanism’

One commenter, Adrianna Williams, called for ACIP to abolish all vaccines until their safety could be proven. She cited data on more than 8,000 incidents and 70 deaths following vaccination for respiratory syncytial virus, per the Vaccine Adverse Event Reporting System.

“Vaccines are known to be a bioweapon mechanism,” Williams said. “Some don't even know it. Evidence shows that many are systemically medically harmed by all vaccines, and the damage has been shown to be done cumulatively over time and in negative interaction with ingredients and adjuvants without bodily functions. You need to do due diligence to address this issue with more integrity than what we have seen.”

Williams cited the Stop the Shots community on social media website X, formerly Twitter.

Restoring trust

Roselie Bright, a retired doctoral level epidemiologist for the Food and Drug Administration, acknowledged she saw many instances when staff and managers wanted to advocate for decisions that “felt right,” although the data supported another decision. She learned to trust input of other experts in different disciplines, and most of the decisions produced by the system were valid and well-supported.

Her trust has been shaken due to mass firings at HHS, intimidation, overruling of science by political appointees, and radical changes to ACIP. Bright proffered suggestions to restore trust and evaluate vaccines:

• Consider long COVID and its severity when recommending COVID-19 vaccine schedules.
• Recommend universal access to FDA-approved COVID-19 vaccines three times a year.
• Call for development of a more effective COVID-19 vaccine.
• Provide ACIP meeting materials to the public when ACIP members get them and allow at least a week to file response of written comments.
• Provide summaries and discussion of public comments at ACIP meetings.
• Allow more and longer time for oral public comments at meetings.
• Reinstate the 17 ACIP members who were let go.
• Require ACIP members to show evidence of the ability to perform science-based assessments of reports and studies.
• Bar ACIP members to those who refuse to follow established principles of clinical and human research ethics.

Additional speakers

The first day of the meeting, there were four other speakers who described their medical experience and generally supported vaccination. The webcast did not display their names. Medical Economics requested a list of the speakers from CDC but did not have confirmed identities of them . The commenters mentioned in this article were identified through online sources, based on the names announced during the webcast.