Physicians to ACIP: Trust vaccine science, or get ready for outbreaks of preventable childhood diseases

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Vaccine supporters called for sound science in the deliberations of the nation’s Advisory Committee on Immunization Practices (ACIP), but skeptics also voiced their concerns about possible harms from the shots.

ACIP met in a two-day session on June 25 and 26, and both days allowed people to comment on their proceedings. It became clear physicians, other clinicians and health advocates are passionate about the issue of inoculating against disease. Others voiced concerns about potentially hurting health from unsafe jabs, and legal ramifications about ACIP recommendations.

It was ACIP’s first meeting with members appointed by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., who has questioned whether doses of childhood vaccines have contributed to chronic health conditions. The ACIP offers its guidance to the U.S. Centers for Disease Control and Prevention (CDC) under Kennedy.

The ACIP members are Chair Martin Kulldorff, MD, PhD; Joseph R. Hibbeln, MD; Retsef Levi, PhD; Robert W. Malone, MD; Cody Meissner, MD; James Pagano, MD; and Vicky Pebsworth, OP, PhD, RN. In the public comment sessions, the ACIP board members did not respond to the speakers. The second day had 13 people talk.

Starting from a conclusion

Uncritical affirmation is not the job of a clinician encountering vaccine hesitancy, said Elias Kass, a naturopathic physician specializing in pediatrics. He said he listens to parents’ concerns about mercury in vaccines, then explains the difference between methyl mercury found in the vaccine preservative thimerosal, and the potential health effects of ethyl mercury. Removing thimerosal from vaccines did not make the shots safer, just more expensive, he said.

Kass referred to the report that a presentation to ACIP contained a nonexistent reference in a presentation about thimerosal, a vaccine additive.

“When presenters on the harms of thimerosal refer to fake citations suggestive of generative AI use, it's clear that they are starting from a conclusion and then looking for or inventing evidence to support it,” Kass said. “That is policy-based evidence making. It's backwards.”

The entire debate makes it appear something was missed or suppressed previously, he said.

‘Science, not politics’

Emmett Patterson, a public health professional and communicator specializing on LGBTQ health, said LGBTQ Americans already are facing an alarming burden of vaccine-preventable illnesses, especially long COVID. He urged ACIP to reinstate universal COVID-19 vaccinations from children to the elderly.

“We cannot afford to strip away the single most effective protection we have — updated COVID vaccines available for all,” Patterson said. “And let's be clear, the science proves that COVID vaccination dramatically reduces the risk of severe illness, disability and death, even for people without any disabilities or health conditions. Delaying or limiting access doesn't just cause confusion, and sows mistrust in communities like mine. It also costs our lives.

“Decisions about vaccines must be guided by science and not politics,” Patterson said. “This means restoring transparency, re-engaging Expert Advisors and committing to equitable access. Marginalized people in 2025 should not die of diseases we know very well how to prevent, and none of us should have to fight for the protection we know works.”

‘An unprecedented moment’

In more than four decades in health care, “this is an unprecedented moment” because there have never been more alarms that lives are at risk by the active and careless undermining of public health and trust, said Millicent Gorham, PhD (Hon), MBA, FAAN, Alliance for Women’s Health & Prevention.

“To put it bluntly, lives are at risk,” she said.

Along with health effects, there are financial ones due to insurance coverage based on ACIP vaccine recommendations, Gorham said. She acknowledged those are recommendations, not requirements, but they support patient choice.

“In eliminating recommendations, you are threatening coverage and essentially removing choice for people who want to get vaccinated to protect their families themselves and their communities,” Gorham said. “Confusing, competing recommendations will only increase preventable, vaccine-preventable, diseases.

“The risks here are not theoretical. They are painfully real,” she said. “Children and adults alike will become sick and die and from these serious illnesses. Disregarding these facts alone, along with public health expertise, is unacceptable. I implore you to recognize that maintaining the integrity of our nation's vaccine infrastructure is critical to doing so.”

‘It’s just the flu’ — and dangerous

Anti-influenza health advocates get frustrated when they hear people refer to the illness as, “it’s just the flu,” said Niki Carelli, executive director of the Coalition to Stop Flu.

Seasonal flu outbreaks are one of the country’s most predictable, preventable public health crises, Carelli said. CDC’s own data show it has an extraordinary annual burden in deaths, hundreds of thousands of hospitalizations, and millions of illnesses, and it likely costs the nation billions of dollars a year in direct and indirect costs, she said.

Meanwhile, the flu vaccine has been administered to billions of people worldwide, making it one of the safest, most studied and most trusted tools in modern public health, Carelli said. More than 100 million Americans got the shot last year.

“As you all know, ACIP does not set requirements. Instead, you serve a vital role as an aggregator and interpreter of evidence-based data, and perhaps most critically, your recommendations are directly tied to insurance coverage,” Carelli said. “The current influenza recommendation preserves access for hundreds of millions of Americans and ensures that patients who choose to be vaccinated can get their shot in a convenient setting. And most importantly, it saves lives.”

Safe and effective — 'that is a lie'

Ronald F. Owens Jr., claimed former HHS Secretary Xavier Becerra knew the COVID-19 vaccine was harmful to people of color, Blacks, Latinos and indigenous people. Owens described himself as a retired employee of the California Department of Public Health, and he is author of the volume, “Muzzled Truth: How The California Dept. of Public Health Rejected COVID-19 Treatment and Vaccine Health Risks Warnings.”

There have been allergic reactions, facial paralysis, miscarriages, heart attacks, heart inflammation, seizures, strokes, and sudden deaths, Owens said.

“Californians were told COVID-19 vaccines are, quote, safe and effective. That is a lie,” he said. During the ACIP meeting, subject matter experts assured the public that vaccines are safe and effective. “Have they reached out and talked to any vaccine injured? There are millions,” Owens said. He suggested ACIP have a COVID-19 vaccine victim listening tour.

“People are suffering, people are dying,” Owens said. “The government urged them to take the COVID-19 vaccines, and now the government has completely abandoned them. Please do not ignore pain and suffering of your fellow citizens who were told COVID-19 vaccines are safe and effective. At minimum, federal health officials must inform Americans today that COVID-19 vaccines are killing people at an alarming rate.”

Five points to consider

ACIP should endorse a five-point plan for recommendations on the nation’s vaccine schedule, said Katrin Werner-Perez, director of health programs for the Alliance for Aging Research.

• Vote to recommend the COVID-19 vaccine, especially because Kennedy’s preemptive removal of the vaccine for healthy pregnant women and children undermines ACIP’s role of providing expert perspectives on vaccination.
• Vote to lower the age for risk-based recommendations for the respiratory syncytial virus vaccine to include adults aged 50 to 59 years.
• Reinstate the vote on influenza vaccines for this year’s strain so Medicare will cover them.
• Restore all originally planned ACIP votes to guarantee free vaccines for children in the fall.

AAR also opposed any vote on thimerosal-containing flu vaccines. It is used only as a preservative in multi-dose adult flu vaccines to prevent bacterial and fungal growth. Removing it would disproportionately harm resource-constrained settings like nursing homes and long-term care facilities that serve older adults, Werner-Perez said.

Rely on the science

In 2009, advocacy group Vaccinate Your Family had a staff member lose her 5-year-old son to flu, so the mission is a professional and a personal one, said Allison Howells, organization communications coordinator. She mentioned the names of other young women, infants and children who lost their lives to illnesses including infection by the meningococcal B virus, whooping cough and COVID-19.

“If access to life saving vaccines is compromised due to changes in recommendations that affect insurance coverage or cause confusion amongst providers and the public, we will be watching to understand how the members handle their new responsibility to protect the American people and keep America healthy,” Howells said. “We call on HHS and CDC to ensure that committee members avoid cherry-picking of data in order to draw conclusions that fit any previously conceived notions about vaccine safety. We hope to see members set aside personal beliefs and ideologies and based their conclusions and recommendations on the preponderance of available credible scientific data.”

ACIP recommendations as a legal weapon

Vaccines have become a weapon in child custody battles, said Avraham Y. Seff, who spoke as a father who lost his child due “due to a system that misunderstood your guidance.”

Seff said his decision about his son led to a protection order from family court. Charges eventually were dropped, “but the damage was done. The relationship with my son was severed, not by violence or abandonment, but by the unintended legal consequences of a medical recommendation. And I'm far from alone,” he said.

Across the country, family courts and child protection systems treat ACIP recommendations as if they are mandates. Then, that becomes grounds to accuse a parent of being unfit, Seff said.

The current and former members of ACIP did not cause the problem. But the panel’s work has been hijacked by courts, agencies and people who use the recommendations as blunt legal instruments, Seff said. He asked ACIP to make a clear disclaimer that its recommendations are expert guidance, not mandates, and should not be used to question parental fitness.

“I sometimes wonder aloud: Could there be a broader systemic incentives, financial, bureaucratic, or even ideological, that benefit when families fall apart? I don't pretend to know the answer, but I do know this: When well-intended medical guidance is stripped of its nuance, real families suffer,” Seff said.

Pediatricians’ perspectives

Paola Ballester, MD, said her team of pediatricians have treated patients who are neurologically devastated by meningitis, healthy children on life support from influenza, and babies gasping for air from pertussis. Those cases are rare due to childhood vaccination, but the effects sometimes are devastating.

“My dreams have been haunted by the guttural screams of parents that have just lost their child and their desperate pleas to turn back time and accept the vaccine that could have given their child a chance to grow up,” Ballester said.

Lives will be in the balance if ACIP lets propaganda guide its decisions, she said. But research, based on tens of thousands of patients with placebo-controlled trials spanning many countries, has not changed, Ballester said.

“Childhood vaccines are safe and effective,” she said. “Parents have every right to ask questions. It's OK to be cautious when it comes to your child, they're your world, and as a mother, I know this. But please, trust trustworthy people who are trained to weigh risks and benefits, not the ones repeating conspiracy theories. Talk to your pediatrician. They have spent their entire careers to understand how to help protect your children and help them grow to their fullest potential.”

Cracks in the dam

Christine Martin, MD, MPH, who specializes in pediatric primary care, described her experience serving in the Peace Corps in South American, where unvaccinated children suffered with mumps and whooping cough, and adults showed disabilities caused by polio. She had a family member who became deaf due to congenital rubella syndrome; now rubella is a vaccine-preventable disease. Her medical training included a case of a 13-year-old girl who was at the emergency department when her headache and fever led to septic shock; if she was not at the hospital, it would have been fatal meningitis.

“Currently, vaccines are a dam that is the best tool available and prevents children and infants from seeing preventable diseases and vaccines are the greatest public health achievement of the 20th century,” Martin said. “Unfortunately, that dam has now cracks and fissures due to misinformation and public fear. At the present time, we are seeing the effect of that with the measles outbreak. If the cracks and holes continue to increase, the dam will fail, and you will start to see more and more cases of vaccine-preventable disease and the harmful effects of these diseases. Right now is the time to support and advocate for the routine vaccination schedule as is.”

Selfish reasons for vaccination

Elizabeth Hornbeck, MD, a pediatric hospitalist, described treating healthy children who lost half their lungs due to influenza, who had neurological devastation due to influenza encephalitis, or were infants in intensive care due to RSV bronchiolitis. Speaking with parents, “I try to reassure them that most do recover, but I am a person for whom honesty is a core value, and sometimes it is difficult to predict,” she said.

“This is not fear mongering. This is to give a backdrop to why I, myself, as a parent and a pediatrician, vaccinate my children,” Hornbeck said. Many physicians speak of selflessness and love of neighbor when discussing vaccines, but Hornbeck said she has selfish reasons first, then public health as a motivation.

“My kids get vaccines because they're safe, and I am much more fearful of the harm the actual diseases can do,” she said.

Another pediatrician spoke, agreeing with his peer physicians and arguing no child, adult, or grandparent should be denied access to life-saving science.

Health sliding backwards

Akshata Hopkins, MD, described here experiences with a 13-year-old boy with meningitis, a 4-week-old infant with pertussis, a five-year-old girl hospitalized for 28 days with complicated influenza and meningitis, who suffered permanent hearing loss.

“These are patients I vividly recall, even now, more than 15 years later. Why? Because these illnesses were preventable,” Hopkins said. “In fact, thanks to vaccines, I haven't seen these diseases in over a decade.

“But here's what deeply concerns me: Many younger physicians have never been trained to recognize or manage these diseases, simply because vaccines have made them so rare,” Hopkins said. “If we weaken vaccine infrastructure or public confidence, we risk losing an entire generation of providers who will be caught unprepared and more importantly, risk children paying the price.

“In a world where we are advancing treatments and cures for complex pediatric conditions, it's alarming to think that we might slide backwards watching children suffer or die from illnesses we know how to prevent,” she said.