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How a purge at one obscure panel could disrupt US vaccinations

How a purge at one obscure panel could disrupt US vaccinations

Boston Globe17 hours ago

On Monday, Kennedy, long a vaccine skeptic,
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On the social platform X, he promised not to replace the panel's experts with 'ideological anti-vaxxers.' On Wednesday, Kennedy
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For years, Kennedy has argued that American children receive too many shots and has falsely claimed that vaccines are not tested in placebo-controlled studies. Critics fear he is now setting the stage for a rollback of federal recommendations.
Robert F. Kennedy Jr., Secretary of Health and Human Services, testifies on Capitol Hill in Washington, May 14, 2025.
HAIYUN JIANG/NYT
'I'm very, very worried about young children in this country,' said Dr. Helen Chu, professor of medicine at the University of Washington and one of the committee members who was fired. If the panel's new members 'don't believe in vaccines, then I think it puts us in a very dangerous place.'
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Richard Hughes IV, who teaches vaccine law at George Washington University, predicted that the new committee would move to pare back the childhood vaccination schedule 'relatively quickly.'
The Department of Health and Human Services did not respond to a request for comment.
'All of these individuals are committed to evidence-based medicine, gold-standard science, and common sense,' Kennedy said in a message on X. 'They have each committed to demanding definitive safety and efficacy data before making any new vaccine recommendations.'
He also acknowledged that the panel would 'review safety and efficacy data for the current schedule as well.'
The upheaval arrives as measles infections approach the highest level in decades; whooping cough has risen significantly, too, compared with this time last year. Steep cuts to global immunization programs also make it more likely that infectious diseases, such as polio, may reach American shores.
Alarmed, members of the House Committee on Oversight and Government Reform have asked Kennedy to provide all communications and documents related to the dismissal of the committee and a 'detailed description of the rationale for removing each individual' by June 24, according to a letter obtained by The New York Times.
The American Medical Association called for an immediate reversal of the purge and resolved to 'identify and evaluate' alternative sources of advice on vaccines.
It is unclear whether Kennedy will appoint more members -- there is no required minimum -- before the next scheduled meeting at the end of June. And no one can say whether or how the decisions of the reshaped panel may diverge from current recommendations.
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But any softening of federal recommendations regarding vaccination would ripple through the nation in unpredictable ways. Access to the shots eventually may depend on where you live, which insurance policy you hold and which doctor you see, experts said.
'That obviously is going to decrease the number of people who are protected with these vaccines,' said Dr. Mysheika Roberts, the health commissioner of Columbus, Ohio. 'I am concerned about what that means about herd immunity, what that means about outbreaks and infections.'
Under the Affordable Care Act, insurance companies are required to cover the cost of any vaccine recommended by the ACIP. Losing that endorsement means that some insurance companies may choose not to pay for immunizations.
Nor could those shots be offered for free through the Vaccines for Children program. The measles vaccine can cost up to $250 and the four-dose polio series up to $340.
'You'd essentially have a two-tier system where people who have cash at hand can purchase their own vaccines if they're not recommended, and those who don't have the money may have to go without,' said Dr. Yvonne Maldonado, a pediatrician at Stanford University and one of the fired panelists.
The panel could take a more measured approach, perhaps advising that a doctor's sign-off should be required for some immunizations. The vaccines program would still cover it, but reimbursement from private insurers would be more difficult to enforce, Hughes said.
The Vaccines for Children program was created after a measles epidemic from 1989 to 1991 led to tens of thousands of cases and hundreds of deaths. More than half of the infected children were unvaccinated even though many had seen a doctor, because they could not afford the shots, according to the CDC.
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Cutting back on free access to immunizations 'is not a strategy to even think about -- only vaccinating potentially the half of the population that has health insurance,' Chu said. If measles continues to resurge, for example, even vaccinated people will be at risk, she said.
Vaccinations are not profitable for clinics, and reduced demand could mean that fewer places bother to offer the shots. 'In places where you know there's a large anti-vax sentiment, there may not be financial incentive, or any incentive, to keep those vaccines in stock,' she said.
ACIP makes recommendations for immunizations. But the authority to mandate them rests with the states.
Even if the federal government walked away from some recommendations, most, if not all, states are likely to maintain the current mandates for school-age children, said Claire Hannan, executive director of the Association of Immunization Managers, which represents state and local officials.
'Even where legislators are chipping away at requirements and mandates, there's a commitment to protect children,' she said.
Still, she added, 'our members are very confused.'
Now some scientists are considering establishing alternatives to federal guidance on vaccines. 'The new ACIP cannot be trusted to oversee unbiased and scientifically sound vaccine policy development,' said Michael Osterholm, a public health researcher at the University of Minnesota.
He and other experts have formed a new group, called the Vaccine Integrity Project, to offer science-based advice on immunization.
Members of the ACIP are usually vetted thoroughly. It took more than four months for Roberts, who was set to join the panel in July, to be accepted, and several more weeks to fill out at least 50 forms, including disclosures of conflict of interest. The committee's members typically rotate in staggered four-year terms to ensure some continuity and institutional memory.
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Mina Zadeh, a CDC scientist, has been named to oversee the committee, but the rest of her team has not been set up. Staff members who lead the committee's work groups may meet with her 'starting early next week,' according to a recording of an internal meeting obtained by the Times.
But the panel's next meeting is scheduled to begin June 25. Dr. Adam Ratner, a pediatric infectious diseases physician and expert on vaccine policy, said he worried the new members could not be prepared on such short notice and without the help of previous members or CDC personnel.
'This raises the question of whether the goal here is for ACIP to be able to do its job,' he added. 'Kennedy has accused the prior committee members of conflicts of interest and for rubber-stamping things, but I think that's exactly what we're looking at with this group.'
This article originally appeared in
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