Medical groups and US states work to circumvent Kennedy's vaccine decisions
This push for an alternative standard to the one set by the federal government runs the risk of increasing confusion among providers and patients, according to health experts.
It also runs up against hundreds of laws at the state level that rely on a federal vaccine advisory panel, the experts said. The Advisory Committee on Immunization Practices, or ACIP, advises the U.S. Centers for Disease Control and Prevention on which people should receive vaccines and at what intervals after they are approved by the Food and Drug Administration.
Kennedy has spent decades sowing doubts about vaccines even when contradicted by scientific evidence. Since being appointed by Republican President Donald Trump to head the U.S. Department of Health and Human Services, or HHS, Kennedy has upended the federal government's process for recommending vaccines for the American public.
Kennedy last month fired all 17 ACIP members, replacing them with hand-picked advisers including anti-vaccine activists. Prior to that, Kennedy in May withdrew a federal recommendation for COVID shots for pregnant women and healthy children without ACIP's input, saying there was not enough evidence to support offering these boosters to healthy children.
Leading U.S. medical organizations including the American Academy of Pediatrics, known as AAP, and the Infectious Diseases Society of America, called IDSA, have sued Kennedy over the COVID decision.
AAP said it will promote its own evidence-based vaccine guidelines starting with the fall respiratory season for COVID, influenza and respiratory syncytial virus, or RSV.
"We simply cannot and will not stay silent as the system we rely on is being intentionally dismantled," Dr. Sue Kressly, the academy's president, told Reuters.
The American College of Obstetricians and Gynecologists, called ACOG, is also developing guidelines for the upcoming respiratory illness season, to be issued in August or September. An ACOG spokesperson said the organization continues to recommend COVID vaccines for pregnant women, a group at increased risk for severe COVID and pregnancy complications.
The spokesperson also said the organization rejects a recommendation by Kennedy's vaccine panel against flu shots containing thimerosal, a mercury-containing preservative that vaccine skeptics long have sought to link to autism despite evidence that these vaccines are safe.
Both organizations and several others including the IDSA are collaborating with the Vaccine Integrity Project, a group of public health and infectious disease experts formed amid concerns about changes to vaccine policy, to review the latest scientific evidence on licensed vaccines for use in their guidelines.
"What we're trying to do is add a piece of non-biased, authoritative review of the data for use by the (medical) societies," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who served as an adviser to Democratic former President Joe Biden on COVID.
An HHS spokesperson defended Kennedy's actions, saying the newly configured panel brings "fresh, independent scientific judgment" and that ACIP "will continue to be the statutory authority guiding immunization policy in this country."
Jen Kates, a senior analyst at the nonprofit health policy organization KFF, said U.S. states have always maintained a patchwork of health policies. But having multiple entities issuing vaccine recommendations at the state and federal levels could make it hard for parents to know who to trust, according to Kates.
"This patchwork could become even more pronounced with significant implications for health. State laws and requirements may vary, but pathogens don't abide by borders," Kates said.
Recommendations issued by ACIP since its founding in 1964 have become embedded in laws across the United States governing health insurance coverage, access to vaccines for children in low-income families, school immunizations, the ability of pharmacists to administer vaccines, and, in some states, vaccine purchasing.
"It is mind-numbing when you compare how many things are impacted by ACIP," said Rebecca Coyle, who serves as executive director of the American Immunization Registry Association, an organization that develops and updates vaccination information systems used by physicians, and as an adviser to ACIP.
An analysis by the Association of State and Territorial Health Officials found that nearly 600 statutes and regulations across 49 of the 50 U.S. states, three U.S. territories and Washington, D.C., reference ACIP recommendations.
Several states have already taken action.
Wisconsin said it continues to recommend the current COVID vaccine during pregnancy and for everyone age 6 months and older, and noted that the state's Medicaid health program for low-income people will continue to cover the shot for eligible people. The Democratic governors of California, Washington state and Oregon condemned Kennedy's dismissal of the ACIP panel members, citing their "grave concerns" about the integrity and transparency of upcoming federal vaccine recommendations.
These states said they will continue to recommend COVID vaccines for children 6 months and older and pregnant women in accord with leading U.S. medical associations.
Some states have started rewriting statutes to no longer defer exclusively to ACIP. Colorado, for instance, has amended laws to include vaccine recommendations from major medical societies in addition to ACIP when setting the state's policies for immunizing schoolchildren.
Massachusetts lawmakers are considering legislation proposed by Democratic Governor Maura Healey to empower the state's public health commissioner to determine routine childhood immunizations in lieu of ACIP's recommendations. Legislators in Maine have removed references to ACIP from a state vaccine access law.
Osterholm said health insurers have told the Vaccine Integrity Project that they would be more likely to cover uniform vaccine recommendations, increasing pressure for alignment among various groups.
"We need to come together the best we can," Osterholm said, but "we can't leave the ACIP or HHS recommendations as the only other source out there."
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