Explainer: What is the role of Kennedy's newly appointed US vaccine advisory panel?

Reuters

5 hours ago

WASHINGTON, June 25 (Reuters) - U.S. Health Secretary Robert F. Kennedy Jr. fired all 17 members of a national vaccine advisory board, naming eight new members of his choosing and upending the process for recommending shots for the American public.
The surprise move drew widespread condemnation from doctors and public health experts, who say it will further undermine confidence in national vaccine policy.
Here are details on how the panel works:
The Advisory Committee for Immunization Practices, or ACIP, is an outside panel of experts that helps the U.S. Centers for Disease Control and Prevention decide how specific vaccines are used, who should be taking them, and when they should do so.
The committee makes recommendations to the CDC on vaccines that have already been approved as safe and effective by the U.S. Food and Drug Administration.
ACIP members vote on recommendations for a vaccine's use in a public meeting, after reviewing data on how specific diseases affect different populations, information on vaccine safety and efficacy, economic analyses and implementation issues.
Their recommendations are not binding and can be overruled by the CDC director, a rare but not unprecedented occurrence.
Once the CDC director signs off on the ACIP recommendations, they become part of the U.S. vaccine schedule for adults and children, which is used to determine health insurance coverage.
The Affordable Care Act generally requires insurers to cover vaccines that are listed on the CDC vaccine schedule. The recommendations also determine what the CDC's Vaccines for Children program will provide free of charge to families without insurance.
Up to 19 voting ACIP members are appointed to four-year terms by the U.S. Secretary for Health and Human Services, according to the panel's charter.
It has six non-voting members representing the Health Resources and Services Administration; the FDA; the Centers for Medicare and Medicaid Services; the National Institutes of Health; the Indian Health Service; and HHS's Office of Infectious Disease and HIV/AIDS Policy.
There are an additional 31 non-voting liaisons from various medical associations, industry groups and other organizations.
All 17 members fired by Kennedy had been appointed by President Joe Biden, including 13 who began their terms in 2024. Kennedy does have authority under the Federal Advisory Committee Act to add and remove members. Firings of advisory committee members are rare, however. The law also requires a diversity of viewpoints across the membership.
Vetting and onboarding new panel members typically takes months to ensure they are qualified and free of conflicts of interest.
Kennedy justified the firings by saying the departing ACIP panel was rife with conflicts of interest but provided no specific evidence for individual advisers.
ACIP members must declare any potential conflicts of interest that arise in the course of their tenure and any relevant business interests, positions of authority or other connections with organizations relevant to the committee's work.
Members must abstain from votes on any vaccine for which they have a conflict, as well as any rival to that vaccine or any product from the same manufacturer, according to CDC rules.
They are required to divest all stock in vaccine makers and stop any active consulting work for those companies before joining the panel. They cannot accept travel or food from vaccine companies or collect product royalties. Similar restrictions apply to family members.
ACIP members can keep working on vaccine clinical trials funded by industry and those research grants can help cover their salaries. They are required to file annual disclosures and recuse themselves from votes when specific conflicts arise.
The American Medical Association, the influential trade group for physicians, urged the U.S. Senate Committee that confirmed Kennedy as health secretary to investigate the ACIP shakeup, saying it undermines public trust in vaccines.
Kennedy's ouster of ACIP members could also end up in court, said Professor Sara Rosenbaum, chair of the Department of Health Policy at the George Washington University School of Public Health and a former ACIP adviser.
Health insurers, drugmakers and providers who all use the committee's recommendations could have grounds to mount legal challenges, she said.
The lawsuits could be brought under the Administrative Procedure Act, which directs how federal agencies make changes such as appointments and removals. Courts have ruled against this type of change to advisory committee membership in other cases.
During President Donald Trump's first administration, at least three courts sided with the challengers in a group of lawsuits over a directive that resulted in the disqualification of many scientists serving on Environmental Protection Agency advisory committees.