CDC's overhauled vaccine panel presses on despite concerns

WASHINGTON — A key vaccine advisory committee on Wednesday kicked off the first meeting of its newly installed lineup under a cloud of controversy — compounded by a financial conflict review that has already led one member to drop out.

Since Health and Human Services Secretary Robert F. Kennedy Jr. fired all 17 members of the Center for Disease Control’s Advisory Committee on Immunization Practices earlier this month and hand-picked eight new members, the public health community has raised concerns about how the panel may influence decisions going forward.

Several of the new members have a history of pushing back against pandemic-era COVID-19 vaccine policies. Health experts say the panel’s overhaul could have consequences for vaccine access broadly because many insurers link coverage to the CDC’s recommendations.The two-day meeting now underway may go a long way in showing whether those fears are justified. On Thursday, for example, the committee is set to make recommendations on the use in flu vaccines of thimerosal, a mercury-containing preservative that is used to prevent germs, fungus and bacteria from growing in vials. Some vaccine skeptics have claimed that the ingredient is linked to ADHD and autism, but the CDC itself says that claim has been debunked.

In remaking the body, Kennedy cited the need to remove conflicts of interest, asserting that the panel has been riddled with members who have close ties to the industry who can’t act independently.

“That committee has been a template for medical malpractice for years,” Kennedy said before the House Energy and Commerce Health Subcommittee on Tuesday.

But hours before the first meeting was set to begin, the panel was down to seven members after one backed out.

“Dr. Michael Ross decided to withdraw from ACIP during the financial holdings review required of members before they can start work on the committee,” an HHS spokesperson said in a statement. “The sacrifice to serve on ACIP varies from member to member, and we appreciate Dr. Ross’s willingness to go through this rigorous process. We would have benefited from his service and expertise on this committee.”

The spokesperson declined to say what the conflicts were and when a replacement would be chosen.

‘Very harsh’

The ACIP meeting began Wednesday with Martin Kulldorff, the new chair, proclaiming in opening remarks that “vaccines are not all good or bad.”

“If you think that all vaccines are safe and effective and want them all, or if you think that all vaccines are dangerous and don’t want any of them, then you don’t have much use for us,” he said.

Kulldorff was part of the Great Barrington Declaration along with Jay Bhattacharya, who is now director of the National Institutes of Health. The declaration called for the lifting of COVID-19 lockdowns before vaccines were available, citing the harm of isolation to society.

Kulldorff on Wednesday continued to defend his stance, saying he was unfairly fired from Harvard University during the pandemic for not complying with its COVID-19 vaccine requirement. He said he didn’t get the vaccine because he had “superior immunity” from being previously infected.

He added that he doesn’t think the news media has been fair to the new members for making them out to be anti-vaccine.

“Some media outlets have been very harsh on the new members of this committee, issuing false accusations and making concerted efforts to put scientists in either a pro-vaccine or anti-vaccine box,” he said.

Nevertheless, the public health community will be watching closely, as some anticipate that the new panel will have a profound effect.

“I fully expect that they will begin to alter recommendations, and I don’t think that it’s always going to be clear what their next move is,” said Richard Hughes, who teaches vaccine policy at the George Washington University and is a partner at the law firm Epstein Becker Green.

He said that in the absence of widely trusted ACIP recommendations, health care providers will be key in picking up the slack. Providers generally are more trusted than public health institutions, and professional societies should encourage them to leverage that trust in the wake of the committee upheaval, he said.

Wanting more expertise

In Congress, Sen. Bill Cassidy, R-La., who chairs the House Education, Labor and Pensions Committee, had voiced reservations about Kennedy’s vaccine stance before ultimately voting for him. In a floor speech ahead of his vote, Cassidy said Kennedy had made a slate of promises, including a pledge that Kennedy would maintain the committee recommendations with no changes.

Later, after Kennedy fired the previous members, Cassidy clarified for reporters that Kennedy committed to not changing the ACIP process but made no commitments about retaining certain members. Still, Cassidy made clear earlier this week that he didn’t think it would be a good idea for the committee to meet in its current form.

“Wednesday’s meeting should not proceed with a relatively small panel, and no CDC Director in place to approve the panel’s recommendations,” Cassidy wrote on X Monday. “The meeting should be delayed until the panel is fully staffed with more robust and balanced representation — as required by law — including those with more direct relevant expertise.”

The nominee for CDC director, Susan Monarez, was on the Hill on Wednesday for a hearing on her nomination at the HELP Committee, where Cassidy further raised concerns about the panel’s makeup.

“Part of the concern is that the people on the panel, although scientifically credentialed, no one has the experience with immunizations,” Cassidy said, adding that, “there are concerns about the rushed nature of this process.”

Others on the HELP Committee have pushed for a deeper look.

Sen. Bernie Sanders, I-Vt., the panel’s ranking member, called on Cassidy to carry out a bipartisan investigation into the firing of the panel’s members. He cited the American Medical Association’s emergency resolution on June 10 urging the committee to conduct oversight of the issue.

HELP member Lisa Blunt Rochester, D-Del., introduced a bill this month that would prevent the HHS secretary from terminating members of ACIP without cause and would require the secretary to reinstate the fired members.

The legislation is co-sponsored by Democratic Sens. Angela Alsobrooks of Maryland and Jeff Merkley of Oregon, who also serve on the committee, and Ben Ray Luján of New Mexico. Speaking on MSNBC’s “Morning Joe” show earlier this month, Blunt Rochester said she spoke with Cassidy about her concerns.

But Hughes said he thinks it will take drastic effects before Congress acts.

“I think it will take death, and visible death as a consequence of recommendations, for some of these members of Congress to have the political will to actually stand up to the administration and to the secretary,” he said. “And I think that is almost inevitable.”

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(Jessie Hellmann contributed to this report.)