ACIP's First Meeting: Core Takeaways After the Dust Settled

I slept on it, and here's what stands out to me

Note: This is not a fact-check document. Several colleagues and I teamed up to create both a pre-ACIP anticipatory briefing and detailed two-day fact-checking documents available here. Instead, these are my core takeaways, having slept on what we witnessed… the moments that stood out most after watching this meeting unfold.

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The anxiety was palpable all week. I was popping TUMS like TicTacs. My public health colleagues and I found ourselves distracted, unable to concentrate well, all fixated on the looming ACIP meeting. We were about to witness the first meeting since all 17 expert members were replaced with 8 new appointees. We didn't know what to expect, but given some members' backgrounds, we were bracing for outcomes that could disappoint those of us who've spent our careers fighting for evidence-based preventive medicine.

The stakes became clear immediately: The American Academy of Pediatrics announced its liaisons would not be participating in the meeting, with AAP President Sue Kressly stating the ACIP process is "no longer credible." This followed similar concerns from other professional medical groups. When one committee member dismissed this professional boycott as "childish," it revealed a troubling disconnect. These organizations represent thousands of physicians who care for patients affected by ACIP decisions. Their absence wasn't petulance– it was a principled stand that sent a clear message about the gravity of this moment.

Despite facing questions that revealed fundamental misunderstandings of basic epidemiologic methods, CDC scientists demonstrated exactly why evidence-based medicine works. Their presentations were masterfully crafted showcases of evidence, thorough, precise, and beautiful in their scientific rigor. This wasn't surprising given their expertise, but it was striking to watch them maintain such professionalism under difficult circumstances. (I don’t know that I could have done the same.)

What Surprised Me

• The RSV monoclonal antibody recommendation passed. The committee voted to recommend the new RSV monoclonal antibody for infants. Given some members' stated skepticism about newer interventions, this caught some of us off guard. It crossed our minds that this might have been an intentional way to signal they aren't anti-vaccine, even though monoclonal antibodies aren't technically vaccines, they're still preventive interventions that vaccine skeptics often oppose.

• The flu vaccine recommendation sailed through. The general flu vaccine recommendation for all persons aged 6 months and older passed 6-1 with one abstention—overwhelmingly in favor. Again, this felt potentially strategic, a way to counter "anti-vaccine" accusations before moving to more controversial territory.

• Unexpected allies. During the public comment period, a naturopath spoke up in defense of evidence-based medicine. Given the frequent tensions between the naturopathic community and the scientific establishment, this was striking. He even highlighted that conflicts of interest extend beyond pharmaceutical companies to include things like supplement sales, calling out what he saw as a double standard. Unfortunately, his audio mysteriously cut off before he could finish his remarks, but hearing this perspective from such an unexpected source was genuinely refreshing.

• The public comments were deeply moving. Countless scientists and clinicians called in to express their concerns, pleading with the committee to put political differences aside and focus on what's best for the American people. I found myself getting teary-eyed hearing the raw emotion in their voices—the recognition that these decisions have very real impacts on people's lives. (I suppose this isn’t surprising - but I did not expect to have to grab a Kleenex!)

• Moments of unintentional levity. A hot mic capturing someone's laugh when a member admitted uncertainty about their conflicts of interest, or watching CDC scientists' facial expressions as they tried to maintain composure while having to educate committee members on how vaccine trials work.

What Worried Me Most

• The casual dropping of anti-vaccine dog whistles. Watching autism (as well as other things like suicidal ideation, tics, etc.) discussed in the context of vaccines (despite decades of evidence showing no connection) felt like stepping back in time. Hearing 250 pediatric flu deaths described as "modest" made me think of grieving parents who might be watching.

• The thimerosal presentation and votes. A presentation that omitted updated data while resurrecting decades-debunked claims, followed by votes against thimerosal-containing flu vaccines (about 4-7% of the supply) based not on new safety data but on fear-based reasoning about theoretical risks from cherry-picked studies. It was also delivered by the former head of the Children’s Health Defense (a known anti-vaxx advocacy group), who ended the presentation with a MAHA battle cry.

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• The procedural breakdown. This felt like watching a strategic game unfold. Normal ACIP processes were systematically bypassed. Presentations that would typically undergo workgroup review and fact-checking were allowed without scrutiny. Materials were posted to the ACIP website, then quietly removed. A comprehensive CDC-authored review of thimerosal based on decades of global data was pulled because the Secretary's office hadn't "approved" its publication, while unvetted materials filled with outdated information moved forward unchallenged.

• What didn't happen. The COVID-19 vaccine vote was mysteriously removed from the agenda at the last minute. Americans now have no official guidance for fall 2025 vaccines, creating confusion for manufacturers, insurers, and healthcare providers planning for the respiratory virus season. This may prove to be the most practically significant outcome for patients this fall.

• Seeds being planted for future meetings. Even discussions without votes felt strategic. The brief mention of MMRV and fever risk, the casual references to reviewing "cumulative vaccine schedules" and vaccines "not reviewed in seven years": these were seeds being planted for future meetings. Thousands tune into these proceedings, and thousands more encounter the takeaways through media coverage.

• Voting inconsistencies. Members who voted AGAINST the RSV monoclonal antibody then voted FOR its inclusion in the Vaccines for Children program. This suggested either confusion about basic ACIP processes or internal logical inconsistencies, and it left me scratching my head.

• The dismissal of expertise. Underneath the procedural chaos was something more troubling: a casual dismissal of the very expertise that has made our vaccine programs among the safest, most effective in the world. Of course, people without PhDs or MDs can offer valuable perspectives and insights on scientific matters, and diverse viewpoints often strengthen scientific discourse. However, suggesting that the rigorous training, methodological expertise, and deep subject knowledge that advanced degrees represent shouldn't carry significant weight in scientific conversations risks undermining the very foundation of evidence-based inquiry and informed decision-making.

The Bigger Picture

This meeting was just the opening move in what appears to be a much longer strategic campaign. The announced workgroups targeting routine childhood vaccines, the systematic undermining of normal scientific processes, the dismissal of medical expertise… to me, it feels coordinated rather than chaotic. The suspicious timing of that pregnancy/miscarriage preprint released just days before the meeting only reinforced this impression and didn’t sit well. I am usually an optimist and tend to assume good intentions, but it kinda feels like something is rotten in the state of Denmark

The ripple effects extend far beyond U.S. borders. When America moves away from preservatives like thimerosal without scientific justification, it signals to the world that there might be safety concerns (even when there aren't). This could affect vaccine access globally, particularly in settings where multi-dose vials with preservatives are essential for reaching vulnerable populations.

The Medical Community's Response

But the medical establishment isn't standing idle. Beyond the professional societies' stance, the American Medical Association issued a strong statement condemning the removal of expert committee members and calling for a Senate investigation. Nearly 80 medical organizations have signaled their commitment to following evidence-based recommendations regardless of political interference. Insurance companies have affirmed their commitment to covering fall vaccines (this is a BIG deal– more on this soon).

We may be witnessing the formation of what some are calling a "shadow ACIP": trusted medical voices stepping up to provide the evidence-based guidance that Americans deserve when official channels fail them. Communication experts are mobilizing to combat confusion and provide clarity where official messaging falls short.

Truthfully, I'm not sure how to feel about this. The American public is already confused about whom or what to trust when it comes to health information. Does having competing sources of guidance add to that confusion? This feels like a real turning point in public health policy—when the official advisory body loses credibility, and we have to rely on parallel systems to maintain scientific integrity.

This is Bigger than One Committee Meeting

This isn't about any individual committee member or single vaccine. It's about maintaining the integrity of a system that has protected public health for decades. When we move from evidence-based to fear-based decision-making, when theoretical risks outweigh proven benefits, when expertise is dismissed as elitism, we're not just changing policy—we're changing how we think about risk itself.

The science behind vaccines remains solid, regardless of who sits on ACIP. These products have undergone the most rigorous safety monitoring in medical history. But this meeting reminded me that expertise, evidence, and careful deliberation can't be taken for granted in our current environment.

We may not have known what to expect going into this week, but I know what's at stake coming out of it: the foundation of preventive medicine itself, and the thousands of lives that depend on evidence-based public health decisions.

The real test isn't what happened in this meeting… It's what happens next, and whether the broader medical community can maintain the integrity of evidence-based recommendations when politics threatens to override science.

Stay curious,

Unbiased Science

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