The ACIP Purge: Science vs. Ideology

Why firing the entire CDC vaccine committee marks a dangerous turning point for American public health

On Monday, RFK Jr announced in a Wall Street Journal op-ed that he is firing all of the members of the CDC Advisory Committee on Immunization Practices (ACIP). He is claiming this is due to conflicts of interest. Let’s discuss this decision and what RFK Jr said in his op-ed…

But first, some context: This move is both alarming and unprecedented. Since 1964, the Advisory Committee on Immunization Practices (ACIP) has guided U.S. vaccine policy across 11 administrations. Members are selected through a nonpartisan process, vetted for expertise, and approved by the CDC Director. They serve staggered terms and have never been politically appointed or fully disbanded—until now. This sets a dangerous precedent, allowing an administration to dismantle an independent scientific body and replace it wholesale, undermining scientific integrity and public trust.

We believe in leading with empathy and keeping politics out of science. But anyone with the power to influence national health policy must be held to the highest standards, no matter who is in office. Our concerns about this action would be the same under any administration.

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What does the Advisory Committee on Immunization Practices (ACIP) even do?

For over 60 years, the ACIP has developed recommendations related to:

• Those who should receive each available vaccine

• When vaccines should be given (timing and scheduling)

• Special circumstances that may affect vaccine scheduling

• Safety concerns and known contraindications

• Protection against outbreaks, pandemics, and emerging threats

Who is on the ACIP?

The ACIP is composed of a distinguished group of experts who bring a wealth of knowledge and experience in clinical medicine, public health, and immunology. ACIP members include up to 19 voting professionals who are recognized leaders in their respective fields, such as physicians, pharmacists, epidemiologists, immunologists, and vaccine researchers (18 members plus one layperson representative for a total of 19). These individuals are selected based on their scientific expertise, professional achievements, and deep understanding of immunization practices and vaccine-preventable diseases. In addition to medical professionals, the committee also includes a consumer representative who provides insights into the social and community aspects of immunization programs.

Members are expected to actively participate in public meetings, contribute to specialized work groups, and help develop evidence-based recommendations that guide national immunization policies. Members of the ACIP serve voluntarily and receive only travel expense reimbursement and an optional $250 daily honorarium when attending meetings—a minimal amount compared to the millions Kennedy has made from anti-vaccine activism. This voluntary service underscores the public-minded commitment of these experts. They contribute their valuable time and expertise to guide national vaccine policy without financial compensation.

Turning Back the Clock: The Consequences of Undermining ACIP

Before the ACIP was established, U.S. vaccine recommendations came largely from the American Academy of Pediatrics (AAP). In 1995, the ACIP, AAP, and the American Academy of Family Physicians (AAFP) jointly approved the first unified childhood immunization schedule. This was a major step that resolved previously conflicting guidance and built trust among clinicians and the public.

Recent actions risk undoing that progress. Without unified recommendations, professional groups, agencies, or states may issue conflicting guidance, leading to confusion and eroding public and clinician confidence.

Why this matters:

• The CDC bases its official vaccine guidelines on ACIP recommendations. Though ultimately the decision rests with the Director of the CDC (or, when there is no Director, the Secretary of HHS), rarely does the Director adopt recommendations different than those of the ACIP. Though it has occasionally happened.

• ACIP guidance also drives access through the Vaccines for Children (VFC) Program, which provides free vaccines to eligible children. This safety net is critical: from 2012 to 2022, over half (52.2%) of U.S. children qualified for the VFC program because they are uninsured, underinsured, Medicaid eligible, or from an at-risk ethnic group (Alaska Native and American Indian).

• Without a trusted national standard, insurance coverage for vaccines could be an issue. Under the Affordable Care Act (Section 2713 of the Public Health Service Act, codified as 42 U.S.C. § 300gg-13), ACIP recommendations determine which vaccines must be covered by insurance. If ACIP guidance were politically compromised or eliminated, insurers could deny or drop coverage, making essential vaccines unaffordable for many families, disproportionately harming communities of color. Some states, like Colorado, have already passed legislation to protect vaccine decisions from political interference, allowing public health officials to follow expert guidance even if national leadership falters. But imagine a future where access to lifesaving vaccines depends entirely on what state you live in.

• ACIP continuously monitors vaccine safety and effectiveness, updating recommendations as new evidence emerges. The voting members don’t do this work alone; this work involves hundreds of experts behind the scenes who rigorously review, analyze, and communicate complex data to guide sound vaccine decisions.

• The ACIP has earned public trust through transparency, including streamed meetings, publicly available conflict-of-interest disclosures, and opportunities for public comment. However, with these recent unprecedented actions, trust in the process is at risk. The current health administration has not demonstrated a commitment to transparency. Announcing unilateral decisions publicly, then offering vague, post-hoc justifications, is not the same as engaging in an open, evidence-based process. A new ACIP may lack the scientific rigor and transparency that have long defined the committee’s work, opening the door to misinformation and political interference.

• The global implications extend beyond vaccine policy. ACIP recommendations serve as the gold standard worldwide. Many countries base their vaccination policies on ACIP guidance, and international health organizations look to these recommendations when developing global strategies. Replacing scientific experts with ideological appointees damages America's credibility as a leader in global health.

Is there really a conflict of interest issue?

In RFK Jr.’s op-ed, he stated that the ACIP committee members all have serious conflicts of interest that impact their vaccine decision-making. However, the data he cites is 15-25 years old and is missing critical context.

For example, he specifically cites a 2009 report. However, he failed to give the true context of this report. The report focused on all 17 CDC advisory committees, not just ACIP. The report did NOT find serious conflicts of interest. Instead, it showed that many forms (97%) had errors and omissions due to form errors, such as putting information in the wrong sections, or failing to initial and date in the correct places. A further dive into the data suggested that only 3% of the votes included some form of COI, and a member who should have recused themselves did not. But we don’t know how many votes within the ACIP were among those impacted. This is an important piece of context RFK Jr. failed to include in his statement.

The evidence directly contradicts Kennedy’s claims. Recent independent investigations into ACIP members since Kennedy began making these accusations have found no substantial conflicts or disclosure errors.

The statement also failed to acknowledge that there already is a public conflict of interest policy that all ACIP members must adhere to– in fact, it is one of the most stringent in government.

Every single meeting member must disclose any potential conflicts of interest. If there are some, the member does not vote on the vaccine recommendations. We can see all stated conflicts of interest on the CDC website, and we can also find many examples from ACIP records of people abstaining from the vote to ensure it was unbiased.

• All relationships must be disclosed publicly at every meeting

• Members routinely recuse themselves from votes when any potential conflict exists

• Financial ties to vaccine manufacturers are strictly limited

• All deliberations occur in public, via live-streamed meetings. Those who miss the live streams can access recordings and all meeting materials.

Has ACIP demonstrated poor decision-making?

In his statement, RFK Jr said, “The committee has been plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine. It has never recommended against a vaccine, even those later withdrawn for safety reasons.”

This quote is problematic because:

1. The committee has recommended against vaccines or given very restricted recommendations. For example, they recommended against the live attenuated influenza vaccine (nasal spray) in the 2016-2017 vaccine season, even though orders had already been placed, due to concerns that it was not effective enough. They narrowed their recommendation for the Janssen (Johnson & Johnson) COVID-19 vaccine, advising preferential use of other vaccines after reports of rare blood clotting side effects. They also restricted the dengue virus vaccine to those of a certain age, in specific locations, with documented prior infection.

2. ACIP makes recommendations about how and if vaccines should be used only after a vaccine has already been authorized or approved by the FDA. This means it has already gone through clinical trials. There are many checks and balances before the ACIP even has the chance to weigh in. Most trials fail long before they even put their application into the FDA for approval! This is not a carte blanche rubber stamp he wants you to believe.

In his op-ed, Kennedy also said, “Four out of eight ACIP members who voted in 1997 on guidelines for the Rotashield vaccine, subsequently withdrawn because of severe adverse events, had financial ties to pharmaceutical companies developing other rotavirus vaccines.” But, hold on a second…

Kennedy's attack on ACIP using the rotavirus example reveals his fundamental misunderstanding of how vaccine safety monitoring works. When he claims ACIP failed because they recommended Rotashield before it was withdrawn due to safety concerns, he's actually describing the post-market surveillance system working exactly as designed.

ACIP made its initial recommendation based on the best available evidence at the time, which showed the vaccine was safe and effective in preventing a disease that killed hundreds of children annually. The intussusception risk was approximately 1 case per 11,000-16,000 vaccine recipients - far too rare to detect in pre-licensure trials of ~10,000 participants under the "rule of 3." This is a basic statistical reality - rare events that occur in 1 in 10,000+ people simply cannot be reliably detected in smaller studies, no matter how rigorous the trial design. There was no data available during the initial ACIP meeting on Rotashield that would have shown this association.

In 1999, the Vaccine Adverse Event Reporting System (VAERS) vaccine surveillance system, VAERS detected the signal with 15 cases reported. Investigations were immediately launched, and the CDC immediately recommended a temporary suspension pending the results of new studies. Several months later, once the association was confirmed, the ACIP withdrew its recommendation. This decision, made by ACIP, highlights the rigorous safety monitoring systems in place for vaccines in the United States. Even after a vaccine is licensed, ACIP and its partners—including the CDC and FDA—continue to monitor for adverse events through systems like VAERS and VSafe.

This wasn't an ACIP failure - this was the entire vaccine safety system working at its BEST as intended. The rapid identification and response to the Rotashield issue demonstrated the commitment to public safety and ACIP's ability to respond swiftly and transparently when new safety data emerge, reinforcing public trust in the immunization process.

The lesson learned led to better vaccines, not fewer vaccines. Current rotavirus vaccines (Rotarix/RotaTeq) have much lower risks (~1.5 cases per 100,000 doses) precisely because manufacturers expanded pre-licensure trials to ~70,000+ participants based on Rotashield lessons. The system identified a problem, fixed it, and improved - exactly what good science should do.

Kennedy's framing of this as an ACIP failure shows he either doesn't understand how vaccine safety monitoring works or he's deliberately misrepresenting a success story as a scandal.

The Real Pattern: Dismantling Scientific Infrastructure

This ACIP firing is part of a broader assault on scientific expertise across federal health agencies. Kennedy has already:

• Bypassed ACIP entirely when changing COVID-19 vaccine recommendations

• Canceled or postponed multiple vaccine advisory meetings

• Terminated or recommended terminating nine other CDC advisory committees

• Promoted individuals with histories of vaccine opposition to key positions

Each move follows the same playbook: attack the credibility of existing experts, claim transparency while operating in secrecy, then replace evidence-based processes with ideologically driven decisions.

What This Means for Families

The practical consequences are immediate and far-reaching:

• Insurance uncertainty: Families may lose coverage for essential vaccines as insurers lose their trusted guidance source

• Fragmented care: Pediatricians may receive conflicting guidance from different sources, creating confusion about the best care for children

• School requirements in chaos: States that tie school vaccination requirements to ACIP recommendations face automatic policy changes

• Pharmacist limitations: In many states, pharmacists can only administer ACIP-recommended vaccines, potentially limiting where families can access immunizations

The real conflict of interest is undermining health for power

We all want rigorous vaccine safety oversight and genuine transparency about conflicts of interest. But if Kennedy truly cares about conflicts of interest, why is he ignoring his own massive financial stakes in undermining vaccine confidence?

Let's talk about actual conflicts of interest. Kennedy has built a financial empire worth millions by opposing vaccines, yet claims ACIP members who conduct legitimate research are "conflicted."His combined actions earned him a place in the “Disinformation Dozen”, a list of the most prolific and dangerous sources of vaccine misinformation.

Kennedy's massive financial conflicts:

• Children's Health Defense revenue: Kennedy founded and led an organization that has raised tens of millions of dollars specifically by promoting vaccine opposition and fear

• Legal profiteering: His law firm profits from high-stakes litigation against vaccine makers, including ongoing Gardasil cases that could yield hundreds of millions.

• Speaking fees and book deals: Kennedy earns income from books, appearances, and events that thrive on vaccine controversy.

• Supplement industry ties: Kennedy has promoted alternative health products positioned as “safer” than vaccines.

• Who he is surrounded by: He surrounds himself with people who also profit from vaccine fear. Those who are anti-vaccine influencers, supplement sellers, and litigants.

The math is simple: Kennedy has made far more money from opposing vaccines than any ACIP member has ever made from researching them. ACIP members are unpaid volunteers who disclose every potential conflict. Kennedy built his career and fortune on vaccine opposition, yet faces no scrutiny for these obvious financial incentives to undermine vaccine confidence.

If conflicts of interest are truly the concern, Kennedy should be the first person removed from vaccine decision-making, not the last person making those decisions.

Despite what headlines may suggest, vaccines remain one of the few issues most Americans still agree on. While confidence is fragile and easily manipulated, a broad majority, across political lines, continues to believe in the safety and benefits of vaccines. Efforts to dismantle access or erode trust in vaccines run counter to what most Americans want and believe.

Senator Bill Cassidy's reaction says it all. The Republican physician who voted to confirm Kennedy despite reservations immediately expressed alarm, saying: "The fear is that the ACIP will be filled up with people who know nothing about vaccines except suspicion." Even Kennedy's supporters recognize this decision crosses a dangerous line.

This isn't about improving vaccine science—it's about replacing scientific expertise with anti-vaccine ideology. When Kennedy claims to be "restoring trust" while systematically dismantling the institutions that built that trust over decades, the contradiction reveals the true agenda.

The 64-year legacy of ACIP ends not with scientific evidence showing it failed, but with a political decision that expertise itself is the enemy. When that becomes acceptable, no scientific institution is safe, and everyone loses, putting lives in unnecessary danger.

Stay Curious,

Unbiased Science

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