The CDC advisory committee meeting on vaccination practices was postponed on February 15th, but the advisory committee has been warned about political interference
“Up to this point, every HHS director and every CDC director has been very enthusiastic about vaccines, as they save money and they’re an excellent preventive tool”, Fiore says. But if public confidence in vaccines gets undermined, vaccination levels could drop below the levels needed to reduce transmission and protect the population from disease, he says.
A meeting of the CDC’s advisory committee on immunization practices that was scheduled to be held in February was instead postponed, raising concerns among scientists about political interference in vaccine policy. The meeting will run for two days.
“I’m reassured and very glad to see that it’s happening,” says Claire Hannan, executive director of the Association of Immunization Managers. The review of data and science is important to look at the evidence that goes into the vaccine schedule.
During this week’s meeting, the committee’s independent advisors will hear from CDC staff on a range of vaccines, including HPV, COVID and flu, and vote on recommendations for some of them such as RSV and the tropical mosquito-borne viral disease chikungunya.
When asked about the change, HHS spokesperson Emily Hilliard responded on behalf of CDC: “ACIP agenda items are always subject to change depending on what the working groups have ready for consideration.” She clarified that the vote was not an annual one for when to use the vaccine.
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The experts who give up their time to serve on the committee are called advisors. Dorit Reiss expects them to remain independent and hold a lot of hardcore discussions while she teaches.
After extensive layoffs, CDC staff who help run the meetings are in a more vulnerable position and she’s concerned about the effects of political interference.
“I’ll be looking to see if they change the process in any way,” Reiss says. She says she’ll be watching for changes in how conflicts of interest are handled and whether or not they put time limits on discussions among committee members.
“You may see subtle signs of interference from political parties,” said Jetelina, who is an epidemiologist and data scientist. What it may take, she says, is “for those of us that have listened to hundreds of ACIP meetings to report back whether it is just business as usual or there’s some sketch things beneath the surface.”
The meeting was postponed to accommodate public comment in advance of it, according to an HHS spokesman.
In a presentation on vaccine efficacy, Heg said that vaccination may be skewed because people will seek out testing. CDC staff responded that their studies are designed to account for these and other types of bias. “We’re confident that [the impact of bias] is minimal and that the estimates are accurate,” said Dr. Aaron Frutos, an epidemiologist with CDC.
In this week’s meeting, Heg raised concerns about vaccine safety. Following a presentation on a study of the mpox vaccine in teens, Høeg said: “They excluded adolescents with underlying significant heart conditions and significant medical conditions. It’s important for providers to be aware of the safety of adolescents because we don’t know it.
The FDA represented them at the meeting, with Dr. Tracy Beth Heg, who has criticized the CDC for suggesting school closings during COVID. She was the liaison when Dr. Peter Marks resigned from the FDA in March.
The outbreak started in late January and has grown to more than 600 cases across Texas, New Mexico and Oklahoma. There are a number of requests from Texas for resources in the CDC’s response to the disease. The state lost hundreds of million of dollars in public health funding due to a federal clawback. Each case of the measles can cost up to $50,000 for public health response work.
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The Advisory Committee on immunization practices decided that meningococcal vaccines should be more widely available, and the age of recommendation forRSV vaccines should be lowered for people with certain risk factors. They voted to recommend that people who are likely to be exposed to the chikungunya virus be given a vaccine.
Over two days, members sat through detailed presentations on data and modeling for a range of vaccines – from mpox to flu, COVID and chikungunya – and asked questions to sharpen their assessments of the risks and benefits of different vaccines. At times the meeting got rowdy, as committee members dug into technical details, which is typical.
The February meeting of the committee was put off because of the appointment of Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services. Concerns about possible interference were heightened by the postponement.
“I am encouraged that the proceedings of ACIP have resumed, giving the American public a glimpse into the future of our nation’s vaccine policy in a time of great uncertainty”, said Sen. Lisa Blunt Rochester, a Democrat from Delaware. “As America faces measles outbreaks and a changing political landscape, the public deserves transparency.”
In watching the meeting, Katelyn Jetelina, an epidemiologist and data scientist, said, “It seems pretty much business as usual – and it’s sad that that is newsworthy.,” She writes the newsletter “Your Local Epidemiologist.”
Still, Jetelina said, there were nuances that reflect changes made by the Trump administration over the past few months. Trump’s team has made deep cuts to funding and resources for public health. The administratione elevated people who had questioned the efficacy and safety of vaccines into positions of influence over research and policy.
The effects were visible from the beginning. Technical issues plagued the beginning of the meeting and required a fresh link to the public livestream. The committee’s chair asked that you be patient because of some changes with the recent reductions in force.
The committee members thought about the resource cuts the most. Charlotte Moser, co-director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, probed for declines in CDC’s ability to evaluate how safe vaccines are, and how well they work.
“Are all of those [data collection systems] still funded to actively collect data through this season and then in anticipation of next season?” Moser asked, after a presentation on the efficacy of the 2024-2025 flu vaccine. In response, CDC epidemiologist Sascha Ellington said three of four flu vaccine surveillance networks would continue operating and that one would be shut down.