New Charter Unveiled for CDC's Influential Vaccine Committee

 'Changes to rules governing ACIP could inject more politicization, advocates warn'

A new charter calls on the CDC's Advisory Committee on Immunization Practices (ACIP) to consider "non-vaccine interventions" and changes the focus, membership structure, and rules that govern the influential panel.

Societies led by the Infectious Diseases Society of America (IDSA) warned the updates could threaten access to immunizations and erode trust in U.S. vaccine policy.

"The new charter inappropriately emphasizes potential gaps or limitations in vaccine data, which could be used to delay, rescind, or refuse to make evidence-based vaccine recommendations," the groups said in a statement.

They also said the "governance of the committee would be the responsibility of the CDC director instead of members with deep expertise on immunization, which would intensify politicization of the ACIP."

While the panel's 2024 charter had the CDC's National Center for Immunization and Respiratory Diseases supporting ACIP, the new charter puts ACIP's support in the hands of the CDC Office of the Chief of Staff and other agency components, as directed by the CDC director.

"That is a meaningful governance change that signals greater political involvement," said Richard Hughes IV, in emailed remarks. Hughes is lead counsel on the American Academy of Pediatrics' lawsuit that halted some of the drastic changes made by HHS Secretary Robert F. Kennedy Jr. to ACIP and the childhood immunization schedule.

Dorit Reiss, PhD, a law professor at the University of California San Francisco, pointed out that the new charter fails to require three meetings a year. The new language instead says "meetings will be held at the discretion of the ACIP Designated Federal Officer in consultation with the Chair."

Dropping the three-meeting requirement will make meetings less predictable, give HHS and CDC more discretion over timing, and could affect the pace of vaccine guidance, cautioned Hughes.

The charter also "adds four problematic organizations with anti-vaccine leanings to the liaison representatives," noted Reiss, including the Association of American Physicians and Surgeons, the Independent Medical Alliance, the Medical Academy of Pediatrics and Special Needs, and Physicians for Informed Consent.

Yet not on the list of ACIP's 33 nonvoting liaison organizations is the American College of Obstetricians and Gynecologists, which withdrew as a liaison organization in February and recently released its own vaccine guidance for pregnant women.

That's not good, Reiss told MedPage Today.

IDSA and the other societies -- which include the Pediatric Infectious Diseases Society, the Society for Healthcare Epidemiology of America, and the Society of Infectious Diseases Pharmacists -- also highlighted that the charter softens requirements about the "publication of vaccine recommendations and their use for informing insurance coverage."

Taken together, Hughes said, "these changes suggest HHS is reshaping ACIP's structure, membership environment, and operating framework while reducing the charter's explicit acknowledgement of the legal consequences that make ACIP so important."

The new charter comes after a federal judge ruled in March that Kennedy likely violated federal procedures when he ousted all of ACIP's members last year, replacing them with members that lacked the requisite experience and included vaccine skeptics.

Reiss said the new charter is an improvement over a prior attempt released in April that put greater emphasis on potential vaccine harms and was pulled by HHS about a month later.

That earlier charter tried to legitimate Kennedy's panel changes and the new charter "is a retreat from that," said Reiss.

First, the new charter provides a thorough and well-organized section on ACIP's functions that's in line with the committee's traditional roles, she noted. It also emphasizes the need for a transparent and evidence-based decision-making process, and the relevance of scientific, clinical, and public health expertise among panel members, in line with the committee's mission.

Finally, it pulls back from the April version's language about vaccine adverse events and safety research gaps, cumulative exposure to vaccines and vaccine components, and mRNA platforms.

Still, "that does not cure the underlying legal concerns -- it appears to revise the paper trail while preserving many of the structural changes," cautioned Hughes.

The new charter has language calling for the panel membership to include "a person(s) knowledgeable about consumer perspectives and/or social and community aspects of immunization programs," but no longer has language from the April version that said members could have expertise in toxicology and pediatric neurodevelopment or on "recovery from serious vaccine injuries."

https://www.medpagetoday.com/infectiousdisease/vaccines/121960