Kennedy's vaccine panel met for the first time. Here's what to know.

Politico

2 days ago

ATLANTA — The first meeting of Health Secretary Robert F. Kennedy Jr.'s handpicked vaccine advisers concluded Thursday — setting the stage to change the childhood vaccine schedule and voting to stop recommending flu shots with an additive that has long been a target of the anti-vaccine movement.
The meeting offered a glimpse into how the new Advisory Committee on Immunization Practices will operate — and how federal vaccine policy is beginning to reflect Kennedy's personal views. Earlier this month, he fired 17 members of the panel and replaced them with eight members, several of whom have histories of vaccine skepticism. One resigned before the meeting began, leaving seven members.
HHS spokesperson Andrew Nixon told reporters that 'the members of the committee are respected experts who take their responsibility to public health seriously' and who 'deliver recommendations rooted in data and medical integrity.'
Here are the takeaways from the two-day meeting at CDC headquarters in Atlanta:
Its agenda was Kennedy's
The panel voted Thursday to stop recommending that anyone get a flu vaccine that contains thimerosal, a preservative that Kennedy has long wanted gone.
Kennedy, in 2014, wrote a book about thimerosal, arguing that it likely causes autism and should be banned.
But many public health agencies have long considered it to be safe — including the CDC, according to its website. 'Scientists have been studying the use of thimerosal in vaccines for many years. They haven't found any evidence that thimerosal causes harm,' the website reads.
The CDC director usually needs to endorse the recommendations before they are official. But Kennedy will likely be the one to endorse these recommendations because there is currently no CDC director or acting director.
What it means: If endorsed, the new recommendations will mark one of the most prominent examples of Kennedy's own views reflected in U.S. vaccine policy since becoming HHS secretary.
'Even though this move only affects a small portion of the flu vaccine supply and likely won't impact access in the US this season, the symbolism is powerful. It signals that falsehoods may have a place in shaping vaccine policy in America,' Katelyn Jetelina, an epidemiologist who has consulted for the CDC, told POLITICO. 'The ripple effects could undermine trust in vaccines, vaccine access globally and weaken pandemic preparedness.'
Thimerosal continues to be used as a preservative in some multi-dose vaccine vials to inhibit germ growth. But its use in FDA-licensed flu vaccines has declined over the last 25 years as manufacturers reformulated their products and shifted to single-use vials. Most of those contain little or no thimerosal, according to the CDC.
That shift was tied to concerns raised in the late 1990s and early 2000s that thimerosal, a mercury-containing compound, could be linked to autism in children. In 1999, the FDA and CDC announced plans to work with manufacturers to reduce or remove thimerosal from vaccines as a precaution. The preservative was largely removed from pediatric vaccines by 2001.
One member's pushback
The panel's lone pediatrician, Dartmouth's Dr. Cody Meissner, was the only voting member to push back on views presented that contradicted scientific consensus, a development that encouraged some public health experts who were otherwise troubled by the meeting.
'He's dealt with vaccine-preventable diseases. He's talked to parents about vaccines, so I thought he was generally a voice of reason,' said Dr. Paul Offit, a pediatrician who serves on the FDA's external vaccine panel.
What it means: It remains to be seen how Meissner will approach controversial topics at future meetings. He's also publicly agreed with Kennedy's move to pull the Covid-19 vaccine recommendation for pregnant women despite ample evidence of its benefits. Meissner told Reuters in May he thought politics had caused officials to overemphasize the importance of Covid vaccination for pregnant women and young children.
Offit and former federal health officials applauded his participation and his defense of science.
Meissner was critical of the American Academy of Pediatrics for not participating in the meeting. Several professional groups send liaisons to ACIP meetings to weigh in, though they don't have voting privileges.
'It's somewhat childish for them not to appear,' Meissner said near the end of the meeting Thursday. 'It's dialogue that leads to the best recommendations for the use of vaccines.'
Dr. Sean O'Leary, the AAP's committee liaison, defended the organization's decision to not participate, saying ACIP 'has drifted so far from its long standing focus on science, evidence, public health.'
'When that focus returns, we will, too,' he said.
More scrutiny of vaccines is ahead
The committee's agenda items in the months ahead signal that Thursday's thimerosal votes were just the beginning of policy shifts that could affect vaccine access in the U.S.
ACIP Chair Martin Kulldorff, an epidemiologist and former Harvard Medical School professor, said Wednesday the panel will review childhood vaccines and shots not studied in more than seven years, opening up the possibility of significant changes to the pediatric schedule.
And he said Thursday the panel may consider at its next meeting advising against use of a combination shot known as MMRV against measles and chickenpox to children under 4. The CDC currently recommends that children under 2 get their first measles, mumps and rubella vaccine and varicella vaccine as separate shots because of an elevated risk with the MMRV shot of febrile seizure, which is common in young children but doesn't cause permanent harm.
Why it matters: The thimerosal vote and the potential MMRV recommendation change wouldn't affect a wide swath of the population, given ample supply of alternatives. But those shifts could disproportionately impact vulnerable groups that already face issues accessing health care, like rural state residents and low-income families because they are more likely to get flu shots from wide-scale vaccination drives, public health experts say — not to mention plant the seeds for distrust in other vaccines.
Anti-vaccine activists have long alleged links between vaccines and autism. They've theorized that thimerosal, the number of vaccines given to young children and post-immunization fevers could all contribute to the rise in diagnoses, despite peer-reviewed science finding no connections.
While the CDC says just 4 percent of the U.S. flu vaccine supply last season contained thimerosal, scientists worry that the ACIP votes will reinvigorate unfounded worries about the ingredient that could generally suppress vaccine confidence — not to mention create access issues for the sliver of the population served by those multi-dose vials. The MMRV vaccine is also not widely used in children under 4.
'The goal was to scare people … the goal was to say, 'Here, look, these companies are putting things in vaccines that are dangerous,'' Offit said.