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In its final days in office, the Biden administration quietly stacked a key committee that reviews vaccine safety and efficacy with several new pro-vaccine members, a move intended to “insulate the scientific integrity of the panel from the incoming administration,” STAT News reported today.
Outgoing Secretary of Health and Human Services (HHS) Xavier Becerra made the last-minute appointments to the Advisory Committee of Immunization Practices (ACIP). They include four new members and four replacements for current members whose terms expire in June.
According to STAT, the appointments were a response to President Donald Trump’s nomination of Robert F. Kennedy Jr., founder of Children’s Health Defense (CHD), to lead HHS. Kennedy, who has not yet been confirmed as HHS secretary, faced two confirmation hearings in the U.S. Senate earlier this week.
“The advisory committee plays an important role of independent eyes on the science,” said Karl Jablonowski, Ph.D., senior research scientist at CHD. “Biden just made ACIP a political appointment, trampling the idea of independent scientists.”
Whether the new appointments will hamper Kennedy’s “Make America Healthy Again” agenda, if he is confirmed to lead HHS, is unclear. According to STAT, while the new members’ terms expire in 2027, ACIP members are “at-will appointments” and can be dismissed at any time.
Kennedy, or any new secretary of HHS, would also have the option to fire other existing members of ACIP, cancel or postpone vaccine-related meetings or disband ACIP altogether. The Centers for Disease Control and Prevention (CDC), under a Trump-appointed director, could also override ACIP’s recommendations.
According to STAT, ACIP “plays a pivotal role in the setting of vaccination policy” in the U.S. ACIP reviews the safety and efficacy data of vaccines that are newly approved by the U.S. Food and Drug Administration (FDA) and issues recommendations to the CDC.
The CDC must formally accept ACIP’s recommendations before the vaccines are allowed on the market.
“The committee’s members are among the only non-governmental scientists in the world who can ask a question of the CDC and expect an answer,” Jablonowski said.
According to STAT though, “the number of occasions when the director has rejected a committee recommendation have been vanishingly rare.”
ACIP also reviews safety signals for previously approved vaccines and issues updated recommendations, based on data from government-controlled surveillance systems such as the Vaccine Adverse Event Reporting System (VAERS).
Drug safety advocate Kim Witczak, a member of the FDA’s Psychopharmacologic Drugs Advisory Committee, said Becerra’s appointments are “frustrating, yet not surprising.” She said:
“The Biden administration’s quiet move to fill the ACIP committee before his departure with industry-aligned members is yet another example of how deeply entrenched the pharmaceutical industry is within our regulatory agencies.
“As someone who serves on an FDA advisory committee, I’ve seen firsthand how critical it is to have independent, unbiased voices — people who are not financially tied to the very companies or agendas they are supposed to be regulating.”
New HHS secretary would have several possible avenues for reforming ACIP
According to STAT, Becerra broke with longstanding practice by bulk-appointing new members to ACIP.
“It was long the practice to line up new ACIP members well before their terms would begin, with the CDC vetting would-be committee members and the HHS having the final say. But under Becerra’s tenure, the appointment process lagged … a problem he eventually remedied with a spate of appointments,” STAT reported.
Eleven of the current 15 members of ACIP were appointed to ACIP in 2024, STAT noted. Becerra’s four new appointments, set to join the committee July 1, subsequently increased ACIP’s roster to 19 members — the result of “an expansion set out when the committee’s charter was renewed last April.”
However, it is far from certain that Becerra’s selections will be allowed to take their seats on the panel or will remain part of ACIP’s roster for long. According to STAT, there are several avenues through which the new HHS secretary could override or otherwise bypass these selections.
One option is to withdraw Becerra’s selections and replace those picks with candidates that might be more closely aligned with the views of the incoming HHS secretary.
According to STAT, solely replacing the new appointees would not give a new secretary a majority of the committee, but additional options include the dismissal of existing members and adding new members to the committee.
Another option is to renew ACIP’s charter — which must occur by April 1, 2026. According to STAT, “There is nothing blocking the HHS secretary from approving a rewritten ACIP charter before the existing one expires.” A new charter could potentially include changes to the size of the committee.
Other options include changing the composition of ACIP work groups that review individual vaccines and issue recommendations to the full committee, postponing vaccine-related review meetings, rolling back existing vaccine-related recommendations and abolishing ACIP entirely.
According to STAT, ACIP votes relating to flu vaccines, RSV vaccines for adults and the first-ever chikungunya vaccine, as well as upcoming meetings of ACIP’s Health Information Technology Advisory Committee, have been postponed.
ACIP recommendations for vaccines people “should” get — such as the HPV vaccine for pre-teens or annual flu shots for everyone over 6 months old, could also be watered down to suggestions that people “may” get these vaccines after consulting with a physician, in what is known as “shared clinical decision-making.”
Such a change “would likely depress vaccine uptake, sending a signal that the vaccination is optional,” STAT reported.
“The previous committees have been discouraging shared clinical decision making, preferring to hand down edicts rather than information. Every corner of medicine should be shared clinical decision-making,” Jablonowski said.
During his confirmation hearings this week, Kennedy suggested that people should have the option, along with their physicians, to make their own decisions regarding vaccines and other treatments, instead of a one-size-fits-all approach.
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97% of ACIP members have conflicts of interest
According to STAT, ACIP nominees are thoroughly vetted for conflicts of interest and are required to submit a confidential financial disclosure upon appointment. Existing members are required to renew these reports annually.
In his testimony before the Senate Finance Committee on Wednesday though, Kennedy said 97% of ACIP’s members have conflicts of interest.
“I don’t believe that that’s right. I think we need to end those conflicts and make sure that scientists are doing unobstructed science,” Kennedy said.
During the same hearing, Kennedy promised that, if confirmed, he would bring “radical transparency” to HHS.
“The public deserves full transparency about who was involved in selecting these new ACIP members and whether any conflicts of interest exist,” Witczak said. “How can we trust the integrity of our public health policies when the selection process itself is hidden from scrutiny?”
HHS did not respond to The Defender’s request for comment by press time.
