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The committee that makes federal vaccine recommendations may be violating federal law by determining those recommendations behind closed doors.
According to MedPage Today Editor-in-Chief Jeremy Faust, most vaccine recommendations have been decided in private meetings before members of the Advisory Committee on Immunization Practices (ACIP) have met or voted publicly.
“The decisions were really made in meetings,” Faust revealed during an interview with infectious disease expert Dr. Jeanne Marrazzo.
Faust also said committee members have access to proprietary information, unavailable to the public, from pharmaceutical companies and other sources. That proprietary information “really did drive these decisions,” Faust said.
Marrazzo, former director of the National Institute of Allergy and Infectious Diseases (NIAID) and a leader of the Infectious Diseases Society of America (IDSA), responded with: “That’s right.”
If those revelations are true, ACIP may have violated federal laws governing federal advisory committees, according to an analysis by James Lyons-Weiler, Ph.D.
“Vaccination recommendations have enormous consequences for the public,” Lyons-Weiler told The Defender. “ACIP recommendations influence the childhood immunization schedule, insurance coverage, the Vaccines for Children Program, state policy, medical practice and, ultimately, what millions of parents are told their children should receive. Decisions of that magnitude demand transparency.”
Dr. Robert Malone told The Defender that ACIP decisions have been made behind closed doors for years.
“I am glad to see that this is finally being acknowledged,” he said. “I have known that this was the case for literally decades. The significance is that this is finally being acknowledged in a publication that has historically been supportive of the vaccine industry and its enablers in academia, CDC [Centers for Disease Control and Prevention] and ACIP.”
The CDC did not respond to The Defender for this story. ACIP could not be reached for comment.
Federal law requires transparency
The Federal Advisory Committee Act (FACA) generally requires federal advisory committee meetings to be open to the public, subject to specified exceptions.
The CDC’s 2018 evidence-based recommendation framework was instituted to improve transparency and consistency of vaccine policy.
The updated ACIP Charter states: “ACIP shall employ a transparent, evidence-based decision-making process. The Committee shall review scientific data, receive input from subject matter experts, and consider public input as appropriate.”
Federal advisory committees may use working groups to review scientific evidence, examine unpublished research and prepare recommendations — those activities don’t necessarily violate federal law.
Under CDC procedures governing ACIP workgroups, closed meetings are permitted for gathering information and developing options. However, workgroups can’t independently issue recommendations to the federal government or substitute their private deliberations for public decision-making.
The rules also allow vaccine manufacturers to present information to workgroups, although manufacturers cannot serve as workgroup members.
If a working group effectively determines a committee’s final recommendations before a public meeting, its activities could prompt scrutiny around FACA compliance, Lyons-Weiler said.
Publicly showcasing final votes does not necessarily establish transparency if the underlying decisions were settled elsewhere, Lyons-Weiler said.
ACIP remains in legal limbo
The questions raised in the MedPage Today interview come as ACIP is stuck in legal limbo, with meetings on hold until further notice.
Earlier this year, U.S. District Judge Brian Murphy blocked 13 appointees from serving on ACIP under U.S. Health Secretary Robert F. Kennedy Jr., and halted several changes to vaccine policy.
The ruling stems from a lawsuit filed by the American Academy of Pediatrics (AAP) against Kennedy and the U.S. Department of Health and Human Services (HHS). The AAP accused Kennedy of violating procedures when he fired previous ACIP members and replaced them.
The ruling — which granted the AAP’s request for a preliminary injunction — effectively froze ACIP and reversed changes the new committee had made to vaccine recommendations.
Earlier this month, the Trump administration asked the 1st U.S. Circuit Court of Appeals to overturn Murphy’s ruling on the injunction.
“We’re asking the court to vacate the order on the appointments so that the Secretary can reconstitute the committee and get it back to work,” deputy general counsel for HHS Matthew Zorn told the court.
The administration’s appeal does not challenge all aspects of Murphy’s ruling.
The ACIP meeting schedule shows that the 2026 March and June meetings were canceled because of the continuing case. Its next meeting, scheduled for Oct. 21-23, has also been cancelled “due to ongoing litigation” unless the committee is reconstituted.
The 1st Circuit has not yet ruled on the administration’s appeal of Murphy’s March ruling. A decision has not yet been made by the appellate judge.
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‘Facts should determine what happens next’
The MedPage Today interview does not establish that pharmaceutical manufacturers improperly influenced ACIP or that its previous recommendations were unlawful.
It provides a basis for examining how the committee operated before Kennedy’s overhaul. Some experts believe a thorough review is now necessary to instill public trust.
Lyons-Weiler put it this way:
“Congress has oversight authority and should obtain the relevant records concerning pre-ACIP meetings: calendars, attendance lists, communications, agendas, presentations, minutes and other contemporaneous records. HHS and CDC should preserve those materials immediately. If voluntary production is inadequate, congressional subpoenas are an available mechanism.
“The inquiry should answer several simple questions. Who participated? How frequently did these meetings occur? What subjects were discussed? Were committee members merely gathering information and preparing for the public meeting, or were they debating the merits and reaching substantive conclusions? Were outside stakeholders participating? And, most importantly, to what extent were outcomes effectively determined before the public meeting began? Those facts should determine what happens next.”
These points may become increasingly significant as the federal appeals court considers the future of Kennedy’s reconstituted committee and whether the transparency standards invoked to challenge today’s vaccine advisers were consistently applied to their predecessors.
Related articles in The Defender
- Lawyers for RFK Jr. Ask Court to Allow CDC Vaccine Advisers to Get ‘Back to Work’
- Federal Government Appeals Ruling in AAP Lawsuit that Struck Down RFK Jr.’s Vaccine Policies
- How a Gaggle of Vaccine Trade Groups Got a Federal Judge to Help Upsell Vaccines No State Thinks Are Necessary
- Breaking: Federal Court Blocks ACIP Meeting, Changes to Childhood Vaccine Schedule
- ACIP Members Push Back on CDC’s COVID Vaccine Safety Claims
- RFK Jr. Overhauls ACIP Rules to Focus More on Vaccine Injuries
