The Centers for Disease Control used to have a vaccine advisory panel made of well-respected experts. This panel, the Advisory Committee for Immunization Practices (or ACIP), would meet to vote on which vaccines should be recommended by the government. An affirmative vote from ACIP means insurance companies have to cover that vaccine. But members of the panel were all abruptly dismissed earlier this month, and now their replacements are set to meet June 25, with votes planned for RSV, flu shots, and somewhat perplexingly, thimerosal.
I’ll break down what this all means, why it’s likely very bad news, and what to watch for when the panel meets next week. And by the way, if you’ve been meaning to get any vaccines, I’d recommend scheduling those sooner rather than later, while we know they’re still covered, because there’s no telling what will happen.
What is (or was) ACIP?
ACIP is the Advisory Committee for Immunization Practices. It’s a panel that the CDC convenes from time to time to decide whether to “recommend” certain vaccines. This is not the same thing as FDA approval—the Food and Drug Administration handles that. Rather, it is a decision to put vaccines on a list of the ones people should get. For example, the flu shot is recommended for nearly everyone aged 6 months and up.
It was ACIP that decided that healthcare workers should be the first people to get COVID shots. It’s ACIP that puts various vaccines on the routine childhood vaccine schedule. Vaccines recommended by ACIP must, by law, be covered by nearly all insurance plans with no copay or out-of-pocket cost for people for whom they are recommended.
Formerly, the members of ACIP included experts in vaccine science, pediatrics, immunology, epidemiology, and public health. There was an extensive vetting process for new members that included probing conflicts of interest, and any members who did have a conflict relating to a specific vote would sit out of that vote.
I’ve watched quite a few ACIP meetings (they are always livestreamed) to report on COVID vaccines and others. The meetings and the members were always professional, focused on facts and on making good judgments that encompassed the big picture effects of any decisions they ended up making. ACIP was widely respected by healthcare professionals and researchers. That’s not to say everybody always agreed with their decisions, but it was widely viewed as a system that was working well, and resulted in millions of Americans having access to vaccines that they needed.
Note carefully my use of the past tense.
What the hell is going on with ACIP now?
That’s all, perhaps, in the past. The current secretary of Health and Human Services, Robert F. Kennedy, Jr., founded an anti-vaccine advocacy group before he became HHS secretary. He said in his confirmation hearings that he didn’t plan to take anyone’s vaccines away, and on occasion has grudgingly admitted that vaccines work—usually alongside spreading or alluding to misinformation about vaccines.
But Kennedy and the other political appointees who control the branches of government that deal with healthcare sure seem like they are trying to reduce access to vaccines. Kennedy attempted to overrule ACIP on COVID vaccines, and now seems to be taking that strategy a step farther by simply getting rid of all 17 ACIP members and filling the panel with eight handpicked replacements. The Center for Infectious Disease Research and Policy at the University of Minnesota has background information on the new picks, some of whom already have a reputation as “vaccine critics,” to use CIDRAP’s phrasing.
Votes on several vaccines are coming up
ACIP’s meetings are announced to the public, and you can see the agenda for the next meeting here. It is a two-day meeting on June 25 and 26, 2025. Some of the agenda items look pretty typical, like presentations that give updates on the current COVID situation, the better to inform any decisions that might be made later about new COVID vaccines.
But there are a few confusing things to note. After the COVID presentations, there is no vote on any COVID vaccines. The Associated Press reports that a few other expected agenda items are missing—policy proposals on HPV vaccines and meningococcal vaccines likewise aren’t on the agenda.
The scheduled votes relate to maternal and pediatric RSV vaccines; RSV vaccines and the Vaccines for Children program; influenza vaccines (that is, flu shots); and “Thimerosal containing influenza vaccine recommendations.”
RSV is a virus that can be particularly dangerous to young infants. There is a vaccine that can be given in pregnancy that protects the infant for a few months after birth, and an antibody that can be given to infants. These are currently recommended by ACIP, and covered by insurance and by the Vaccines for Children program. We don’t know from the agenda exactly what the vote is about, or whether the panel may try to overturn that recommendation.
Influenza vaccines are also currently recommended, and an influenza vaccine vote seems to be a routine part of ACIP’s agenda (it was on last year’s June meeting agenda, for example). Normally the decisions are about which flu shots to recommend, since the vaccines on offer can change from year to year. Let’s hope this year’s vote is just as straightforward.
Finally, there’s that perplexing vote about thimerosal in influenza vaccines. Thimerosal is a mercury-containing preservative that has been blamed (without any solid evidence) for a link to autism. Out of an abundance of caution, it was removed from the formulation of most vaccines in 2001. Some multi-dose vaccine vials still contain it, including the flu shot, which is also available in single-dose versions without the preservative. Study after study has shown that thimerosal is not linked to autism or neuropsychological problems. Scientists generally consider this a closed case.
We can hope that the votes will be conducted appropriately and in keeping with the actual science surrounding these vaccines. But given that this meeting follows a sketchy-sounding shakeup of ACIP’s membership, I’m not very hopeful.
