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Members of the ACIP typically serve four-year terms. The HHS secretary has the authority to remove and appoint members.
The HHS office press release stated that the new panel will meet in Atlanta on June 25, but no new members have been appointed.
Kennedy cites “conflicts of interest”
Kennedy said the move would help restore trust in vaccines and eliminate conflicts of interest in the committee.
“A clean sweep is necessary to reestablish public confidence in vaccine science. ACIP’s new members will prioritize public health and evidence-based medicine. The Committee will no longer function as a rubber stamp for industry profit-taking agendas,” Robert F. Kennedy Jr. said in the HHS office press release.
The 17 dismissed members of the CDC’s Advisory Committee on Immunization Practices (ACIP) included (top row, left to right): Karyn Lyons, MS, RN; Dr. Albert C. Shaw, MD, PhD; Dr. Edwin Jose Asturias; Dr. Helen Y. Chu; Dr. Yvonne (Bonnie) Maldonado and Dr. Helen Talbot. Middle row (left to right): Dr. Jane R. Zucker; Dr. Lin H. Chen; Dr. Oliver Brooks; Dr. Robert Schechter; Dr. Sybil Cineas and Dr. Denise J. Jamieson. Bottom row (left to right): Dr. George Kuchel; Dr. Noel T. Brewer; Dr. Jamie Loehr; Dr. Mini Kamboj and Charlotte A. Moser.
In an opinion piece for the Wall Street Journal, Kennedy stated that the ACIP has a “history of conflicts of interest”.
“The groups that inform ACIP meet behind closed doors, violating the legal and ethical principle of transparency crucial to maintaining public trust,” Kennedy wrote.
The ACIP uses subgroups called work groups to review relevant data and present it to the committee. While these groups meet privately, they present their findings at publicized ACIP meetings, which are live-streamed and announced in advance.
Members of the work groups are screened for potential conflicts of interest upon the establishment of the group and each year following, according to the work group conflict of interest policy.
According to the ACIP policies and procedures, each voting member of the ACIP is required to file an Office of Government Ethics 450 form and a Confidential Financial Disclosure Report upon appointment. These are reviewed by the ACIP secretariat, the federal advisory committee management branch and the office of general counsel at the CDC. The Confidential Financial Disclosure Report must be updated annually by each member.
Additionally, each member is required to disclose conflicts of interest at each meeting. These disclosures are publicly available on the CDC website, dating back to 2000. Members with a conflict of interest are asked to recuse themselves from discussions and decisions that relate to that interest.
Kennedy also wrote that “new members won’t directly work for the vaccine industry.” Current ACIP membership requirements, listed in the policies and procedures, prevent members from working for a vaccine manufacturer or parent company. Members also cannot have a spouse or immediate family member employed by a vaccine manufacturer or parent company.
Experts react
Experts from the University of Michigan’s School of Public Health reacted to the news today.
“To do this now, when we are facing measles outbreaks at a level not seen in decades, is extremely concerning,” said Emily Martin, associate professor of epidemiology at the School of Public Health, “The statements surrounding the HHS decision to remove the ACIP committee meetings contain a number of things that are factually incorrect. The meetings are posted online and anyone can listen to the discussions, held livestreamed in public view, where members openly debate all aspects of these vaccines,” she continued.
Mark Fendrick, professor of internal medicine and public health, heads the Center for Value-Based Insurance Design, stated, “The decision by Secretary Kennedy to replace all of the ACIP members has far-reaching implications, since the vaccines recommended by the committee must be provided at no cost to most insured Americans. . . This could lead to increases in the number of cases of preventable illness, worsened health outcomes and more financial strain on an already stressed U.S. healthcare system.”
Potential market ramifications
This decision may affect insurance coverage of vaccinations, as insurers use ACIP recommendations to decide which vaccines they will cover. Vaccines have high out-of-pocket costs, making them unaffordable for some without insurance. For example, a flu vaccine can cost about $70 without insurance. Flu vaccines for seniors can cost $115.
Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University, stated in an interview with Scientific American that this may affect the market. “If vaccine manufacturers fear that they’re not going to be able to sell vaccines then they may simply decide not to make them. They might decide that the U.S. market is not where they want to invest their resources and may decide to instead serve other countries.”
BMO Capital analysts stated that potential risks for Merck and Pfizer stocks following the decision are likely minor. The stock of Moderna, the prominent developer of the Spikevax COVID-19 vaccine, has been relatively flat, while that of Novavax is slightly down over the past few days.
The analysts mentioned that Kennedy’s previous appointments to health agencies did not result in drastic changes, and this situation may follow a similar path.
After-hours share reactions showed a limited impact on the stocks. The analysts expect the impact on share prices to be slight.
Filed Under: Infectious Disease
