Vaccine board purge stokes talk of CDC alternatives

• "We are clearly working on it and we think it's very important, but I don't think anyone has an answer yet," said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, who's behind one ad hoc effort. "Right now, we're in such uncharted territory."

The medical establishment has floated ideas such as state-appointed boards or medical specialty associations serving as clearinghouses for information on vaccine safety and efficacy for clinicians.

• California Gov. Gavin Newsom (D) during the pandemic created a state entity to review the safety of federally approved COVID-19 vaccines before distributing them to the public.
• But it would be difficult to replicate the professional clout of ACIP, whose recommendations can influence whether insurers cover vaccines.
• That would leave Kennedy's handpicked successors controlling the narrative — a prospect many researchers and physicians think will bring a radical departure from ACIP's evidence-based deliberations on safety and efficacy.

Friction point: Kennedy and other Trump health officials' assertions that ACIP has been a rubber stamp for vaccines have infuriated public health officials, who say the physicians, infectious disease experts and researchers constituted a vital body of nongovernmental health leaders who took their jobs seriously.

• Panel members were carefully vetted for conflicts and had their professional credentials scrutinized. Discussions took place in a high-profile public forum that would be difficult, if not impossible, to replicate.
• "Many of us can provide a read of the science, and we can convene formally or informally to create consensus around vaccine recommendations," said Megan Ranney, dean of the Yale School of Public Health.
• "But I suspect that it won't be sufficient for insurers, for Medicaid, for the Vaccines for Children program, and it's unclear how pediatricians and primary care physicians and pharmacies across the country are going to be able to respond," she said.

The other side: Kennedy wrote on X Tuesday night that he would announce new ACIP members in the coming days.

• "None of these individuals will be ideological anti-vaxxers. They will be highly credentialed physicians and scientists," Kennedy wrote. He added he would detail instances of "historical corruption at ACIP to help the public understand why this clean sweep was necessary.
• "Kennedy cited the panel's "stubborn unwillingness to demand adequate safety trials before recommending new vaccines for our children" as the most "outrageous example."

What to watch: All eyes are on the new appointees for the board, including their scientific backgrounds, track records when it comes to defending vaccines and any potential conflicts of interest.

• HHS has indicated it has every intention of moving forward with ACIP's next meeting, scheduled for June 25-27. The agenda includes recommendation votes for COVID–19, HPV, influenza, meningococcal and RSV vaccines.
• "If nothing else, I think [the committee] may have trouble functioning because you've just lost a whole lot of institutional memory," said Adam Ratner, a member of the American Academy of Pediatrics' Committee on Infectious Diseases.
• "That agenda has the committee voting on real things that matter to real people, and I don't know how they're possibly going to do that in any kind of way that is based on science or evidence," he said.