RFK Jr. vaccine panel's rocky debut

• The leading professional association of pediatricians publicly boycotted the proceedings.
• And planned votes on recommendations for RSV vaccines were postponed when the committee ran out of time.

The big picture: The events underscored how the Advisory Committee on Immunization Practices is on a less predictable course under Kennedy, who maintains he isn't against vaccines but is pro-safety.

• The ramifications could be huge if the panel upends decades of vaccine policy. ACIP's recommendations not only influence insurance coverage decisions but what physicians tell patients.

Driving the news: The committee quickly served notice that it will create new subgroups to look into the "cumulative effect" of current federal childhood and adolescent vaccine schedules, and to study vaccines that haven't been reviewed in more than seven years.

• Questions may include whether a hepatitis B vaccine should be recommended for all newborns, as well as the optimal time for administering the measles, mumps and rubella (MMR) vaccine and possible exemptions from the shot on religious grounds, Chair Martin Kulldorff said.
• Kennedy has for many years said that the government recommends too many vaccines for kids, and he's cast doubt on the safety of shots that have been delivered for decades.

Panel members voiced skepticism about mRNA vaccines during presentations on COVID-19 vaccine safety and efficacy and questioned the way the Centers for Disease Control and Prevention they now advise designed past studies and analyzed data.

• "I wonder to what extent we need to inform or maybe change our approach when it comes to the COVID vaccine," said Retsef Levi, a committee member and a professor of operations management at MIT, noting the presence of residual mRNA and COVID spike protein can stay in the body long after inoculation.
• CDC staff scientists said they feel very confident in the vaccine safety system and noted the farther removed a patient is from a vaccination, the higher possibility there is for variables that make it hard to tell whether harm was caused by the vaccine itself.

The other side: Kulldorff said in his opening remarks that classifying panelists as pro- or anti-vaccine undermines scientific integrity and "further feeds the flames of vaccine hesitancy."

• "Vaccines are not all good or bad. If you think that all vaccines are safe and effective and want them all, or if you think that all vaccines are dangerous and don't want any of them, then you don't have much use for us," he said.

Health experts and providers during a public comment period expressed concerns over Kennedy's ouster of the previous 17-member committee, and over whether new members were willing to continue recommending vaccines.

• "At a time when trust in public health is already low, the sudden dismissal of an entire committee will only cause additional confusion and distrust," Chrissie Juliano, executive director of the Big Cities Health Coalition, told the committee members.

What's next: The committee will start making its recommendations during the second day of deliberations on Thursday.

• The panel will vote on recommendations for infant and maternal RSV vaccines, influenza vaccines and thimerosal-containing influenza vaccines.
• That last item will follow a presentation on the mercury compound given by Lyn Redwood, president emerita of Children's Health Defense, the anti-vaccine group with close ties to Kennedy. The presentation reportedly cites a research paper that doesn't exist.