Medical organizations bumped from vaccine working groups

Driving the news: Major medical organizations last week reported being booted from working groups that advise Health Secretary Robert F. Kennedy Jr.'s handpicked Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.

• The government labeled organizations including the Infectious Diseases Society and the American Medical Association "special interest groups" that inject bias in decision-making.
• Kennedy earlier this summer replaced the 17-member ACIP board with seven people who are not experts in infectious disease, some of whom have expressed anti-vaccine views.
• Other groups removed from the working groups include the American Academy of Pediatrics, the American College of Physicians and the American Geriatrics Society. Several issued a joint statement calling on the administration to reconsider.
• "To remove our deep medical expertise from this vital and once transparent process is irresponsible, dangerous to our nation's health, and will further undermine public and clinician trust in vaccines," they said.

The working groups evaluate published and unpublished data on vaccines and develop policy options for the vaccine advisers.

• "Under the old ACIP, outside pressure to align with vaccine orthodoxy limited asking the hard questions," HHS spokesperson Andrew Nixon said in a statement to Axios.
• "Experts will continue to be included based on relevant experience and expertise, not because of what organization they are with."

Between the lines: In a sign of the deepening rift, an ad hoc group of infectious disease and vaccine experts calling itself the Vaccine Integrity Project is planning its own public meeting later this month to present the latest peer-reviewed research around COVID vaccines and act as a kind of shadow ACIP.

• That includes acting as a convening organization for other medical groups and preparing science briefs for COVID, influenza and RSV to medical societies to base recommendations on for their special populations, said Michael Osterholm, a University of Minnesota epidemiologist leading the effort.
• Expert volunteers, vetted using ACIP's own conflict of interest guidelines, identified and are independently reviewing more than 1,640 new studies, to provide the latest safety and efficacy data on COVID vaccines.
• From there, it's up to the medical societies to make their respective recommendations, Osterholm said.

The group's efforts are needed because, in the case of COVID-19 vaccines, there's no ACIP guidance for current boosters with respiratory virus season due to begin in a few weeks, said Brigid Groves, vice president of professional affairs at the American Pharmacists Association.

• "The Vaccine Integrity Project is helping to fill the gap ... to make sure that we have high-quality, accurate evidence that is guiding these recommendations," she said.

• Convening the medical establishment around the evidence could provide needed certainty for providers and insurers, Osterholm said.
• "Once you give the public mixed messaging, it creates confusion. It creates indecision. And the public may not be equipped to assess messages that are inconsistent with each other and determine for themselves what the appropriate course of action is," Jesse Hackell, chair of the American Academy of Pediatrics' committee on pediatric workforce, told Axios.
• The pediatricians, along with the American College of Physicians, American Public Health Association and Infectious Disease Society of America were among organizations to sue the administration in June over Kennedy "unilaterally" changing COVID-19 vaccine policy.

HHS' Nixon said the Vaccine Integrity Project is "a self-appointed echo chamber masquerading as oversight" that's intent on restoring credibility to a public health establishment that failed during the COVID-19 pandemic.

• "Let's be clear: America doesn't need another unaccountable group of former officials circling the wagons to protect outdated narratives," he said.

What we're watching: Medical organizations say they intend to continue making recommendations about vaccines to clinicians as they have in the past.

• The prospect of future federal vaccine recommendations diverging from the medical establishment when it comes to required childhood vaccinations like the MMR is a cause for concern, Hackell said.
• "RFK Jr. has made the statement that the decision to vaccinate should be a parental choice. If [ACIP makes] that statement and that starts to impact the state regulations for attending school, then we're going to have a real problem," Hackell said.