Vaccine Policy Working Group Report on Meeting Postponed Due to Political Concerns in the Immunization Sector of the US Department of Health

“Up to this point, every HHS director and every CDC director has been very enthusiastic about vaccines as they save money and they’re an excellent preventive tool,” Fiore says. He warns that if public confidence in vaccines gets undermined it could lead to vaccine levels being less than needed to protect against disease.

A meeting of the CDC’s advisory committee on immunization practices was initially scheduled for February but was postponed, raising concerns among some scientists and those working in public health about political interference in vaccine policy. The two-day meeting starts Tuesday morning.

The lottery winners who spoke during the public comment period for this meeting praised the work of the committee. They play a very important role in determining vaccine recommendations as they are reviewed rigorously by scientists who are qualified to do so, according to the co- editor of the journal Vaccine. “Public trust and accountability can only happen in a transparent and inclusive way, that the public can observe and participate in.”

The committee’s independent advisers will hear from CDC staff on a range of vaccines, as well as vote on recommendations for some, such as rikungunya and COVID, during the meeting this week.

When asked about the change, HHS spokesperson Emily Hilliard responded on behalf of CDC: “ACIP agenda items are always subject to change depending on what the working groups have ready for consideration.” She said that the vote was not for the yearly use of the vaccine for the upcoming season.

A Commissioner’s View of the ACIP Committee: Conflicts of Interest on Vaccine Use, and Biases in Our Estimates

Independent experts who volunteer to serve on the committee are the advisors. Dorit Reiss, a law professor at UC San Francisco, says she expects them to remain independent and hold thoughtful, rigorous discussions as they usually do.

But she’s concerned about the effects of political interference on CDC staff who help run these meetings, who “are in a much more vulnerable position after extensive layoffs,” Reiss says.

“I’ll be looking to see if they change the process in any way,” Reiss says. She will be looking for changes in how conflicts of interest are handled as well as whether there is time limits on discussions among committee members.

The newsletter “Your Local Epidemiologist” was written by Jetelina who is an epidemiologist and data scientist. She suggests that the people who have listened to hundreds of ACIP meetings report back if it’s just business as usual or there are some sketches beneath the surface.

When HHS postponed the meeting in February, the reason was “to accommodate public comment in advance of the meeting,” according to an HHS spokesperson at the time.

Høeg asked about “bias in our estimates” in a presentation on influenza vaccine efficacy, arguing that vaccinated people may be overrepresented because they may be more likely to seek out testing. The CDC’s studies are supposed to account for these biases. The impact of bias is minimal and estimates are accurate, according to an epidemiologist with the CDC.

Høeg has questioned vaccine safety, and she raised concerns in this week’s meeting. Heg said after the presentation that adolescents with underlying medical conditions were excluded from the study. So I think it’s important for providers to keep in mind that … we don’t really know about the safety in those adolescents.”

For this meeting, the Food and Drug Administration was represented by Dr. Tracy Beth Høeg, a special assistant to the commissioner, who has criticized CDC for recommending school closures during COVID. She took the liaison seat previously occupied by Dr. Peter Marks, the top vaccine regulator at FDA who was forced to resign in March.

More than 600 cases of the disease have been reported in Texas, New Mexico and Oklahoma. “There are quite a number of resource requests coming in, in particular from Texas,” said Dr. David Sugerman, a senior scientist at CDC working on its measles response. The state recently lost several hundred million dollars in public health funding, in a federal clawback of COVID funds that began late last month. “The estimates are that each measles case can be $30,000-$50,000 for public health response work, and that adds up quite quickly,” he said.

Summary of the 2016 Joint Working Group on Vaccines and Influence on Immunization Practices (CIP) Meeting in Del. (France)

The Advisory Committee on Immunization Practices voted to include people 50 to 59 who have certain risk factors in the recommendation for the age of recommendation for the meningococcal vaccine. They also voted to recommend vaccines for the tropical disease chikungunya for travelers or lab workers who are likely to be exposed to the virus.

Over two days, members sat through detailed presentations on data and modeling for a range of vaccines – from mpox to flu, COVID and chikungunya – and asked questions to sharpen their assessments of the risks and benefits of different vaccines. The meeting got weedy at times as members of the committee looked into technical details.

The committee had been scheduled to meet in February, but the event was postponed shortly after the confirmation of Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services, which oversees CDC. Concerns about possible interference were raised by the postponement.

“I am encouraged that the proceedings of ACIP have resumed, giving the American public a window into the future of our nation’s vaccine policy in a time of great uncertainty,” Sen. Lisa Blunt Rochester, a Democrat from Delaware, said in an emailed statement. The public should be aware of the changing political landscape as evidenced by the recent outbreak of measles.

In the newsletter “Your Local Epidemiologist”, she writes that “it seems pretty much business as usual, and it’s sad that that isn’t news.”

Jetelina said that there were some nuances that reflect the changes made by the Trump administration. The funding for public health has been slashed by the Trump team. The administratione elevated people who have long questioned the safety and efficacy of vaccines to positions of influence over policy and research despite strong evidence supporting them.

From the start, some effects were visible. Technical issues plagued the beginning of the meeting and required a fresh link to the public livestream. “As you may have noticed, there have been some changes with the recent reductions in force, including our communications group, so I ask that you please be patient with us,” said Dr. Keipp Talbot, professor of medicine at Vanderbilt University and chair of the committee.

The resource cuts were top of mind for some committee members. Charlotte Moser, co-director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, probed for declines in CDC’s ability to evaluate how safe vaccines are, and how well they work.

Are all of the data collection systems still funding to collect data through this season and into next? The presentation about the efficacy of the flu vaccine was followed by a question. As a result of the situation, the CDC said three of four flu vaccine networks were still operating and one would be shutting down.