Dr. Martin Kulldorff, chairman of the Advisory Committee on Immunization Practices. Photo: Mike Stewart/Associated Press

Health Secretary Robert F. Kennedy Jr. ’s new panel of vaccine advisers will re-evaluate the recommended schedule for vaccines for children and teenagers, including for measles and hepatitis B, its new chairman said Wednesday.

The new slate of advisers met for the first time Wednesday in Atlanta, kicking off a two-day meeting with an agenda partially set by political appointees. Meanwhile, on Capitol Hill, the nominee to lead the Centers for Disease Control and Prevention, Susan Monarez , told senators she believes vaccines save lives and there is no causal link between vaccines and autism.

(CNN) — At the first meeting of a controversial new group of vaccine advisers to the US Centers for Disease Control and Prevention, the committee announced new plans to study established vaccine guidelines.

The Advisory Committee on Immunization Practices will create new work groups to study the cumulative effects of the childhood and adolescent vaccine schedules, the hepatitis B vaccine dose given at birth and the combination measles, mumps, rubella and chickenpox vaccine, new chair Dr. Martin Kulldorff announced at Wednesday’s meeting in Atlanta.

It was the first time the new group of seven outside CDC vaccine advisers has convened since US Health and Human Services Secretary Robert F. Kennedy Jr. dismissed the previous panel of 17 experts this month, claiming that they had conflicts of interest. He appointed a new group of eight members two days later; one withdrew during the financial holdings review, leaving seven to review the nation’s vaccine recommendations.

Public health experts were concerned about both the unprecedented dismissal of the previous committee and the background and positions of some of the new advisers; two have served as expert witnesses against vaccines in trials, and another has suggested, against evidence, that Covid-19 vaccines contributed to the deaths of young people and should be removed from the market.

Kennedy, who helmed the anti-vaccine group Children’s Health Defense before becoming HHS secretary, has suggested that childhood vaccines have been inadequately studied, something pediatricians and infectious disease experts say is not the case.

The American Academy of Pediatrics said Wednesday that it would no longer participate in ACIP meetings because, “with the committee dismissals, it is no longer a credible process.”

“We won’t lend our name or our expertise to a system that is being politicized at the expense of children’s health,” President Dr. Sue Kressly said, pledging that the organization will continue to publish its own recommended immunization schedule “developed by experts, guided by science, trusted by pediatricians and families across the country.”

Kulldorff said the new work group on the childhood and adolescent vaccine schedules will review “interaction effects between different vaccines, cumulative amounts of vaccine ingredients and the relative timing of different vaccines.”

Each time a vaccine is added to the schedule, its interaction with other vaccines is reviewed, said Dr. Paul Offit, a vaccine scientist at the Children’s Hospital of Philadelphia and a member of an outside vaccine advisory panel to the US Food and Drug Administration.

“You have to prove that your vaccine doesn’t interfere with the safety or immunogenicity profile of existing vaccines and vice versa,” he told CNN on Wednesday.

Offit said the plans from the new committee are “just a purely anti-vaccine agenda springing to life in public policy.”

A second new work group will look at vaccines that haven’t been reviewed in more than seven years, Kulldorff said, including whether the hepatitis B vaccine should be universally recommended for newborns.

“Unless the mother is hepatitis B-positive, an argument could be made to delay the vaccine for this infection, which is primarily spread by sexual activity and intravenous drug use,” Kulldorff said.

The CDC says that “universal HepB vaccination of all infants beginning at birth provides a critical safeguard and prevents infection among infants born to [hepatitis B]-positive mothers not identified prenatally.”

“Scientific evidence overwhelmingly supports the safety of hepatitis B vaccines,” the agency says.

The American Academy of Pediatrics said on social media on Wednesday that “Hepatitis B can be passed from parent to baby at birth – and when that happens, the consequences can be deadly. It is unscientific and dangerous to ignore the success of US vaccination programs or argue that the US should not vaccinate babies for hepatitis B at birth.”

When the universal birth dose recommendation was temporarily suspended in 1999, some confusion ensued, and about 10% of hospitals suspended all birth doses regardless of infants’ degree of risk, Offit wrote in the New England Journal of Medicine in 2007. “One 3-month-old child born to a Michigan mother infected with hepatitis B virus died of overwhelming infection,” he said.

A third new work group will look at vaccines for measles, mumps, rubella and chickenpox, or varicella, Kulldorff said, noting that “vaccines are important for combating measles for the first dose at age 12 to 15 months.”

The vaccine is available as a combination of all four, or as two shots with the one protecting against varicella given separately. There is a well-understood higher risk of febrile seizures when the four-vaccine combination is given to children between ages 1 and 2; giving the varicella vaccine separately from the MMR vaccine avoids this increased risk, which the CDC points out is “very low for both options.”

Kulldorff said that the committee may reevaluate the combination vaccine recommendation for 1-year-olds and that the working group may look at the optimal timing of the vaccine and potential alternatives, such as one used in Japan.

Measles vaccination rates have been declining in the US, and more than 1,200 cases have been reported this year, among the most since the disease was declared eliminated in the US in the year 2000. Two school-age children have died in an outbreak centered in West Texas, and one adult died in New Mexico. All were unvaccinated.

The ACIP’s recommendations historically have held significant sway; they influence both insurance coverage and state policies around vaccination.

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COVID-19 remains a public health threat, resulting in 32,000 to 51,000 U.S. deaths and more than 250,000 hospitalizations since last fall, according to the Centers for Disease Control and Prevention. Most at risk for hospitalization are seniors and children under 2 — especially infants under 6 months who could have some protection if their mom got vaccinated during pregnancy, according to the CDC’s presentation.

First on the agenda is an awkward scenario: Kennedy already announced COVID-19 vaccines will no longer be recommended for healthy children or pregnant women, and his new advisers aren’t scheduled to vote on whether they agree. Yet government scientists prepared meeting materials calling vaccination “the best protection” during pregnancy — and said most children hospitalized for COVID-19 over the past year were unvaccinated.

ATLANTA (AP) — US Health Secretary Robert F. Kennedy Jr.’s new vaccine advisers began their first meeting Wednesday under intense scrutiny from medical experts worried about Americans’ access to lifesaving shots.

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It’s one signal that this week’s two-day meeting of the Advisory Committee on Immunization Practices isn’t business as usual.

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Another sign: Shortly before the meeting, a Virginia-based obstetrician and gynecologist stepped down from the committee, bringing the panel’s number to just seven. The Trump administration said Dr. Michael Ross withdrew during a customary review of members’ financial holdings.

The meeting opened as the American Academy of Pediatrics announced that it will continue publishing its own vaccine schedule for children but now will do so independently of the ACIP, calling it “no longer a credible process.”

The panel, created more than 60 years ago, helps the CDC determine who should be vaccinated against a long list of diseases, and when. Those recommendations have a big impact on whether insurance covers vaccinations and where they’re available, such as at pharmacies.

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Earlier this month, Kennedy abruptly dismissed the existing 17-member expert panel and handpicked eight replacements, including several anti-vaccine voices. And a number of the CDC’s top vaccine scientists — including some who lead the reporting of data and the vetting of presentations at ACIP meetings — have resigned or been moved out of previous positions.

The highly unusual moves prompted a last-minute plea from a prominent Republican senator to delay this week’s meeting. Sen. Bill Cassidy of Louisiana, a physician who chairs the chamber’s health committee, said Monday that many of Kennedy’s chosen panelists lack the required expertise and “may even have a preconceived bias” against new vaccine technologies.

In a House hearing Tuesday, Kennedy defended his purge, saying the old panel had been “a template for medical malpractice.”

Rep. Kim Schrier, a pediatrician and Democrat from Washington state, told Kennedy: “I will lay all responsibility for every death from a vaccine-preventable illness at your feet.”

Committee will vote on RSV protections

The two-day meeting’s agenda on was abruptly changed last week.

Discussion of COVID-19 shots will open the session on Wednesday. Later in the day, the committee will take up RSV, with votes expected. On Thursday, the committee will vote on fall flu vaccinations and on the use of a preservative in certain flu shots.

RSV, or respiratory syncytial virus, is a common cause of cold-like symptoms that can be dangerous for infants.

In 2023, U.S. health officials began recommending two new measures to protect infants — a lab-made antibody for newborns and a vaccine for pregnant women — that experts say likely drove an improvement in infant mortality.

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The committee will discuss another company’s newly approved antibody shot, but the exact language for the vote was not released prior to the meeting.

“I think there may be a theme of soft-pedaling or withdrawing recommendations for healthy pregnant women and healthy children,” even though they are at risk from vaccine-preventable diseases, said Lawrence Gostin, a public health law expert at Georgetown University who co-authored a recent medical journal commentary criticizing the COVID-19 vaccination decision.

Flu shot recommendations to be debated

At its June meetings, the committee usually refreshes guidance for Americans 6 month and older to get a flu shot, and helps greenlight the annual fall vaccination campaign.

But given the recent changes to the committee and federal public health leadership, it’s unclear how routine topics will be treated, said Jason Schwartz, a Yale University health policy researcher who has studied the committee.

Thursday also promises controversy. The advisory panel is set to consider a preservative in a subset of flu shots that Kennedy and some antivaccine groups have falsely contended is tied to autism. In preparation, the CDC posted a new report confirming that research shows no link between the preservative, thimerosal, and autism or any other neurodevelopmental disorders.

Gostin said the agenda appears to be “a combination of what we would normally expect ACIP to cover along with a mixture of potential conspiracy theories,” he said. “We clearly are in a new normal that’s highly skeptical of vaccine science.”

The committee’s recommendations traditionally go to the Centers for Disease Control and Prevention director. Historically, nearly all are accepted and then used by insurance companies in deciding what vaccines to cover.

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But the CDC currently has no director, so the committee’s recommendations have been going to Kennedy, and he has yet to act on a couple recommendations ACIP made in April.

The CDC director nominee, Susan Monarez, is slated to go before a Senate committee on Wednesday.

RFK Jr.’s picks for CDC vaccine advisers meet this week amid controversy

toggle caption Alyssa Pointer for The Washington Post/Getty Images

An influential committee that helps craft federal vaccine policy and recommendations for the Centers for Disease Control and Prevention begins a two-day meeting in Atlanta on Wednesday.

The Advisory Committee on Immunization Practices, or ACIP, often meets in obscurity, but was thrown into the spotlight two weeks ago when Health Secretary Robert F. Kennedy Jr. fired all 17 seated members of the panel and replaced them with a smaller selection of his own.

The committee meets over the objections of Sens. Bill Cassidy, R-La., and Patty Murray, D-Wash., chair and former chair of the Senate Health, Education, Labor and Pensions committee, who have both called for the meeting to be postponed over concerns about the new committee members.

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The committee typically meets three times a year in public meetings to discuss and vote on how vaccines, approved by the Food and Drug Administration, should be used to protect public health.

The run-up to this week’s meeting has been chaotic and controversial, according to several current and former CDC staffers who were involved in preparing for it.

It will be closely watched by those concerned about the direction of vaccine policies under Kennedy. “It will be hard to look away,” says Jason Schwartz, associate professor at the Yale School of Public Health. “We’ll see a lot about what this next chapter for vaccine policy looks like.”

The Department of Health and Human Services did not respond to NPR’s request for comment on this story.

Fears of politicization

Kennedy’s firing and replacing the entire slate of advisers shifts the fundamental purpose of the group, says Schwartz.

“This has been an apolitical group of public servants, volunteers from the scientific and medical community who have gone through their terms independent of changes in the political administration and in CDC leadership,” he says. “That we’re thinking about ‘Biden ACIP members’ and ‘Trump ACIP members,’ that this is being viewed — like the Supreme Court — in terms of who has a majority, is unprecedented in the committee’s history.”

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The ACIP has played a key role in U.S. vaccine policy since it was formed in the 1960s. At the time, new vaccines for measles and polio had recently come online, and national health leaders felt the need for a regular panel of experts to determine how best to use these and other products to protect the public.

So they brought together specialists on medicine, public health and children’s health to weigh and discuss the available evidence.

Now the committee makes recommendations that, with the CDC director’s approval, become policy. Committee members help set the national vaccine schedule, which state and local jurisdictions and doctors rely on. Their votes affect which vaccines insurers will cover and the federal government will pay for, for low-income kids.

A break with precedent

In late May, Kennedy announced that he was changing the vaccine schedule without ACIP’s input — a breach in the transparent, consensus-driven way the schedule had been made for decades.

He directed the CDC to remove the recommendation that children and pregnant women get routine COVID-19 vaccines.

“No one from CDC who works on vaccine policy was involved in that process. No one knew that was coming,” says Dr. Fiona Havers, a former senior CDC official who left the agency in June. “For RFK Jr. to be unilaterally dictating to CDC what the vaccine recommendation should be was shocking.”

For Havers, who led the team that analyzed hospitalization data for COVID and RSV and was previously scheduled to present at this week’s meeting, Kennedy’s subsequent firing of every ACIP committee member was the last straw.

“I knew I was done at that moment,” she says. “For my own scientific and personal integrity, I did not feel like I could present to this committee and help legitimize them.”

New members with a record of questioning vaccines

Many of the panel’s eight new members don’t have deep, current expertise in vaccines. Some rose to prominence in recent years by spreading false claims about them.

For instance, Retsef Levi, a professor at the MIT Sloan School of Management, has said on social media that COVID vaccines are killing young people and must be stopped. Dr. Robert Malone, who had worked on early research into mRNA technology but is now critical of mRNA vaccines, has suggested that COVID vaccines may cause cancer. Neither of these claims are true.

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Martin Kulldorff, an epidemiologist and biostatistician formerly at Harvard who will serve as the new ACIP chair, has been paid to serve as expert witnesses in litigation against the drug company Merck, as has Malone.

Vaccine supporters worry that this panel could be dismissive of vaccines and discourage their use.

“I don’t feel like I can trust the information and recommendations from ACIP now,” says Dr. Alexandra Cvijanovich, a pediatrician in Albuquerque, N.M., and a spokesperson for the American Academy of Pediatrics.

The mixed messaging from the Kennedy-led HHS is confusing for patients, she adds.

“People who have always trusted vaccines are now beginning to second-guess them,” she says. “And then people who have had full faith in our vaccine system are now worried that it’s been taken apart with the dissolution of the original ACIP committee.” Parents have asked her about the accessibility and safety of future vaccines, she says.

Meeting agenda items raise flags

In the past, ACIP’s public meetings have been reassuringly predictable. Committee members sit through data presentations, ask thoughtful questions, and vote when asked. It tends to go smoothly because it takes months to years of work behind the scenes — by committee members, CDC staff and other stakeholders — before they present a final analysis and bring a product to a vote.

Some topics were dropped from the agenda for this week’s meeting, such as discussions on vaccines that protect against cervical cancer and pneumonia. The abrupt firing of the previous committee made it impossible for the related work groups — who can’t meet without active ACIP members — to finish their work, according to current CDC staff, who requested anonymity because they were not authorized to speak for the agency.

Instead, those topics have been subbed out for some long-standing priorities for people who question vaccines.

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There’s a vote scheduled over thimerosal, a preservative used in influenza vaccines. Back in the mid-to-late 1990s, there were theories that it could be a cause of autism in children.

That claim has long been disproven. Even so, manufacturers voluntarily removed it from childhood vaccines.

It’s used infrequently today and there hasn’t been much new research on it for years, according to a CDC briefing posted in the ACIP meeting materials in advance of the meeting.

Still, the group will be asked to vote on a recommendation on the topic, after reviewing a presentation by Lyn Redwood, a registered nurse and former president of Children’s Health Defense, the anti-vaccine advocacy group that Kennedy used to chair.

The inclusion of the MMRV (measles, mumps, rubella, and varicella, aka chicken pox) vaccine on the agenda also comes as a surprise to vaccine policy experts at the Vaccine Integrity Project, an initiative housed at the University of Minnesota that is working to safeguard vaccine policy and access.

Years ago, there was evidence that the MMRV vaccine was linked with seizures during fevers in some young children. The committee addressed it then by recommending that young kids be vaccinated separately for chicken pox — a policy that hasn’t changed in more than 15 years.

“It is possible that there are new data, but CDC experts with decades of experience haven’t seen them,” says a briefing from the Vaccine Integrity Project. Still, it’s up for discussion at this meeting.

New CDC advisers will skip some expected topics and explore a target of antivaccine activists

U.S. Health Secretary Robert F. Kennedy Jr.’s new vaccine advisers meet next week, but their agenda suggests they’ll skip some expected topics — including a vote on COVID-19 shots — while taking up a longtime target of anti-vaccine groups.

The Advisory Committee on Immunization Practices makes recommendations on how to use the nation’s vaccines, setting a schedule for children’s vaccines as well as advice for adult shots. Last week, Kennedy abruptly dismissed the existing 17-member expert panel and handpicked eight replacements, including several anti-vaccine voices.

The agenda for the new committee’s first meeting, posted Wednesday, shows it will be shorter than expected. Discussion of COVID-19 shots will open the session, but the agenda lists no vote on that. Instead, the committee will vote on fall flu vaccinations, on RSV vaccinations for pregnant women and children and on the use of a preservative named thimerosal that’s in a subset of flu shots.

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It’s not clear who wrote the agenda. No committee chairperson has been named and the U.S. Department of Health and Human Services did not comment.

Committee won’t take up HPV or meningococcal vaccines

Missing from the agenda are some heavily researched vaccine policy proposals the advisers were supposed to consider this month, including shots against HPV and meningococcal bacteria, said Dr. Susan Kressly, president of the American Academy of Pediatrics.

Instead, the committee is talking about subjects “which are settled science,” she said.

“Every American should be asking themselves how and why did we get here, where leaders are promoting their own agenda instead of protecting our people and our communities,” she said. She worried it’s “part of a purposeful agenda to insert dangerous and harmful and unnecessary fear regarding vaccines into the process.”

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The committee makes recommendations on how vaccines that have been approved by the Food and Drug Administration should be used. The recommendations traditionally go to the Centers for Disease Control and Prevention director. Historically, nearly all are accepted and then used by insurance companies in deciding what vaccines to cover.

But the CDC has no director and the committee’s recommendations have been going to Kennedy.

Thimerosal is a longtime target of antivaccine activists

Thimerosal was added to certain vaccines in the early 20th century to make them safer and more accessible by preventing bacterial contamination in multi-dose vials. It’s a tiny amount, but because it’s a form of mercury, it began raising questions in the 1990s.

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Kennedy — a leading voice in an antivaccine movement before he became President Donald Trump’s health secretary — has long held there was a tie between thimerosal and autism, and also accused the government of hiding the danger.

Study after study has found no evidence that thimerosal causes autism. But since 2001, all vaccines manufactured for the U.S. market and routinely recommended for children 6 years or younger have contained no thimerosal or only trace amounts, with the exception of inactivated influenza vaccine.

Thimerosal now only appears in multidose flu shot vials, not the single-shot packaging of most of today’s flu shots.

Targeting thimerosal would likely force manufacturers to switch to single-dose vials, which would make the shots “more expensive, less available and more feared,” said Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia.

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Doctors’ groups have opposed Kennedy’s vaccine moves

Last week, 30 organizations called on insurers to continue paying for COVID-19 vaccines for pregnant women after Kennedy said the shots would no longer be routinely recommended for that group.

Doctors’ groups also opposed Kennedy’s changes to the vaccine committee. The new members he picked include a scientist who researched mRNA vaccine technology and became a conservative darling for his criticisms of COVID-19 vaccines, a top critic of pandemic-era lockdowns and a leader of a group that has been widely considered to be a source of vaccine misinformation.

The American Academy of Pediatrics has long put out its own immunization recommendations. In recent decades it has matched what the government recommended. But asked if they might soon diverge, depending on potential changes in the government’s vaccination recommendations, Kressly said; “Nothing’s off the table.”

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“We will do whatever is necessary to make sure that every child in every community gets the vaccines that they deserve to stay healthy and safe,” she said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Mike Stobbe And Lauran Neergaard, The Associated Press