By now all of you know Kennedy removed all then current members of the Advisory Committee on Immunization Practices (ACIP), the federal advisory body responsible for developing vaccine recommendations in the United States.
RFK Jr. fires all 17 members of CDC vaccine advisory panel
ACIP had been composed of experts who play an important role in our immunization schedules (for kids and adults) and deciding coverage for critical programs like the VFC and affordable care act.
Though Kennedy prior to his confirmation promised to “maintain” the committee in a conversation with Senator Bill Cassidy, we all knew that was BS and that he would do exactly what he did this week. The end game is of course to greatly reduce the adult and child vaccine schedule and thereby stop reimbursement for vaccines via insurance plans.
I don’t think his goal is to revoke vaccine licenses – rather he simply wants the vaccines to stop being administered.
The legal framework governing ACIP gives Kennedy tons of leeway in appointing and removing members, so there’s basically no chance legal actions can reverse this week’s decision.
When he reconstitutes the committee it’s sure to be a cadre of anti-vaccine and fringe groups who will quickly build agendas to remove vaccines from the schedules (and thereby stop reimbursement for their administration.
The new appointees will have the power to end vaccine recommendations—changes that the CDC director will adopt without resistance.
If (when) the new ACIP recommends removing key vaccines like the HPV and meningococcal vaccine from the recommended schedule (the first two in his sights), insurers will no longer have to cover them, drastically reducing access (the PPV vaccine prevents cervical cancer while the meningococcal vaccine prevents deadly bacterial meningitis).
While Medicare is legally bound to cover certain vaccines, Medicaid coverage through VFC is directly tied to ACIP’s list. Because childhood vaccines for kids who are Medicaid members (AHCCCS) is tied directly to the VFC program there would be an immediate impact for those kids, and they will no longer be protected.
In some cases ACIP/CDC may not totally pull vaccines off the recommended schedule – they might move the vaccine to a ‘shared clinical decision-making’ category – meaning they won’t be routine and more importantly VFC providers won’t have to stock it.
The downstream effects are predictable: vaccination rates will drop. We’ve already seen troubling declines in routine immunization across the country in recent years, including in Arizona.
Arizona schoolkids’ immunization coverage declines, new numbers show
Diseases we’ve largely controlled—like measles, pertussis, and even certain cancers prevented by vaccines like HPV—could surge again. The U.S. could become a hotspot for preventable infectious diseases, reversing decades of public health progress.
Arizona confirms 4 measles cases amid national surge
When all is said and done 3.5 years from now, we will be able to dig out of the hole Kennedy is excavating – but it’ll take time and resources and a cadre of professionals like yourselves to make it happen.
In the meantime, many people will unnecessarily suffer, and lives will be unnecessarily lost.
Note: Lawsuits have been a key (actually the only) tool for stopping some of the president’s actions this far – with over 64 Preliminary Injunctions or Restraining Orders in place. Sadly, these ACIP/CDC/Antivax actions by Kennedy appear to use existing authority and it seems to me that we won’t be able to successfully challenge the eventual wholesale scale back of the child vaccine schedule (and vaccination rates) that’s sure to result.
However, in 3.5 years we’ll hopefully be able to restore an evidence-based vaccine schedule – although there will be a lot of catching up to do because the vaccines that will shortly be removed from the schedule will become cash pay and immunization rates will plummet.
