Jason Mast , 2025-04-15 23:27:00
A meeting of vaccine advisers long targeted by health secretary Robert F. Kennedy Jr. unfolded Tuesday seemingly without fireworks or interference, although the new administration’s imprint could be seen from the start, when staff for the Centers for Disease Control and Prevention, gutted by layoffs, struggled to get a livestream running.
“We’re working through some broadcasting issues,” said ACIP chair Keipp Talbot, to begin the meeting. “As you may have noticed, there have been some changes with the recent reduction in force, including to our communications group.”
The Health and Human Services Department abruptly cancelled the February meeting of the Advisory Committee on Immunization Practices, or ACIP, a 60-year-old body that provides recommendations for how vaccines should be deployed across the country. Public health professionals were relieved to see the committee reconvened but nervous about potential interference from a department now run by the country’s most prominent vaccine critic.
For nine hours, though, experts walked through dense data on vaccines for Covid-19, Mpox and HPV, as well as shots in development for Lyme disease and cytomegalovirus, which can cause devastating complications for newborns.
When the growing measles outbreak came up, committee members stressed the importance of vaccination but avoided direct confrontation with Kennedy, who has at times urged people to get the measles vaccine but also pushed ineffective treatments and downplayed the scale of the epidemic.
“I find it absolutely devastating we’re having this update today — there’s no reason why we have healthy children dying of measles in the U.S. when this vaccine is amazing,” Talbot said. “It’s highly effective and has very long lasting immunity.”
Kennedy’s name was not mentioned. But when asked if there were enough resources to stem the outbreak, David Sugerman, the CDC’s measles team lead, acknowledged that the agency was struggling.
He pointed to “Covid-19 funds dissipating,” an apparent reference to the administration’s move — currently in legal limbo — to recess $11 billion in Covid funding to local public health departments. In Texas, local officials said the cuts would impair their response. Kennedy claimed he had no idea the funds had been rescinded.
“We’re trying to support what we can, but I’m assuming that if this is going to be ongoing, that those will be significant financial resources needed,” Sugerman said. He added that responses to measles cases are estimated to cost $30,000 to $50,000 apiece. “That adds up quite quickly… we are scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions.”
Kathryn Edwards, a longtime vaccinologist at Vanderbilt University and former ACIP member, said she was pleased with the meeting.
“I did not listen to every minute of the session today but when I did listen it seemed pretty much like usual,” she said in an email. “It seemed people were asking questions as usual.”
Still, it’s not clear what that means for vaccine policy more broadly. Looming over the meeting was an unstated question: Is the FDA still properly reviewing vaccines?
Earlier this month, the agency declined to approve Novavax’s Covid-19 vaccine, despite reviewers having cleared it for approval. The move, still not fully explained, raised questions around whether the agency will approve a next-generation Covid-19 shot from Moderna at the end of April.
Tracy Beth Høeg, a rehabilitation medicine specialist and epidemiologist who rose to prominence during the pandemic as a skeptic of Covid policies and now serves a top aide to FDA commissioner Marty Makary, reportedly played a role in the Novavax decision. She attended the meeting as the agency’s ex officio but demurred when asked about the move.
“That is a good question!” she said. “I don’t know to what extent I’m allowed to give an update on that, but there will be an update coming out publicly very soon.”
Nevertheless, members discussed data around the new Moderna shot, which provoked higher levels of antibodies at a lower dose in clinical trials, and whether to adjust recommendations for all Covid vaccines to be more tailored to specific risk groups. Høeg spoke repeatedly throughout the morning, mostly voicing skepticism or asking a seemingly basic question about vaccine study design.
The administration’s imprint was seen in at least one other area. Early in the morning, the committee considered whether to revise a previous recommendation for Jynneos, the vaccine for Mpox, which had sparked a 2022 outbreak that disproportionately affected men who had sex with men and transgender people.
The previous recommendation had included transgender and nonbinary individuals among groups in defining at-risk. But on Tuesday, “transgender” and “nonbinary” individuals had been removed, in compliance with an executive order to scrub references to transgender people from federal documents.
The committee was skeptical of a proposed change for expanding a recommendation for routine mpox vaccination to cover at-risk adolescents. CDC scientists saw it as a logical step now that new data from adolescent trials were in, but outside experts were uncertain about rolling out a vaccine for a virus that has infected only a handful of adolescents in the U.S. over the last couple of years.
They also noted Jynneos can cost over $200. “This seems like an extraordinary expenditure of resources for a very small number of cases,” said Jamie Loehr, an adviser and a family physician in Rochester, New York.
In the end, committee members simply seemed glad they were able to conduct the meeting.
“We were anticipating a lot of challenges today, most of which didn’t materialize,” said ACIP executive secretary Melinda Wharton.