RFK Jr fires vaccine advisory committee and replaces members with vaccine skeptics

Robert F Kennedy Jr. has fired the entire panel that oversees vaccine recommendations in the US and replaced them with his own picks, including prominent vaccine skeptics.

In a Wall Street Journal op-ed, RFK Jr. announced his decision to fire all 17 members of the CDC's vaccine advisory committee (ACIP). He said the change was needed to "restore trust" because he believes the group is too close to the pharmaceutical industry, exaggerating conflicts of interest and falsely claiming ACIP has never recommended against a vaccine (it has). In a follow up post, he claimed ACIP hasn't ensured adequate safety trials for childhood vaccines and argues the childhood vaccine schedule should be investigated as a cause of chronic disease in children.

This ACIP change appears to contradict RFK Jr.'s promise to Senator Bill Cassidy that he would maintain ACIP's recommendations "without changes." Senator Cassidy is a physician who strongly supports vaccines, and his vote was key in confirming RFK Jr as HHS Secretary.

What is ACIP, and what does this mean?

The Advisory Committee on Immunization Practices (ACIP) is an independent committee typically composed of pediatricians, immunologists, vaccine scientists, and epidemiologists. They review data on new vaccines, updated vaccines, and emerging safety concerns and make recommendations on who should or shouldn't get vaccines. While the CDC director has the final say, they typically adopt ACIP's recommendations.

ACIP's recommendations carry a lot of weight. They influence:

• the childhood vaccine schedule
• annual COVID boosters and flu shots
• which vaccines are covered by insurance
• which vaccines are available through the Vaccines For Children program, which provides free vaccines for underinsured children

Simply put, ACIP members have a lot of authority in influencing recommendations and access to vaccines in the United States.

Who are the new members?

After firing all 17 members who typically hold four year terms, RFK Jr announced eight new members on Wednesday. Several are well known for spreading false information about vaccines, and others are less well known and have no apparent background or expertise in vaccine science. Here's the list:

Robert Malone, MD – a prominent vaccine skeptic who rose in influence during the COVID pandemic, claiming to be the "inventor of mRNA vaccines" for work he performed in the 1980s. He previously served as CEO and co-founder of Atheric Pharmaceutical and was CMO of Alchem Laboratories, a pharmaceutical company implicated in a 2020 whistleblower complaint over a $21 million federally-funded study of pepcid (a common heartburn medication) to treat COVID, a hypothesis for which Malone claims credit. Malone has repeatedly spread false, fearful rumors about vaccines:

• COVID vaccines: he has claimed COVID vaccines worsen COVID-19 outcomes and cause a "form of AIDS", "turbo cancer," and may cause infertility and brain damage.
• Influenza vaccines: Malone said annual flu shots are forced on people to keep vaccine makers in business in case of a future flu pandemic. He also said concerns about a flu pandemic are based on a lie, wrongly arguing that the 1918 Spanish flu wasn’t really caused by the flu virus because bacteria were involved too—misunderstanding that influenza infections can lead to bacterial superinfections.
• Measles: During the recent measles outbreak in Texas, Malone announced the second death of a child before it had been made public – and without the family's permission or knowledge – the day before the child's funeral. The child had died from respiratory failure from measles, but Malone blamed the death on the hospital and said measles wasn't the cause. He was also a paid expert witness in a lawsuit against the manufacturers of the MMR vaccine.

Martin Kulldorff, PhD – an epidemiologist who rose to prominence during the COVID pandemic and helped write the "Great Barrington Declaration" along with current NIH director Jay Bhattacharya, which advocated for targeted COVID lockdown measures for the elderly and vulnerable without providing a feasible plan on how to accomplish that. Dr. Kulldorff has been highly critical of COVID vaccines and was a paid expert witness in a lawsuit against the manufacturer of the human papilloma virus (HPV) vaccine, which prevents cervical cancer.

Joseph Hibbeln, MD - a psychiatrist and neuroscientist whose work has focused on nutrition and various mental health conditions. A PubMed search reveals no publications on vaccines previously.

Cody Meissner, MD - a pediatrician at Dartmouth who has served on several federal vaccine committees. He has been supportive of COVID vaccines and critical of repeated COVID boosters for children. He has published extensively on vaccines and previously served on ACIP from 2008-2012.

James Pagano, MD – a relatively unknown emergency medicine physician. A PubMed search reveals no publications on vaccines previously. An X account matching this name and description includes posts disparaging of Islam and critical of patients who use opioids.

Michael A. Ross, MD – an obstetrician at George Washington University and and operating partner at Havencrest Capital Management. His LinkedIn profile lists him as a current or former CMO, advisor, or board member of multiple pharmaceutical companies ranging from implantable devices to contact lenses. A PubMed search reveals no publications on vaccines previously.

Vicky Pebsworth (formerly Vicky Debold), PhD, RN - A nurse and health policy analyst who is on the board of the National Vaccine Information Center (NVIC), an organization which aims to highlight vaccine risks and injury. She also previously served as a consumer representative on a FDA National Vaccine Advisory Committee working group. A PubMed search reveals two publications related to vaccines, one analysis of nonmedical vaccine exemptions and a second on adverse events after the HPV vaccine.

Retsef Levi, PhD - a professor of Operations Management at MIT. In February 2023, one of his tweets went viral saying COVID vaccines were indisputably causing serious harm and death among young people. His background before COVID seems to be predominately focused on operations management; a PubMed search for vaccine-related research revealed a handful of publications relating to COVID and COVID vaccines.

Trust goes both ways

I don't have great words for how bad this is. I agree with RFK Jr. that we need to work to restore trust in vaccines, but this is not how you do it. He's put U.S. vaccine decisions in the hands of people who mostly either don’t have a background in vaccine science or are known for spreading doubt about vaccines—the very thing they’re meant to evaluate objectively. And while he claims the shake-up was to reduce pharmaceutical influence, he then appoints a pharma CMO?

How can pediatricians, scientists, and families trust the decisions they make when the deck is so stacked against vaccines? As a clinician, how can I trust the recommendations of a doctor like Robert Malone who doesn't seem to understand that influenza can lead to bacterial superinfections? This is basic stuff – we learned it the first year of med school, and I was surrounded by it last winter in the ICU. If bird flu takes off, what will his response be – we don't need a vaccine because it's not actually the virus that's killing people?

Some have argued that we won't restore trust in vaccines until a vaccine skeptic like RFK Jr is in charge. And for the minority who are deeply suspicious of vaccines, perhaps that is true. But we cannot restore trust for one group by destroying it for everyone else. This change damages trust in ACIP and their recommendations for thousands of clinicians, scientists, and families – those who can look back at history and recognize the immense public health benefit of vaccination.

Kristen Panthagani, MD, PhD, is completing a combined emergency medicine residency and research fellowship focusing on health literacy and communication. In her free time, she is the creator of the newsletter You Can Know Things and author of Your Local Epidemiologist’s section on Health (Mis)communication. You can subscribe to her website below or find her on Substack, Instagram, or Bluesky. Views expressed belong to KP, not her employer.