Multiple healthcare organizations that have historically helped the CDC’s Advisory Committee on Immunization Practices (ACIP) develop vaccine recommendations have been told they can no longer participate in ACIP work groups, leaving the organizations frustrated and worried about what will happen next.
“We’re very concerned and disheartened that our organizations are considered ‘special interest groups’ and because of that, they feel we’re biased,” said Brigid Groves, PharmD, vice president of professional affairs at the American Pharmacists Association (APhA), one of the groups that received the notification. “It disregards the clinical and scientific expertise that the individuals [from APhA] have dedicated voluntarily over many years.”
Eight other medical organizations that also received Thursday’s notice included the American Medical Association (AMA), American Academy of Pediatrics (AAP), Infectious Diseases Society of America (IDSA), American Osteopathic Association, American Academy of Family Physicians, American College of Physicians, American Geriatrics Society, and National Medical Association.
The 11 work groups, which meet in between general ACIP meetings, “review relevant published and unpublished data and develop recommendation options for presentation to the ACIP,” the CDC says on its website. “Work groups review specific topics in detail and clarify issues in a way that helps ACIP voting members make informed and efficient decisions, with the best and most current information available.”
Notice Via Email
According to an email sent late Thursday afternoon from the ACIP Secretariat, which is made up of CDC staff members, “Liaison organizations are special interest groups and therefore are expected to have a ‘bias’ towards their constituency and/or population that they represent. It is important that the ACIP workgroup activities remain free of influence from any special interest groups, so ACIP work groups will no longer include liaison organizations.” It added, however, that “the ACIP charter will continue to include approved liaison organizations. Representatives will be permitted to continue to participate in the meetings that are open to the public.”
Groves said that APhA was especially surprised to receive the notice, because in May, the organization had received confirmation that it had representation on work groups for vaccines for COVID, respiratory syncytial virus (RSV), influenza, and pneumococcal disease; APhA also has a liaison to ACIP itself, although it never had someone on the committee. APhA is one of 31 officially approved liaison organizations to ACIP.
The eight other medical groups — AMA, APA, IDSA, and others — issued a joint statement on Friday afternoon.
“We are deeply disappointed and alarmed that our organizations are being characterized as ‘biased’ and therefore barred from reviewing scientific data and informing the development of vaccine recommendations that have long helped ensure our nation’s vaccine program is safe, effective, and free from bias,” the statement said. “We represent physicians who care for patients throughout their lifespan, who share a common goal and responsibility to keep patients healthy and protect public health. We bring to the table real-world clinical experience on how vaccine recommendations are implemented in practice.”
“For decades, liaisons from our organizations have reviewed published and unpublished data and literature related to vaccine efficacy, effectiveness, and safety and provided unbiased input for ACIP’s consideration,” the groups continued. “To remove our deep medical expertise from this vital and once transparent process is irresponsible, dangerous to our nation’s health, and will further undermine public and clinician trust in vaccines. We strongly urge the administration to reconsider excluding our organizations from participating in the ACIP vaccine review process so we can continue to feel confident in its vaccine recommendations for our patients.”
HHS Response
Asked to comment on the notice, an HHS spokesperson said in an email that “under the old ACIP, outside pressure to align with vaccine orthodoxy limited asking the hard questions. The old ACIP members were plagued by conflicts of interest, influence, and bias. We are fulfilling our promise to the American people to never again allow those conflicts to taint vaccine recommendations. Experts will continue to be included based on relevant experience and expertise, not because of what organization they are with.”
The notice comes in the wake of HHS Secretary Robert F. Kennedy Jr.’s ousting of all 17 members of ACIP itself; he replaced them with eight other people, including some known vaccine skeptics (one new member resigned shortly after being appointed). Groves said APhA plans to “send a letter to Secretary Kennedy asking to reinstate the work groups as they have been existing. We will continue to fight for science and make sure that our patients can receive the vaccines that they need.”
At the most recent ACIP meeting in late June, several groups — including the American Academy of Pediatrics, the Pediatric Infectious Diseases Society, and the Society for Adolescent Health and Medicine — that were upset by the new members’ lack of expertise, opted not to attend. The Infectious Diseases Society of America also did not send a representative to the meeting, but told MedPage Today that it wasn’t a boycott; rather, liaisons were invited to attend just a few hours before the start of the meeting.
Will New Members Be Vetted?
The new members of ACIP did not go through a vetting process — something that has taken a year or more for previous ACIP members — and that has Groves concerned about what the CDC might or might not do when it replaces work group members.
“As one of the liaison organizations, we had the opportunity to evaluate that individual [candidate] — their history, their records, their clinical acumen, their scientific evidence and research basis, but also their conflicts of interest, potential or not,” she said. “So we would evaluate and assure that the individuals we were identifying, certainly from a scientific and clinical standpoint, were suitable, but were also free from conflicts of interest.”
Groves said she also is wondering about the next round of vaccine recommendations. “We’re really concerned about the upcoming fall respiratory virus season,” she noted. “Right now, we don’t have guidance from ACIP on whether or not the updated COVID-19 vaccine is recommended for use. They did not talk about it or vote on it at their most recent meeting. They intend to have an ad hoc meeting at some point in September, but we don’t have a date for that yet.”
Another concern is whether the recent moves by HHS will increase vaccine hesitancy. “When the information from the leadership of the country comes out, it’s stoking hesitancy and concern among patients about whether or not they should get a vaccine,” said Groves. “They’re going to take that to their physician, to their pharmacist, to their other healthcare friend, and say, ‘Hey, you know, they’re making me feel like I shouldn’t get a vaccine. Should I or should I not?’ So, it’s just going to make it more difficult to wade through the myths and disinformation during those appointments with our patients to help clarify what information is true and accurate.”
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