Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.'s influence on vaccination guidelines in the United States came into focus this week as his controversial and hand-picked members of a panel that makes immunization recommendations to the Centers for Disease Control and Prevention (CDC) met for the first time.
Despite concerns from public health experts over Kennedy’s abrupt removal earlier of all 17 members of the Advisory Committee on Immunization Practices (ACIP) and replacing them with seven well-known critics of vaccines and COVID-19 interventions, the panel on Thursday voted in favor of a vaccine to protect babies from respiratory syncytial virus (RSV), a dangerous virus that can cause death and is the leading cause of hospitalization among newborns.
ACIP voted 5-2 to recommend the use of a new vaccination made by Merck for infants and also voted to include the shot in a federal program that provides free vaccines to eligible children, CNN reports. The new vaccine, which the Food and Drug Administration approved earlier this month, will join two other interventions previously approved to protect against RSV: an antibody shot and an immunization given during pregnancy.
Later in the day, the panel voted to recommend annual flu shots for all Americans aged 6 months and older. But the committee voted against flu vaccines that contained the mercury-based preservative thimerosal. According to the CDC, thimerosal has been used for decades in the United States in multi-dose vials of medicines and vaccines. The CDC said there is no evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site.
In July 1999, as a precautionary measure, the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines. ABC News reports that public health experts believe that decision fueled allegations by anti-vaccine groups that thimerosal isn’t safe and a theory that mercury causes autism. Indeed in 2014, Kennedy wrote a book falsely claiming that thimerosal is "toxic to brain tissue,” calling for its removal from all vaccines, ABC News noted.
The vote by the ACIP panel took place following a presentation by Lyn Redwood, R.N., MSN, the former president of Children's Health Defense, a group Kennedy founded, who refuted evidence-based claims that there was no proven harm from thimerosal in vaccines. Cody Meissner, M.D., a professor of pediatrics at the Geisel School of Medicine at Dartmouth, was the only ACIP member to vote against the recommendation, according to ABC News. The risk of influenza is much greater than thimerosal, he said.
ACIP’s recommendations must be approved by the CDC before they become official policy, but the agency currently doesn’t have a director. The decisions the panel make have enormous implications for insurance coverage. If the panel doesn’t recommend a new vaccine or takes an existing one off the approved list, insurers are not obligated to cover it.
On Wednesday, the panel announced plans to create new workgroups to study established childhood and adolescent vaccine guidelines. One group will examine vaccines that haven’t been reviewed in more than seven years. CNN reports those vaccines include whether the hepatitis B vaccine should be universally recommended for newborns. The CDC has established that the vaccine is safe and effective and recommended at birth. Removing the birth dose would jeopardize the progress the United States has made in eliminating perinatal hepatitis B, according to the American Academy of Pediatrics.
The public also supports childhood vaccines, according to a new poll. The survey, conducted by the Harvard T.H. Chan School of Public Health and the de Beaumont Foundation, found that 79 percent of the 2,509 adults surveyed support childhood vaccine requirements for preventable infectious diseases for children to attend school. The support includes most adults across party lines—90 percent among Democrats and 68 percent among Republicans—as well as 66 percent of those who support the “Make America Great Again” movement. It also includes 72 percent of all parents. The most common reason for opposing vaccine requirements is parental choice, not concern about safety.
"Childhood vaccine requirements are less controversial than many people may think," said Brian Castrucci, DrPH, president and CEO of the de Beaumont Foundation, in the poll announcement. "This poll shows that they're widely supported across political groups—and it's heartening to see that so many Americans understand the importance of vaccination, which remains a fundamental pillar of public health and disease prevention."