Further Insights Into the ACIP’s Recent Series of Meetings

Back in June, US Department of Health and Human Services Secretary Robert F. Kennedy Jr dismissed all 17 members of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP).

Those members were replaced, and as previously reported in Contagion, the newest members of the committee were announced on 2 different occasions: the first in June and the second just a few days before the ACIP’s September meetings.

“The membership of the ACIP, made up of experts in vaccinology of all different types, they were all discharged and replaced by a new group, and this new group has now met twice and is making recommendations and is using not the usual kinds of rigorous procedures for data presentation and evaluation,” William Schaffner, MD, professor of medicine in the Division of Infectious Diseases at Vanderbilt University School of Medicine, said.

This marked departure has played out in the ACIP’s latest series of meetings held last month, where they discussed the hepatitis B, measles-mumps-rubella-varicella, and COVID-19 vaccines. During the series of meetings, there was some confusion and there were limitations put on the various vaccines.

For example, Schaffner points to the differences in the ACIP’s COVID-19 vaccine recommendations vs the US Food and Drug Administration’s licensure for the vaccine.

“It's a very interesting recommendation, because they say in shared clinical decision-making, 'This can be available to everyone 6 months of age and older, with a special emphasis on people in high-risk groups, those 65 years of age and older, as well as those younger who have chronic medical conditions.' So it also does provide the opportunity for people who are younger, if they have a discussion with their provider, even if they don't have a chronic medical condition, to receive the vaccine,” Schaffner said. “This is in some contrast to the way the Food and Drug Administration has actually licensed the vaccine, where they have targeted explicitly the vaccine to people aged 65 and older and to those who have chronic medical underlying conditions. So you see there's overlap, but it's not completely harmonized. So how we can provide this vaccine going forward this season, I think, is still going to have to be worked out.”

Additionally, many of the medical professional societies are offering some of their own differing recommendations.

“So there have been caution lights set up about the recommendations that are coming, sadly, out of this new ACIP,” Schaffer said. “Professional organizations such as the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and others, including public health departments and state public health departments, are providing alternative recommendations. We might call them more traditional recommendations. So we're now in a position of some confusion and concern.”