CDC Vaccine Advisors Convene for First Meeting Since RFK Jr.'s ACIP Overhaul
After a chaotic two weeks that saw the ousting of the 17 standing members of the CDC’s Advisory Committee on Immunization Practices, Health Secretary Robert F. Kennedy’s newly appointed advisors are expected to discuss COVID-19, RSV and MMR vaccines, as well as the use of thimerosal.
Unvaccinated And vaccinated people as anti-vaxxer or individuals that oppose taking the vaccine with 3D illustration elements.
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The first meeting of the newly-assembled CDC Advisory Committee on Immunization Practices is underway, running through Thursday, with members expected to discuss topics ranging from the safety and efficacy of COVID-19, respiratory syncytial virus (RSV), anthrax, chikungunya, influenza and measles-mumps-rubella (MMR) vaccines, to the use of preservative thimerosal in vaccines—an issue most experts believed to have been settled two decades ago.
This meeting has been highly anticipated, after Health Secretary Robert F. Kennedy Jr. ousted the previous 17 ACIP members earlier this month. Two days later, Kennedy replaced them with eight of his own selections—many of whom experts believe could be more critical of vaccines and sympathetic to the secretary’s anti-vax viewpoints. One of the newly appointed members, Michael Ross, withdrew before Wednesday’s meeting, following the financial holdings review, an HHS spokesperson said in a statement, per Reuters, leaving the committee with just seven members.
Following MacNeil was Sarah Meyer, the director of the CDC’s Immunization Safety Office. Her presentation covered the safety of COVID-19 vaccines, focusing on the mRNA vaccines developed by Pfizer and BioNTech and Moderna.
According to Meyer’s presentation, 17,631 deaths were reported to the Vaccine Adverse Event Reporting System (VAERS) following COVID vaccination. After noting that VAERS does not assign causality to the events reported to it, Meyer presented results of a data analysis showing that deaths following mRNA vaccination were below the background death rate for the U.S. population. This indicated that mRNA vaccines are not dangerous but in fact protective, she said.
In the Q&A section, Robert Malone—an early mRNA vaccine researcher turned skeptic—questioned the safety of mRNA vaccines, suggesting that mRNA epitopes stay in the body for upwards of “700 days.” That statement is contradicted by an overwhelming body of evidence, which has shown that mRNA vaccines are destroyed by the body within a few days, persisting at most to about 30 days.
Vicky Pebsworth, speaking for the first time in this meeting, said without elaborating that many adverse effects from mRNA vaccines are not reported. Meyer responded that most unreported adverse effects are for mild effects like sore arms, but that CDC studies show most serious adverse effects are in fact reported.
“For those serious events, we are confident that we get a majority of those reported to VAERS,” she said.
After the introductions, Kulldorff said that upcoming ACIP work groups would look at cumulative childhood vaccine schedules as well as the adolescent schedules. This includes reconsidering giving newborns a vaccine for hepatitis B, which the CDC currently recommends for all infants. The American Academy of Pediatrics recommends the vaccine for newborns within 24 hours of birth.
“An argument could be made for delay of vaccine for this infection, which is primarily spread by sexual activity and intravenous drug use,” Kulldorff said.
Addendum: While common perception of hepatitis B is that it only transmits through sexual contact or needle usage, horizontal transmission is a major factor in hepatitis B infections. For example, one study found that the vast majority of hepatitis B infections in a family can be attributed to simple exposure to an infected person.
The meeting’s first presentation was given by Adam MacNeil, a supervisory epidemiologist at the CDC. He gave a presentation on COVID-19 epidemiology and vaccine effectiveness, recapping the current CDC recommendations for who should get COVID-19 vaccines. As it stands now, the agency recommends essentially everyone older than six months of age get vaccinated, though in May 2024 the CDC changed its recommendation for healthy children to be a “shared clinical decision,” including parental input.
MacNeil’s data presentation showed that vaccine uptake across the U.S. population is rather low, at about 25% for most adults and peaking slightly north of 30% for some sub-groups aged 65 or older. The data further showed that for children aged 2 to 17, hospitalizations due to COVID-19 were low, but children six months or younger were hospitalized at about the same rate as adults aged 65–74 years.
MacNeil reported about 21,000 deaths over the past year, the cause of which was listed on death certificates as COVID-19, though he noted that this is likely an underestimation, with a suggested death rate of 32,000–51,000 based on surveillance data.
In a Q&A session after MacNeil’s first presentation, several members of the committee questioned MacNeil’s data, particularly the death rate figures. Cody Meissner suggested that some patients who were listed as having died from COVID-19 might have died of something else while also having a COVID-19 infection.
“Like people who have appendicitis and happen to have positive PCR result,” Meissner said. “As we know, asymptomatic colonization is quite common with this virus.”
MacNeil and a second expert pushed back, noting that results were limited to where COVID-19 was the “likely reason for admission,” noting that recent work from CDC could accurately identify which patients were hospitalized and died because of COVID-19 and not just having a coincidental infection alongside something else, due to testing positive for COVID and having COVID-related symptoms like pneumonia.
“This is a rare disease,” Meissner said, pointing to dropping rates of infection over the last few years.
COVID-19 is “still a substantial burden,” MacNeil responded, noting high rates of long COVID and that COVID-19 far outpaces other respiratory diseases in hospitalizations because the disease infects year-round, unlike influenza and RSV, which are much more seasonal.
“Opposing mercury in fish does not mean you oppose fish,” Martin Kulldorff, the new ACIP chair, said in his opening remarks to the first meeting of the committee’s new members. The same is true for thimerosal, the uncommonly used preservative that contains a mercury atom but is safe for human use, including as a vaccine additive. ACIP surprised many by putting thimerosal’s use in influenza vaccines—of which 94% don’t contain the preservative—up to a vote. Thimerosal was removed from most other vaccines 25 years ago.
If public trust in one airline falls, it falls for all airlines, Kulldorff added, contending that the same holds true for vaccines.
At its first meeting, a few members of the new ACIP committee kicked things off by introducing themselves and discussing their potential conflicts of interest. Kulldorff and Robert Malone—both reported to have conflicts with Merck—disclosed no conflicts. Kulldorff said he used to work at Harvard but was fired for not getting a COVID-19 vaccine, choosing the “superior immunity” he said he obtained from a previous infection.
Vicky Pebsworth, a nurse with a doctorate in public health, said her stock holdings in healthcare companies and vaccine manufacturers were below what she claimed was the maximum allowable amount and therefore she was allowed to participate in the meeting. After Cody Meissner, a professor of pediatrics at the Geisel School of Medicine at Dartmouth, introduced himself, technical issues precluded the other three members from doing so.
