Increasing pediatric deaths and decreasing vaccination rates: the new ACIP continues the dangerous dismantling of our public health infrastructure

When public health is working, it’s often invisible. Most Americans had likely never heard of the Advisory Committee on Immunization Practices (ACIP) before its public meeting last month, though its quiet, rigorous work has shaped vaccine recommendations over the past six decades and saved lives. That’s what makes its unprecedented dismantling so alarming.

An essential engine of the nation’s vaccine system, the ACIP was abruptly gutted when the Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. dismissed all 17 of its voting members weeks before its scheduled meeting last month. In their place came eight new appointees, including several with little relevant scientific backgrounds or histories of spreading vaccine misinformation.

At its June meeting, the newly appointed ACIP appeared to be broadly unfamiliar with both the foundational data and the basic function of immunization policy. The new chair expressed concern that children today receive more vaccines than most did in the past, perhaps unaware that many—himself included—were born before vaccines for measles, mumps, rubella, or hepatitis B existed.

The committee ignored surveillance data and recommendations from the Centers for Disease Control and Prevention (CDC), instead spending valuable time debating a thoroughly debunked claim about the preservative thimerosal. Thimerosal has been removed from nearly all vaccines for over two decades, used only as needed to maintain sterility during storage and shipment. It has never been shown to pose a health risk. Yet, members debated it as if it were a new threat, with the presentation even citing a study that does not exist. Only one panelist a pediatric infectious disease specialist, reminded the group that the risk from flu “is so much greater than the nonexistent risk, as far as we know, from thimerosal,” he was the lone dissenting voice.

The ACIP’s recent meeting speaks to a broader, coordinated campaign to dismantle the infrastructure that has protected Americans from vaccine-preventable diseases for decades. By elevating pseudoscience that weakens trust and public health, we are seeing a rapid shift from evidence-based policy to policy-based evidence. Thimerosal isn’t the threat. Measles, polio, and influenza are the real, and resurging, dangers.

Why This Matters Now

The past flu season marked a grim milestone: the highest number of pediatric flu deaths in more than a decade. These are preventable tragedies that coincide with falling childhood vaccination rates. Now, as the U.S. also reaches a 33-year high in measles cases, it’s the worst possible moment for the nation’s top vaccine advisory body to abandon science.

The ACIP does not approve vaccines; the Food and Drug Administration (FDA) does. ACIP decides who should get them and when. Their recommendations determine not just what pediatricians offer at check-ups, but what vaccines insurance must cover, what schools and hospitals can require, and what public programs like Vaccines for Children (VFC) provide.

The ACIP now plans to reevaluate the entire childhood immunization schedule, something previous committees have already looked at and found no cause for concern. This reassessment appears to be the next step in undermining confidence and sowing confusion, which has consequences when you’re dealing with the health of children and families.

Without ACIP’s careful recommendations, states may begin issuing their own conflicting vaccine rules, creating a patchwork of standards that can lead to supply shortages, delays in immunization, and lower vaccination rates overall. Recent federal guidance removed the COVID-19 vaccine recommendation for pregnant women, ignoring all established procedures and any review by the ACIP to do so. This kind of sudden shift, made without rigorous data analysis or expert guidance, leaves healthcare providers scrambling for information, puts patients at risk, and makes outbreaks of vaccine-preventable diseases more likely.

Trust and Transparency in Public Health Benefits Everyone

Vaccines are among the most effective public health tools in our history. The CDC estimates that vaccinations have prevented approximately 508 million cases of illness, 32 million hospitalizations, and over one million deaths among children in the U.S. since the VFC program began in 1994. That success depends on not just good science but public trust in the process behind it.

There’s room to improve how the government manages industry influence in clinical trials, but eliminating entire scientific advisory bodies and replacing them with ideologically aligned appointees is not the answer. Removing safeguards in the name of rooting out “corruption” invites misinformation and risks dismantling the structure that drives vaccine innovation. Without trust in science-based recommendations, there may be hesitation to invest in lifesaving research, hurting everyone from parents protecting their kids to cancer patients relying on cutting-edge immunotherapies.

The vaccine approval and guidance process was already more transparent, rigorous, and public than most, at least until this moment. These new actions compromise integrity when trust in science is fragile, risking outbreaks of vaccine-preventable diseases and worsening illnesses like flu and RSV. Diversity of opinions and reasonable discussions among experts should be encouraged in professional committees like the ACIP. Debating the long-accepted gold standard scientific methods for interpreting data or determining safety should not.

Public health doesn’t fail all at once. It erodes decision by decision, meeting by meeting. This moment demands urgency. More preventive health services may soon be under attack. In July, the U.S. Supreme Court upheld that while insurance must cover services recommended by the U.S. Preventive Services Task Force (USPSTF), the HHS Secretary can fire USPSTF members at will. USPSTF is a voluntary body of medical experts who provide science-based recommendations about screenings for cancer, heart disease, diabetes, and many other common health conditions.  Within days of the decision, their next meeting was abruptly canceled. Weeks later, no updates have been provided; possibly forecasting that USPSTF will go the way of ACIP in terms of membership and policy.  Now, more than ever, we must hold our health agencies accountable to support science-based policy and protect the public and future generations.