Threat to US vaccines as CDC staff supporting key advisory panel laid off | US healthcare
TStaff supporting the Advisory Committee on Immunization Practices (ACIP) were laid off earlier this month following a broad round of layoffs that gutted entire departments at the U.S. Centers for Disease Control and Prevention (CDC).
Most of the committee’s working groups, which review data and help set agendas, have not met in months, and there was little communication from staff even before receiving Reduction in Force Notices (RIFs) during the U.S. government shutdown.
The ACIP meeting scheduled for October 22-23 has been postponed indefinitely.
These changes mean that the U.S. government may not make routine vaccine recommendations for more than half of children in 2026, and they will likely affect the ongoing development and recommendation of new vaccines.
ACIP made headlines in June when Robert F. Kennedy Jr., the U.S. Secretary of Health, replaced all independent vaccine advisers with his own hand-picked advisers, an unprecedented move.
Some of these advisers, as well as others added in September, are staunch anti-vaccine activists. But the committee’s work is not carried out only by independent advisers; it is supported by CDC staff and external experts who are members of working groups.
CDC staff provide logistical support and subject matter expertise, and ensure the committee complies with rules and regulations.
The entire department is now “gone,” Demeter Daskalakis, former director of the National Center for Immunization and Respiratory Diseases, said last week at a news conference with Defend America Action. Only one designated federal official remains for the group, he said.
“CDC scientists are being held hostage by Robert F. Kennedy Jr.,” Daskalakis added.
With the ACIP staff, “a lot of what they do is logistics,” said Kevin Ault, an obstetrician-gynecologist at Western Michigan University Homer Stryker MD School of Medicine.
In recent meetings, “you kind of saw that fall apart,” he said.
Some presentations were unavailable for the most recent meeting and several Zoom meeting links and microphones were not working. The language of the vote was not distributed to the public or apparently to councilors in advance, with one committee member objecting to the vote due to lack of information. With support staff leaving, these delays and errors could get worse.
It’s not just the agency’s scientists and staff who are feeling the effects of layoffs and reshuffles.
ACIP working groups are often composed of subject matter experts, local health department officials, and representatives of medical groups in addition to CDC employees. There are typically eight to ten working groups at any given time focusing on pathogens such as influenza, respiratory syncytial virus (RSV), human papillomavirus (HPV), and cytomegalovirus (CMV).
“We usually do the very boring work of going through the data and deciding what information is most important to present at the public meeting,” Ault said.
Most working groups have not met for at least six months. Ault was attending an RSV task force meeting in June when news broke that all 17 ACIP advisors – some of whom were leading the session – were being fired.
“They weren’t informed in advance. It was in the Wall Street Journal and someone was on the phone and said, ‘Hey, did you know you just got fired?'” Ault said.
Since then, Ault has not attended any meetings and heard little from staff.
“The only communication I received was usually about the day of a scheduled meeting – that one had been canceled. Other than that, I haven’t received much communication at all,” Ault said.
Ault was a member of ACIP from 2018 to 2022. He has served on the influenza task force on and off since the 2009 influenza pandemic, and he serves as chair of the planning committee.
“Most of them haven’t met in six months or more,” Ault said. “It’s been very fragmented and haphazard.”
The flu recommendations were released in August despite no task force meeting, meaning experts and medical groups had no input on the recommendations.
Representatives of some groups received an unsigned email in August stating that their input was no longer needed. Uninvited groups included the American Medical Association, the American Academy of Pediatrics, and the Infectious Diseases Society of America. Other representatives, including the American College of Obstetricians and Gynecologists (ACOG), were not informed whether they were still participating in the working groups, Ault said.
One apparent exception to the pause in working groups is the new Covid vaccine group led by Retsef Levi, a professor of operations management at the MIT Sloan School of Management and one of the new vaccine advisers. It is not clear who is on the Covid committee and whether they are following the usual task force processes.
Working group members have presented data at ACIP meetings since the redesign. But they were “sidelined,” Daskalakis said. “Really, they’re just providing data that, frankly, is just being criticized and ignored.”
A meeting scheduled for October was postponed “to be determined,” according to the ACIP website.
A vaccination schedule is expected to be released by the CDC by Jan. 1, and Vaccines for Children — a program that provides vaccines to 52% of children in the United States — is dependent on that schedule, Ault said.
Normally, the schedule would have been published in the Morbidity and Mortality Weekly Report, but that publication is temporarily closed during the government shutdown. And the schedule would have been discussed at the October meeting.
“All vaccines for children and, to some extent, adults are at risk if this work is not done in the next two and a half months,” Ault said.
Emptying the committee also means that promising new vaccines in the late stages of clinical trials may never be recommended, he added.
“I don’t know what the future holds with the new vaccines that are on the horizon. The path forward just seems very murky.”
With the layoff of ACIP staff, “it’s like the operating system of the advisory committee is gone,” Daskalakis said. “The hardware is there, the software is there” – but there is no way to make the system work, he said.
The RIFs, which also affected departments including human resources, could limit what happens with the committee in the future, Debra Houry, former CDC chief medical officer, said at the same news conference with Daskalakis.
“If they want to add new people, HR is gone. All of CDC HR is gone. That’s who’s bringing in the special government employees and the new FACA. [Federal Advisory Committee Act] members,” she said.
The ethics office has also been abandoned entirely. If “these people have a basic conflict of interest, we will never know because they will no longer be evaluated by the ethics office,” Daskalakis said. “That’s another pretty big red flag.”
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