The Centers for Disease Control and Prevention’s (CDC’s) new vaccine advisers announced Wednesday they will be conducting a review of the child and adolescent vaccine schedules, a move the AAP criticized as aiming to sow distrust in immunizations.
The AAP said it will continue to publish its own evidence-based recommendations and schedules. The AAP has provided vaccine recommendations for its entire 95-year history.
“What we heard in this meeting was really a false narrative that the current vaccine policies are flawed and that they need fixing,” Sean T. O’Leary, M.D., M.P.H., FAAP, chair of the AAP Committee on Infectious Diseases, said in a press conference. “That's completely false. These policies have saved millions of lives, trillions of dollars.”
The CDC’s Advisory Committee on Immunization Practices (ACIP) met Wednesday for the first time since Health and Human Services Secretary Robert F. Kennedy Jr. fired all 17 voting members and replaced them with eight new ones, one of whom reportedly stepped down before the meeting. Several of the new members have a history of spreading vaccine misinformation. Dr. O’Leary said AAP liaisons to ACIP did not participate in the meeting “because we view it as illegitimate.”
As the meeting opened, ACIP Chair Martin Kulldorff, Ph.D., a former Harvard University professor of medicine fired for refusing a COVID vaccine, announced a new working group to “evaluate the cumulative effect of the recommended vaccine schedule.”
Reviewing the schedule “has been an anti-vaccine trope for many, many years, and it sounds good at first glance, but the fact is, these vaccines are essentially always being reviewed in real time through a number of different mechanisms, safety surveillance mechanisms, as well as disease surveillance mechanisms,” Dr. O’Leary said.
Another new ACIP work group will look at vaccines that have not been studied for more than seven years. Dr. Kulldorff specifically brought up the birth dose of hepatitis B vaccine, a move Dr. O’Leary called “deeply concerning.”
“The hepatitis B birth dose is one of the cornerstones of our hepatitis B prevention policy here in the U.S., and it has been highly successful in reducing the rate of perinatally acquired hepatitis B,” Dr. O’Leary said.
A child infected at birth has a 90% chance of developing chronic hepatitis B, according to an AAP Fact Checked article published Wednesday. Without treatment, about one-quarter of those children with chronic infection will die of the disease.
In a video released Wednesday morning, AAP President Susan J. Kressly, M.D., FAAP, said creation of federal immunization policy is “no longer a credible process.”
“We won’t lend our name or our expertise to a system that is being politicized at the expense of children’s health,” she said. “But we’re not stepping back, we’re stepping up. The AAP will continue to publish our own immunization schedule just as we always have, developed by experts, guided by science, trusted by pediatricians and families across the country.”
Wednesday’s ACIP meeting also included an in-depth review of data on COVID-19 vaccines, although no votes were taken. Kennedy already directed the CDC to stop routinely recommending COVID-19 vaccination for healthy children and people who are pregnant. Children could get vaccinated following a conversation with their doctor.
Despite Kennedy’s attempts to downplay the need for vaccination, CDC staff highlighted the dangers of COVID-19 to young children. Rates of COVID-19 hospitalization among infants under 6 months are comparable to rates for adults ages 65-74 years. The only way to protect these children is through maternal vaccination, CDC staff said. Hospitalization rates for children ages 6-23 months are nearly equal to people ages 50-64 years. Among children under 2 years admitted to an intensive care unit for COVID-related illness, 53% did not have underlying medical conditions.
ACIP members peppered CDC staff with questions about the data. Similar to the announcement about immunization schedules, Dr. O’Leary said their discussion was “designed to sow mistrust in the data.” The group is expected to discuss COVID-19 vaccines again at a future meeting.
The group also heard presentations on a new monoclonal antibody to protect infants from respiratory syncytial virus (RSV). Clesrovimab from Merck is proposed for use in infants under 8 months born during or entering their first RSV season. It received approval from the Food and Drug Administration (FDA) earlier this month. The committee is scheduled to discuss the immunization and vote on its use Thursday.
Thursday’s agenda also includes a discussion and vote on the preservative thimerosal in flu vaccines. Vaccine skeptics have claimed thimerosal is linked to neurodevelopmental disorders including autism. However, several valid studies have debunked this, according to an AAP Fact Checked article. A review of evidence by CDC staff published Tuesday also found thimerosal to be safe, but it was removed from the ACIP website Wednesday.
The group also will discuss measles, mumps, rubella and varicella vaccine for young children on Thursday.
The agenda no longer includes proposals to reduce the number of recommended HPV vaccine doses and reword recommendations on the ages to get vaccinated. In addition, ACIP will not be voting on Sanofi’s meningococcal conjugate vaccine MenQuadfi, which recently received FDA approval for use in children ages 6 weeks and older
