The Trump administration published on Thursday a new charter for the federal vaccine advisory committee that would allow Health Secretary Robert F. Kennedy Jr. to reclaim his changes to national vaccine policy, despite a ruling last month by a federal judge blocking them.
The ruling, in a lawsuit brought by several medical organizations against Mr. Kennedy, froze the committee and reversed many of the decisions the health secretary and the panel had made in the last year to rescind longstanding recommendations for childhood vaccines. The judge also said the committee’s members were not qualified to recommend shots for Americans.
The new charter, posted on the website of the Centers for Disease Control and Prevention, revises the makeup and purpose of the panel, called the Advisory Committee on Immunization Practices. The changes may allow Mr. Kennedy to reconstitute the committee with some or all of its previous members and resuscitate at least some of their decisions.
The move is the latest in a whiplash-inducing series of decisions, reversals and revisions to vaccine policy by Mr. Kennedy and his department. The conflicting messages have left many Americans confused about which shots are safe and recommended and whom they should trust.
The new charter places a heavy emphasis on vaccine safety and includes “recovery from serious vaccine injuries” as among the types of expertise that would qualify someone to be a committee member. The document appears to draw from a petition to the health secretary by Aaron Siri, a lawyer who for years joined with Mr. Kennedy in court battles over vaccine safety.
In the petition, Mr. Siri asked the health secretary to reframe the committee’s charter and to nominate at least two members who “have direct and substantial experience advocating for and/or treating those injured by vaccines.”
In a separate petition, Mr. Siri has also asked the acting head of the C.D.C. to make vaccines for diseases — including polio, tetanus, whooping cough and meningitis — optional. He said the C.D.C. should recommend that Americans decide whether to receive the shots in consultation with a health care provider, instead of saying that all Americans should get them.
The approach — called shared clinical decision making — should ideally be applied to all vaccines, but at the very least to those that do not prevent disease transmission, the petition said, according to a copy viewed by The New York Times. Neither Dr. Jay Bhattacharya, who is overseeing the C.D.C.’s activities in the absence of an agency director, nor the Health Department responded to questions about their response to the petition.
The White House has indicated that it wants to tamp down negative discussions of vaccines as the midterms approach. In meetings with C.D.C. staff, Dr. Bhattacharya has praised vaccines and the measles vaccine in particular, offering to publicly endorse immunizations. Still, he delayed publication of a report showing that the Covid vaccine significantly reduced the likelihood of hospitalizations and emergency visits last winter, saying the study’s design produced an inaccurate picture of how effective the vaccines were.
The C.D.C. does not set rules or mandates for immunizations, but states have traditionally followed recommendations by the agency and its A.C.I.P. advisers. The committee’s previous charter required its members to “have expertise in the use of vaccines and other immunobiologic agents in clinical practice or preventive medicine, have expertise with clinical or laboratory vaccine research, or have expertise in assessment of vaccine efficacy and safety.”
In his ruling, the federal judge said last month that the members of the A.C.I.P. appointed by Mr. Kennedy did not have the required expertise, nor had they been selected after careful vetting, as had been customary for decades.
Last week, the Health Department took the first step toward reviving the committee in a modified form, posting a renewal document for the charter that broadened the qualifications to include biostatistics, toxicology, immunology, family medicine and nursing. It is unclear whether Mr. Kennedy will nominate new members, or bring back at least some of the previous members by saying they had already been vetted.
“This isn’t a good-faith effort to right the wrongs in our lawsuit,” said Richard Hughes, a lawyer for the medical organizations that brought the suit. “It’s a calculated effort to shift the focus and balance of the committee to advance an anti-vaccine agenda.”
The charter posted on Thursday also included as liaisons to the committee some organizations known to be skeptical of vaccines, including the Association of American Physicians and Surgeons, Physicians for Informed Consent and the Independent Medical Alliance.
Some members of the frozen committee, including the chair, Dr. Kirk Milhoan, are affiliated with the Independent Medical Alliance. Dr. Milhoan has said that vaccines against polio and measles — and perhaps all diseases — should be optional for Americans and offered only in consultation with a clinician.
The polio vaccine in particular has strong bipartisan support, including from President Trump and some Republican lawmakers who have invoked the horror of the time before the vaccine was available, when the disease paralyzed tens of thousands of Americans each year and killed thousands.
In his petition to Dr. Bhattacharya, Mr. Siri similarly argued that vaccines that blunt illness but do not prevent infection or transmission do not have an impact more broadly on the population, so individuals should be free to choose for themselves whether they wish to be immunized. He included in this category vaccines against polio, tetanus and human papillomavirus or HPV.
“This change is an important step toward assuring individualized care for each child rather than vaccinating children like cattle,” Mr. Siri said in an emailed statement. “To be clear, that should be the case for all vaccines, but it should, at the very least, be the case for the ones that do not prevent infection and transmission.”
But experts in infectious diseases said they disagreed with that argument, noting that by decreasing the duration and severity of illness, vaccines indirectly affect whole populations, even when they do not prevent infection or transmission. For example, a study published in January in the journal Lancet Public Health showed that widespread vaccination for HPV decreased precancerous lesions, even among those who had not received the shots.
“The ongoing effort to sow doubt on vaccines that have prevented millions of illnesses and deaths by indicating that they don’t work well enough to be recommended routinely is unconscionable,” said Dr. Demetre Daskalakis, who directed the C.D.C.’s National Center for Immunization and Respiratory Diseases before he resigned in August.
Apoorva Mandavilli reports on science and global health for The Times, with a focus on infectious diseases and pandemics and the public health agencies that try to manage them.
The post With New Charter, Kennedy Redesigns Vaccine Committee and May Sidestep Court Ruling appeared first on New York Times.
