Editor's note: This story has been updated since publication to include Robert F. Kennedy Jr.’s response to criticism, and to note a relevant emergency resolution voted on Tuesday by the American Medical Association's House of Delegates.
Department of Health and Human Services Secretary Robert F. Kennedy Jr.’s removal of all 17 sitting members of a key vaccine advisory panel has ignited criticism from medical associations and experts as well as concerns that the promised replacements won’t be trustworthy.
The secretary announced the move Monday afternoon, describing the decision to upend the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) as “prioritizing the restoration of public trust.”
He noted that the Biden administration had appointed all 17 of the members, including 13 in 2024, and that the Trump administration would not have the ability to appoint a majority of the committee until 2028 if their terms were allowed to expire.
“A clean sweep is necessary to reestablish public confidence in vaccine science,” said RFK Jr., who has often described government health advisors, researchers and others as compromised by the pharmaceutical industry. “ACIP's new members will prioritize public health and evidence-based medicine. The Committee will no longer function as a rubber stamp for industry profit-taking agendas.”
RFK Jr. had made several concessions to lawmakers during his confirmation process regarding vaccine policy. Of particular note, Sen. Bill Cassidy, M.D., R-La., shared in a floor speech that the secretary had promised to “maintain the [CDC’s ACIP] without changes.”
Within hours and through Tuesday, healthcare groups, medical experts and lawmakers condemned RFK Jr.’s announcement as a breach of his promise and a danger to children and adults’ health.
“Today’s action to remove the 17 sitting members of ACIP undermines that trust and upends a transparent process that has saved countless lives,” American Medical Association (AMA) President Bruce Scott, M.D., said in a Monday statement. “With an ongoing measles outbreak and routine child vaccination rates declining, this move will further fuel the spread of vaccine-preventable illnesses.”
Similar comments came in statements from:
- Infectious Diseases Society of America President Tina Tan, M.D., who called allegations on the ACIP’s integrity “completely unfounded;”
- American Academy of Pediatrics President Susan Kressly, M.D., who described “an escalating effort by the administration to silence independent medical expertise and stoke distrust in lifesaving vaccines;” and
- American Academy of Physician Associates President Jason Prevelige, who said the move was “deeply damaging to confidence in vaccines that have proven to be safe for decades and in the healthcare providers who counsel patients and their families about immunization decisions every day.”
Paul Offit, M.D., director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a former ACIP member, outlined a series of vaccines greenlighted by the committee within the past 25 years that have had substantial positive impacts on disease incidence.
These included a vaccine for rotavirus “that virtually eliminated the 70,000 hospitalizations from severe dehydration caused by that virus,” an HPV vaccine that cut U.S. cervical cancer incidence by 60% and a respiratory syncytial virus vaccine for mothers that cut hospitalizations from the virus during the first two months their infants' lives by more than half.
"I think RFK Jr. is fixing a problem that doesn’t exist,” Offit told Fierce Healthcare. “The ACIP has served us well. He can point to no specific instance where an ACIP voting member has been unduly influenced by the pharmaceutical industry that has caused them to vote against the data. It’s just all innuendo and conspiracy.”
RFK Jr., in a Tuesday evening social media post, wrote that he plans to share "examples of the historical corruption at ACIP to help the public understand why this clean sweep was necessary."
Tom Frieden, M.D., who previously served as director of the CDC, described RFK Jr.’s “dangerous and unprecedented action” of axing the committee members as politization that will “undermine public trust under the guise of improving it.” Should the change lead to vaccines no longer being recommended, “millions of people could lose access [and] pay more for vaccines … for preventable illness, and children will be at greater risk of diseases we haven’t faced in decades.”
What's next for ACIP
Richard Hughes, a healthcare attorney at Epstein Becker Green, said RFK Jr. does have the statutory discretion to set the terms and qualifications for the committee and is permitted to remove a member—though he acknowledged that this decision “could be subject to a challenge under the Administrative Procedure Act on the basis that it is arbitrary and capricious.”
Hughes went on to note that a new ACIP could change existing recommendations, which are tied to coverage obligations under private health insurance, Medicaid and Medicare Part D, though Medicare’s vaccines are specified in statute. The ACIP also determines the vaccines that must be included in the Vaccines for Children program, which provides all recommended vaccines against 19 different diseases to low-income or underinsured minors at no cost, he said.
RFK Jr.’s announcement affirmed the ACIP would convene its next meeting June 25, setting up a tight timeline for the committee to continue its work. An agenda for that meeting has not yet been published.
Pointing to RFK Jr.’s prior affiliations with vaccine skepticism activists and more recent stumbles on vaccine-preventable diseases like measles since stepping into government, multiple experts and organization heads raised doubts about the qualifications and motives of those who will be tapped to fill the empty roles.
“I think RFK Jr. is just picking up the phone and calling people, and saying ‘you’re in,’” Offit said. “… Will they be people who are like-minded to him? How will the public, meaning medical professionals and scientists, look at that advice? Will they not be able to trust it because he won’t bring in people who have expertise in the field?"
Hughes said it’s likely that new members “will be drawn from fringe ‘medical’ and ‘public health’ groups and overtly anti-vaccine organizations.” He added that the June meeting “is likely to be upended by objections to CDC statements and presentations, misstatements of science and proactive attempts to eliminate or change recommendations.”
The secretary has “opened the door for fringe theories rather than facts to guide the recommendations that doctors rely on to protect patients,” Frieden said.
RFK Jr., in the Tuesday evening social media post, said that he would be announcing ACIP's new members "over the coming days."
"None of these individuals will be ideological anti-vaxxers," he wrote. "They will be highly credentialed physicians and scientists who will make extremely consequential public health determinations by applying evidence-based decision-making with objectivity and common sense."
Will Congress step in?
RFK Jr.’s apparent about-face on the ACIP has turned the spotlight on Congress, where the secretary made his initial commitment regarding the committee and vaccines at large.
Cassidy, in a post on X, acknowledged “the fear is that the ACIP will be filled up with people who know nothing about vaccines except suspicion. I’ve just spoken with Secretary Kennedy, and I’ll continue to talk with him to ensure this is not the case.”
Cassidy, who chairs the Senate Health, Education, Labor and Pensions (HELP) Committee, later told reporters that the back door promises he received from RFK Jr. ahead of his confirmation were related to the ACIP’s process, not its expert members.
HELP Committee Ranking Member Sen. Bernie Sanders, I-Vt., said in a statement that RFK Jr., “with Trump’s backing, [is] doubling down on misinformation that will lead to preventable illness and death. … It cannot stand.”
A similar statement was released by fellow HELP Committee Democrat Lisa Blunt Rochester, from Delaware, who noted that her questions to RFK Jr. on the specific membership of ACIP in March were never answered.
“I’ll be doing everything in my power to investigate and reverse this decision,” she said.
Sen. Susan Collins, R-Maine, who also sits on the HELP Committee, told reporters the move caught her off guard and that “it seems to be excessive to ask for everybody’s resignations.”
While RFK Jr.’s promises to lawmakers regarding the ACIP were ultimately made behind closed doors, Offit called Monday’s decision “exactly the opposite” of what was communicated during the confirmation process. He was also skeptical that any meaningful pushback would come from Capitol Hill.
“In a better world, Congress would stand up in defense of children’s health and adults’ health in this country and do the right thing, and not allow this to go on,” he said. “We are all going to be suffering RFK Jr. for years to come."
The AMA, in an emergency resolution voted on during the ongoing annual meeting of its House of Delegates, voted Tuesday (PDF) to immediately request the HELP Committee launch an investigation of RFK Jr. and his administration of ACIP. The association, alongside plans to petition RFK Jr. for a reversal, also said it would "initiate sustained public advocacy in support of the current [ACIP] structure" and will being work to "identify and evaluate alternative evidence-based vaccine advisory structures and invest resources in such initiatives, as necessary."