New ACIP charter: Broader membership, focus on vaccine injuries

Following a legal setback, health officials from the Trump administration have amended the governing documents of a crucial federal vaccine panel. These revisions aim to expand the panel’s membership, emphasize potential vaccine harms, and bolster the influence of Robert F. Kennedy Jr.’s allies, the health secretary.

The committee, which advises the Centers for Disease Control and Prevention (CDC) on vaccine usage, has introduced a new charter. This move seems designed to circumvent legal challenges that have stalled the current body. The document also highlights the Advisory Committee on Immunization Practices’ (ACIP) role in examining vaccine-related injuries, despite the committee’s ongoing vigilance regarding any safety concerns associated with vaccines.

Last month, a federal court issued a preliminary ruling declaring most ACIP members, appointed by Kennedy, as “distinctly unqualified” for the panel. The revised charter, released on Thursday, broadens membership qualifications to include expertise in toxicology, pediatric neurodevelopment, and vaccine injury recovery. It also allows individuals with general medical knowledge to join, casting a wide net.

“The expertise requirement has been weakened, likely making it harder for judges to demand specific expertise, although other language still addresses expertise,” commented Dorit Reiss, a UC Law San Francisco professor specializing in vaccine policy.

Andrew Nixon, a spokesperson for the Health and Human Services Department, stated, “The ACIP charter renewal and its publication are routine statutory requirements and do not signal any broader policy shift.”

The ACIP advises the CDC on vaccine recommendations, traditionally incorporated into state school attendance requirements. Under Kennedy, the committee has become a policy battleground, with efforts to reduce vaccines recommended for infants and children.

The charter, renewed every two years, traditionally undergoes minimal changes. However, the recent rewrite risks elevating vaccine policy issues amid the Trump administration’s focus on popular initiatives like food reforms and affordability. This move might also appease some of Kennedy’s MAHA allies by creating advisory roles within ACIP.

The revised charter extends the list of liaison organizations, now including non-voting participants in the ACIP process. Previously, about 30 entities, like the American Medical Association, attended ACIP meetings in this capacity.

The updated charter includes groups such as the Association of American Physicians and Surgeons, the Independent Medical Alliance, the Medical Academy of Pediatrics and Special Needs, and Physicians for Informed Consent. AAPS is a conservative doctor group skeptical about some vaccines, while Physicians for Informed Consent challenges vaccine mandates. The Medical Academy advocates for children with autism or complex conditions.

The Independent Medical Alliance, established in 2020, has supported Covid treatments contrary to mainstream medical advice and backed Kennedy’s vaccine agenda. Kirk Milhoan and Robert Malone, chair and former vice-chair of Kennedy’s ACIP, were associated with this group.

Malone recently resigned from ACIP, citing a lack of response from HHS to a federal judge’s critique of his qualifications.

“The new charter shifts ACIP toward a risk-focused organization and gives a platform to groups historically opposing vaccination,” said Demetre Daskalakis, previously head of CDC’s National Center for Immunization and Respiratory Diseases. He added, “This aligns with rhetoric that led to the ACIP committee being stayed by the court. Vaccine policy is turning into a chess game instead of serving public health.” Daskalakis resigned last August following Kennedy’s dismissal of CDC director Susan Monarez, who resisted accepting all ACIP recommendations.

The charter uses language popular among anti-vaccine advocates, suggesting ACIP should study “the cumulative effects of vaccines and their components.” Despite these claims, researchers have found no link between vaccines and neurodevelopmental conditions like autism after decades of study.

“While vaccine safety is crucial, the committee’s purpose is being manipulated to undermine vaccine confidence and usage in the U.S.,” said Richard H. Hughes, a lawyer with Epstein Becker Green, leading the lawsuit against Kennedy’s restructuring of ACIP and vaccine policy changes.

The new committee’s budget exceeds twice the previous charter’s allocation, increasing from $410,000 to $1.08 million, without detailed explanations for the cost rise. The updated charter, like its predecessor, allows for up to 19 members serving four-year terms. When disbanded, the previous ACIP had 17 members, while Kennedy’s ACIP had 15.

Since last month’s preliminary ruling, ACIP’s future has been uncertain. A mid-March meeting was canceled following the ruling. Previously, ACIP charters required at least three annual meetings, but the new charter allows meetings at the discretion of the designated federal official, in consultation with the chair.

The revised charter also addresses the contentious changes to the childhood vaccine schedule made earlier this year. It assigns ACIP the duty of “reviewing global initiatives and vaccination schedules from other countries and international organizations.”

In early January, HHS announced that, following a memorandum from President Trump, the list of recommended vaccines for children had been altered to align with Denmark’s, which recommends significantly fewer vaccines for all children. While this change was intended to bring the U.S. in line with peer countries, it actually made the U.S. an outlier, contributing to a lawsuit filed by the American Academy of Pediatrics.

Notably, ACIP was not consulted on this revision; it was based on data compiled by two federal health officials and approved by the then-acting CDC director, Jim O’Neill.