Threat to US vaccines as CDC staff supporting key advisory panel laid off | US news

TStaff supporting the Advisory Committee on Immunization Practices (ACIP) were let go in a sweeping layoff that gutted entire departments of the U.S. Centers for Disease Control and Prevention (CDC) earlier this month.

Many of the committee’s working groups that review data and help set agendas have not met in months, and there was little communication from staff even before receiving reduction-in-force (RIF) notices during the U.S. government shutdown.

The ACIP meeting planned to be held on October 22-23 has been postponed indefinitely.

The changes mean the US government will no longer be able to make routine vaccination recommendations for more than half of children in 2026, and they will likely affect the development and recommendation of new vaccines.

ACIP made headlines in June when U.S. health secretary Robert F. Kennedy Jr. replaced all independent vaccine advisers with advisers of his own choosing, in an unprecedented move.

Some of those advisors and others added in September are anti-vaccine activists. But the committee’s work is not done solely by independent consultants; It is supported by CDC staff and outside experts in working groups.

CDC staff provide logistical support and subject matter expertise and ensure the committee follows rules and regulations.

Demetre Daskalakis, former director of the National Center for Immunization and Respiratory Diseases, said at a press conference with Defend America Action last week that the entire department is now “gone.” He said only one designated federal official remained for the group.

“CDC scientists are being held hostage by Robert F Kennedy Jr.,” Daskalakis added.

“A lot of what ACIP staff do is logistics,” said Kevin Ault, an obstetrician-gynecologist at Western Michigan University Homer Stryker School of Medicine.

In recent meetings, “you’ve seen it kind of fall apart,” he said.

At the last meeting, some presentations were not available and some Zoom links and microphones were not working. The language of the votes was not distributed to the public or advisors in advance; one committee member objected to the vote due to lack of information. With support staff now gone, such delays and errors may get worse.

It’s not just internal scientists and staff who are feeling the effects of terminations and shakeups.

ACIP’s working groups typically consist of CDC employees as well as subject matter experts, local health department officials, and medical group representatives. There are usually eight to ten working groups focused on pathogens such as influenza, respiratory syncytial virus (RSV), human papillomavirus (HPV), and cytomegalovirus (CMV) at any given time.

“We often do the very tedious job of sifting through 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. While Ault was at a meeting for the RSV working group in June, news broke that all 17 consultants at ACIP (some of whom were leading the session) had been fired.

“They weren’t given advance notice. This was in the Wall Street Journal and someone was on the phone and said, ‘Hey, did you know you were fired?'” Ault said. he said.

Since then, Ault has not attended any meetings and heard little from staff.

“The only communication I received was usually the day a scheduled meeting was canceled. Other than that, I didn’t receive much communication,” Ault said.

Ault was a member of ACIP from 2018 to 2022. He has been on the flu working group intermittently since the 2009 flu epidemic and is chair of the planning committee.

“Most of them haven’t seen each other in six months or more,” Ault said. “It was very fragmented and haphazard.”

Flu recommendations were issued in August, even though the working group had no meetings; This meant that experts and medical groups had no input into the recommendations.

In August, representatives of some groups received an unsigned email stating that their input was no longer needed. Groups not invited included the American Medical Association, the American Academy of Pediatrics and the Infectious Diseases Society of America. Ault said he hasn’t heard from other representatives, including the American College of Obstetricians and Gynecologists (ACOG), about whether they are still participating in the working groups.

One notable exception to the pause in working groups is the new Covid vaccine group, chaired by Retsef Levi, a professor of operations management at MIT Sloan School of Management and one of the new vaccine advisors. It is unclear who is on the Covid committee and whether it followed the usual processes for working groups.

Working group members have presented data at ACIP meetings since the change. But Daskalakis said they were “left aside.” “They actually only provide data that is openly criticized and ignored.”

The meeting planned to be held in October was rescheduled as “TBD”, based on to the ACIP website.

A immunization schedule must be released by the CDC by Jan. 1, and the Vaccines for Children program, which provides vaccines to 52% of children in the U.S., is committed to that schedule, Ault said.

Normally the calendar would be published in the Morbidity and Mortality Weekly Report (MMWR), but this publication was temporarily closed during the government shutdown. And the program would be discussed at the meeting in October.

“If this work is not completed within the next two and a half months, all vaccines for children and, to some extent, adults, will be at risk,” Ault said.

He added that gutting the committee also means new vaccines promised in the final stages of clinical trials will never be recommended.

“I don’t know what the future holds for new vaccines on the near horizon. The path forward looks very dark.”

With the layoffs of ACIP staff, “it’s like the operating system of the advisory committee disappears,” Daskalakis said. “The hardware is there, the software is there,” but there is no way to run the system, he said.

Debra Houry, the CDC’s former chief medical officer, said at the same news conference as Daskalakis that RIFs, which also affect departments such as human resources, could limit what happens with the committee in the future.

“If they want to add new members, HR goes. All of CDC’s HR goes. That’s what hires special government employees and the new FACA. [Federal Advisory Committee Act] our members,” he said.

The ethics office was also completely released. “We will never know whether these individuals have a fundamental conflict of interest because they will no longer be evaluated by the ethics office,” Daskalakis said. “That’s a pretty significant red flag.”