The US Health and Human Services (HHS) has cancelled this week’s meeting of its Advisory Committee on Immunization Practices (ACIP) amid a court challenge to the committee’s composition and decisions, led by the American Academy of Pediatrics (AAP).

Meanwhile, the long-delayed Senate panel confirmation hearing for US President Donald Trump’s nominee for Surgeon General, Casey Means, convenes on Wednesday (25 February). Means, a 38-year-old wellness influencer who has linked vaccines to autism, was nominated on the advice of HHS Secretary Robert F Kennedy Jr, according to Trump

Her brother, Calley Means, co-founder of an online wellness sales platform, is Kennedy’s special advisor. The Means siblings co-authored a book called Good Energy, in which they argue that all chronic conditions are caused by metabolic dysfunction linked to lifestyle.

Since Kennedy took office last February, he has consistently chipped away at vaccines’ credibility and access.

Last June, Kennedy fired all 17 members of ACIP, which advises the US Centers for Disease Control and Prevention (CDC) on immunisation, and appointed several vaccine sceptics in their place.

In early January, the CDC announced that vaccines for Hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19 would no longer be routinely recommended but “remain on the schedule based on shared clinical decision-making”.

The AAP has issued its own routine child and adolescent vaccine schedule, endorsed by 12 other national health organisations, which retains as routine the vaccines that the CDC no longer recommends.

In the past, the AAP partnered with the CDC to present a unified set of vaccine recommendations, but says that “recent changes to the CDC immunisation schedule depart from longstanding medical evidence and no longer offer the optimal way to prevent illnesses in children.”

“AAP recommends immunisations that have been designed to teach the immune system to recognize and resist serious diseases,” said Dr Sean O’Leary, chair of the AAP Committee on Infectious Diseases. “They are carefully tested and monitored over time. The pacing and combination of vaccines are based on what we know about when your child’s immune system is ready to learn and respond best.”

The US has seen a resurgence in measles cases in the past year, fueled by misinformation and falling vaccination coverage. South Carolina has reported nearly 1,000 cases since October.

Kennedy’s ‘arbitrary and capricious actions’

Last week, the AAP, American Public Health Association (APHA), American College of Physicians, Infectious Diseases Society of America and several other US medical organisations applied for a preliminary injunction to block the CDC’s changes to federal vaccine recommendations and to stop the ACIP meeting.

In their court papers, the bodies accuse Kennedy of “arbitrary and capricious actions” that “sow confusion and undermine public health, purposefully disregard and contravene required process, and ignore decades of established science.”

Judge Brian Murphy of the US District Court of Massachusetts has yet to rule on the application, which he heard on 13 February. But in the meantime, the ACIP meeting, which was due to start on Wednesday, has been called off.

But the decision to cancel the ACIP meeting, which removes the urgency for the judge to rule, may simply have been taken because the HHS failed to announce the meeting on the Federal Register within seven days and post an agenda, as required by law.

Kennedy’s former organisation, the Children’s Health Defense (CHD), also issued an urgent court application last week to join the case as a defendant, alongside Kennedy and the HHS. Murphy has yet to decide on CHD’s application.

CHD is routinely involved in opposing vaccinations, erroneously claiming on its website that “countless peer-reviewed observational studies show unvaccinated populations consistently have fewer chronic health conditions than vaccinated peers.”

The next court hearing about the injunction is on 4 March. The case is part of a series of AAP-led court actions aimed at preserving federal vaccine recommendations, which started last July after HHS removed COVID-19 vaccines for children and pregnant women. The court papers have since been amended to include a challenge to Kennedy’s firing of all 17 ACIP members and the January changes to routine childhood vaccination.

Meanwhile, Kennedy ally Dr Jay Bhattacharya, currently head of the National Institutes of Health, has also been appointed  as acting CDC director. Bhattacharya can only serve until late March as federal law requires the US president to nominate a replacement within 210 days of HHS firing the previous director, Susan Monarez, which took place in late August.

After her firing, Monarez and Dr Debra Houry, the CDC’s former Chief Medical Officer, told a Senate health committee hearing that Kennedy is driving an agenda based on ideology not science, and he had tried to reduce the CDC to a rubber stamp.

Since Kennedy took over HHS, thousands of people working in the CDC, NIH and other government health bodies have been fired. The Trump administration has also dismantled major global health 

In response, several organisations have been formed to contest the views and actions of Kennedy and his allies. These include Stand up for Science, which was formed to oppose political interference in science, secure and expand funding for science and safeguard equal opportunities for all people to become scientists. It is leading a call to impeach and remove Kennedy. 

Fired CDC workers – estimated to number over 4,000 – have formed the National Public Health Coalition to champion health causes that are no longer supported in the current CDC, and monitor the health cuts via the CDC Data Project.

Image Credits: CDC/ Unsplash, CDC Data Project.