How would the world still be if scientists had not developed a COVID-19 vaccine? Would we still be under lockdown, in a world where masks and social distancing protocols dominate cities? In a country recovering from the impacts of the COVID-19 pandemic, one thing can be assured by most medical providers: vaccines are essential for public health. 

Public health in the United States is protected by the Centers for Disease Control and Protection, though to most it’s known as the CDC. Headed by the Secretary of Human and Health Services (HHS), the CDC implements public health laws that prevent the spread of disease, in addition to organizing research dedicated to non-infectious diseases like obesity. 

The CDC is broken up into different subcommittees focused on different aspects of public health. One of these groups is the Advisory Committee on Immunization Practices, otherwise known as the ACIP. 

The ACIP, as noted by the CDC, is responsible for aiding the HHS and the CDC in the selection and evaluation of vaccines used. This includes determining who should receive specific vaccines, such as COVID boosters, and more importantly, vaccines which children should receive as they age.

RFK Jr. Strikes A Move

In spite of the ACIP’s importance, current HHS Robert F. Kennedy Jr. (commonly referred to as RFK Jr.), made the bold decision on June 9th to fire all 17 members on the ACIP, initially replacing them with 8 new members. Since then, one member has resigned. 

All of the members that were previously on the board had been appointed by Biden during his presidency. Since these members serve on a four year basis, RFK Jr. should have been unable to appoint any new members to replace the old ones until at least 2028. However, as RFK Jr. pushes to improve health policy under the ‘Make America Healthy Again’ commission, the choice to fire the ACIP members in favor of new ones reflects RFK Jr’s desire to rework current vaccination policies. 

On the same day as the change to the ACIP, RFK Jr. made this comment in a statement announcing the removal of the committee members:

Despite assuring that he wants to strengthen public confidence in widespread vaccine usage, some of the ACIP members appointed by RFK Jr. have expressed anti-vaccination opinions in the past, leaving some government officials from both political parties concerned about how vaccine policy will continue in the future. This includes Louisiana state Senator Bill Cassidy, and Washington state Senator Patty Murray, who both share experience dealing with public health through the Senate Health, Education, Labor, and Pensions (HELP) Committee.

Make America Healthy Again

The change to the committee board remains as an effect of the ‘Make America Healthy Again’ movement established by RFK Jr. himself. 

The movement’s title is a play on President Donald Trump’s ‘Make America Great Again’ slogan, instead focused on improving the health of American citizens. 

As the country’s HHS, the commission is based on a set of promises that RFK Jr. has made to improve the country. His main goal besides the overall idea of making America healthy focuses on stopping childhood chronic disease. So how will he do it? RFK Jr. has promised big changes, and one of those is improving current vaccination policies.

Although he does not express total anti-vaccination ideas within the commission, he has taken a much more ‘skeptic’ stance on some vaccines in the past, including the polio and HPV vaccines. Under the MAHA commission, RFK Jr. claims that he wants to “restore the transparency" surrounding vaccination policy (CBS News). 

This means that while he will not necessarily ban vaccines, he wants the American people to become more aware about vaccinations, and to approach vaccine usage with much more precaution. 

The Future of Vaccines, For Now

How exactly will this impact future vaccination policies? 

The ACIP recently held its first meeting with the new members on the 25th and 26th of June, despite not having a full committee. The meeting was set to address the use of a variety of vaccinations, including both maternal and pediatric respiratory syncytial virus (RSV) vaccines, MMRV, COVID-19 vaccines, and the use of thimerosal in influenza vaccines. 

While most of the meeting was set to focus on adjusting the age requirements for different vaccines, one major stand out was targeting the use of thimerosal in vaccinations. 

During the meeting, three separate votes were held regarding thimerosal-containing influenza vaccines. In the end, the ACIP has chosen to recommend influenza vaccines without thimerosal to children and pregnant women. 

According to the FDA (Food and Drug Administration), thimerosal is a preservative that has been used since the 1930s in vaccines and some medications. The development of single-dose packaging has led to thimerosal becoming less common within vaccinations. Vaccines that aren’t single-dose are more prone to contamination, which calls for the use of thimerosal to prevent bacterial and fungal growth. 

While the CDC has assured that it poses no health risks to people receiving them in vaccines, RFK Jr. has believed otherwise. Published in 2014, “Thimerosal: Let the Science Speak” voices all of RFK Jr’s concerns for the uses of thimerosal. In his book, he labeled thimerosal as a dangerous neurotoxin. However, to many others, thimerosal is a game-changer for vaccines that have not been adapted into a single-dose format. 

When asked about the ACIP’s looming meeting and the concept of thimerosal’s removal by ABC News, associate professor Dr. Craig Spencer claimed that the fate of thimerosal use and other vaccinations will likely be influenced by RFK Jr’s past sentiments.

Dr. Spencer isn’t wrong. RFK Jr’s choice to proceed with the ACIP meeting despite not having a full board ultimately impacts the overall judgement of the committee, especially considering he hand-picked every member. With less voices being shared on the committee, there is less room for opinions that differ from RFK’s.

What is next?

All hope is not lost for those who believe in the positive uses of vaccines. Most of the general  public and public health experts have not outwardly supported the changes made to the ACIP, and continued backlash received by RFK Jr. may impact how he approaches further policies. 

All meetings held by the ACIP are open to the public. Ultimately before engaging in any vaccine policy it’s critical to educate yourself as thoroughly as you can, even if it means listening to a side you don’t agree with. Relying only on what you hear from one source limits your knowledge and it can leave you vulnerable to misinformation, something you don’t want to be during a period of such extreme influence and change.