In the final weeks of the Biden administration, a significant health committee was quietly filled with pro-vaccine members, a move that could potentially hinder Robert F Kennedy Jr’s vaccine initiatives.

The previous President endorsed the selection of eight candidates in favor of vaccines to an essential committee responsible for shaping immunization policies in the United States.

Sources say the flood of 11th-hour appointments, with terms lasting until 2028, is an attempt to block RFK Jr from rolling out his antivax agenda.

During his confirmation hearing in the Senate this week, RFK Jr emphasized multiple times his commitment to not taking any actions that may create obstacles or decrease the likelihood of individuals getting vaccinated against diseases like polio or measles.

However, he has often argued the risks outweigh the benefits of many childhood shots and this week he refused to rule out that some may cause autism in children.

A former senior Health and Human Services Department official told STAT News the flurry of confirmations to the Advisory Committee on Immunization Practices (ACIP) was ‘very intentional.’

They added: ‘It was our goal to fill every vacancy on every [federal advisory committee] the department has, with particular focus on ones like ACIP where maintenance of our scientific expertise was critical.’

But sources fear Kennedy — or whoever replaces him, should the Senate reject his bid to be head of the Department of Health and Human Services (HHS) — could fire the committee members, who all have at-will contracts.

In its final months, the Biden administration blocked the Trump administration’s health agenda, which vaccine skeptic RFK Jr would lead, by approving eight new appointments to a key committee shaping US vaccination policy

Denise Jamieson, chair of the Department of Gynecology and Obstetrics at Emory University School of Medicine, has advocated for pregnant women to get vaccinated for Covid (though has not said she is in favor of mandating the shots), which may prove controversial

The ACIP consists of clinicians and scientists who recommend schedules, dosing, and vaccine approval.

The new experts are a mix of pediatric and geriatric infectious disease experts, experts on health behavior, and former public health officials 

When the FDA approves a new vaccine, the ACIP is responsible for evaluating its safety and efficacy data.

They all emphasize the crucial role of vaccines in preventing infectious diseases and enhancing public health. This includes backing well-established vaccine schedules and guidelines, like those provided by the CDC and the American Academy of Pediatrics. 

They also emphasize the importance of vaccines not just for individual health, but for community protection. Their work often involves educating the public on vaccine safety and addressing concerns about side effects or vaccine hesitancy. 

Some of the new members will be controversial among vaccine-skeptical parents.

Dr Yvonne Maldonado, a professor of pediatrics at Stanford University, is a staunch supporter of eliminating non-medical exemptions for vaccines in schools. 

She said after a California law passed in 2015 to nix all but medical exemptions, Dr Maldonado said: ‘It’s the right thing to do. We have to protect children if we have the means to do so.’ 

Dr Yvonne Maldonado, a professor of pediatrics at Stanford University, is a staunch supporter of eliminating non-medical exemptions for vaccines in schools

Dr Helen Chu is an infectious diseases specialist at the University of Washington. She supports the safety of vaccines and likely advocates for maintaining a consistent vaccine schedule to prevent outbreaks, particularly in high-risk communities

Meanwhile Dr Asturias is a strong proponent of sticking to the CDC’s recommended vaccine scheduling and dosages, a viewpoint that stands in contrast to earlier statements that President Trump has made, including that vaccines should be ‘smaller doses over a longer period of time.’ RFK Jr has made similar points. 

And Denise Jamieson, chair of the Department of Gynecology and Obstetrics at Emory University School of Medicine, has advocated for encouraging pregnant women to get vaccinated for Covid (though has not said she is in favor of mandating the shots). 

She told NPR: ‘I can’t think of any potential reason or theoretical reason to be concerned about mRNA vaccines in pregnancy, with the one exception of when you give a vaccine and you mount an immune response, you can get a fever. 

‘Knowing what I know about the [mRNA vaccine’s] mechanism of action, I would anticipate that this vaccine should be very safe in pregnancy.’ 

This may prove controversial given widespread hesitancy around vaccinations in pregnant women and potential effects on the unborn baby, despite evidence showing that benefits of vaccination when pregnant outweigh the risks.  

ACIP submits its recommendations about whether the vaccine should be approved to the CDC, which does not have to agree with their verdict but often does.

The ACIP also regularly reviews the safety data on already-approved vaccines, looking for signs of injuries of adverse effects.

But the HHS Secretary has full authority to reshape ACIP, including its membership, mandate, scope, meeting frequency, or even its existence. 

The former President’s move was ‘very intentional’, sources have revealed

Measles vaccinations stalled before the pandemic and since then, rates have continued to fall

RFK Jr has insisted that, as head of HHS, he would not restrict access to lifesaving vaccines for polio, measles, and other shots.

But Democrats in the Biden administration and scientists fear he could do an about-face when appointed.

Possible actions include canceling or delaying meetings, blocking outgoing HHS boss Xavier Becerra’s appointees, removing current members, overriding ACIP recommendations more often, or dissolving the committee entirely.

New members could also disrupt ACIP’s recommendations by reclassifying certain childhood vaccines as requiring ‘shared clinical decision-making,’ meaning they would be given only after a parent consults a doctor rather than as part of routine immunizations.

Dr Larry Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, said: ‘You can have ACIP questioning certain vaccines and casting doubt in the public’s mind about them.

‘That’s going to particularly affect state policymakers in red states, who will then loosen childhood vaccination laws.’

Softening recommendations for vaccines might not take them away, but public health experts fear that it will still lead to fewer parents getting their children vaccinated because the shots seem unimportant.

According to Dr Paul Offitt, a pediatric infectious diseases expert at the Children’s Hospital of Philadelphia, said: ‘He could do a lot of things. If the FDA chooses to license a drug or a vaccine, he could say, I don’t think enough studies have been done. He could gut the drug advisory committees.

‘Kennedy would be an agent of chaos when it came to vaccines and the people who would suffer the most are children because it’s always the most vulnerable among us who suffer our ignorance.’

Dr Anthony Fauci, former head of the National Institute of Allergy and Infectious Diseases, has often found himself in the center of a culture war over Covid vaccines, how safe they are, who should get them, and whether they should be compelled to do so 

The new ACIP members will join officially at the committee’s next meeting February 26-28. Whether it actually happens or not is up in the air.

A meeting of the National Vaccine Advisory Committee, another vaccine advisory group within HHS, scheduled for early February has already been canceled, while members of the Health Information Technology Advisory Committee were told that future meetings of the group have been postponed indefinitely.

If RFK Jr is approved, he’ll be responsible for overseeing several agencies, including the FDA and CDC, as well as child refugee resettlement, and has a budget of about $140 billion.