The CDC’s Advisory Committee on Immunization Practices (ACIP) will meet this week under unprecedented scrutiny, as the typically low-profile panel navigates intense political pressure, public skepticism, and significant internal upheaval. The outcomes of the two-day meeting could reshape public trust in childhood immunizations, alter vaccine access through Medicare and Medicaid, and determine whether scientific consensus or political influence will guide the nation’s public health strategy.
While the specific language of the measures up for a vote has not been made public, CDC insiders anticipate major changes to long-standing vaccine recommendations.
Political Turmoil and Congressional Testimony
At a Senate hearing on Wednesday, former high-ranking CDC officials painted a stark picture of an agency under political siege. Dr. Susan Monarez, the recently fired acting director, testified that her termination followed her refusal to pre-approve new vaccine policies without scientific evidence. She asserted that for such decisions to be credible, they “cannot be divorced from” data.
Dr. Debra Houry, who resigned as the CDC’s Chief Medical Officer just hours after Monarez’s dismissal, stated that Health and Human Services Secretary Robert F. Kennedy Jr.’s “actions repeatedly censored CDC science, politicized our processes, and stripped agency leaders of the ability to protect the health of the American people.” She added, “I could not in good conscience remain under those conditions.”
The administration has forcefully contested this narrative. HHS spokesperson Andrew Nixon accused Monarez of acting “maliciously to undermine the president’s agenda” after being “tasked with returning the CDC to its core mission after decades of bureaucratic inertia, politicized science and mission creep.”
In an internal email, acting CDC Director Jim O’Neill acknowledged that the agency lost public trust during the COVID-19 pandemic and stated, “we are working hard to refocus and earn that trust back.” He emphasized that “rigorous science, transparency,” and treating citizens “as adults who can make their own informed decisions will be well received.”
This clash has left many agency staff feeling caught between their scientific mission and political directives. One longtime employee described the internal shift as being less about public protection and “more about putting science on trial.”
A Revamped Panel with Controversial Members
This week’s meeting is notable not only for its agenda but also for the makeup of the committee. In June, Secretary Kennedy removed all 17 sitting ACIP members, replacing them with a smaller group of allies. Days before this meeting, he appointed five more, bringing his total number of appointees on the panel to 12.
The new members include figures who have previously questioned vaccine safety and mandates, such as Dr. Robert Malone, who has spread misinformation about COVID vaccines, and Martin Kulldorff, a biostatistician who opposed vaccine mandates for children. Others, like pediatric cardiologist Dr. Kirk Milhoan, have promoted unproven COVID treatments. Critics note that several appointees have potential conflicts of interest, having served as paid expert witnesses against vaccine manufacturers.
The accelerated appointment process, bypassing the usual months-long vetting for conflicts, has alarmed career scientists. Compounding these concerns, the ACIP abandoned its traditional evidence-to-recommendation framework at its June meeting, which featured presentations from a well-known anti-vaccine advocate and claims that many experts deemed inaccurate.
COVID-19 Vaccine Recommendations at Risk
CDC insiders expect the committee to vote on narrowing the list of conditions that qualify a person as high-risk for severe COVID-19. Such a change would reduce the number of people recommended for vaccination. Dr. Lakshmi Panagiotakopoulos, a former ACIP working group lead who recently resigned, warned that a narrower recommendation could be misinterpreted “as meaning the vaccine doesn’t work, when in fact it’s still highly protective against severe disease.”
Particular concern surrounds the potential exclusion of healthy pregnant women and infants from the high-risk category. This would contradict guidance from leading medical bodies. The American Academy of Pediatrics recently recommended the COVID vaccine for all infants aged 6 to 23 months, citing their high hospitalization rates. The Society for Maternal-Fetal Medicine also continues to recommend the vaccine for all pregnant and breastfeeding women.
It is also unclear if the ACIP will consider raising the age for routine vaccination from 65 to 75, a move infectious disease experts caution against. “Age is a blunt instrument,” said Dr. Helen Chu of the University of Washington, noting that many people aged 65-74 have complicating health conditions.
Revisiting the Hepatitis B Birth Dose
A cornerstone of public health, the universal hepatitis B vaccine for newborns, may also be reconsidered. The U.S. adopted the universal birth-dose policy to act as a crucial safety net, as prenatal screening often misses cases of maternal infection. When transmitted at birth, the virus causes chronic infection in about 90% of infants, a quarter of whom will die prematurely from related liver cancer or cirrhosis.
Experts warn that reversing this policy would be a grave mistake. Dr. Samuel So of Stanford University called the current initiative “one of the most successful public health initiatives of the past 30 years.” Dr. Anna Lok of the University of Michigan cautioned that making the birth dose optional means “it will be rarely done.”
For Alex Lee, a 68-year-old liver transplant recipient who contracted hepatitis B from his mother at birth, the issue is deeply personal. “I didn’t want my daughters to go through what I went through,” he said. “Pulling back now would be a huge mistake.”
The MMRV Combination Vaccine
The committee is also expected to revisit guidance on the measles-mumps-rubella-varicella (MMRV) vaccine. The current recommendation advises against using the four-in-one shot for a child’s first dose at 12-23 months due to a slightly elevated risk of fever-related seizures. The combination shot is recommended for the second dose at ages 4 to 6, when that risk is gone. Experts are questioning why this established guidance, based on clear data, is being reopened.
Trust, Precedent, and Future Coverage
Revisiting established vaccine guidance in a highly politicized climate risks deepening public distrust. A recent KFF/Washington Post poll found that one in three parents believe they should be able to decline routine school-entry vaccines, up from 16% in 2019.
While a national health insurance trade group has stated that commercial plans will continue to cover all immunizations recommended as of September 1, 2025, through the end of 2026, any new ACIP recommendations could immediately affect coverage under Medicare and Medicaid.
Ultimately, the most significant impact may be on public trust. “Process matters because trust matters,” Dr. Houry stated in her testimony. “If people believe outcomes are predetermined, or that recommendations are slanted by ideology rather than scientific data, they are less likely to accept even well-supported recommendations.” This week’s meeting will be a critical test of whether that trust can be maintained.
