Opinion: How to restore credibility to the CDC’s vaccine advisory committee

OpinionFirst Opinion How to restore credibility to the CDC’s vaccine advisory committee To prevent further disruption and confusion, ACIP must make five important changes Manage alerts for this article Email this article Share this article By Jesse L. GoodmanMay 18, 2026 Goodman is professor of medicine and infectious diseases and attending physician at Georgetown University. He served as director of CBER from 2003 to 2009 and as the FDA’s chief scientist from 2009 to 2014. The Advisory Committee on Immunization Practices (ACIP) is responsible for developing recommendations for the use of licensed vaccines in the U.S. and has vast influence on immunization practices and financing. But in the past year its members were summarily replaced by the secretary of Health and Human Services and its processes disrupted. The participation of Centers for Disease Control and Prevention scientific experts in meetings was curtailed, and the Food and Drug Administration’s liaison representative, normally a senior vaccine expert, was replaced by a political appointee.Advertisement Its meetings at times became chaotic venues for casting doubt and airing unsubstantiated claims, often unchallenged, on the safety and efficacy of vaccines. Recommendations were made contrary to the advice of federal scientists and the medical and public health community. In addition, without ACIP review, the HHS secretary removed several vaccines from those previously routinely recommended, sowing tremendous confusion. For now, public health can breathe a little easier: In March, a federal judge ruled that the administration’s reconstitution of ACIP, and the committee’s actions, were likely to be found illegal, restoring most vaccine recommendations to how they looked pre-January 2025. However, without an ACIP, no new vaccines can be recommended and no changes can be made to existing recommendations, even if warranted. Now is the time, however challenging it may be, to prevent further disruption and confusion and to restore integrity to the ACIP and enhance public confidence.Advertisement Prior to 1964, different medical and governmental groups provided differing vaccine recommendations using differing approaches. ACIP was founded to bring consistency to this process, bringing groups together and ultimately resulting in nationally recommended vaccine schedules. Using an “evidence to recommendation” framework, ACIP conducts open deliberations on vaccine safety, effectiveness, and factors such as cost-benefit and disease burden, obtaining nongovernmental expert and stakeholder input as it develops recommendations. Traditionally, members have been recognized vaccine experts selected from nominees “knowledgeable in the fields of immunization practices and public health” with “expertise in the use of vaccines” as stipulated in ACIP’s charter. ACIP also includes non-voting liaisons from federal agencies and medical, public health, and patient groups. Its recommendations, once approved by the CDC director, have long helped guide providers and state and local governments to achieve high levels of protection from vaccine-preventable diseases and enhance vaccine access, serving as a reference for financing by government programs (Vaccines for Children, Medicaid, Medicare) and private insurers. HHS Secretary Robert F. Kennedy Jr.’s reconstituted ACIP abandoned both its evidence-to-recommendation framework and its own long-standing processes that help ensure balanced, thorough, and transparent deliberations consistent with the Federal Advisory Committee Act (FACA) and in so doing, has then repeatedly acted contrary to the assessments of the CDC and other governmental experts and the broader scientific community. In response, in July 2025 and in later filings, the American Academy of Pediatrics, Infectious Diseases Society of America, other organizations, and affected patients sued Kennedy and CDC, National Institutes of Health, and FDA agency heads, asking the court to enjoin the government from ”unlawful final agency actions that have abruptly and unlawfully altered the nation’s vaccine policy, bypassing the customary evidence-based review framework, and inflicting immediate, ongoing, and compounding harm on public health organizations, medical associations, clinician-members, and patients nationwide.”Advertisement The plaintiffs scored a major victory on March 16, when a judge ruled to invalidate the secretary’s Jan. 6 removal of six vaccines from those routinely recommended by the CDC. The judge also invalidated the appointment of the current ACIP, all votes taken by it, and further meetings, until a trial. He noted that CDC, in bypassing ACIP in January 2026, likely violated required processes and congressional statute, undermining the integrity of ACIP’s decisions and its compliance with FACA, including that its membership was not selected through a deliberative process, not suitably expert or balanced, and did not follow its own processes. The court’s action comes as much of the public has become alarmed by such threats to U.S. immunization policies and vaccine access. For now, the White House is reportedly encouraging a shift in focus away from actions impacting vaccines, perhaps signified by the FDA’s reversal of its refusal to file one company’s application for a new influenza vaccine, the departure of the FDA official who made that decision, and the nomination of a CDC director with a sound public health background and no history of anti-vaccine bias. This shift may present a window of opportunity to begin to restore the functions of and trust in the ACIP. To accomplish this will require vigilance from stakeholders and courage on the part of new leaders at CDC and FDA, including the new CDC director, new FDA commissioner, and new director of the FDA’s Center for Biologics Evaluation and Research (CBER), whoever they may be. These leaders will need to strongly support the appointment of only credible, expert ACIP members; ensure CDC and FDA staff scientists’ unfettered participation in ACIP; and promote science-based review, recommendation and decision processes, free from political influence. Unfortunately, early signs suggest that HHS may try to comply only nominally, if at all, with the court’s rulings. In April, HHS simply replaced ACIP’s charter with one that could potentially justify appointment of membership with a similar lack of vaccine expertise. While the 2024 charter stated clearly that members are selected from nominees “knowledgeable in the fields of immunization practices and public health”and with vaccine expertise, the recent revision adds other areas in which nominees may be “knowledgeable.” Some are overly broad with respect to the core mission of ACIP (e.g. “medicine”), while others align with activists’ focus on alleged vaccine harms, such as toxicology, pediatric neurodevelopment, and “recovery from serious vaccine injuries.”Advertisement In addition to eroding requirements for vaccine expertise, the revised charter eliminated transparency requirements for three annual meetings and publication of recommendations in the CDC journal MMWR. The revised charter adds, as liaison members, representatives from activist organizations outside the scientific mainstream and removes the American College of Obstetrics and Gynecology (ACOG), which resigned in protest of recent changes. Such changes suggest intent to empanel a “new” ACIP, perhaps before a scheduled June meeting, with membership similar to the judicially enjoined one, selected to support activists’ agendas and suppress CDC and other experts’ assessments (also recently seen in the acting CDC director’s action blocking publication of a study supporting Covid vaccine effectiveness and FDA’s blocking publication of studies supporting Covid and zoster vaccine safety). Such an ACIP, without expertise to make credible vaccine recommendations, could, under the new charter, seem in compliance with the judge’s ruling but, if allowed, again undertake an agenda focused on unsubstantiated allegations and undermining vaccine recommendations and public confidence. Finally, HHS has notified the court it will appeal the March ruling. In addition, other actions of the administration, including undefined vaccine safety investigations by HHS that circumvent agency experts and processes, as well as some of the president’s own recent words, indicate that science-based vaccine policy and communications remain in jeopardy. Given such warning signs, it is critical for all concerned with vaccine access and disease prevention to monitor and, where needed, call attention to developments related to restarting ACIP. Medical and public health professional organization can lead this accountability effort. Five areas where vigilance and insistence on specific actions can, starting now, help prevent the manipulation, chaos, and confusion that led to the present crisis are to:Advertisement Ensure appropriate membership: ACIP membership should require, with rare exception other than for its consumer representative, scientific expertise related to vaccines, as stipulated in the prior charter. While unlikely, ideally, new CDC leadership would reappoint most pre-RFK Jr. ACIP members, who were carefully selected for such expertise.In any case, members should be nominated and selected for expertise relevant to ACIP’s core mission and without influence from political officials. A limited number with expertise in other disciplines, such as mentioned in recent charter changes (e.g. economics, statistics) may be appropriate, but generally such candidates would better serve as ad hoc work group members or presenters on specific matters. A CBER vaccine expert should be restored as FDA liaison and allowed to play an active role. Organizations that recently withdrew from ACIP, such as the AAP, should be reinvited under conditions supporting their return. Restore integrity to meeting agendas: CDC (and, as appropriate, FDA) subject matter experts should be included in speaking roles, with public presentation of and access to their assessments and supporting documents. People without relevant expertise should generally not give presentations but can provide comments through existing procedures. When nongovernment scientists or others are invited as speakers, government scientists should be available to speak, ask questions and respond. All possible conflicts of interest should be disclosed. Restore integrity and transparency to ACIP processes: This includes ensuring timely, early posting of agendas, meeting materials, presentation slides, draft recommendations, and votes, and restoration of appropriate CDC staff and other expert input to work groups. Limit and disclose any political appointee involvement: Political appointees should generally not be engaged in developing or revising scientific assessments, reports, publications, or recommendations, except if specifically required, such as final sign-off on ACIP recommendations. There should be full transparency when assessments are changed and/or career scientists overruled by political appointees or other supervisors, including providing the original analyses. Such transparency can help ensure that when differences of opinion do arise, ACIP members and the public can consider the differing views in their decision making. Revise the ACIP charter: A further updated charter is needed to explicitly address the above needs. These changes may seem overly ambitious or optimistic. After all, even if the new leaders of the CDC, FDA, and CBER support objective and transparent evaluation of scientific evidence, they will be working within an environment and answering to political leadership that has often supported a very different agenda on vaccines. But even in this environment, it is important to call out what’s right. Protecting the health of children and communities, including through access to approved vaccines, is something Americans overwhelmingly endorse. Restoring credibility to ACIP, and its processes and recommendations, is important to earning the public’s trust and supporting informed immunization decisions by everyone. Jesse L. Goodman, M.D., M.P.H., is professor of medicine and infectious diseases and attending physician at Georgetown University. He served as director of CBER from 2003 to 2009 and as the FDA’s chief scientist from 2009 to 2014. He thanks Walter Orenstein, Dorit Rees, and Melinda Wharton for their helpful comments on this essay. Letter to the editor Have an opinion on this essay? Submit a letter to the editor. CDC, children’s health, law, RFK Jr., Vaccines Submit a correction requestReprints Jesse L. 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