After a courtroom defeat, Trump administration health officials have revised the governing documents for a key federal vaccine panel to broaden its membership, increase its focus on potential harms of vaccines, and empower allies of health secretary Robert F. Kennedy Jr.
The new charter for the committee that advises the Centers for Disease Control and Prevention on vaccine use appears aimed at trying to evade the type of legal challenge that has left the currently appointed body in limbo. In addition, the document puts greater emphasis on the role of the Advisory Committee on Immunization Practices in studying injuries possibly linked to vaccination — though the committee has always paid close attention to any emerging evidence that called into question the safety of individual vaccines.
Last month a federal court said in a preliminary ruling that most of the members of the ACIP, all of whom were appointed by Kennedy, who is a long-time vaccine critic, were “distinctly unqualified” to sit on the panel.
The revised charter, published Thursday, expands the list of qualifications for membership, adding expertise in toxicology, pediatric neurodevelopment, and knowledge about “recovery from serious vaccine injuries.” It also states that people knowledgeable in the field of medicine should be eligible — a very broad umbrella.
“They weakened the expertise requirement, just making members ‘knowledgeable’, likely to make it harder for judges to demand expertise, though other language there does talk about expertise,” said Dorit Reiss, a professor of law at UC Law San Francisco who focuses on vaccine policy.
Health and Human Services Department spokesperson Andrew Nixon said “the ACIP charter renewal and its publication are routine statutory requirements and do not signal any broader policy shift.”
ACIP advises the Centers for Disease Control and Prevention on which vaccines should be routinely recommended, and for whom. The recommendations have traditionally been incorporated into state requirements for school attendance. Under Kennedy, the committee has become a health policy battleground as the secretary has pushed to limit the number of vaccines recommended for all babies and children.
The charter is required to be renewed every two years, but past changes have typically been minimal. The move to rewrite the document risks bringing vaccine policy issues to the fore at a time when the Trump White House is seeking to focus public attention on politically popular initiatives, such as food reforms and affordability.
At the same time, it may satisfy some of Kennedy’s MAHA allies by creating a new role for them in advising ACIP.
The new charter expands the list of liaison organizations, which are non-voting participants in the ACIP process. In the past, approximately 30 entities — groups like the American Medical Association and the Council of State and Territorial Epidemiologists — were allowed to attend ACIP meetings in this capacity.
The new charter adds the Association of American Physicians and Surgeons, the Independent Medical Alliance, the Medical Academy of Pediatrics and Special Needs, and Physicians for Informed Consent. AAPS is a conservative doctor group that has expressed skepticism of some vaccines. Physicians for Informed Consent opposes vaccine mandates and has questioned the benefits of some routine shots. The Medical Academy of Pediatrics and Special Needs advocates for children with autism or who have other complex chronic conditions.
The Independent Medical Alliance is a group formed in 2020 that has advocated for Covid treatments at odds with the medical mainstream and supported Kennedy’s vaccine agenda. Kirk Milhoan and Robert Malone, the chair and former vice-chair of Kennedy’s reconstituted ACIP, were also affiliated with the group.
Malone said recently that he had resigned from the ACIP in protest of the lack of pushback from HHS to the federal court judge’s critique of his lack of relevant expertise to sit on the panel.
“The new charter shifts ACIP into an organization focused more on risk and has provided a platform for organizations that have historically been opponents of vaccination,” Demetre Daskalakis, former head of CDC’s National Center for Immunization and Respiratory Diseases, told STAT.
“This is in line with the same rhetoric that led to the ACIP committee that has subsequently been stayed by the court. Vaccine policy is being transformed into a chess game rather than a service to the health of people,” said Daskalakis, who quit last August in protest of Kennedy’s firing of CDC director Susan Monarez, who refused to commit to accepting all recommendations from the newly constituted ACIP.
The new charter echoes language frequently used by anti-vaccine advocates. It tasks the panel with monitoring the safety and effectiveness of vaccines produced using a new platform, specifically mentioning mRNA — a particular concern of the anti-vaccine movement. And it suggests that ACIP should study “the cumulative effects of vaccines and their constituent components.” Anti-vaccine groups have long alleged the number of vaccines administered in childhood increase the risk of neurodevelopment conditions such as autism.
Researchers have studied the matter for decades, and have not found a link between vaccines and autism.
“While vaccine safety is always an important consideration, what we are witnessing is a manipulation of the committee’s purpose toward the singular goal of upending vaccine confidence and use in the United States,” said Richard H. Hughes, a lawyer with Epstein Becker Green who was the lead counsel on the suit brought against Kennedy’s restructuring of the ACIP and revisions to vaccine policy.
The budget for the new committee is more than double that set out in the last iteration of the ACIP charter, which was signed in 2024 and expired on April 1. The new charter provides a budget of $1.08 million for the running of the ACIP, compared to $410,000 previously. There are no details that would explain the sharp increase in costs.
The new iteration of the charter — like the version it replaces — stipulates that the panel can include up to 19 members who serve four-year terms. At the time it was disbanded, the previous ACIP had 17 seated members; the ACIP Kennedy appointed had 15.
Since the issuance of the preliminary ruling last month, ACIP’s status has been in doubt. A meeting scheduled for mid-March was cancelled after the ruling. And where previously ACIP charters stipulated that the committee would meet at least three times a year, the new charter states that meetings will be called at the discretion of the designated federal official responsible for the committee, in consultation with the chair.
The revised charter also appears to address the controversial rewriting of the childhood vaccine schedule earlier this year. The new charter gives ACIP responsibility for “reviewing global initiatives; and reviewing vaccination schedules by other countries and international organizations.”
HHS announced in early January that, in accordance with a memorandum from President Trump, the list of which vaccines children are recommended to get had been revised to reflect that of Denmark, which recommends substantially fewer vaccines for all children. The rationale was that the pared down schedule put the United States in line with peer countries, but in fact the new schedule — which is part of the lawsuit brought by the American Academy of Pediatrics — makes the U.S. an outlier.
Ironically, ACIP was not consulted on that revision; it was based on evidence assembled by two federal health officials and authorized by the then-acting CDC director, Jim O’Neill.
