The Advisory Committee on Immunization Practices’ (ACIP) meetings used to be a geek’s dream: hours of long, maybe dreary presentation of extensive data followed by lengthy discussions that drilled into details of vaccine safety, effectiveness, and the best way to balance protecting people and risks and costs.
Not health secretary Robert F. Kennedy Jr.’s ACIP. The two-day meeting on Thursday and Friday was certainly lively, and if this were a TV show, it would be much more interesting than usual ACIP meetings, even funny at times.
But ACIP shouldn’t be this lively, interesting, or funny. These people make decisions that impact people’s lives. Given that, the members’ lack of expertise, incompetence, and blatant anti-vaccine biases were dismaying. Our nation’s public health is not in good hands.
Lack of expertise
The only votes the committee took this meeting were about hepatitis B vaccines. Hepatitis B is a virus that causes liver disease and cancer, and our vaccine schedule for it has dramatically reduced cases in children. Sen. Bill Cassidy (R-La.), who worked as a liver doctor and treated hepatitis B cases, called out ACIP’s decision and its harms. The committee had several presentations on hepatitis B vaccines. But none were presented by experts in hepatitis B, and none of the workgroup members, once they were mentioned, were experts in hepatitis B.
It quickly became clear that the presentations were not vetted by anyone with expertise in the subject matter. One presenter, Cynthia Nevison, is a climate researcher who co-authored a retracted paper on vaccines and autism. Another, Mark Blaxill, is a long-time anti-vaccine activist who, in 2017, tried to convince the Somali community in Minnesota that vaccines cause autism — in the middle of a measles outbreak that hospitalized many of their young, unvaccinated children. Kennedy has made him a senior CDC adviser.
The only member on the committee with ACIP expertise, physician Cody Meissner, strongly criticized the presentations on exactly that ground. So did many of the liaisons, members of organizations with expertise in the subject matter, who know hepatitis B. CDC has access to subject matter experts; they answered some questions, and they presented in September showing the vaccine was safe and effective. But they were not brought in to present this time.
On the second day, a presentation on the vaccine schedule was led by anti-vaccine lawyer Aaron Siri. In a large part of the presentation, Siri talks about what would be appropriate clinical trials and tried to evaluate some clinical trials — something a lawyer would usually turn to an expert witness for. There are people in the country with expertise in conducting vaccine clinical trials and their ethics. Siri is not one of them.
The last presentation was by Evelyn Griffin, an OB-GYN from Baton Rouge General Hospital. Griffin presented on aluminum in vaccines — something there is no indication she has any expertise in. Indeed, the presentation itself suggested lack of expertise: She missed a very large study on aluminum adjuvants safety from Denmark, covering more than a million children, that found no safety concerns, and several other studies on the topic that, likewise, found no issue. Here, too, CDC no doubt had access to qualified experts, but ACIP did not bring them to present.
Incompetence
Several observers of ACIP compared the meeting to a clown car, but my husband, Fred, reminded me that clowns are seasoned professionals who work very hard on their shows, and this meeting did not reflect such professionalism.
Maybe the most glaring example of incompetence was the fact that members asked to delay the vote from Thursday to Friday because they were not sure what they were voting on. Voting language was put up a few days before the meeting, but was, apparently, changed multiple times before the meeting, confusing members (and probably creating a notice issue). In fact, the language that was up on the morning of the vote was not what the committee ended up voting on.
During a vote on coverage of the shot in the Vaccines for Children program — which covers vaccines for uninsured and underinsured children — several members were clearly confused and abstained on those grounds.
ACIP also voted to recommend that parents see if they need titer blood tests after each dose of vaccine to determine whether more doses are needed. But ACIP does not have authority to tell insurers to cover blood testing; the United States Preventive Services Task Force has authority over screenings. ACIP can only require insurance coverage for vaccines. So this recommendation, as several members pointed out, has no real basis in the data and it is outside the committee’s mandate. It shows that most of this committee’s members don’t understand their job. That is even besides the strangeness of telling parents to get multiple unnecessary blood tests for young babies with no evidence that they would be helpful.
Tracy Beth Høeg from the Food and Drug Administration provided a presentation trying to argue that the United States should be more like Denmark in its approach to immunization. What Høeg did not seriously address is that the United States is a large, heterogenous country where many people do not have access to care, with substantial income inequality. Those fundamental differences mean that we require different vaccine policies.
Anti-vaccine bias
The meeting was tainted with a glaring anti-vaccine bias. This time, unlike in ACIP’s September meeting, there was no presentation from CDC to provide objective data.
This was a thread throughout the presentations, so I will only provide a few examples. Vicky Pebsworth, a member of the anti-vaccine National Vaccine Information Center, justified a reconsideration of the hepatitis B birth dose — even though there was no new data — by pointing to growing parents dissatisfaction with hepatitis B birth dose. But her own data showed that the vast majority of parents do not skip hepatitis B vaccines. So ACIP was more concerned with removing the recommendations for everyone to satisfy the minority of parents who do not want the vaccine. Several members expressed the view that children should not be protected from hepatitis B at all.
In Blaxill’s safety review, he tried to explain away the very clear data on safety by, among other things, presenting studies that considered fever and fussiness signs of encephalitis — brain inflammation. He also focused on studies by Mark and David Geier that the CDC, correctly, has dismissed as unreliable both in the past and in their September 2025 materials .
Siri opened his presentation by suggesting that a growth in the number of vaccines given to children is a negative thing, reflecting the anti-vaccine view that protecting children from more dangerous diseases is bad. He also claimed, falsely, that the hepatitis B vaccine clinical trials lasted only five days and the vaccine was insufficiently tested. He claimed no vaccines underwent good clinical trials, a common (and false) anti-vaccine trope.
In Griffin’s presentation about aluminum, she completely omitted the many studies on aluminum in vaccines that show they’re safe. She instead relied on a badly flawed study of five brains, and a problematic claim of a syndrome called ASIA that has no good support. These studies are favorites of anti-vaccine activists to claim problems with aluminum adjuvants.
Since 1964, ACIP gave us careful, evidence-based recommendations on vaccines. That is no longer true. The current ACIP is biased, incompetent, and makes decisions that will harm children and adults.
We deserve better.
Dorit Reiss is professor of law at UC Law San Francisco (formerly Hastings) who focuses on vaccine policy.
Correction: A previous version of this essay misstated the presence of an item on the ACIP meeting agenda.
