I am the co-Editor-in-Chief of the journal Vaccine, so whenever big vaccination news happens, I usually hear about it pretty quickly. Unfortunately, these days most of the big vaccination news is not good and last week was no exception. Last Monday, one of my co-EICs texted me that several members of the CDC’s Advisory Committee on Immunization Practices (ACIP) had been fired, so we started reaching out to our colleagues on ACIP.

They didn’t know what we were talking about until Health and Human Services Secretary Robert F. Kennedy, Jr. unceremoniously fired them all in an op-ed in the Wall Street Journal. In an accompanying press release, HHS declares this a “bold step to restore public trust.”

It’s a bold step, alright, if you think that allowing the most famous and powerful anti-vaxxer in the world to decide the composition of a panel whose recommendations determine access to vaccines. I’m not sure how it restores public trust in evidence-based medicine and vaccine science to fire a panel of unpaid, independent experts for no cause other than they were appointed during the Biden administration. According to Kennedy, that means they were a “rubber stamp for industry profit-taking agendas” and were part of a “concerted effort to lock in public health ideology.”

However, Kennedy assumes that most people don’t know that much about ACIP or its role in deciding how vaccination policy is made. They don’t know how much damage to American public health Kennedy will be able to inflict with an ACIP composed of his anti-vax (mostly) brethren. So I’m going to break down why this is really bad news for those of us who object to children dying of preventable diseases.

The ACIP is an independent panel of experts convened by the CDC that evaluates evidence about vaccine safety and effectiveness using a defined analysis framework that ensures consistency and objectivity. The panel then makes evidence-based recommendations that are voted on by members of the panel. The CDC Director then approves the ACIP recommendations, they are published in the MMWR, and they become official.

ACIP recommendations aren’t just friendly advice about what vaccines you should get. They are used to develop the CDC’s official vaccine schedule. They are used by physicians to advise their patients about what vaccines to get. They are used by insurance companies to process reimbursements. They are essential to ensuring that vaccines are given to people who need them and will benefit from them, based on hard evidence rather than beliefs, with the public observing and participating in the process.

Speaking of Kennedy’s demand for “radical transparency”, the current ACIP process is very transparent. ACIP meets 3 times per year to review evidence and vote on recommendations. These meetings are open to the public and provide opportunity for public comment. I did comment at the last meeting to emphasize the importance of the panel and demand that ACIP retain its current membership roster (my comment is at 7:32:00). Although several ACIP members reached out to thank me for putting my support behind their evidence-based, democratic vaccine policy decisions, it seems my public comment didn’t land with Kennedy.

Despite Kennedy’s promises to Republican Senator Bill Cassidy that he would not replace ACIP with anti-vaxxers, these were promptly broken when he announced the first class of new ACIP members via tweet manifesto. Unsurprisingly, several of the names belong to prominent anti-vaxxers.

Malone is famous for his claim that he invented mRNA vaccines, although this is not true. In the 1980s, Malone performed an experiment that showed that he could introduce mRNA into human cells by packaging it in a globule of fat (this process is called transfection). This was an important advance at the time, even though it apparently wasn’t sufficient to encourage him to finish his PhD, but ended up being incremental in the development of mRNA vaccines. However, that hasn’t stopped Malone from declaring himself the inventor of the technology and using that street cred to cash in on the unsupported and untrue contention that mRNA and the SARS-CoV-2 spike protein that it encodes being the most deadly toxin known to science (this is not true). Malone makes millions from his Substack and his eponymous research institute (composed of him and his wife), as well as paid appearances along the Rumble-sponsored antivax rally circuit and appearances on Joe Rogan’s podcast where he falsely claimed that vaccines kill people and compared vaccination to the Holocaust. He also has testified as a compensated expert witness against Merck in a case about the mumps vaccine that was dismissed in 2023.

claims he invented mRNA vaccine technology, claims mRNA vaccines are deadly and spike protein is toxic, ivermectin superfan
Bachelor’s, biochemistry, UC-Davis, 1984; Master’s, biology, UC-San Diego, 1988; unfinished PhD program at Salk Institute; MD, Northwestern University Feinberg School of Medicine, 1991
in-demand speaker at “medical freedom” rallies sponsored by Children’s Health Defense, paid witness against vaccine manufacturers, specific conflicts unknown since none of the new ACIP disclosures are available on the CDC website
Malone is a no vote on every vaccine that comes up for consideration by ACIP

Kulldorff is a Swedish statistician who co-authored the Great Barrington Declaration. As I described previously, the GBD was a proposal for mass infection that would supposedly end the pandemic, with the inconvenient side effect of increasing the death toll by millions. Kulldorff, along with his co-author NIH Director Jay Bhattacharya, has a very thin skin when it comes to criticism of his brilliant insights. When he wasn’t writing petulant, self-pitying essays about how unfairly his proposal for unfettered COVID spread at population scale was treated by Big Public Health, he spent most of 2021 challenging his critics to debates, including me. During this time, he was fired from Harvard and assumed a leadership role at the Brownstone Institute, an anti-public health propaganda mill, which published this essay implying that Kulldorff thinks the experts who criticized him should lose their heads for it.

Kulldorff evidently has tired of churning out garbage for Brownstone and assorted other minor players in the anti-vax blogosphere, so more recently he started producing content for Children’s Health Defense as well as started his own members-only fake scientific journal to get more academic credibility in spite of the fact that his scholarly work cannot pass peer review.

Kulldorff lacks the fortitude to just admit that he is anti-vax, so he says ad nauseum that he is the biggest vaccine fan on the planet and is merely concerned about safety and effectiveness. However, he neglects to mention his extensive expert witness work testifying against the safety of Gardasil, in which he has exclusively focused on his concerns instead of the actual evidence.

co-authored the Great Barrington Declaration with Bhattacharya, previously served on an ACIP working group, fired from Harvard for refusing a COVID vaccine, extensive right-wing media portfolio
Bachelor’s, mathematical statistics, Umeå University, 1984; PhD, operations research, Cornell University, 1989
paid witness against Merck on a Gardasil case that Kennedy gets 10% royalties on, consulted for nearly every anti-vax, anti-lockdown, anti-mask, anti-public health group out there, previously the head of and a prolific contributor to the Brownstone Institute, multiple anti-vax panels and other content produced with Bhattacharya and their merry band of cranks
Kulldorff will do whatever Kennedy asks, probably with a great deal of self-righteous whining about how nobody serious would debate him and a lot of tedious fanboying for Anders Tegnell, the architect of Sweden’s “let ‘er rip” pandemic policy

Levi is an alumnus of the same PhD program that spawned Kulldorff, so I suppose it makes sense that two men specializing in mathematics and trained in operational logistics rather than immunology or microbiology would find a common home under the anti-vax tent after they both crawled out of the same contrarian rabbit hole. It’s not entirely clear to me how Levi found his way from studying food supply chain logistics to climb aboard the quack-wagon, but in 2023 he was claiming without evidence on Twitter that mRNA vaccines don’t work and kill children. Like Kulldorff and Bhattacharya, this earned him a spot in Florida Governor Ron DeSantis’s good graces. Levi has responded to this honor by dutifully churning out anti-vax propaganda with Florida Surgeon General Joseph Ladapo to justify policies limiting vaccine access across the state. Other politicians who oppose vaccination, such as Republican Senator Ron Johnson, have subsequently utilized Levi’s baseless assertions about vaccine lethality.

hates mRNA vaccines
Bachelor’s, mathematics, Tel Aviv University, 2001; PhD, operations research, Cornell University, 2005
sat on panels with Kulldorff, Bhattacharya, and a host of anti-vaxxers when consulting with Ron DeSantis and other politicians on vaccines and school closures
Levi will go after mRNA vaccines first. But I will not be surprised when it turns out he thinks other vaccine platforms are also dangerous and deadly based on no evidence and whatever expertise a food supply chain logistics expert can muster

Pebsworth has long served on the board at the National Vaccine Information Center (NVIC), an organization whose core mission is to peddle doubt about vaccination. NVIC has received millions in funding from Joseph Mercola, an anti-vax osteopath who has made a $100M fortune peddling health disinformation. In this regard, Pebsworth has been an enthusiastic participant since 2006, when she first emerged on the scene after her son was allegedly vaccine injured. Although she has previously served on the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC), which recommends vaccines for FDA approval, her tenure was characterized by opposition to most of the vaccines presented to VRBPAC. She also is the California regional director for the National Association of Catholic Nurses (NACN), which assembled a task force in 2021 to assist Catholic providers with demanding religious exemptions for COVID-19 vaccines, despite the fact that the Catholic church does not prohibit or discourage vaccination and mRNA vaccines are not made with cells derived from fetal tissue.

years of dedicated service promoting anti-vax disinformation at NVIC, previous contrarian service opposing vaccines as a member of the FDA VRBPAC
PhD, nursing, University of Michigan, 1999
the NVIC has published numerous articles with Children’s Health Defense
Nurse Vicky is a reliable no vote on recommending any vaccine for children, as well as any vaccine developed using embryonic cell lines (NACN maintains an anti-abortion shit list).

At first glance, Meissner seems like a qualified choice. He previously served as a voting member of ACIP and VRBPAC and is a pediatric infectious diseases specialist. However, he signed the Great Barrington Declaration and co-authored an editorial in the Wall Street Journal with FDA Commissioner Marty Makary opposing masks for children on the basis of the misleading claim that children rarely die from COVID (they still can die and also can get severely ill) and do not transmit COVID (they do). Although he voted to approve COVID vaccination for kids, he opposed school mandates in 2021 and there’s reason to think his views may have shifted to aligning more closely with the administration’s views. More recently, he expressed strong support of Kennedy’s unilateral decision to stop recommending COVID vaccination to pregnant women and young children. In addition to being unsupported by evidence, this decision completely undermined the existing ACIP recommendation that all people over the age of 6 months receive an updated COVID booster. Meissner’s assent to overriding the existing transparent, democratic, evidence-based process does not bode well for his participation in that process as a voting member.

signed the Great Barrington Declaration, hates school closures, thinks vaccines are magically dangerous only in children, previously served on ACIP and VRBPAC
Bachelor’s, unspecified, University of Vermont, 1967; MD, Tufts University School of Medicine, 1973
original signatory of the GBD, co-authored opinion pieces opposing public health policies with Kulldorff
Meissner will likely advocate for some sensible vaccine policies and has more expertise than any of his new ACIP colleagues, but has demonstrated clear ideological alignment with the administration’s goals. There is a high likelihood that he will go along with unsupported proposed recommendations to restrict other vaccines, particularly those given to children

I had never heard of Michael Ross before, but a quick perusal of his LinkedIn indicates that he a physician who has long worked as an executive at a variety of medical companies and investment firms. His specialties include contact lenses but not vaccines. He claimed to hold faculty appointments at George Washington University and Virginia Commonwealth University, but these may not be all that current. His sole scientific contribution was signing an open letter to the Journal of the American Medical Association complaining about a study that showed that ivermectin does not treat COVID-19. This letter was rightfully rejected by JAMA and has aged very poorly, considering it contains an extended rant against randomized controlled trials providing evidence that ivermectin does not, in fact, work:

Ross may be compelled to sing a different tune now, considering that randomized, placebo-controlled clinical trials have been declared Gold Standard Science by executive fiat and will be required for all new vaccine approvals. But he should have no fear: many of these trials will never happen, because it would be unethical to put the people in the placebo group in danger by knowingly putting them at risk of being infected with a potentially deadly pathogen. This is intentional. It is a strategy that Kennedy is using in parallel to remaking ACIP to keep vaccines off the market and put millions of Americans at risk.

ivermectin curious, no evidence of any vaccine expertise whatsoever
Bachelor’s, biology, Dickinson College, 1971; MD, George Washington University, 1975
he is an executive at a bunch of health-related companies, although they aren’t vaccine companies
The ivermectin crowd always turn out to be anti-vax. However, I do predict that Ross will change his opinion of randomized controlled trials to fall in line with the Gold Standard

Other than his now-dormant blog, it was pretty hard to find out much about Pagano’s history. He’s a retired ER doctor who hasn’t made public statements about vaccines and whose public output mostly consists of two medical fiction novels and an album of acoustic guitar stylings. He did write a 2016 blog from his dog’s point of view about how he didn’t like Obama because of the Affordable Care Act. However, it’s worth noting that emergency medicine physicians do not specialize in vaccination and from what I can tell, Pagano has never published a scientific paper about anything, much less vaccines.

???—I guess he is a board-certified physician
MD, Rush Medical College, 1978; EM residency at UCLA, 1979-1981
Kennedy thinks he’s amazing, but it’s not clear why. At least one theory has been floated that Kennedy has confused him with a different James Pagano.
I can’t predict much since there’s so little information about Pagano. Based on his old blog and his musical career, Pagano at least seems like maybe he might be kind of entertaining when he’s considering whether or not to vote for a recommendation that would kill children with a preventable infection.

A reporter called last week to ask me about the new selections and when Hibbeln’s name came up I said “Who?”. So I Googled him and saw that he is a retired NIH nutrition and neuroscience researcher and psychiatrist who has consulted a lot with the seafood industry. Still no obvious relevance to vaccines, so I looked at his publication record and it hit me: this guy specializes in the impact of mercury consumption, particularly in pregnant people. This may not be obvious to everyone who hasn’t been bathing in vaccine disinformation, but one of the classic anti-vax pieces of lore is the claim that thimerosal, a mercury-based preservative used in multi-dose vaccines, causes autism. Not only has this been disproven, but thimerosal is no longer included in most vaccines given in the US since most manufacturers have switched to single-dose vaccine vials. Besides, the amount of thimerosal in a single vaccination exposes you to less mercury than eating a tuna sandwich in honor of Hibbeln’s enthusiasm for fish consumption. As far as I can tell, Hibbeln has mostly focused on dietary mercury, so there’s no indication that he is anti-vax or subscribes to the belief that thimerosal causes autism.

worked at NIH for his entire career, officer in the Public Health Service, expertise in mercury exposure
Bachelor’s, biology and cultural anthropology, University of Chicago, 1983; MD, University of Illinois, 1988; psychiatric residency at UCLA, 1992
???
No idea, but thimerosal-containing flu shots are on the voting agenda for his maiden voyage on the ACIP, so we’ll find out soon which way Hibbeln is leaning

Not all of these people are anti-vaxxers, but that does not mean they have any business sitting on this panel making vaccine decisions for all Americans. Compared to the prior ACIP, these new members are grossly unqualified to make critical vaccine policy recommendations. An analysis by Science magazine showed that, despite Kennedy’s acclaim, many of the freshly appointed members have far published fewer papers on vaccines or vaccination than their predecessors, and half have none at all.

I regret to inform you that there’s more in store when it comes to unfit potential voting members of the panel. ACIP’s charter requires 19 people for quorum. People can be named on an ad hoc basis, and I suspect that’s how they will round out the squad at the ACIP meeting next week. But there are 11 spots to fill, so who will be the second round picks?

Given the rank disqualification for this position by the 8 newcomers appointed already, I don’t think the next 11 members will be magically sound, reasonable choices. We are likely to see some more monsters of anti-vax legend wriggle their way out from their burrows. My money is on Andrew Wakefield, but there’s a deep bench of credentialed or credential-adjacent quacks for Kennedy to choose from.

My internet haters in the anti-vax sphere like to talk about how wrong I am all the time. However, it gives me no pleasure whatsoever when I am right about things like this. In fact, it’s extremely upsetting and worrisome because of what the consequences will be.

Replacing ACIP is much, much worse than just disbanding it or cancelling meetings. If ACIP doesn’t meet, the existing recommendations remain in place. No new vaccines will be recommended, but at least the existing vaccine schedule remains set. The vaccines we have now remain available.

But if ACIP is replaced with people who reject science and are determined to stop immunization at any cost, then they can make new recommendations. Including recommendations to stop vaccinating certain populations, like children. Or older people. Or everyone.

Here’s a scenario with the new Gold Standard ACIP that I find plausible. First, ACIP forms working groups to look into “safety signals” for vaccines they don’t like. Based on the ACIP draft agenda for next week’s meeting, that might be the measles, mumps, rubella, and varicella (MMRV) vaccine.

Dr. TBD will present these data, whatever they are, and then the committee will begin discussing recommendations. The MMRV vaccine has been recommended since 2010 as part of the vaccination schedule beginning at 12-15 months of age, with a second dose at 4-6 years old. So why is it being reviewed now for under-five year olds?

There’s a big measles outbreak happening now in Texas and Kennedy has been doing everything in his power to help it expand. Kennedy knows full well that the measles vaccine is the only way to prevent measles. He begrudgingly said so in April. There is no known effective treatment for measles. Thus the MMRV is very important. So the MMRV gets discussed and one or more of the new ACIP members develops a serious case of the concerns. More research is demanded. The quality or even existence of that research is irrelevant, because at the next ACIP meeting they will recommend against using the MMRV. Then they’ll come after the regular MMR. Hepatitis B and Gardasil. And they’ll come after polio. I am currently in the weekly polio outbreak nightmares phase of my life.

A former member of ACIP told me last week that they didn’t think my prediction about ACIP being replaced would come true, but here we are. We are facing a situation in which a panel of unqualified ideological minions will put millions of people at risk of severe illness, permanent disability, and death. Children will suffer, get permanently paralyzed, and die. Immunocompromised people will be at greater risk everywhere they go. Cancer rates will rise. We won’t be able to respond to flu outbreaks. The economic, social, health, and human toll will be immense.

I really want to be wrong about this, but Kennedy is a man of his word when it comes to inflicting his heinous beliefs on the entire American public. The nation’s top health official is actively working to damage every person’s health. He is dismantling panels like ACIP that were assembled to serve the public by making serious, evidence-based, trustworthy vaccine recommendations. I am unwilling to sit quietly while a mad carcass-eating falconer blithely creates policy that will result in mass death. If you are concerned by this, you should let ACIP know by giving an oral public comment or a written public comment. You should let your Congressional representatives know too.