Introduction to the Controversy
U.S. health officials have told more than a half-dozen of the nation’s top medical organizations that they will no longer help establish vaccination recommendations. The government told the organizations on Thursday via email that their experts are being disinvited from the workgroups that have been the backbone of the Advisory Committee on Immunization Practices.
The Affected Organizations
The organizations include the American Medical Association, the American Academy of Pediatrics, and the Infectious Diseases Society of America. “I’m concerned and distressed,” said Dr. William Schaffner, a Vanderbilt University vaccine expert who for decades has been involved with ACIP and its workgroups. He said the move will likely propel a confusing fragmentation of vaccine guidance, as patients may hear the government say one thing and hear their doctors say another.
Reasoning Behind the Decision
One email said the organizations are “special interest groups and therefore are expected to have a ‘bias’ based on their constituency and/or population that they represent.” A federal health official on Friday confirmed the action, which was first reported by Bloomberg. The decision was the latest development in what has become a saga involving the ACIP. The committee, created in 1964, makes recommendations to the Centers for Disease Control and Prevention on how vaccines that have been approved by the Food and Drug Administration should be used.
The Role of the ACIP
CDC directors have traditionally almost always approved those recommendations, which are widely heeded by doctors and greenlight insurance coverage for shots. U.S. Health Secretary Robert F. Kennedy Jr. was a leading voice in the anti-vaccine movement before becoming the U.S. government’s top health official, and in June abruptly fired the entire ACIP after accusing them of being too closely aligned with manufacturers. He handpicked replacements that include several vaccine skeptics.
Structure and Function of Workgroups
The workgroups typically include committee members and experts from medical and scientific organizations. At workgroup meetings, members evaluate data from vaccine manufacturers and the CDC, and formulate vaccination recommendation proposals to be presented to the full committee. The structure was created for several reasons, Schaffner said. The professional groups provide input about what might and might not be possible for doctors to implement. And it helped build respect and trust in ACIP recommendations, having the buy-in of respected medical organizations, he said.
Reaction from Medical Organizations
Also disinvited from the groups were the American Academy of Family Physicians, the American College of Physicians, the American Geriatrics Society, the American Osteopathic Association, the National Medical Association, and the National Foundation for Infectious Diseases. In a joint statement Friday, the AMA and several of the other organizations said: “To remove our deep medical expertise from this vital and once transparent process is irresponsible, dangerous to our nation’s health, and will further undermine public and clinician trust in vaccines.” They urged the administration to reconsider the move "so we can continue to feel confident in its vaccine recommendations for our patients.”
Impact on Public Health
Some of the professional organizations have criticized Kennedy’s changes to the ACIP, and three of the disinvited groups last month joined a lawsuit against the government over Kennedy’s decision to stop recommending COVID-19 vaccines for most children and pregnant women. In a social media post Friday, one of the Kennedy-appointed ACIP members — Retsef Levi — wrote that the working groups “will engage experts from even broader set of disciplines!” Levi, a business management professor, also wrote that working group membership “will be based on merit & expertise — not membership in organizations proven to have (conflicts of interest) and radical & narrow view of public health!”
Conclusion
The decision to disinvite medical organizations from the ACIP workgroups has sparked controversy and concern among healthcare professionals. The move is seen as a threat to the integrity and transparency of the vaccine recommendation process, and could lead to confusion and mistrust among patients and clinicians. As the situation continues to unfold, it remains to be seen how the administration will address the concerns of the medical community and ensure that vaccine recommendations are based on the best available scientific evidence.
FAQs
- Q: Which medical organizations were disinvited from the ACIP workgroups?
A: The organizations include the American Medical Association, the American Academy of Pediatrics, the Infectious Diseases Society of America, the American Academy of Family Physicians, the American College of Physicians, the American Geriatrics Society, the American Osteopathic Association, the National Medical Association, and the National Foundation for Infectious Diseases. - Q: Why were the medical organizations disinvited from the ACIP workgroups?
A: The government stated that the organizations are “special interest groups and therefore are expected to have a ‘bias’ based on their constituency and/or population that they represent.” - Q: What is the potential impact of the decision on public health?
A: The move could lead to confusion and mistrust among patients and clinicians, and potentially undermine the integrity and transparency of the vaccine recommendation process. - Q: How have the medical organizations responded to the decision?
A: The organizations have criticized the decision, stating that it is “irresponsible, dangerous to our nation’s health, and will further undermine public and clinician trust in vaccines.” They have urged the administration to reconsider the move.
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