How the vaccine committee ACIP really works

The recent postponement of a key federal advisory committee meeting is deeply alarming and signals that it may no longer be able to provide independent scientific guidance to federal agencies.

The Advisory Committee on Immunization Practices (ACIP), has served the American people since 1964. ACIP advises the director of the Centers for Diseases Control and Prevention on how to use vaccines in the U.S. population to prevent the spread of infections, such as measles, influenza, whooping cough, and polio, and how to prevent serious complications from infections such as hearing loss, cancer, or death. But the ACIP meeting planned for three days in late February was recently delayed, reportedly to allow for public comment.

But we remain worried. Since the delay, an unvaccinated child in Texas died from measles, highlighting the vacuum that has been created in scientific leadership and communication. As past chairs of the ACIP, we want to share why this committee matters to the health care profession, and to all Americans.

First, ACIP is comprised of scientific experts independent from the federal government and from industry. All members undergo a rigorous review of conflicts of interest before appointment to ACIP and at the start of each public meeting.

Second, public transparency is critical to the process of ACIP review. The committee considers the public health importance of the disease, the effectiveness and safety of the vaccine, and the value of its use. All data, discussions, and votes that affect decision-making are required to occur in public view, accessible to all.

Third, ACIP aligns vaccine recommendations across the lifespan. The committee brings together key implementation partners from more than 30 professional organizations to achieve consensus, making it easier for health care providers to support their patients in protecting their family’s health.

Fourth, ACIP ensures access to recommended vaccines. The committee recommendations are connected to funding for vaccines by the Affordable Care Act (for insurance plans that would not otherwise cover vaccines) or through the Vaccines for Children program (which provides vaccines to more than half of children in this country).

However, ACIP can only provide sound and meaningful guidance to the country through access to data crucial for decision-making, such as the burden of illness, efficacy, effectiveness, and safety data. Without data, relevant scientific expertise, public transparency, and a robust process for deliberating on evidence to inform recommendations, trust will erode among health care providers who are caring for patients across the lifespan.

The future of ACIP as an independent, scientific advisory committee remains unclear. Despite being supported by statutory requirements to enable access to recommended vaccines to protect the health of the public, there may be attempts to influence the composition of the ACIP, remove deliberations from public view or comment, or change the way scientific data is reported, interpreted, or disseminated. 

ACIP, at its heart, is a public body that has served a critical role in reviewing the science to keep Americans healthy and providing guidance as the country faces new, emerging threats. Regardless of how this committee evolves, we believe in and remain committed to a focus on science, an evidence-based approach, and the existing transparent process as the foundation for recommendations to protect the health of all Americans for future generations.

Grace Lee, M.D., MPH; José Romero, M.D.; Nancy Bennett, M.D., M.S.; Jonathan Temte, M.D. Ph.D.; Carol Baker, M.D.; and Myron Levin, M.D., are all past chairs of the U.S. Advisory Committee on Immunization Practices from 2003-2005 and 2009 to 2023. Since completing service on ACIP, some have provided consultation to pharmaceutical companies working on new vaccines.