Advisory Committee on Immunization Practices

Advisory Committee on Immunization Practices — latest news, discussion & facts — IJR

Recommendation process

Regularly scheduled ACIP meetings are held three times a year. Notices of each meeting, along with agenda items, are published in the Federal Register under the Federal Advisory Committee Act (FACA) requirements. A vote on vaccine recommendations may be taken when a quorum of at least eight eligible ACIP members is present. Eligible voters are those members who do not have a conflict of interest. If there are not eight eligible voting members present, the ACIP executive secretary can temporarily designate ex officio members as voting members, as provided in the committee charter. Meetings are advertised and open to the public and are now available online via webcast. The minutes of each meeting are available on the CDC website within 90 days of the conference.

In October 2010, ACIP adopted the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. Their process includes a review of labeling and package inserts; a review of the scientific literature on the safety and efficacy; an assessment of cost-effectiveness; a review of the morbidity and mortality associated with the disease; a review of the recommendations of other groups; and a consideration of the feasibility of vaccine use in existing programs. Each piece of evidence is judged as very low, low, moderate, or high quality. Problems such as lack of reliability and biases are taken into account, and the quality of the evidence is adjusted accordingly. Vaccines suitable for nearly all persons in an age- or risk-factor-based group are assigned Category A. Category B recommendations are made for individual clinical decision-making between the patient and physician. Both Category A and Category B vaccines must be covered by insurance companies (following the ACA).

At meetings, the ACIP may vote to include new vaccines in the VFC program or to modify existing vaccine schedules. These votes are codified as VFC resolutions. In most cases, a resolution takes effect after establishing a CDC contract for purchasing that vaccine in the necessary amounts.

Recommendations are then forwarded to the CDC Director for approval. Once approved, the recommendations appear in the CDC's Morbidity and Mortality Weekly Report and represent the official CDC recommendations for immunizations in the US.

Under RFK, Jr.

On June 23, 2025, Secretary of Health and Human Services Robert F. Kennedy Jr. fired all 17 ACIP members and—with one exception—appointed members who are either anti-vaccine activists or who lack expertise in vaccines.

At the first meeting of the newly constituted group on June 26, 2025, ACIP voted in favor of recommending that most Americans receive influenza vaccines that do not contain thiomersal, a preservative. HHS Secretary Kennedy adopted ACIP's recommendation on July 22, 2025, formally incorporating the removal of thiomersal from influenza vaccines into federal public health policy.

Unusually, a presentation of the scientific information developed by the CDC's staff was not made; instead a presentation was made by Lyn Redwood, (formerly of Kennedy's anti-vaccine group Children's Health Defense) who said that thiomersal is a neurotoxin. The presentation was a variation of one Redwood posted to the CDCs site earlier, which referred to a study which did not exist. This slide was removed in the committee presentation.

In September 2025, ACIP voted to end its recommendation for the MMRV vaccine for children under age 4.

On December 5, 2025, the group voted 8–3 to end the universal recommendation that every infant receive a Hepatitis B vaccine at birth, instead advising individualized recommendations be made based on the mother's Hepatitis B infection status.

The change of the long-standing recommendation for the Hepatitis B vaccine at birth was criticized. One of the critics was ACIP member Cody Meissner: "I will just say: we have heard that do no harm is a moral imperative. We are doing harm by changing this wording. And I vote no."

Scientific American wrote:

About 18,000 infants and children were infected with hepatitis B annually before the vaccine was recommended to all newborns in the U.S., according to the Children's Hospital of Philadelphia. "... And the regimen has been effective: cases from 1990 to 2019 dropped by 99 percent."

The changes to the vaccine schedule were criticized by many mainstream medical organizations including the American Academy of Pediatrics, the American Medical Association, the National Foundation for Infectious Diseases, and the Infectious Diseases Society of America.

On January 26, 2026, Dr. Kirk Milhoan, the director of ACIP, said in an interview that polio and MMR vaccines should not be mandated.

Allegations of conflicts of interest in vaccine advisory committees

On June 23, 2025, Health Secretary Robert F. Kennedy Jr. dismissed all 17 members of ACIP, arguing in an op-ed for The Wall Street Journal that the committee was compromised by financial conflicts of interest. He cited a 2009 inspector general's report which he said showed that 97% of members had conflicts.

Experts and fact-checkers disputed this characterization. Former CDC Director Tom Frieden, who received the 2009 report while in office, explained that the 97% figure referred to incomplete paperwork—such as missing signatures—rather than actual financial ties. According to Frieden, "16 of those 17 people reported no conflicts of interest. One reported a conflict of interest … and so she recused herself."

Further evidence came from a peer-reviewed study published in JAMA in August 2025, which found that conflicts of interest among ACIP members had declined sharply over the previous two decades and had been at historic lows when Kennedy dismissed the committee. The study reported that the share of members with financial conflicts dropped from 42.8% in 2000 to 5% by 2024. Since 2016, the average conflict rates were 6.2% for ACIP and 1.9% for the FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC). Almost all interests involved research funding, and less than 1% involved personal compensation like consulting fees from vaccine manufacturers.

In a statement to NBC News in response to the JAMA article findings, the Department of Health and Human Services did not address the apparent contradiction directly, stating only that "Secretary Kennedy is committed to eliminating both real and perceived conflicts to strengthen confidence in public health decisions".

During a hearing before the Senate Finance Committee on September 4, 2025, Secretary Kennedy admitted that several of the members he appointed to replace the ACIP members had previously served as paid expert witnesses in litigation against vaccine manufacturers.

Advisory Committee on Immunization Practices

Advisory Committee on Immunization Practices

Article

Related journals

Live room · 1 here

Article

Purpose and impact

Recommendation process

Working groups

Members

2025

Selected recommendations

Until 2024

Under RFK, Jr.

Allegations of conflicts of interest in vaccine advisory committees

American Academy of Pediatrics v. Kennedy

State alternatives

Related journals

About Advisory Committee on Immunization Practices

About Advisory Committee on Immunization Practices

Article

Related journals

Live room · 1 here

Article

Purpose and impact

Recommendation process

Working groups

Members

2025

Selected recommendations

Until 2024

Under RFK, Jr.

Allegations of conflicts of interest in vaccine advisory committees

American Academy of Pediatrics v. Kennedy

State alternatives

Related journals