US Vaccine Guidelines Shift from Science to Intuition
The recent changes to the U.S. vaccine guidelines have sparked significant concerns among healthcare professionals. The Advisory Committee on Immunization Practices (ACIP), under the Centers for Disease Control and Prevention (CDC), has undergone major shifts in its approach to vaccine recommendations.
Background of ACIP and Its Framework
ACIP has traditionally relied on a scientific evaluation process called Evidence to Recommendations (EtR). This method provided a transparent framework for assessing vaccine data based on seven established criteria, which included:
- Public health problem: Identifying the key issues at hand.
- Benefits and harms: Weighing the potential advantages against possible risks.
- Values: Assessing public acceptance of recommendations.
- Acceptability: Evaluating the willingness of healthcare providers and manufacturers to adopt the recommendations.
- Resource use: Considering the economic feasibility of proposed recommendations.
- Equity: Understanding the impact on different population groups.
- Feasibility: Determining whether recommendations can be implemented nationally.
Recent Changes and Controversies
In June 2025, Health and Human Services Secretary Robert F. Kennedy Jr. appointed new ACIP members. Concerns arose when healthcare professionals noted these new members may prioritize personal agendas over scientific evidence.
During a crucial ACIP meeting, Jason Goldman from the American College of Physicians voiced his apprehension over the panel’s departure from the EtR framework. He urged for a return to a scientific approach, stating that the absence of data in discussions was alarming.
The foundation laid by the EtR framework has been largely ignored in recent recommendations. Yvonne Maldonado, a global health expert, expressed the difficulty in understanding the current decision-making process, emphasizing the lack of clarity surrounding ACIP’s methodology.
Impact of Changes on Vaccine Recommendations
The last EtR framework published was on June 19, 2025, regarding the Jynneos vaccine for at-risk adults. However, CDC has since failed to provide any detailed methodology for subsequent ACIP recommendations, including those for COVID-19 and hepatitis B vaccines.
Concerns intensified when testimonies during ACIP meetings, including one from Lyn Redwood of Children’s Health Defense, lacked the prior scrutiny by subject matter experts that ensured accuracy. Critics argue that these shifts undermine the scientific rigor traditionally upheld by ACIP.
Public Response and Legal Challenges
Many healthcare experts and organizations, including the American Academy of Pediatrics, have taken action against the new ACIP recommendations. The Academy has filed a lawsuit against HHS, seeking to halt upcoming ACIP meetings related to the changes in vaccine scheduling.
Furthermore, 19 states have announced their intentions to ignore the new guidelines, fearing they are not grounded in solid scientific evidence. Experts now worry that the public’s trust in vaccine recommendations may dwindle as ACIP diverges from its evidence-based practices.
Conclusion
As the landscape of U.S. vaccine guidelines shifts from a science-based framework to a more intuitive approach, the implications for public health and trust remain uncertain. Healthcare professionals continue to advocate for a reevaluation of the committee’s methods to ensure that vaccination policies are founded on robust scientific evidence.
