The needles of two syringes cross to make an X
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As former chairs of the CDC’s Advisory Committee on Immunization Practices (ACIP), we are deeply alarmed by the growing politicization of vaccines — a public health innovation that has saved 154 million lives globally. While politicization of science is not new, the escalating distrust in science across the political spectrum, and its intrusion into the vaccine ecosystem, now threatens the very infrastructure that has long protected Americans from infectious diseases.

The shift in the vaccine debate — from disagreements over science to battles over access — is unprecedented. Without immediate action, we risk losing access to life-saving immunizations and the ability to respond to future public health threats. The damage, once done, may not be easily repaired.

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We are witnessing a dismantling of the systems that develop, license, recommend, and monitor vaccines.

1. Scientific development

At the foundation of every vaccine is a process of rigorous scientific development. Yet today, this process is being undermined in ways that jeopardize both innovation and pandemic preparedness. Amid stalled National Institutes of Health grant reviews and proposed cuts, NIH is now advising researchers to omit references to mRNA vaccines — despite their proven value — from grant proposals. Contracts worth over $766 million for mRNA pandemic flu vaccines have been canceled, while funding is redirected to older technologies without peer review. Some legislators are even proposing penalties for providing mRNA vaccines. Instead of prioritizing what the goal is (e.g., protecting us from infectious disease pathogens with pandemic potential) and removing barriers, policymakers without expertise in vaccinology are deciding how to address the problem. (i.e., which technology must be used and excluding other approaches to development). This politicized shift stifles innovation, undermines science, and ignores the expertise needed to prepare for future pandemics.

2. Vaccine licensure 

The Food and Drug Administration is responsible for licensing vaccines in the U.S.  Similar to other health agencies, FDA has experienced a significant reduction in force that will delay the development of new products and potentially reduce safety inspections. In early 2025, the FDA canceled a key public advisory meeting of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) and instead held a closed-door session — followed by the resignation of a top vaccine official. Simultaneously, the FDA revised its regulatory framework for Covid-19 vaccines, now mandating placebo-controlled trials for anyone 6 months to 64 years without underlying medical conditions, even though more than 270 million people in the U.S. have already received these vaccines. 

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Without regulatory approval, access to vaccines is compromised for people who seek protection, such as health care workers or family members of those with high-risk conditions.  Perhaps most concerning, the FDA, NIH, and Health and Human Services announced the removal of Covid-19 vaccines from the U.S. immunization schedule for children and pregnant women (despite pregnancy being listed as a high-risk condition in the new regulatory framework) — not through the usual transparent processes but via a social media post.  In addition to going beyond its regulatory authority, these actions are eroding necessary conditions for public trust, including consistency, expert decision-makers, noninterference, transparency, and reflection of public preference. This departure from established decision-making and communication processes damages public confidence and sets a dangerous precedent.

3. Vaccine recommendations

The ACIP is a federal advisory committee that has existed since 1964 to advise on the use of vaccines in the U.S. civilian population.  As former ACIP chairs, we previously highlighted key processes that are critical for trust in evidence-based decision making: scientific independence, public transparency, partnership with key implementation partners from more than 30 professional organizations, and data to drive decision-making. In the past several weeks, we have seen a shift from a standardized, explicit evidence-to-recommendations process that enhances transparency, consistency and communication, to a process in which decisions bypass the federal agency responsible for vaccine recommendations (CDC) and are communicated via social media. Furthermore, all ACIP committee members were removed on June 9 and completely replaced two days later.  If relevant scientific expertise on vaccines is not maintained, access to vaccines may fundamentally change since ACIP is directly linked to the Vaccines for Children (VFC) program, which provides vaccines without cost to approximately 50% of children in the U.S., and the Affordable Care Act that requires insurance coverage for ACIP-recommended vaccines to approximately 150 million people in the U.S.

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4. Vaccine monitoring 

The lifecycle of vaccines continues post-licensure with ongoing monitoring of changes in the burden of disease, effectiveness, and safety.  Robust monitoring is challenging when data disappears and reappears without transparent communication and documentation of changes over time. And public health scientists responsible for supporting vaccine decision-making are leaving due to fundamental concerns about data integrity and use.  Furthermore, policymakers have invested resources in re-examining a previously debunked link between vaccines and autism instead of understanding, addressing, and supporting the needs of people with autism, while also cutting funding on grants that support research on vaccine hesitancy.  At the same time, we are seeing alarming moves to directly access private health data that has previously been protected and attempts to access personally identifiable data from pharmacies, labs, genomics data, smartwatches, and fitness trackers without involving the people and organizations directly impacted.  Data is being used as a means to an end.  

Without transparent, evidence-based processes, vaccines may become inaccessible, unaffordable, or unavailable. Public trust will erode, innovation will stall, and lives will be lost unnecessarily. The systematic unraveling of our vaccine infrastructure endangers our freedom to protect ourselves and our communities.  We urge congressional leaders to reflect on how these fragmented decisions collectively dismantle our ability to prevent disease and save lives. Oversight and action are urgently needed to restore stability to our health systems.

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