Ever since taking his seat as Secretary of the U.S. Health and Human Services (HHS) under a banner of “radical transparency,” Robert F. Kennedy Jr. has been reshaping healthcare agencies as part of his personal mission to remove industry influence and restore public trust.
Earlier this summer, the Kennedy-led HHS wiped the existing slate of the Advisory Committee for Immunization Practices (ACIP) clean, replacing all 17 sitting members with his own picks. The abrupt move was attributed to the “restoration of public trust above any specific pro- or anti-vaccine agenda,” Kennedy said in a release at the time. ACIP has made vaccine recommendations to the U.S. Centers for Disease Control and Prevention (CDC) since 1964.
Kennedy further pointed to “persistent conflicts of interest” within the committee, arguing that the panel has become “little more than a rubber stamp for any vaccine,” he wrote in a Wall Street Journal opinion piece.
The ousted ACIP members quickly slammed Kennedy’s suggestion that “public trust has eroded” in their own Journal of the American Medical Association (JAMA) editorial, arguing that the committee has historically ranked among the “most stringent and transparent of the federal committees.”
The former members aren’t the only ones who took issue with their dismissal. Democrats on the Senate's Health, Education, Labor and Pensions Committee (HELP) launched an investigation into Kennedy’s decision, which gave a platform to “conspiracy theorists” as the “new ACIP makes recommendations based on pseudoscience,” the senators wrote in a letter to Kennedy.
Now, new research from the USC Schaeffer Center for Health Policy & Economics can inform the discussion surrounding Kennedy's move. In a study published in JAMA on Monday, researchers found that reported conflicts of interest within the panel had been at a historic low prior to the shake-up, while conflicts of interest involving income from vaccine makers had been “virtually eliminated.”
For both ACIP and the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC), members must declare any ties to vaccine makers or competitors at issue during relevant meetings. In the 2000s, annual rates of reported conflicts of interest among members peaked at 43% for ACIP and 27% in VRBPAC, according to the report.
Since 2016, an average of 6.2% of ACIP members and 1.9% of VRBPAC members have reported a financial conflict of interest at any meeting, with fewer than 1% of reported conflicts on both committees relating to personal income from vaccine makers, according to the study.
The decline of conflicts of interest could be attributed to “heightened public scrutiny of industry influence in health agencies’ decision-making” and steps the FDA has taken to root out the issue, the researchers noted.
In 2024, the rate of reported conflicts of interest in ACIP dropped to 4%. Those conflicts typically related to research grants, which are “generally considered less concerning” than financial ties, according to the researchers.
“Secretary Kennedy is right that conflict of interest is an important issue, but he is wrong that it is present at substantial levels on HHS vaccine advisory committees,” co-author Peter Lurie, a former FDA associate commissioner and current president of the Center for Science in the Public Interest, said in the report.
Early on in his HHS secretary's tenure, Kennedy urged FDA staffers to be conscious of the “gravities of agency capture,” calling the FDA the “sock puppet” of the industries it regulates at an April event with staffers. Since then, the secretary has also banned employees of companies regulated by the FDA (such as biopharma companies) from serving on FDA advisory committees.
His new slate of ACIP members includes a prominent critic of COVID-19 vaccines and others who were critical of government policies during the pandemic. As one of its first moves, the panel recommended the removal of the preservative thimerosal from all vaccines in the U.S.
The revamped ACIP also recently moved to exclude medical organizations such as the American Medical Association from the process of informing vaccine recommendations.
"Under the old ACIP, outside pressure to align with vaccine orthodoxy limited asking the hard questions,” an HHS spokesperson told Fierce Healthcare in response to a request for comment on the decision. “The old ACIP members were plagued by conflicts of interest, influence and bias.”