Five troubling themes that show where CDC vaccine policy is headed

Here are five ominous themes that surfaced, foreshadowing what we can expect at future meetings:

1) Advisers are deliberately subverting the established vaccine review process. Recommendations have long followed a rigorous evidence-to-policy framework in which experts systematically review and weigh scientific data before making decisions. That process was largely missing during this meeting.

CDC experts were permitted to give some presentations, but their scope was tightly constrained. In their place, individuals with fringe views were given a platform to promote conspiracy theories, such as the false claims that mRNA vaccines interact with DNA and that coronavirus shots can cause cancer. Allowing these presentations was alarming enough. That they were not posted online in advance, as is standard practice, only compounded the breach of transparency. Even the language of key votes was withheld until the last minute, leaving committee members confused about what they were deciding on.

Removing standard processes means that advisers are, at best, making decisions with incomplete information. There is no indication that this will improve; if anything, I fear CDC scientists will be further sidelined in future meetings.

2) Data are cherry-picked to fit a predetermined narrative. I lost track of how many times a CDC staff member presented a careful analysis of high-quality studies, only for one of Kennedy’s advisers to counter with “evidence” drawn from small case studies in obscure journals or even personal anecdotes. Randomized controlled trials showing no link between vaccines and alleged harms were brushed aside, while anything that reinforced the opposite view was amplified.

This is a perverse inversion of science. Scientific inquiry demands openness to being proved wrong and a shared standard for what counts as valid evidence. If anecdotes can outweigh large clinical trials, then there can be no meaningful way to assess the safety and effectiveness of vaccines or any medical recommendation.

3) The goalposts have shifted to proving negatives. Despite three decades of hepatitis B vaccine use and billions of coronavirus shots administered worldwide, several advisers insisted there wasn’t enough information to prove safety. They demanded long-term studies to rule out potential effects years down the line, even though vaccines have never shown such effects. They called for new placebo-controlled trials, ignoring the ethics of withholding protection from children when effective vaccines exist. They wanted sample sizes large enough to detect the most obscure possibilities. Some went so far as to suggest running separate trials for every vaccine, alone and in combination, over many years.

These are not reasonable scientific standards. They are impossible hurdles, which might be the point. What the advisers fail to acknowledge is that vaccines have already been studied extensively in the real world, across decades and using data from millions of people. Meanwhile, the dangers of the diseases they prevent are not hypothetical.

4) Diseases are being downplayed. The flip side of exaggerating vaccine risks is minimizing the illness itself. If vaccines carry “unknown harms” but the disease is “not so bad,” then, by this logic, it’s better just to get the disease. Kennedy has used this line for years, dismissing the severity of measles and claiming that the polio vaccine killed far more people than the disease itself.

His chosen advisers mirrored his language. They spent considerable time questioning the true death toll of covid-19. They downplayed the contagiousness of hepatitis B and insisted that testing pregnant women was enough to prevent transmission, ignoring clear data that showed the virus can spread through household and community contacts and that newborn vaccination is the most reliable safeguard.

5) It’s all about “informed consent.” This rhetoric comes straight from the anti-vaccine playbook. On its face, who could oppose giving people full information about medical choices? In practice, though, “informed consent” is code for putting up unnecessary barriers to vaccination.

At last week’s meeting, several advisers invoked this language to argue for prescription requirements for coronavirus shots. Information sheets and pharmacist screenings — already required by law — weren’t enough, they said; patients should also be forced to book a doctor’s appointment, go to a consultation, persuade their doctor who is not used to writing vaccine prescriptions to do so, and, because 90 percent of coronavirus shots are given in pharmacies, find their way to a pharmacy that would accept the prescription and administer the shot.

If those prescription requirements had been recommended, the consequences would have been severe. More than 100 million Americans lack a primary care doctor, and even those who have one often face long waits for appointments. Many would have given up altogether.

Thankfully, this ridiculous provision failed (though narrowly, with advisers voting 6-6 and the chair casting the deciding vote). But they did pass recommendations for the CDC to rewrite informed consent language to include exaggerations of vaccine risks and misinformation about unproven harms. This tactic might not only frighten hesitant patients but could also discourage physicians from initiating the conversation due to time constraints and fear of liability. The goal isn’t really to inform, but to intimidate.

The meeting’s final votes might not have delivered everything the anti-vaccine coalition wanted, but as I have warned, this is only the beginning. Expect the same playbook to resurface at future meetings. This is why medical societies and state health departments must step up as a countervailing force, defending established processes and upholding scientific judgment before more damage is done to public health.