UCLA clinicians and policy experts said Robert F. Kennedy Jr.’s overhaul of a vaccine advisory committee could create healthcare disparities and undermine public trust in vaccine recommendations.

Kennedy, the United States Secretary of Health and Human Services, dismissed all 17 members of the Advisory Committee on Immunization Practices on June 9 – claiming that many members of the panel had “persistent conflicts of interest.” The Centers for Disease Control and Prevention uses recommendations from this committee to develop immunization schedules, which affect when and which populations should be vaccinated, according to the ACIP charter.

“These are people who are incredibly well-respected in the field, people who I look up to and who I try to emulate,” said Dr. Nava Yeganeh, a visiting assistant professor in the division of pediatric infectious diseases at the David Geffen School of Medicine. “To fire them and wrongly accuse them of being political picks when the ACIP is an apolitical group and calling them out for having conflicts of interest when there’s no evidence to really back that up – that was difficult.”

Eight new committee members were appointed to replace the original 17. These picks include Dr. Robert Malone, a former mRNA researcher who spread misinformation about the COVID-19 vaccine during the pandemic, and Vicky Pebsworth, volunteer director for the National Vaccine Information Center, a group criticized for its advocacy against immunizations – according to reporting from the Associated Press.

ACIP recommendations impact which vaccinations are ordered by hospitals and covered by insurance companies, said Dr. Sanchi Malhotra, a pediatric infectious disease specialist with UCLA Health. The immunizations covered by the Vaccines for Children program – a CDC initiative that provides free immunizations to children from underserved families, according to the CDC website – are also affected by ACIP guidance, she added.

“If vaccines are no longer being covered under that program, that’s going to disproportionately affect underrepresented minorities, people who have a harder time accessing healthcare, and people who don’t have a lot of resources,” Malhotra said.

Malhotra also said limited access to vaccines could lead to more outbreaks of vaccine-preventable diseases, such as measles and pertussis.

Dr. Richard Jackson, a professor emeritus at the Fielding School of Public Health and a pediatrician, said herd immunity – which is reached when a large portion of the population gains immunity to an infectious disease – is universally beneficial, and can be achieved through vaccination. He added that some of his childhood peers were left with lasting complications from diseases that are now vaccine-preventable.

“I think people feel like it’s an intrusion of one’s rights to have a mandate that you have to have your child vaccinated before they go to school,” Jackson said. “I understand that reluctance, but I think there ought to be a sensible middle ground where we can pay attention to people, but also make it as safe as we can for the population at large.”

The new ACIP panel met June 25 and June 26. No changes were made to the current immunization schedule, but the committee voted to recommend that citizens receive influenza vaccinations without thimerosal, a preservative used in few influenza vaccines in the U.S.

Despite claims that the preservative causes reproductive harm made in a presentation delivered at the meeting, peer-reviewed literature has shown no link between thimerosal and developmental issues, according to the Food and Drug Administration.

In light of potential distrust of new ACIP leadership, different national organizations – including the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists – will continue to develop immunization guidelines, Yeganeh said. She added that the groups currently provide vaccine recommendations consistent with those from the ACIP.

“If there should be changes that don’t seem to align with the science, there will be these national organizations that will step in and make recommendations that providers can follow,” Yeganeh said.