Osterholm: Recommendations from federal vaccine advisory panel are untrustworthy

NINA MOINI: The CDC's Advisory Committee on Immunization Practices meets today and tomorrow. A once obscure board, its work was thrust into the spotlight after Health and Human Services Secretary Robert F. Kennedy, Jr., fired all 17 of its members earlier this month. He named eight replacements, some of whom have been outspoken about their mistrust of COVID-19 vaccines and lockdowns.

The board wields enormous influence, deciding who gets vaccines in the US and when. So joining me to talk about this is Michael Osterholm, the director of the Center for Infectious Disease Research and Policy and the leader of the Vaccine Integrity Project at the University of Minnesota. Thank you so much for your time this afternoon.

MICHAEL OSTERHOLM: Thank you. It's good to be with you.

NINA MOINI: I wondered if you could start by telling us a little bit more. We talked a little bit about it in the introduction there. But how does this Advisory Committee on Immunization Practices operate? What is it responsible for?

MICHAEL OSTERHOLM: Well, first of all, let's talk about how it's supposed to operate because right now it's not operating in that mode. More than 60 years ago, this committee was formed as a way to advise the Centers for Disease Control and Prevention as to which vaccines should be recommended for use and how they should be used. And this was part of a long process, where at the Food and Drug Administration, which is the first stop for a vaccine to be evaluated, occurs, and they, too, have a special committee there of experts that decide, is the vaccine safe and effective.

And if, in fact, that passes muster at the FDA, it then gets sent to the CDC for consideration by the Advisory Committee on Immunization Practices. Let me remind everyone. These are experts from around the country, who have a variety of different expertise, specifically aimed at understanding how best to use vaccines.

And so what would happen in the past was that that process of the vaccine being moved from FDA to CDC, it would be discussed at great length with a very careful analysis, often months of study, to make sure that all the data that were available were considered. And then the open discussion occurs at the ACIP meeting. That vote is taken.

If the vaccine recommendation is passed, it's then sent to the director of the Centers for Disease Control and Prevention. And they then basically put it into place as a formal recommendation. That has had tremendous implications because many of the payers in this country actually use the ACIP recommendation as the status of whether they should cover a vaccine for the general public or whatever group that it's recommended for. So it has really important standing.

In addition, there are a group of other organizations or societies, like the American Academy of Pediatrics, the Infectious Diseases Society of America, et cetera, that also make their own recommendations. But they're based off of the existing ACIP recommendations. So it's a very, very important organization.

NINA MOINI: Yeah, sort of at the core is kind of what you're describing. And many times, people will say, well, what's going on federally impact us at a state or a local level in terms of different regulations or just resources to be able to distribute. Could you talk a little bit about how that kind of trickles down?

MICHAEL OSTERHOLM: Well, actually, it's even more than a trickle. It's a tsunami. And what I mean by that is the fact that how a vaccine is recommended and who decides then will it be paid for, often determines if the public actually has access to it.

And what I mean by that is for many individuals, they're not able to afford these vaccines. And we have understood for decades the benefit to the community of having individuals vaccinated so they themselves don't become ill, infected, et cetera, but, more importantly, they don't transmit these infectious agents onto others. And so when we look at these vaccines and how they're evaluated, it's everything about, will a vaccine get used.

In some cases, we're already seeing the impact of what has been carried out at the Department of Health and Human Services to date, where Secretary Kennedy basically just laid out in a 58-second video on X that we will no longer cover COVID vaccines for a number of different individuals, including pregnant women. Pregnant women are at increased risk of having serious, serious illness, hospitalizations, and deaths associated with COVID. And so to be vaccinated is really a very important issue.

The Secretary, just unilaterally on his own, decided, no, we won't cover that anymore. We're already hearing many stories of pregnant women trying to obtain the vaccine, even if they wanted to pay for it themselves, not being able to get it. And so the implications are really far-reaching, and they're immediate. They're not something that we can debate for a few months and then make a decision on. We need to help bring these vaccines back into the same kind of approach that we've been using for 60 years, and that has worked very successfully.

NINA MOINI: Are you aware of even how much, say, a COVID-19 vaccine would cost if it wasn't covered? I'm just trying to get an idea for the scale.

MICHAEL OSTERHOLM: We're talking about many vaccines at the $150 range.

NINA MOINI: Wow.

MICHAEL OSTERHOLM: Which, for a family, particularly if they have several family members that should be vaccinated, that becomes cost prohibitive for many, many households. And in addition to that, remember, as I just noted, with pregnant women, we're already seeing institutions, such as pharmacies, et cetera, saying, well, we don't think we can give you the vaccine because it's not recommended, and with the sense that they're concerned that they might somehow be practicing medicine in a way that is not appropriate. And so that, too, is very important. Even if you had all the money in the world, you may not be able to get it. And we've had that very situation occur where pregnant women have been turned down from getting vaccinated, even when they wanted to pay for it.

NINA MOINI: So you talked a little bit about where COVID-19 is at. This committee made up of these newer members is going to be meeting today again for the first time, voting on, it sounds, like a number of vaccines, including COVID-19, flu, RSV. What are you going to be watching for amid all of this? What stands out?

MICHAEL OSTERHOLM: Well, at this point, we're not sure what's going to happen. If this were a normal ACIP meeting, we would have had extensive work groups meeting for the past four or five months. And they would make their work product publicly available well in advance of the meeting. The agenda would be well-rehearsed, and we would know who is going to be speaking, what they are going to be representing.

And the CDC staff, which often more than 50 different staff people, will be involved in preparing for this meeting so that the members have an extensive background document on what the issues are that they're addressing. None of that was done. And, in fact, of note, one of the presenters, who is someone who has had a long history of being involved with the Children's Health Defense Fund, which basically is really an anti-vaccine organization that was started by the Secretary, and in that regard, basically, they were going to present data to suggest that thimerosal, a type of preservative that we use in vaccines, should be removed and off the market.

Well, let me just be clear. Thimerosal has been evaluated for decades. Its safety is absolutely clear and compelling. The reason we use it is because you have a multi-dose vial.

You may take a dose out now and a dose out next hour and even a dose maybe as late as tomorrow. And you don't want any contamination to be a problem with that. And thimerosal prevents that.

Well, this presentation was supposed to be done by this individual tomorrow, maybe still will be. But the document that they put up yesterday for a review to address what they're going to address, in fact, had errors in it that were very significant, references that were obviously AI-generated references that didn't even exist, references that actually were 180 in terms of what the study actually showed and what the authors were concluding. So it's been a real problem, and we don't know today what's going to happen.

NINA MOINI: Yeah, so you're kind of unclear on what some of the content of the meetings will be. When we're talking about the federal government, we're talking about the Centers for Disease Control, of names that have been trusted for a very long time for people to look to, to decide what to do with their own bodies, their families, what's your advice right now in moving forward to people when it comes to who should they be looking to and trusting on the issue of vaccines from your perspective? What are the better resources?

MICHAEL OSTERHOLM: Well, let me be really clear. There are some incredibly gifted, talented, and committed people that work at the CDC. This is not about them. This is the standing group of people who have been there year after year, day after day, fighting it out in the public health trenches.

What we're talking about is a very small, limited number of recent political appointees that are now running the show. And in that regard, you can't trust anything coming out of CDC right now. You just can't.

And my colleagues feel the same way. And so that's a real challenge for us because CDC has played such an important role for so long in providing the kind of definitive, science-based information. So right now, I would say, we're working hard with the Vaccine Integrity Project to help support the development of recommendations for vaccines that are based on the latest, most current, and comprehensive science.

And we are working closely with the various societies. I mentioned a couple a moment ago, the American Academy of Pediatrics, et cetera, that they then make recommendations, too, but it's always based on the ACIP recommendations. And so we're going to try to still put out a document like that, that will be hopefully helpful to everyone. Our job is going to be helping clinicians and parents understand the difference between what the ACIP and CDC might generate versus what we're generating and why the one, I believe, you should trust is the one that we're putting up that will be clearly science-based.

NINA MOINI: And just, lastly, do you have or is it possible to get any sort of an idea of a timeline here. If folks are listening and thinking, what if I have a child in two years, what's going to be going on? Do you have a sense for that?

MICHAEL OSTERHOLM: Well, I can't say in terms of what the administration is going to do. I can only anticipate that as long as the administration is in place and Mr. Kennedy is in charge of the Department of Health and Human Services, we'll see more of the same. In terms of our commitment in public health and the groups that we're all working with, we're in this for the long haul. We're in it for however long it takes to make sure that we have the kind of established organizations, like ACIP, that function based on the science and that they bring together the best minds that we have in the business to do this. And that's going to be a lifetime commitment.

NINA MOINI: All right. Michael Osterholm, thank you so much, as always, for your time. Really appreciate it.

MICHAEL OSTERHOLM: Thanks, sure.

NINA MOINI: That was Michael Osterholm, with the Vaccine Integrity Project at the University of Minnesota.