CDC Advisors October meeting recap

The CDC’s Advisory Committee on Immunization Practices (ACIP) met October 25-26, 2023, for their annual review of the childhood and adult schedules, as well as updates on changes to come.

Much of the discussion revolved around how complicated the schedule is because it’s growing so quickly. Chair Grace Lee made the comment, “I can see we’re going to need a bigger refrigerator for all the vaccines.” And Matt Daley observed, we’re “going to run into the situation where we can’t fit the schedule on one page.” 

Top takeaways:

1. The schedules are now for “vaccines and other immunizing agents,” because of the addition of nirsevimab, a monoclonal antibody, aimed at preventing RSV in infants. This is an unwelcome expansion of what can go on the table.
2. The Mpox vaccine was put on the childhood schedule, even though the vaccine is not licensed for children. It is recommended for use in at-risk adolescents at the age of 18, with acknowledgement that the recommendation could change once data from trials in 12-18-year-olds is available. The committee voted for federal purchases of the Mpox vaccine through the Vaccines for Children (VFC) program. Mpox is the second non-licensed, EUA vaccine added to the schedule. This addition is notable for School-based Health Centers (SBHCs) as well, as the addition to the schedule would trigger the ability for children to be given the drug without parental knowledge or consent.
3. The Adult Immunization Schedule is expanding in tandem with the childhood schedule, and the drumbeat for a “Vaccines for Adults” financing program to mirror VFC sounded loudly throughout the two days.
4. The RSV vaccine was added to both the adult and childhood schedules for pregnant mothers, but as of publication, RSV is not covered by the Vaccine Injury Compensation Program. People anticipate that it will be, but since RSV vaccines will be new to “vaccine court,” additional regulatory steps must be taken.
5. Expect meningococcal (“meningitis”) vaccine recommendations to mutate as Pfizer’s new “pentavalent” vaccine was licensed. Though the ACIP wasn’t in lockstep yet about how to recommend three different meningococcal shots (one with five strains, one with four, and one with only one), they did all agree an update was necessary and that Pfizer’s new product should be paid for by taxpayers through VFC.
6. Immunization manufacturers have a blank check for adding to the schedule on a rolling basis, as a new addendum has been added as a placeholder for anticipated changes or additions to the schedule. (We know the GBS vaccine for pregnant mothers is very close to the end of the pipeline.) 
7. A common talking point through many presentations were the shortcomings of “commercialization” through sales of the drugs directly from manufacturers, rather than a public health program of massive purchases and subsequent distribution. In other words, the government claims they’re better at getting people to take vaccines than the private sector is. Let’s keep an eye on where the rubber meets the road on this: Will we see an acceleration of public-private partnerships? Will the government become more of a market player as stock prices drop from their astronomical COVID heights?
8. There was considerable discussion about the rush for the ACIP to publish recommendations after the FDA grants a new or expanded license. The 21^st Century Cures Act mandates that the ACIP move along quickly, but one of the members also made a telling comment about the role of the ACIP in comparison to the practice of medicine: “No recommendation means people will have to make up what they’re going to do with no guidance.” That mentality reflects the fact that the “practice” of medicine (with the federal government at the helm) has become following directions, rather than individualized and thoughtful care.
9. Injury claims in the Countermeasures Injury Compensation Program (CICP) for COVID products are at 12,233; 9,221 of which are from the jab. 
10. Saved the best updates for last: As the number of recommended shots in pregnancy increases, uptake decreases. To address that, multiple presentations cited new propoganda statistics about how safe and effective flu shots during pregnancy are.
11. The government’s National Immunization Survey showed 7.1% of adults and 2.1% of children self-reported getting the new 2023-2024 COVID shot. These numbers are higher than reality, because the data comes from people who are willing to answer a government survey, giving a very slanted picture.

If you’re feeling gloom and doom, be uplifted by the comment made by David Kimberlin from the American Academy of Pediatrics, who was stuttering in disbelief at the low numbers of people vaccinated with the latest COVID shot and the high number of people who say they don’t plan on it for themselves or their children. 

“Um… Two percent of children have received the current version of the vaccine, and 40% of parents say they’re not going to get their children vaccinated. Seven percent of adults have received the current vaccine; forty percent or so say they’re not going to get vaccinated. Uh, this is…I don’t even really have words for this…I-I-I-I-I appreciate everything that, you know, the AAP is doing, that-that ACIP is doing, CDC and so forth to, to make recommendations, but the recommendations are not being heard.”

Keep up the good work health freedom warriors! People are hearing our signal through the noise. We’re in the thick of it, standing shoulder to shoulder. Things are hard, but there are glimmers of hope and light shining through the darkness. It’s our job to carry that light for all to see and to stoke the fires of courage in all our hearts.