PFID Urges ACIP to Recommit to Processes that Foster Trust and Vaccine Access

The following is a transcript of PFID's statement during the public comment period at the Sept. 19 meeting of the Advisory Committee on Immunization Practices (ACIP):

Good afternoon. I’m Candace DeMatteis, Vice President of Policy and Advocacy for the Partnership to Fight Infectious Disease.

We’re very concerned about recent changes to ACIP membership and movement away from the evidence to recommendations processes – and most importantly, what those changes mean for access to vaccines and the public’s health. 

Historically, ACIP’s strength resulted from its rigorous, deliberative processes, moving from evidence to recommendations by engaging a variety of experts to examine research, and that’s what delivered recommendations grounded in evidence that people could trust. Historically, becoming an ACIP member required more than a year of careful vetting, reviewing independent expertise, committee needs, professional qualifications, and conflicts of interest. Often, voting members started on working groups, gaining critical experience and insight into the detailed processes that informed ACIP’s deliberations. 

Those working groups allow experts from multiple fields to review scientific and clinical data, including fully investigating adverse events before sharing options with the ACIP for consideration. Traditionally, that’s where data were examined, instead of bringing up unvetted research and anecdotes during the course of discussion. Every current ACIP member was appointed outside of that process. Respectfully, that does not build trust or confidence. Yesterday’s revelation that revisiting the HepB birth dose arose not because of new evidence of risk reduction or safety issues, but because of vaccine skepticism, was shocking. 

That is not gold standard science and further erodes trust. Tabling that discussion today was the right decision. Your recommendations access and choice to vaccines across America. Physicians rely on ACIP recommendations and insurers and public health programs depend on sound recommendations to determine coverage. Recent changes of ACIP have so tarnished trust that several states are moving to divorce their vaccine policies from ACIP recommendations. That will mean disparate protection and access depending on the state of residence.

The former recommendations for MMRV and the existing ones for HepB reflect the rigorous, evidence-driven process that should guide ACIP decisions. Changes outside the evidence to recommendations process will lead to restrictions in access that increase risk, limit coverage, and reduce access for families trying to keep themselves and their children healthy.

On COVID, last year alone, polls estimate that more than 55 million American adults said they would definitely get a COVID booster. Their reasons varied, and often included reducing risk to others. They should be able to make that choice.

We urge you to recommit to and follow the processes foundational to ACIP’s leadership. Thank you.