This week, Health Secretary Robert F. Kennedy, Jr., removed all 17 of a CDC vaccine advisory group. Kennedy replaced them with eight new . At least three have made misleading or false statements about vaccine safety.
The committee holds three regular meetings each year to review scientific data and make vaccine recommendations. It plans to have one of those meetings in less than two weeks.
Before he was removed this week, Noel Brewer served on the committee for nearly a year. Brewer is a professor of public health at UNC-Chapel Hill and a behavioral scientist who studies why people get vaccines.
WUNC's Will Michaels spoke with Brewer about the Advisory Committee on Immunization Practices, or ACIP.
This interview has been lightly edited for clarity and brevity.
What is the ACIP and what was your role on it?
"The Advisory Committee on Immunization Practices establishes vaccine policy for the United States. That may seem a bit arcane, but what it means is that they say who should get vaccines, how many doses, and at what age. I created a model that explains why people get vaccines that's used by the CDC and the World Health Organization.
What's your impression of the new put on the committee by the secretary?
"I'm not going to talk about them. That there's so much out there already and I don't have anything that I can contribute to that conversation. I know it's what you want to talk about. It's the news today, but I'm not taking part in that news."
Okay. Let me just get a piece of context from you, then. What sorts of information does the committee get, how much information, and how often?
"The work of ACIP consists of weekly and monthly work groups that go through all of the evidence for why vaccines are effective and safe, or cases where that evidence is not known, or there are safety concerns, or perhaps the effectiveness is sub-par, and using all of those data, we then try to craft recommendations for who should get the vaccine, when and how many doses."
You were on work groups for the HPV and COVID-19 vaccines. So, let's take COVID-19 as an example. Why do people get the COVID-19, or why don't they get the COVID-19 vaccines?
"So, the most important thing for people to get a vaccine is to receive a recommendation from a healthcare provider, and that is not always present with COVID 19 vaccines. They're often provided through pharmacies. That provides a lot of convenience for some people. They can save money, but it doesn't allow them to have a recommendation from the healthcare provider who they've been talking to for the past several years. That's one of the barriers.
Other barriers include all of the conversations in the public about the vaccine, or the vaccines being problematic or having various issues. Most of that doesn't have a lot of basis to it, but it still has clouded the picture.
And, then the final thing is, the vaccines aren't that good. They save lives, they reduce hospitalization, but they don't really prevent infections so well. So, if you're 65 and you get a COVID-19 vaccine, it may save your life, but you also might still get sick for a little bit from having COVID-19.
It's kind of a problem because our imagination of vaccines is that they're perfectly effective, that they reduce any chance of infection, and that they will do everything for you. That's true pretty well for HPV vaccine. It's an outstanding vaccine. It's different, though, for things like seasonal influenza vaccine and COVID-19 vaccine. For those, we're trying to make things better by having fewer sick and dead people, but we may not achieve the perfection that people have in their minds, and as a result, people are a bit skeptical of the vaccine.
And I guess I should add one more thing. COVID-19 vaccines can pack a wallop. 20% of people are out of work for a day. It's called reactogenicity, and the reactogenicity of COVID-19 vaccines is something else."
Any advice for the new [of the committee]?
"Good luck. They're about to embark on a journey with a lot of data over a short period of time. The committee has lost all institutional knowledge and does not have much currently from healthcare providers. I really hope they can rebuild trust."
