'efficacy Will Be Secondary': Rfk Jr.'s Vaccine Advisers Have A New Mission

Robert F. Kennedy Jr. fired the government’s vaccine advisers, replaced them with skeptics of the shots like himself and is now giving them a new mandate: investigating the harms of immunization.

The Advisory Committee on Immunization Practices has for decades served as an impartial outside group of experts to advise the government and reinforce public confidence that decisions on the vaccine schedule are backed by science.

But the panel’s new chair, an evangelical pastor from Hawaii, pediatric cardiologist and Covid vaccine skeptic, says it needs to instead spend more time looking into vaccine side effects.

Americans should view the panel "more as a safety committee," Kirk Milhoan told POLITICO. "Efficacy will be secondary,” he said.

The committee’s pivot goes against decades of best practices. The federal government once saw having a panel of outside, impartial advisers to weigh in on vaccine schedule changes as necessary. No longer. The members, who largely share Kennedy's vaccine ideology, are in position to help legitimize Kennedy's longstanding view that vaccines are unsafe.

Public health experts who spoke with POLITICO worry that the group’s new “watchdog” persona could cause it to downplay benefits and stoke fears about vaccines, leading to lower vaccination rates and the return of diseases Americans haven't worried about in decades.  

"They're going to be the mechanism to sow discord and confusion by presenting weird stuff,” Demetre Daskalakis, who resigned last year from his post leading the National Center for Immunization and Respiratory Diseases, said.

If the panel is even considering recommending a vaccine, it should work, Milhoan noted. In the year ahead, he wants the committee to focus on sussing out risk — including for vaccines already on the recommended list — which he says has been ignored in some cases. “If you're not looking for safety signals, you won't necessarily find them," he said.

Daskalakis said that sounded like an excuse to find reasons to discourage vaccination. Safety data is already meticulously tracked by the Centers for Disease Control and Prevention and the Food and Drug Administration and safety signals that emerge are thoroughly investigated, he argued.

For decades, the decisions of the advisory committee Milhoan now leads have served as a precursor for changes to the federal childhood and adult immunization schedules. In the past, the panel reassessed recommendations only if significant new data warranted revisiting them.

Milhoan is undeterred. Last month, he questioned whether the risk of taking the polio vaccine, which prevents disability and death and which President Donald Trump has said he supports, was worth it: "As you look at polio, we need to not be afraid to consider that we are in a different time now than we were then,” he said on the podcast "Why Should I Trust You?" "Our sanitation is different,” he said. “Our risk of disease is different, and so those all play into the evaluation of whether this is worthwhile of taking a risk for a vaccine or not."

Kennedy himself described the committee as “Americans’ watchdog for vaccine safety and transparency” in a statement when announcing two new members last month.

Milhoan and Kennedy’s reframing of the advisory committee's mission follows a tumultuous year for the group. In June, Kennedy fired its previous members and replaced them with new picks, who largely share his suspicion of vaccines. As an independent advisory panel, the group can't directly change the vaccine schedule. Instead it makes recommendations to the CDC, which historically almost always adopts them.

Kennedy has in multiple cases leapfrogged that process. Last spring, he changed the recommendations for Covid shots before the advisers considered it.

Early last month, he downgraded a slate of childhood vaccine recommendations, including for flu, meningitis, hepatitis A and rotavirus, without committee input.

But while the panel has been repeatedly left out of critical decisions, it remains useful to Kennedy because of its megaphone.

Milhoan said he did not feel that ACIP needed to be involved in the recent schedule change.

“Both the president and the secretary have the right to do this,” Milhoan said. “It doesn't offend me that I wasn't specifically involved in the discussions, because I just don't think that's what my role is.”

A person familiar with Kennedy’s thinking, granted anonymity because they were not authorized to speak about the matter, told POLITICO that Kennedy bypassed the committee during his January vaccine overhaul in order to move quickly on a presidential memorandum urging him to consider aligning the U.S. vaccine schedule with recommendations in other developed countries.

A ‘safety’ committee

For decades, there was almost “no daylight” between the committee's recommendations and the federal government’s, explained Jason L. Schwartz, an associate professor at Yale’s Department of Health Policy and Management.

While under Kennedy, the group has been left out of major decisions, Schwartz said he's worried that ACIP is becoming a forum where fringe ideas about vaccine risks can be aired, rather than “the centerpiece of how the federal government evaluates and promotes vaccines.”

When Joe Biden was president, former CDC Director Rochelle Walensky overrode the panel’s recommendations and broadly recommended Covid-19 boosters, but that was unusual. Schwartz said you can “count on one hand" cases in which the director or administration overrode its advisers.

The committee's role began to shift in 2025, he said, as Kennedy left it out of changes to the Covid recommendations and the panel abandoned best practices, such as its evidence-to-recommendation framework of reviewing existing vaccine data. In June, the panel dropped that framework and began devoting chunks of its meetings to presentations by vaccine skeptics.

The panel voted to downgrade recommendations for the hepatitis B vaccine in December after panel members and presenters suggested giving a dose to newborns could be linked to health complications, though they did not present enough data to establish those risks. The panel voted in June to stop recommending flu shots containing thimerosal, a mercury-based preservative the anti-vaccine movement and Kennedy have long targeted.

Those changes, which aligned with Kennedy’s views, were swiftly adopted by CDC Acting Director Jim O’Neill and Kennedy. American Academy of Pediatrics spokesperson Molly O'Shea thinks that's by design. “The way Secretary Kennedy is running HHS seems to be if ACIP agrees with his approach, and they can come to a quick decision …. they will definitely be part of the process,” she said.

Otherwise, O'Shea said, Kennedy has shown he is willing to leave them out.

Kennedy, for his part, said in January that future changes to the schedule will be “up to ACIP.” It’s unclear how long that mandate will hold.

The panel is scheduled to meet in February and hasn't said what members will vote on, but Milhoan told POLITICO he would like to revisit Covid vaccine safety.

As for the meetings slated for this year, Milhoan said: “What we're going to be doing is watching the safety signals."