Specifically, the VIP will investigate practices to strengthen scientific independence, conflict-of-interest safeguards, transparency, emergency response protocols, and sharing across presidential administrations.
“It will be an examination of how this process has evolved and how it occurs today and then looking at whether other things could be done to improve transparency or to improve how input is gathered from the public, from experts,” said Kevin Griffis, director of media relations and public affairs at CIDRAP. “Ultimately we want to wind up with an ACIP and CDC recommendation and evaluation process that can generate as much confidence from the public as possible.”
‘A hard time to be alive’
The Evidence Collective’s Rebuilding Vaccine Governance project will look at the groups currently involved in vaccine recommendations to understand what shapes vaccine recommendation development, regulation, communication, and implementation. The organization plans to have conversations about how to “rebuild trust in vaccines and science and public health more broadly,” said Elisabeth Marnik, PhD, executive director of The Evidence Collective.
“We are all concerned by what’s happening in this moment, but we also recognize that the solution isn’t just to go back to the ways things were,” said Marnik. “The world we live in now is so different, and just saying it’s enough to go back to the way things were ignores the fact that the ways thing were, were not perfect, and also contributed to what’s happening in the moment.”
David Higgins, MD, MPH, project lead for The Evidence Collective, agreed.
“In the past year and a half there has been significant disruption to the vaccine policy landscape, and that’s in part due to some of the actions and activities of the current health administration,” Higgins said. “Trust in healthcare professionals, in your child’s doctor, in your doctor, remains pretty resilient, surprisingly resilient. But trust in many of the institutions, organizations, and processes upstream of that have been declining year over year for several years now, predating the current health administration.”
First convened in 1964, ACIP became the international gold standard for evidence-based vaccine recommendations. While some critics allege that ACIP doesn’t consider all perspectives, recent changes could be an opportunity to improve the vaccine evaluation and recommendation process and rebuild some lost trust.
“A lot of people are upset and frustrated and burnt out, because it’s a hard time to be alive,” Marnik said. “Change is possible. But change will never happen if we don’t try.”
Opportunity to improve on the past
The past 18 months have been tumultuous for federal vaccine policy. Last year, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. dismissed all previously appointed members of ACIP and replaced them. The department also changed the childhood immunization schedule, slashing the number of recommended vaccines from 17 to 11 to align with “peer nations” like Denmark.
A judge later blocked these efforts, and currently there’s no working ACIP. An executive order from the White House last month indicates the administration wants ACIP to defer to HHS when it comes to vaccine policy.
“This moment where the policy process has essentially gone off the rails does give us opportunity to step back and examine how we’ve done things in the past and whether there are opportunities to make the process better, make them more transparent, and do more to ensure the independence of groups like ACIP,” Griffis said.
“There will be a moment in the future, in all likelihood, where future health leaders are going to take a look at how this process has been done, and see whether there are opportunities to improve it,” he added. “This is an avenue to ensure that we have some options out there.”