Welcome to our biweekly series in partnership with CIDRAP at the University of Minnesota.
If you’ve seen The Good Place, you likely remember the stretch of episodes in Season 2 where Michael keeps resetting his fake “Good Place” neighborhood.
Over and over and over.
Each reset is a fresh attempt to make the same arrangement work. Needing another one each time is a reminder that the last version didn’t hold up.
The American Academy of Pediatrics (AAP) v Kennedy case has followed a similar rhythm. Since District Judge Brian Murphy’s March 16th stay left the Advisory Committee on Immunization Practices (ACIP) without a quorum, the government has tried rewriting the ACIP charter (April), rewriting it again (May), and issuing an Executive Order in late May. Then last week, a request to fast-track the related appeal arrived—88 days after the original stay was issued.
There is still no quorum, and that’s a gap that both sides agree needs to be filled. After all, fall respiratory vaccine recommendations have to come from somewhere. Let’s discuss…
The PDF version of today’s update is here. Read past installments here and today’s update on the Unbiased Science Substack here.
Hurry Up and Wait (Then Hurry Up Again)
Since we last wrote, the Department of Health and Human Services (HHS) asked the court to expedite its appeal of the stay and set a shorter briefing schedule, arguing the ACIP wouldn’t be able to act in time for fall respiratory season otherwise. AAP opposed the motion, and the court resolved it by setting a briefing schedule. However, in this context, “expedited” means the response brief is due July 16th, with another reply to follow after that. That is still too late to matter for fall vaccine ordering timelines that they purport to be racing against.
But the concern is manufactured, because there’s nothing inherently stopping the ACIP from meeting if fall immunizations were truly the motive here. The stay blocks the current ACIP appointees, specifically. If new, qualified members were appointed through the standard vetting process, the ACIP could reconvene and issue recommendations while the broader litigation continues.
It took the government 44 days to file its initial Notice of Appeal after the stay. It took another 44 days to request that the appeal be expedited. None of the deadlines driving the urgency were a surprise. The fall respiratory season arrives around the same time every year. The ACIP itself had a meeting on the books for June 24th through 26th since the beginning of the year, which has since been canceled due to ongoing litigation. Insurers have already committed to covering vaccines that were ACIP-recommended as of September 1, 2025, with no cost-sharing through the end of 2027, regardless of how this case turns out. None of it was unpredictable. So, why did it take nearly three months to call it urgent?
Approved COVID-19 Vaccine Formulation Stuck in ACIP Limbo
On May 28th, the U.S. Food and Drug Administration’s (FDA’s) Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted to recommend that the fall 2026-27 COVID-19 vaccine target the XFG strain. The FDA adopted the recommendation the following day. Normally, the next stop would be the ACIP, which would make the official recommendation on who should receive the vaccine and how the costs would be covered. With no functioning ACIP, that hasn’t happened.
Beyond the expedited appeal, federal procurement records show that in early June, the Centers for Disease Control and Prevention (CDC) invested roughly $1.24 billion in COVID-19 vaccine contracts with Pfizer for both pediatric and adult vaccines for fiscal years 2026 and 2027, as well as separate agreements with Moderna and Sanofi. HHS Secretary Robert F. Kennedy Jr. has denied the framing of these contracts, saying that they are indefinite delivery agreements that “ensure availability if needed” but aren’t representative of a completed purchase.
Aaron Siri, the vaccine injury lawyer and Kennedy ally that we’ve covered before, sent a letter last week demanding that the contracts be canceled, arguing that the vaccines cannot be administered through the Vaccines for Children (VFC) program without an ACIP recommendation. But the ACIP already approved the inclusion of COVID-19 vaccines in the VFC program in 2022, so it does not need to reaffirm its recommendation.
A Rare Hand of Flu Vaccine Wild Cards
If February’s flu vaccine debacle was a double-reverse card, then VRBPAC’s vote on June 18th was the rarest hand in the deck consisting of all wild cards.
The committee voted unanimously (9-0) to recommend Moderna’s mRNA influenza vaccine (mFlusiva) for adults aged 50 through 64 through the traditional approval pathway, and for adults 65 and older under an accelerated approval process requiring an additional post-marketing safety study. This was VRBPAC’s first review of a new vaccine application since 2023, and a memorable turnaround for a product that the FDA had previously refused to even review back in February, reversing course just a few days later. The FDA’s ultimate decision to adopt VRBPAC’s recommendation is due by August 5th.
If the right pieces fall into place, the vaccine could be available for the upcoming respiratory viral season. But Mamma Mia, here we go again. VRBPAC makes recommendations for FDA licensure. But the ACIP ultimately decides who gets the vaccine and whether insurers should cover it.
The importance of the flu vaccine cannot be overstated. Two months after Defense Secretary Pete Hegseth lifted the flu vaccine requirement for U.S. troops, a flu outbreak has infected at least 275 recruits in basic training at the Lackland Air Force Base in Texas, where quarters are close and therefore infectious diseases thrive. Recruits receive vaccines (including flu) on a rolling basis when they enter basic training, regardless of the season. However, reports suggest that only about 40% of new recruits received their flu vaccine once it became optional, compared to nearly 100% before the mandate was lifted. Already, the flu vaccine mandate is back in place.
Spotlight on the Sudden Infant Death Playbook
In this session for state legislators, beneath the overt anti-vaccine legislation we covered here (vaccine exemptions, schedule changes), ran a quieter campaign: bills introduced across many states built on a debunked link between vaccines and sudden infant and child deaths.
A quick terminology, note because these bills use a lot of acronyms: Sudden unexpected infant death (SUID) is the umbrella category for any sudden, unexpected death in an infant under 1 year of age. Under that umbrella term, sudden infant death syndrome (SIDS) is a diagnosis of exclusion that is assigned after other causes of death have been ruled out. For deaths that occur after age 1, the parallel term is sudden unexplained death in childhood (SUDC), under the umbrella term of sudden death in the young (SDY). We will refer to SUID from now on for simplicity, but these bills actually use all of these acronyms.
Using recycled language from state to state, the bills would require coroners to record a child’s recent vaccination history on any autopsy reports for sudden or unexplained infant and child deaths. It was signed into law in Oklahoma in May and in Louisiana in June. Similar bills were introduced in states such as Mississippi, Iowa, Florida, and South Carolina, but stalled. One such bill made it to the governor’s desk in Arizona before it was vetoed last week.
Collecting as much information as possible when a child dies is a no-brainer, and, for grieving parents and caregivers, no policy could touch what it means to cope with the loss of a child. But behind the facade of empathy and emotion, these bills are explicitly built around a claim unsupported by scientific evidence that SUID is caused by vaccination.
Another aside: studies have shown either no association between vaccines and SUID, or a slightly lower risk of SUID among vaccinated children. Nobody is claiming that vaccines directly prevent SUID, but families who vaccinate their children on schedule tend to also follow other health recommendations.
Most infant deaths occur within the first few months of life. This is also when most infants receive several routine vaccines. The overlap is coincidental, but in a way that makes it easy to exploit. Requiring that vaccines be noted on autopsy reports does not add scientific rigor, because, by timing alone, most sudden infant deaths will occur near a vaccination.
The unfounded claims about a causal relationship between vaccines and SUID hinge on the Vaccine Adverse Event Reporting System (VAERS), a passive database in which anyone can report a health event after receiving a vaccine. The system is valuable for detecting safety signals, but frequently misused, because a report shows only that an event occurred after a vaccine, not that the vaccine caused it. In fact, this is the same error that was made in a recently removed journal article by Neil Z. Miller, who has largely been the face of the push for SUID legislation. Recently, Kennedy wrote to the journal demanding a full explanation for the removal.
The legislative push applies the same flawed logic at scale, creating an even larger passive surveillance source in which correlations will be cited as evidence. Compiling results from each state in which the legislation passes could create an even larger dataset that is difficult to push back against, despite its manufactured nature. And while most legislative sessions have wrapped up, this plan of attack will likely continue into subsequent years.
What Else We’re Watching
- COVID-19 vaccines still work. A CDC study showing the effectiveness of updated COVID vaccines was published in JAMA Network Open with the same methods that caused the publication to be blocked from publication in the CDC’s Morbidity and Mortality Weekly Report this spring by Acting CDC Director Jay Bhattacharya due to “methodological concerns.” The analysis found that the updated COVID vaccine halved the odds of an emergency department visit or hospitalization among healthy adults, consistent with results from previous seasons.
- Another new name floated for FDA head. The permanent commissioner position for the FDA has been vacant since last month following Marty Makary’s departure. Bloomberg reports that Dr. Heidi Overton is now a finalist to run the agency, though nothing has been officially decided. Overton holds a medical degree and doctorate in clinical investigation from Johns Hopkins, and is currently a presidential adviser on domestic policy.
- An inquiry was opened into HHS’s vaccine policy. Senate Finance Committee Democrats sent Kennedy a letter urging HHS to provide documentation about how the ACIP was overhauled, including details like who signed off, which risks were considered, and the process for new member screening. As the minority party, Democrats cannot force the agency to respond, but the letter likely lays groundwork for more stringent oversight in the future, depending on how midterm elections shape up.
- The Office of Management and Budget (OMB) proposed a sweeping rework of federal grant oversight. The proposed rule would significantly affect how research is both funded and conducted across the National Institutes of Health and other agencies. Individual comments carry more weight than form letters, and comments don’t need to be long or technical. The public comment period is open until July 13 if you would like to submit something.
Michael kept resetting the neighborhood because each version collapsed the moment anyone looked closely. The reset button works only until people stop forgetting. We’re not forgetting; and neither, it seems, are the courts, the insurers, or the manufacturers already making this year’s shots.
As a reminder, we have a dedicated inbox for reader questions about vaccines and vaccine policy. Whether it’s something you saw in the news or a question you just can’t find the answer to, send it to vaccines@unbiasedscience.com. Your questions directly shape the content that we cover.
Stay Curious,
Unbiased Science