View source for Advisory Committee on Immunization Practices

{{short description|Centers for Disease Control committee}}
{{Infobox government agency
| name = Advisory Committee on Immunization Practices
| logo = 
| jurisdiction = [[Politics of the United States|Government of the United States]]
| motto = 
| budget = 
| formed = {{Start date|1964|03}}
| employees =
| chief1_name = Grace M. Lee
| chief1_position = Chair
| parent_department =[[Centers for Disease Control and Prevention (CDC)]]
| website = {{URL|https://www.cdc.gov/vaccines/acip/index.html}}
}}
The '''Advisory Committee on Immunization Practices''' ('''ACIP''') is a [[National Immunization Technical Advisory Group|committee]] within the United States [[Centers for Disease Control and Prevention (CDC)]] that provides advice and guidance on effective control of [[vaccine-preventable disease]]s in the U.S. civilian population. The ACIP develops written recommendations for routine administration of [[vaccine]]s to the pediatric and adult populations, along with [[vaccination schedule]]s regarding appropriate timing, dosage, and [[contraindication]]s of vaccines. ACIP statements are official federal recommendations for using vaccines and [[immune globulin]]s in the U.S. and are published by the CDC.

In June 2025, secretary of health and human services [[Robert F. Kennedy Jr.]] fired all 17 ACIP members and—with one exception—appointed members who are either anti-vaccine activists or who lack expertise in vaccines.<ref name="advisory" />

ACIP reports directly to the CDC director, although its management and support services are provided by the CDC's [[National Center for Immunization and Respiratory Diseases]].<ref>{{Cite web |last= |date=2024-09-13 |title=ACIP Charter |url=https://www.cdc.gov/acip/about/acip-charter.html |access-date=2024-12-05 |website=U.S. Centers for Disease Control and Prevention |language=en-us}}</ref>

==Purpose and Impact==
{{further|Vaccination policy}}
The ACIP was established in March 1964 by the [[US Surgeon General]] to assist in preventing and controlling [[communicable diseases]],<ref>{{cite journal|title=History and Evolution of the Advisory Committee on Immunization Practices — United States, 1964–2014|journal=Morbidity and Mortality Weekly Report|volume=63|issue=42|pages=955–8|date=2014-10-24|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6342a5.htm|first1=Jean Clare|last1=Smith|first2=Alan R|last2=Hinman|first3=Larry K.|last3=Pickering|pmid=25340913 |pmc=5779473 }}</ref> it recommends licensed new vaccines to be incorporated into the routine [[immunization schedule]], recommends vaccine formulations, and reviews older vaccines to consider revising its recommendations; it is a key committee responsible for shaping U.S. [[vaccination policy]].<ref name=pmid20413002>{{cite journal |doi=10.1016/j.vaccine.2010.02.037 |pmid=20413002 |title=The structure, role, and procedures of the U.S. Advisory Committee on Immunization Practices (ACIP) |journal=Vaccine |volume=28 |pages=A68–A75 |year=2010 |last1=Smith |first1=Jean Clare |doi-access=free }}</ref>

As of 2023, with the [[Inflation Reduction Act]] changes to Medicare Part D coverage of vaccines, the [[Affordable Care Act]] and [[Medicare (United States)|Medicare]] insurance coverage of a vaccine ($0 cost sharing) are mandated when the CDC Director adopts the ACIP recommendation for the vaccines as published on the CDC website.<ref>{{Cite web |last=Duran |first=Vanessa |date=July 24, 2023 |title=Contract Year 2023 Guidance Related to Inflation Reduction Act Changes to Part D Coverage of Vaccines |url=https://www.cms.gov/files/document/irainsulinvaccinesmemo09262022.pdf |url-status=live |access-date=January 19, 2025 |website=CMS.gov}}</ref> Many private insurers follow [[Centers for Medicare and Medicaid Services]] precedent.

==Recommendation process==

Regularly scheduled ACIP meetings are held three times a year. Notices of each meeting, along with agenda items, are published in the [[Federal Register]] under the [[Federal Advisory Committee Act]] (FACA) requirements.  A vote on vaccine recommendations may be taken when a quorum of at least eight eligible ACIP members is present. Eligible voters are those members who do not have a [[conflict of interest]].  If there are not eight eligible voting members present, the ACIP executive secretary can temporarily designate ex officio members as voting members, as provided in the committee charter.<ref name=charter/> Meetings are advertised and open to the public and are now available online via webcast. The minutes of each meeting are available on the CDC website within 90 days of the conference.<ref name="auto">{{Cite web|title = ACIP Agendas, Minutes, Videos, Presentations {{!}} Immunization Practices {{!}} CDC|url = https://www.cdc.gov/vaccines/acip/meetings/meetings-info.html|website = www.cdc.gov|access-date = 2015-11-19}}</ref>

In October 2010, ACIP adopted the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework.<ref>{{Cite web|title = New Framework (GRADE) for Development of Evidence-Based Recommendations by the Advisory Committee on Immunization Practices|url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6118a3.htm|website = www.cdc.gov|access-date = 2015-11-19}}</ref> Their process includes a review of labeling and package inserts; a review of the scientific literature on the safety and [[Vaccine efficacy|efficacy]]; an assessment of cost-effectiveness; a review of the [[morbidity]] and [[death|mortality]] associated with the disease; a review of the recommendations of other groups; and a consideration of the feasibility of vaccine use in existing programs. Each piece of evidence is judged as very low, low, moderate, or high quality. Problems such as lack of reliability and biases are taken into account, and the quality of the evidence is adjusted accordingly. Vaccines suitable for nearly all persons in an age- or risk-factor-based group are assigned Category A. Category B recommendations are made for individual clinical decision-making between the patient and physician. Both Category A and Category B vaccines must be covered by insurance companies (following the [[Patient Protection and Affordable Care Act|ACA]]).<ref>{{Cite journal |pmid = 29678594|pmc = 6123258|year = 2018|last1 = Kempe|first1 = A.|title = Knowledge and Attitudes Regarding Category B ACIP Recommendations Among Primary Care Providers for Children|journal = Academic Pediatrics|volume = 18|issue = 7|pages = 763–768|last2 = Allison|first2 = M. A.|last3 = MacNeil|first3 = J. R.|last4 = O'Leary|first4 = S. T.|last5 = Crane|first5 = L. A.|last6 = Beaty|first6 = B. L.|last7 = Hurley|first7 = L. P.|last8 = Brtnikova|first8 = M.|last9 = Lindley|first9 = M. C.|last10 = Liang|first10 = J. L.|last11 = Albert|first11 = A. P.|last12 = Smith|first12 = J. C.|doi = 10.1016/j.acap.2018.04.005}}</ref>

At meetings, the ACIP may vote to include new vaccines in the VFC program or to modify existing vaccine schedules. These votes are codified as VFC resolutions. In most cases, a resolution takes effect after establishing a CDC contract for purchasing that vaccine in the necessary amounts.<ref>{{cite web |url = https://www.cdc.gov/vaccines/programs/vfc/providers/resolutions.html|date = 2015-06-30|access-date = 2015-11-20|title = The ACIP-VFC vaccine resolutions|publisher = National Center for Immunization and Respiratory Diseases}}</ref>

Recommendations are then forwarded to the CDC Director for approval. Once approved, the recommendations appear in the CDC's [[Morbidity and Mortality Weekly Report]] and represent the official CDC recommendations for immunizations in the US.<ref>{{Cite web|title = ACIP {{!}} Home {{!}} Advisory Committee on Immunization Practices {{!}} CDC|url = https://www.cdc.gov/vaccines/acip/|website = www.cdc.gov|access-date = 2015-11-19}}</ref>

===Working groups===

To ensure a thorough review of available information, ACIP often appoints working groups to assist in drafting its recommendations, composed of ACIP members, CDC staff, and others with immunization expertise. Workgroups work year-round to catalog specific vaccines and safety information. They review all available scientific information about vaccines which will be discussed at the next ACIP meeting so that they can present the relevant information after the vaccine is licensed at the meeting. Work groups do not vote on the final recommendation.

==Members==
The ACIP nominally contains fifteen regular members, each an expert in one of the following fields:<ref name="charter">{{cite web |title = ACIP charter|date = 2014-04-01|access-date = 2015-11-20|url = https://www.cdc.gov/vaccines/acip/committee/charter.html|publisher = National Center for Immunization and Respiratory Diseases}}</ref>
*immunization practices and public health
*use of vaccines and other immunobiologic agents in clinical practice or preventive medicine
*clinical or laboratory vaccine research
*assessment of vaccine efficacy and safety
*consumer perspectives and/or social and community aspects of immunization programs; at least one member must be an expert in this category.

No one currently employed by or involved with any employees of vaccine manufacturing companies or who holds a patent for a vaccine can be a member of ACIP. In addition, the ACIP includes ''ex officio'' members from Federal agencies involved with vaccine issues, and non-voting liaison representatives from medical and professional societies and organizations.<ref>{{cite web |title = ACIP members|date = 2015-09-30|access-date = 2015-11-20|url = https://www.cdc.gov/vaccines/acip/committee/members.html|publisher = National Center for Immunization and Respiratory Diseases}}</ref>
===2025===
Before leaving office in January 2025, the Biden administration's [[United States Secretary of Health and Human Services|Secretary of Health and Human Services]] [[Xavier Becerra]] approved the appointment of eight new members.<ref name="Stat">{{Cite web |last=Owermohle |first=Helen Branswell, Sarah |date=2025-01-31 |title=With little fanfare, Biden administration stacked vaccine advisory committee with new members |url=https://www.statnews.com/2025/01/31/vaccine-policy-acip-members-appointees-hhs/?utm_campaign=pharmalittle&utm_medium=email&_hsenc=p2ANqtz-9eA0BKvNGzDYLcYd_fbtAIbfb_-IUgbMvIQtuwVa_ZDpDrbHHs_KSiboNFKNYAdHkBdjmUdNRFxjUhe1BH2EzywSh8bQ&_hsmi=345120439&utm_content=345120439&utm_source=hs_email#:~:text=Before%20leaving%20office,%20President%20Biden's,administration%20to%20shape%20the%20panel |access-date=2025-02-01 |website=STAT |language=en-US}}</ref><ref>{{Cite news |date=2025-01-31 |title=Biden Stacked Vaccine Committee; Sickle Cell and Sudden Death; NFL Concussions Down |url=https://www.medpagetoday.com/infectiousdisease/vaccines/114020 |archive-url=http://web.archive.org/web/20250201115659/https://www.medpagetoday.com/infectiousdisease/vaccines/114020 |archive-date=2025-02-01 |access-date=2025-02-01 |language=en}}</ref> The decision to fill four newly created positions and replace four members whose terms were to end in June was described as being "motivated by a desire to try to insulate the scientific integrity of the panel from the incoming administration". The newly appointed members were seen as strong immunization supporters.<ref name="Stat"/><ref>{{Cite web |title=Biden's Parting Panacea: 8 Members Added To Vaccine Advisory Panel |url=https://kffhealthnews.org/morning-breakout/bidens-parting-panacea-8-members-added-to-vaccine-advisory-panel/ |access-date=2025-02-01 |website=KFF Health News |language=en-US}}</ref>

President [[Donald Trump]]'s Secretary of Health and Human Services [[Robert F. Kennedy Jr.]] was a prominent voice in the anti-vaccine movement, spreading anti-vaccine [[misinformation]], [[disinformation]], and [[propaganda]].<ref name="mnookin-2017">{{Cite magazine |last=Mnookin |first=Seth |date=January 11, 2017|title=How Robert F. Kennedy, Jr., Distorted Vaccine Science |url=https://www.scientificamerican.com/article/how-robert-f-kennedy-jr-distorted-vaccine-science1/ |url-status=live |archive-url=https://web.archive.org/web/20170112025044/https://www.scientificamerican.com/article/how-robert-f-kennedy-jr-distorted-vaccine-science1/ |archive-date=January 12, 2017 |magazine=[[Scientific American]] |quote=For more than a decade, Kennedy has promoted anti-vaccine propaganda completely unconnected to reality.}}</ref><ref name="KW"/><ref name="NBC_2021-03-11">{{cite news |last1=Zadrozny |first1=Brandy |author-link1=Brandy Zadrozny |last2=Adams |first2=Char |date=March 11, 2021 |title=Covid's devastation of Black community used as 'marketing' in new anti-vaccine film |url=https://www.nbcnews.com/news/nbcblk/covid-s-devastation-black-community-used-marketing-new-anti-vaxxer-n1260724 |url-status=live |archive-url=https://web.archive.org/web/20210318224620/https://www.nbcnews.com/news/nbcblk/covid-s-devastation-black-community-used-marketing-new-anti-vaxxer-n1260724 |archive-date=March 18, 2021 |access-date=March 15, 2021 |work=[[NBC News]] |quote=The video{{snd}}the newest in a series of anti-vaccine propaganda films produced or promoted by Kennedy{{snd}}was distributed through Kennedy's organization, Children's Health Defense,}}</ref><ref name="Smith_12/15/2021"/><ref name="Time20230614">{{Cite magazine |first=Vera |last=Bergengruen |date=June 14, 2023 |title=Inside the Very Online Campaign of RFK Jr. |url=https://time.com/6287001/rfk-jr-interview-2024-campaign/ |access-date=June 14, 2023 |magazine=[[Time (magazine)|Time]]}}</ref> In June 2025, Kennedy removed all 17 members of the ACIP and replaced them with only 8 new members.<ref>{{Cite web |last=Kekatos |first=Mary |date=2025-06-09 |title=RFK Jr. removes all 17 members of CDC's vaccine advisory committee |url=https://abcnews.go.com/Health/rfk-jr-removing-17-members-cdcs-vaccine-advisory/story?id=122670046 |url-status=live |archive-url=https://web.archive.org/web/20250610022328/https://abcnews.go.com/Health/rfk-jr-removing-17-members-cdcs-vaccine-advisory/story?id=122670046 |archive-date=2025-06-10 |access-date=2025-06-10 |website=[[ABC News (United States)|ABC News]] |language=en}}</ref> [[The Wall Street Journal|''The Wall Street Journal'']] published an editorial asserting that Kennedy's statement concerning the mass dismissals reveals a deliberate effort to stymie vaccine development: "His goal is to eliminate incentives to develop vaccines".<ref>{{Cite web |last=The Editorial Board |first= |date=June 10, 2025 |title=RFK Jr. conducts his vaccine purge |url=https://www.wsj.com/opinion/rfk-jr-vaccine-advisory-committee-purge-acip-hhs-pharma-2249465f |access-date=2025-06-11 |website=WSJ |language=en-US}}</ref> This action was identified by experts as Kennedy continuing a pattern of degrading public health protections in the United States based solely upon personal and political biases, disregarding clear evidence and scientific data.<ref>{{Cite web |last=Vaccine Integrity Project Staff and Advisors |date=2025-06-10 |title=Viewpoint: RFK's reckless firing of CDC vaccine advisors not supported by evidence |url=https://www.cidrap.umn.edu/covid-19/viewpoint-rfks-reckless-firing-cdc-vaccine-advisors-not-supported-evidence |access-date=2025-06-11 |website=The Center for Infectious Disease Research and Policy |language=en}}</ref><ref name="mole-acip">{{cite news |last1=Mole |first1=Beth |title=RFK Jr. announces 8 appointees to CDC vaccine panel—they’re not good |url=https://arstechnica.com/health/2025/06/yep-rfk-jr-appoints-anti-vaccine-advocates-to-cdc-vaccine-panel/ |access-date=16 June 2025 |work=Ars Technica |date=11 June 2025 |language=en}}</ref><ref>{{Cite web |last=Stolberg |first=Sheryl |author-link=Sheryl Gay Stolberg |date=June 11, 2025 |title=Kennedy Announces Eight New Members of C.D.C. Vaccine Advisory Panel |url=https://www.nytimes.com/2025/06/11/us/kennedy-cdc-vaccine-panel.html |url-access=subscription|access-date=June 11, 2025 |work=[[The New York Times]]}}</ref> [[Paul Offit]] described two of the appointees (Malone and Pebsworth) as anti-vaccine activists.<ref name="advisory" /> One of the new appointees, Michael A. Ross, withdrew prior to the first meeting.<ref name="withdraw">{{cite news |last1=Mandavilli |first1=Apoorva |title=Vaccine Panel Gutted by Kennedy Loses a Member Ahead of First Meeting|url=https://www.nytimes.com/2025/06/24/us/politics/rfk-jr-cdc-vaccine-panel.html |url-access=subscription|access-date=25 June 2025 |work=The New York Times |date=24 June 2025}}</ref>

{| class="wikitable" style="margin: 1em auto; width: 70%; text-align:left;"
|+ Members appointed by Robert F. Kennedy Jr., June 2025
! Portrait !! Name!!Position and expertise
|-
|
|Joseph Hibbeln||psychiatrist and nutritional scientist<ref name="advisory" /> without "discernible expertise" in immunology or vaccines.<ref name="Stolberg">{{Cite news |last=Stolberg |first=Sheryl Gay |date=2025-06-11 |title=Kennedy Announces Eight New Members of C.D.C. Vaccine Advisory Panel |url=https://www.nytimes.com/2025/06/11/us/politics/rfk-jr-cdc-vaccine-panel.html |access-date=2025-06-19 |work=The New York Times |language=en-US |issn=0362-4331}}</ref>
|-
| [[File:Martin Kulldorff.jpg|75px]] || [[Martin Kulldorff]]|| Swedish [[biostatistician]], developed tools for CDC's Vaccine Safety Datalink project, advocated for COVID 19 [[herd immunity]]<ref name="advisory" />
|-
| [[File:Retsef Levi, ראיון עם פרופ' רצף לוי על הדרך הנכונה לנהל את משבר הקורונה.png|75px]]
|[[Retsef Levi]]||professor of operations management at [[Massachusetts Institute of Technology]]<ref name="advisory">{{Cite web |date=2025-06-12 |title=Meet the new members of CDC's vaccine advisory panel |url=https://www.advisory.com/daily-briefing/2025/06/12/acip-members |access-date=2025-06-16 |website=www.advisory.com |language=en}}</ref>
|-
| [[File:Robert Malone (54361759880) (cropped).jpg|75px]] || [[Robert W. Malone]] || physician and researcher claiming to have invented mRNA vaccine<ref name="advisory" />
|-
|
|H. Cody Meissner||physician with expertise in pediatric infectious diseases and childhood vaccinations, professor of pediatrics at [[Geisel School of Medicine]] at [[Dartmouth College|Dartmouth]]; ACIP member from 2008 to 2012<ref name="advisory" /><ref>{{cite web |title=NVAC Public Member: H. Cody Meissner, MD |url=https://www.hhs.gov/vaccines/nvac/members/cody-meissner/index.html |website=HHS.gov |access-date=16 June 2025 |language=en |date=10 February 2017}}</ref>
|-
|
|James Vincent Pagano||ED physician<ref name="advisory" /><ref>{{cite web |title=Docinfo profile James Vincent Pagano, MD |url=https://www.docinfo.org/doctor-profile/97ea96af-6ec6-411f-a7a4-55aff56a7b7c |website=Federation of State Medical Boards of the United States |access-date=16 June 2025}}</ref> without "discernible expertise" in immunology or vaccines.<ref name="Stolberg"/>
|-
|
|Vicky Pebsworth||board member of the anti-vaccine group [[National Vaccine Information Center]],<ref name="mole-acip"/> nurse, Ph.D. in public health,{{Better source needed|reason=Can't confirm PhD area of focus|date=June 2025}} prior [[Vaccines and Related Biological Products Advisory Committee]] member<ref name="advisory" />
|}

== Selected recommendations ==
On February 26, 2015, ACIP voted to deliver a Category A recommendation for administering MenB vaccines to persons older than 10 years who were at higher risk of meningococcal disease.

On June 24, 2015, ACIP heard the arguments for recommending Pfizer and Novartis's serogroup B meningococcal vaccines for everyone in the 16-22 age group. The vaccines were licensed to be administered to persons 10 to 25 years of age.  ACIP was unable to grade all of the evidence according to the GRADE system, but they considered the evidence given to be of enough quality to consider a recommendation. The proposed wording was as follows:

“A serogroup B meningococcal (MenB) vaccine series may be administered to adolescents and young adults 16 through 23 years of age to provide short-term protection against most strains of serogroup B meningococcal disease. The preferred age for MenB vaccination is 16 through 18 years of age. (Category B)”<ref name="auto"/>

The motion was passed, 14 to 1.

In 2020, ACIP created a phased vaccine allocation recommendation for the [[COVID-19 vaccine|COVID vaccines]].<ref>{{Cite web|title=National Academies release framework for equitable allocation of a COVID-19 vaccine for adoption by HHS, state, tribal, local, and territorial authorities|url=https://www.sciencedaily.com/releases/2020/10/201002111729.htm|access-date=2021-01-01|website=ScienceDaily|language=en|date=2020-10-02}}</ref><ref>{{Cite journal|last=Oliver|first=Sara E.|date=2020|title=The Advisory Committee on Immunization Practices' Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine — United States, December 2020|journal=MMWR. Morbidity and Mortality Weekly Report|language=en-us|volume=69|issue=50|pages=1922–1924|doi=10.15585/mmwr.mm6950e2|pmid=33332292|pmc=7745957|issn=0149-2195|doi-access=free}}</ref><ref name=vox>{{Cite web|title=Who should get the vaccine first? The debate over a CDC panel's guidelines, explained.|url=https://www.vox.com/future-perfect/22193679/who-should-get-covid-19-vaccine-first-debate-explained|website=Vox|language=en|first=Kelsey|last=Piper|date=2020-12-22|access-date=2021-11-15}}</ref>

In the 2024 case of ''[[Braidwood v. Becerra]]'', the [[United States Court of Appeals for the Fifth Circuit]] entertained questions about the constitutionality of ACIP recommendations having certain binding legal effects, pursuant to the [[Presentment Clause]] of the [[Constitution of the United States]], since members of the body are not appointed by the president to be confirmed by the Senate. Although the court did not decide that using such ACIP recommendations was unconstitutional, it held that another board that similarly made recommendations with binding legal effects was unconstitutional and remanded the question of the constitutionality of ACIP's role to the district court.<ref>{{Cite web|url=https://www.healthaffairs.org/content/forefront/braidwood-v-becerra-threat-preventive-services-just-got-worse|title=Braidwood v Becerra: The Threat to Preventive Services Just Got Worse|first1=Richard|last1=Hughes IV|work=Health Affairs|date=June 28, 2024}}</ref>

== Resources ==

* [https://www.cdc.gov/acip/meetings/index.html ACIP Meeting Information]
* [https://www.cdc.gov/acip-recs/hcp/vaccine-specific/index.html Vaccine-Specific Recommendations] 
* Most Recent Immunization Schedules
** [https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html Children and Adolescents] 
** [https://www.cdc.gov/vaccines/hcp/imz-schedules/adult-age.html Adults]

==See also==

* [[National Immunization Technical Advisory Group]], generic terms for immunization advisory committee 
* [[Joint Committee on Vaccination and Immunisation]], the [[National Health Service]] counterpart in the [[United Kingdom]]
* [[National Advisory Committee on Immunization]], immunization advisory committee in [[Canada]]
* [[Standing Committee on Vaccination]], immunization advisory committee in [[Germany]]

==References==
{{reflist}}

==External links==
* [https://www.cdc.gov/vaccines/acip/index.html ACIP home page]

{{vaccines}}
{{Vaccine safety}}
{{authority control}}

[[Category:American advisory organizations]]
[[Category:Vaccination-related organizations based in the United States]]
[[Category:Medical and health organizations based in Georgia (U.S. state)]]