No ACIP this week

This week, ACIP was supposed to meet. But the legal battle led by the AAP (American Academy of Pediatrics) against HHS and RFK Jr. over the process for selecting members remains in limbo. The meeting has been officially canceled.

Every June, ACIP meets to discuss the annual respiratory season vaccines (like the new formulations of the flu and Covid-19 vaccines). Traditionally, this is one step in a long chain of dominoes to ensure that people have access to the vaccines they need by September. So, what does it mean for this one particular domino to be absent?

The answer is: Not much. Thanks to the massive coordination outside of the federal government to provide an alternative pathway forward. This means vaccines will be available at no out-of-pocket cost to Americans this fall.

Vaccine approval process with possible alternative pathways. Figure by Your Local Epidemiologist.

There are three roles ACIP has traditionally played:

1. Recommends who should get the vaccines. The professional organizations, as well as the Vaccine Integrity Project, have been stepping up and covering this step. This should come in early Fall, then trigger vaccine campaigns.

2. Triggers health insurers to cover the vaccine. The national health insurance group (AHIP) has already announced that its members will cover vaccines at no out-of-pocket cost for patients.

3. The Vaccines for Children program is a federal program that ensures vaccines are free for 50% of all US Children (those who are uninsured, underinsured, or enrolled in Medicaid). Reassuringly, the ACIP vote is more of a formality than a hurdle for annual fall vaccines. There is some risk that the federal government declines to purchase the vaccines, but we rank this risk low given the political fallout that would follow.

This is still the case even if CDC doesn’t sign off on fall vaccine recommendations. This is even the case among states that have not decoupled from ACIP. The Common Health Coalition put together this scenario planning table.

So operationally, everything should be covered. The real threat is chaos, confusion, and doubt that disrupt vaccine access and uptake. The antidote to this is two things: clear communication that vaccines will be available at no out-of-pocket cost to patients and families this fall and clear evidence-based recommendations about who should get them. The first is secured, and the second will come from professional societies, and clinicians and patients should look there.

Best,
TEC and CHC (Common Health Coalition)