RFK Jr.’s Vaccine Panel Votes Down Its Own Proposal to Require Prescriptions for Covid-19 Shots

On the second day of a pivotal vaccine meeting that was at times heated, confusing, and chaotic, a group of federal advisers chosen by Health and Human Services secretary and longtime anti-vaccine activist Robert F. Kennedy Jr. voted against requiring a prescription to receive a Covid-19 vaccination.

The vote took place after hours of discussion, in which several advisers sowed doubts about the Covid-19 vaccines and went on tangents about their safety and efficacy—both of which have been well-established.

The group, known as the Advisory Committee on Immunization Practices, or ACIP, was tasked with considering whether state and local jurisdictions should require a prescription for the administration of a Covid vaccine. ACIP has historically provided expert advice to the Centers for Disease Control and Prevention on vaccine usage. The current committee is made of 12 members installed by Kennedy after he dismissed all 17 previous sitting members in June. Several members have expressed anti-vaccine views, and five of them were appointed just this week.

Some of the new ACIP members were seemingly unaware that recommendations made by the committee are tied to insurance coverage, and that in many states, they determine what immunizations a pharmacy is allowed to administer.

After hearing from a workgroup member and liaisons from professional medical and pharmacy groups on how a yes vote would overwhelm doctors’ offices with prescription requests and restrict access to Covid vaccines, the committee voted 6-6 on whether to require a prescription. Since it was a tie, the decision went to the ACIP chair, Martin Kulldorff, who voted no.

“I'm really concerned about the requirement of a prescription, because I believe the segment of the population that is underinsured, has lack of access to health care, they're going to be unable to get a prescription, and those are the people that are at highest risk for a lot of these,” said ACIP member Catherine Stein, an epidemiologist at Case Western Reserve University, who was previously critical of the US response to Covid-19 but voted “no” on the issue.

Access to Covid-19 vaccines is already muddled after the Food and Drug Administration’s recent move to limit eligibility for the latest version of the shots. In August, the agency approved updated Covid vaccines but only for people 65 and older, or those who are younger with underlying health problems that makes them at risk for severe disease complications. Previously, Covid vaccines were approved for anyone 6 months or older.

But the recent FDA changes mean that in some states, pharmacies are currently not offering the jab. Other states, meanwhile, are taking steps to preserve access—during the panel’s meeting, for example, Michigan’s chief medical executive issued a standing recommendation stating that anyone who has not received a seasonal and FDA-approved Covid-19 vaccine is considered to have an underlying condition making them eligible for one.

On Friday, the committee also voted on a vague proposal to recommend that Covid vaccination be based on “individual-based decision-making” for those ages 6 months and older. Ostensibly, it would mean that people wanting to get a vaccine would first need to have a conversation with a health care provider about the risks and benefits of vaccination.

In another vote, advisers recommended adding language on the shot’s risks to the vaccine’s information sheet, which is already required by law.

The committee’s focus on Covid-19 vaccines reflects Kennedy’s long-held suspicion of them. Since taking office in February, Kennedy has canceled a half-billion dollars in mRNA vaccine research and separately ended a major contract with Moderna, one of the Covid vaccine manufactures, for work on a pandemic bird flu vaccine.

During Friday’s meeting, CDC scientists presented extensive data on the safety and efficacy of the Covid vaccines. They also explained in detail how the agency tracks Covid hospitalizations and said the agency has a “rigorous and standardized process” to determine whether hospitalizations are classified as being due to Covid-19.

During the discussion portion of the meeting, committee members made several unfounded claims. Robert Malone, a former mRNA researcher who has spread vaccine misinformation, questioned whether there is actually evidence of disease protection from the Covid shots. "Are there any well-defined, characterized correlates of protection for Covid, yes or no?" he demanded.

Cody Meissner, a pediatrician at Dartmouth College, responded that there is “a reasonable measurement of neutralizing or binding antibodies that correlate with protection against symptomatic infection in the first few months” after vaccination.

At one point, Hillary Blackburn, a pharmacist on the committee, questioned whether the Covid vaccine could be connected to her mother’s lung cancer diagnosis, which occurred two years after receiving a Covid vaccine. She said she is aware of four other individuals in her small hometown diagnosed with the same kind of cancer. “Is it related to the vaccine?” she asked.

In a tense exchange about potential birth defects associated with the Covid vaccines, some ACIP members pressed manufacturer Pfizer about eight birth defects that occurred in a group of pregnant women who received the company’s vaccine and two birth defects that occurred in an unvaccinated group. Alejandra Gurtman, who heads vaccine clinical research and development at Pfizer, replied that those rates are comparable to rates of congenital abnormalities seen in the general population.

Carol Hayes, a liaison with the American College of Nurse-Midwives who was present during the meeting, clarified that most birth defects arise during the first trimester of pregnancy, and in the cited study, mothers received the vaccine at 12 to 24 weeks of pregnancy.

At Friday’s meeting, the committee also reversed a decision it made just a day before. On Thursday, advisers voted to no longer recommend the combined measles, mumps, rubella, and varicella (MMRV) vaccine to children under age 4. Yet puzzlingly, it voted to maintain coverage of that vaccine through the federal Vaccines for Children program, which provides free vaccines to low-income children and those without insurance. On Friday, they voted that the program should not, in fact, cover it.

On Friday, advisers also voted 11 to one in favor of tabling a decision on whether to delay the birth dose of the hepatitis B vaccine until one month of age. The committee had discussed that vaccine extensively on Thursday, though it’s unclear why the committee was asked to look into the potential change at all, as the hepatitis B vaccine has been given to newborns in the US since 1991.

Infants get the vaccine before leaving the hospital because the virus can be passed from an infected mother to the baby during birth. Hepatitis B is a serious liver infection that can lead to cirrhosis and cancer. The vaccine is highly effective at preventing infection in newborns.

Chari Cohen, president of the Hepatitis B Foundation, tells WIRED there is no scientific rationale for delaying the hepatitis B vaccine until one month after birth, and she worries about an increase in hepatitis B infections if the panel eventually recommends delaying the immunization.

“We will likely see more babies and young children who become infected,” Cohen says. “From a public health infrastructure perspective, we are concerned that this risk-based approach will miss preventing infection to babies born to infected moms.”

Up to 16 percent of HBV-positive pregnant women don’t get tested for hepatitis B, so screening doesn’t capture all infected mothers.

“We do not understand the motivation or rationale for this debate," Cohen says.