‘Uncharted Waters’: Stanford Doctor Fired From US Vaccine Panel by RFK Jr. Speaks Out

Dr. Yvonne Maldonado found out she’d been fired from a key federal vaccine advisory panel by reading Secretary Robert F. Kennedy Jr.’s op-ed in the Wall Street Journal on Monday.

While her firing wasn’t entirely surprising, she said, “I was still shocked at the method and the unprecedented termination of all 17” members of the Advisory Committee on Immunization Practices.

The committee, which was relatively obscure until this week, wields tremendous influence over vaccine adoption across the country. Its recommendations to the Centers for Disease Control set the grounds for which vaccines are provided free of charge to low-income children and which immunizations insurance companies can be expected to cover.

Two days after the mass firing, Kennedy appointed eight new members to the committee, saying the complete turnover of the board was a “major step towards restoring public trust in vaccines.”

“ I think it’s pretty disruptive,” Maldonado said. “And so, disruption generally doesn’t sow trust.”

Maldonado is a professor of global health and infectious diseases at the Stanford University School of Medicine, and an infectious disease epidemiologist and vaccinologist. She has been a voting member of ACIP since last June and served as liaison to the committee for the American Academy of Pediatrics from 2018 to 2022.

Dr. John Swartzberg, a vaccine expert and professor emeritus at the UC Berkeley School of Public Health, likened the firings of Maldonado and her colleagues to the CDC “cutting off half its brain.” In an email, the California Department of Public Health called the “abrupt removal” of the committee members “deeply troubling for the health of the nation.” The governors of California, Oregon and Washington have also condemned the move.

Continuity has been a key feature of the committee up until now. Members are generally appointed to staggered four-year terms, and usually, there is a vetting process for approving new members that Maldonado said can take months or even years. Because the committee’s recommendations have such a broad reach, she said, it is key to have members who work with a range of demographic populations — from infants to people who are immunocompromised — and who represent expertise in a range of fields.

“We’re in completely uncharted waters here. Completely,” Maldonado said. “We have no knowledge of, number one, how these committee members were selected, when they were selected, what information they had to submit; that may or may not become public — we don’t know.”

The U.S. Department of Health and Human Services did not directly respond to KQED’s questions about how the new panelists were chosen or vetted.

The new members include doctors who have served on federal vaccine advisory committees in the past, as well as an emergency room doctor from Los Angeles and a professor of operations management at the Massachusetts Institute of Technology. Many of them have expressed skepticism about vaccines and the COVID-19 vaccine in particular.

“Secretary Kennedy has replaced vaccine groupthink with a diversity of viewpoints on ACIP,” a spokesperson for the agency wrote in an email. She also said that “the new members’ ethics agreements will be made public” before they start work on the committee, which is scheduled to meet on June 25.

In his op-ed, Kennedy said that part of the reason a “clean sweep” was needed was because members of the board who were fired “have received substantial funding from pharmaceutical companies, including those marketing vaccines.”

On the CDC’s website, a page listing the former members’ stated conflicts of interest shows that Maldonado, who was part of the team working on the Pfizer COVID-19 and RSV vaccine trials, abstained from voting on those vaccines.

Maldonado did not want to comment on the makeup of the new board, saying “it wouldn’t be fair” to judge ahead of time.

Her concern was more practical. A number of different vaccines for different populations are discussed at committee meetings, and she said preparation involves ingesting a great deal of material from working groups and subject matter experts.

“For every single member to be able to have that information at their fingertips, review it and be ready for this meeting is going to be, I would say, challenging,” she said.

According to the Federal Register, the newly formed committee is expected to vote on recommendations for “COVID-19 vaccines, HPV vaccine, influenza vaccines, meningococcal vaccine, RSV vaccines for adults, and RSV vaccine for maternal and pediatric populations” at its June meeting.

In the short term, Maldonado said her biggest question is about the upcoming fall, when we can expect to see flu, COVID-19 and RSV make a resurgence.

”Are those vaccines going to be recommended?” She asked. “Are they not?”

Whatever the committee decides will have a huge impact on public health.

In the wake of the pandemic, Maldonado acknowledged that there are “ significant issues around vaccine confidence.” She said she hopes that this doesn’t make those issues worse.

“We don’t see a pathway to that yet,” she said.