ACIP - Advice or Policy?

Clarifying fundamental misunderstandings

Corporate media, many of the medical guilds, and even certain Senators apparently do not understand what the Advisory Committee on Immunization Practices (ACIP) actually is and what it is not. Based on my personal experience, even some current ACIP members misunderstand the charter and scope of responsibilities of the ACIP. This essay seeks to clarify and correct these misunderstandings explicitly.

Speaking plainly, the ADVISORY committee on immunization practices (ACIP) is one example of a Federal ADVISORY committee, constituted under the Federal ADVISORY Committee Act (FACA). The ACIP does not make policy, it provides advice to policy makers. Federal health policymaking is the responsibility of elected officials or those appointed by the executive (POTUS or his designees such as the Secretary, HHS). FACA committees do not make policy; they provide independent advice to policymakers. This is a critical function and role. Policy makers receive information from a wide range of sources - lobbyists, public interest groups, individual members of the public, industry organizations (such as medical guilds), and their respective bureaucracies- a long list of stakeholders whose interests often compromise their independence and objectivity. Accessing advice from an independent group empaneled by relevant policy maker(s) is essential to avoiding various forms of bias, groupthink, and sycophants. This is true in both industry and in government. Good decisions require diverse, independent thought and advice.

The ACIP does not establish vaccine policy for the Federal Government. By Federal Statute (FACA), the ACIP may only provide advisory recommendations (no decision-making authority). The Director (or acting Director) of the CDC holds that responsibility. The ACIP ADVISES the CDC Director. Functionally, the ACIP serves as an independent ADVISORY panel to the CDC Director. Using a private-sector analogy, the CDC Director would be akin to an executive-level client who has contracted an independent consultancy to provide advice on questions the client may have regarding vaccines and vaccine-preventable diseases.

Neither the ACIP nor the Federal Government establishes vaccine policy for the States. Each State has the right and responsibility to regulate the practice of medicine in that state (see for instance Dobbs v. Jackson Women's Health Organization, 597 U.S. 215 (2022)). If a State wishes to adopt or not adopt Federal (CDC) vaccine recommendations is up to each individual state. According to the Association of State and Territorial Health Officials' review of over 600 state and territorial laws and regulations that reference ACIP, such laws may direct the use or consideration of ACIP recommendations in several circumstances, including in defining the scope of

(1) immunization requirements for school enrollment and attendance,

(2) vaccine coverage by certain health plans, and

(3) immunizations certain health care professionals (such as pharmacists) are authorized to administer.

Why use a Committee?

All bureaucracies and elected officials use committees to diffuse or create a cover for plausible deniability when choosing and implementing difficult decisions, particularly ones that may involve ambiguous topics. By creating and assigning difficult topics to a committee, responsibility for decisions and consequences can be assigned to a diffuse, unaccountable group rather than to a single individual. Historically, the capture of the ACIP by CDC bureaucracy has functioned to protect career government employees from the consequences of their actions.

What is the ACIP?

On September 15, 2025, the Congressional Research Service (CRS) published a report entitled “The Advisory Committee on Immunization Practices (ACIP)” for the Library of Congress. This report reflects and summarizes both the statutory basis for the ACIP and the current ACIP charter and policy manual. Historically, there have been many revisions to the ACIP charter and policy manual. The current ACIP charter and policy manual is being revised.

The CRS summarizes the ACIP as follows:

The Advisory Committee on Immunization Practices (ACIP) is a committee of experts who make recommendations to the Department of Health and Human Services (HHS) regarding the use of vaccines and related agents for the control of vaccine-preventable disease in the U.S. civilian population. As a critical function, ACIP recommendations have informed the Centers for Disease Control and Prevention’s (CDC’s) annual immunization schedules of recommended vaccines for both children and adolescents (18 years of age and younger) and adults (19 years of age and older). ACIP has also made recommendations for nonroutine vaccines, including for travel or for emergencies such as disease outbreaks.

On June 9, 2025, HHS Secretary Robert F. Kennedy Jr. removed the 17 then-sitting ACIP committee members and has since appointed several new members. To date, ACIP’s official charter and its policy manual have remained as they were prior to the current Administration.

ACIP Establishment and History

The Surgeon General established ACIP in March 1964 under Section 222 of the Public Health Service Act (PHSA; 42 U.S.C. §217a), a general authority that allows appointment of advisory committees. ACIP was created to provide ongoing expert advice to the Surgeon General on federal immunization policy as several new vaccines came to market and federal immunization programs expanded (the Surgeon General oversaw federal immunization programs at the time). In 1972, ACIP was designated a federal advisory committee under the Federal Advisory Committee Act (FACA, P.L. 92-463; provisions of FACA have moved to 5 U.S.C. Chapter 10).

Agency Adoption of Recommendations

ACIP's recommendations are not automatically adopted as official federal recommendations. The CDC Director reviews and decides whether to formally adopt ACIP's recommendations. Official recommendations are published in the CDC Morbidity and Mortality Weekly Report. In emergency situations, CDC may issue a vaccine recommendation without ACIP consultation.

Federal Statutory Authorization

ACIP remains authorized under general authority of the HHS Secretary. Some laws, such as the Cures Act, have addressed ACIP and its recommendation process. In addition, ACIP’s recommendations play a role in defining some statutory requirements, for example:

• Vaccines for Children (VFC): Under Social Security Act Section 1928 (42 U.S.C. §1396s) ACIP is tasked with developing the list of vaccines covered under the VFC program, which provides vaccines at no cost to eligible children.

• Health care coverage: Several laws reference ACIP recommendations in the context of health care coverage, including for private health insurance (PHSA Section 2713; 42 U.S.C. §300gg–13), and more recently for Medicare Part D, Medicaid, and the State Children’s Health Insurance Coverage Program as added by P.L. 117-169, “The Inflation Reduction Act.” See CRS Report R47396, Health Care Provisions of the Budget Reconciliation Measure P.L. 117-169.

• Immigration: The Immigration and Nationality Act Section 212 (8 U.S.C. §1182) makes certain foreign nationals inadmissible to the United States if, among other things, they cannot demonstrate that they have received vaccinations as recommended by ACIP (in addition to those listed in statute). CDC determines which ACIP-recommended vaccines are required, reflected in its technical instructions.

• Vaccine Injury Compensation Program (VICP): Under PHSA Section 2114 (42 U.S.C. §300aa-14), when the CDC recommends a vaccine for routine administration to children and pregnant women, the Secretary must add it to the table of covered vaccines under VICP, a no-fault system to compensate individuals injured as a result of a covered vaccine. While not specifically mentioned in the statute, ACIP informs CDC recommendations. A CDC recommendation alone does not guarantee compensation under VICP for a certain vaccine. Other actions are required, including addition of that vaccine type to the list of taxable vaccines under 26 U.S.C. §4132.

What is the Federal Advisory Committee Act?

The Federal Advisory Committee Act (FACA) is a U.S. federal law enacted in 1972 (Public Law 92-463, codified as amended at 5 U.S.C. Chapter 10). It governs the establishment, operation, management, and termination of advisory committees in the executive branch of the federal government. This includes the Advisory Committee on Immunization Practices.

FACA ensures that advice from advisory committees (such as panels, task forces, boards, or commissions providing recommendations to federal agencies) is objective, accessible to the public, and free from undue special-interest influence. It promotes transparency and public involvement while curbing the proliferation of such committees.

FACA has been amended several times, notably in 1997 (to address procedures for certain academies) and recodified in 2022. Regulations were last significantly updated in 2001, with minor revisions in 2024 to reflect policy changes. FACA balances the need for expert input in policymaking with public accountability and has been upheld despite occasional constitutional challenges related to presidential authority.

Key FACA Provisions

• Applicability — FACA applies to committees established or utilized by the President or federal agencies that include at least one non-full-time federal employee (e.g., experts, stakeholders, or representatives). It does not apply to committees composed entirely of federal officials, certain entities like the National Academy of Sciences, the CIA, or the Federal Reserve, or local/state advisory groups.

• Establishment and Chartering — Committees must be formally chartered, with the charter outlining the mission, duties, and operations. Charters are filed with the agency, Congress, the General Services Administration (GSA), and the Library of Congress, and renewed every two years.

• Transparency and Public Access — Meetings must be open to the public (with limited exceptions under the Government in the Sunshine Act), announced at least 15 days in advance in the Federal Register, and allow public participation. Records, reports, and minutes must be made available for public inspection.

• Oversight — The GSA’s Committee Management Secretariat oversees government-wide compliance, including a public database tracking approximately 1,000 active committees. Agencies must report annually on costs, activities, and membership.

• Limitations — Committees provide only advisory recommendations (no decision-making authority), must be balanced in membership viewpoints, and terminate upon completing their objectives or after two years unless renewed.

• Ethics and Membership — Members (often Special Government Employees) are subject to federal ethics rules, including conflict-of-interest disclosures.

So, why is there So Much Controversy?

What has happened over time since the original chartering in 1964 is that the ACIP has lost its independence, and in a variety of ways has become captured by Medical Guilds (such as the American Academy of Pediatrics), the vaccine industry, and (in particular) the CDC bureaucracy. As a consequence, it no longer served the statutory purpose of providing independent advice to the intended client, the Director of the CDC. This is what prompted the retirement of the ACIP members empaneled during the Biden administration and replacement with a new panel.

Not surprisingly, the stakeholders who lost control and influence over the ACIP have stridently objected to these changes, and have turned to corporate media and politicians opposed to the current administration in an attempt to rescind these changes and return to the historically captured structure predating the current administration. One strategy for litigating this in the court of public opinion employed by these stakeholders, who have been deprived of control over the committee, has been to promote the false narrative that the ACIP sets vaccine policy for the nation. They assert that the ACIP should be free of political influence, and that any involvement of the current executive branch leadership in setting the topics, priorities, and agenda of the ACIP is somehow nefarious, shady, or illegal. In fact, as demonstrated above and by any objective assessment of the actual statutory laws governing the ACIP, this committee is explicitly created and empaneled to provide advice to executive branch leadership. The scope of topics covered by the ACIP charter is broad, and the committee must have input and guidance from what are functionally its customers - the Director of the CDC and senior HHS leadership. This is not nefarious, shady, suspicious, or illegal; it is completely aligned with both the FACA statutes and the ACIP charter and policy manual.

The staged, harmonized, disproportionate outrage and the promoted fear surrounding these issues are clear indications of a propaganda campaign. This propaganda campaign has been designed to exploit political divisions (right versus left) and the major cultural divide that has developed between those who endorse utilitarian/socialist political philosophies (pro-mandate, for example), and traditional liberal (otherwise known as libertarian) political philosophies. It is specifically designed to divide the public and to exploit those divisions to advance the interests of partisan, Pharmaceutical industry-funded Medical Guilds (such as the American Academy of Pediatrics), the Vaccine industry, and the academics (and their institutions) that have become dependent surrogates for the Vaccine industry.

Is ACIP Advice Required for Vaccine Policy Decision Making?

ACIP (Advisory Committee on Immunization Practices) advice is not legally required for Federal vaccine policy decision-making in the United States.

As summarized above, ACIP serves as a federal advisory committee under the CDC, established in 1964 and governed by the Federal Advisory Committee Act (FACA). ACIP recommendations remain advisory, not binding. The CDC Director (or, in some cases, the HHS Secretary) can:

• Reject them

• Modify them

• Issue alternative guidance

Historical examples include instances where CDC/HHS bypassed or altered ACIP input, such as certain COVID-19 policy adjustments in 2025.

While not mandatory, ACIP recommendations carry significant weight in practice because they:

• Trigger no-cost insurance coverage under the Affordable Care Act (for adopted recommendations on CDC schedules)

• Inform the Vaccines for Children (VFC) program

• Influence state laws (many reference ACIP for school requirements, provider authority, etc.)

• Historically have shaped clinical guidelines from organizations like the American Academy of Pediatrics (AAP). However, the AAP is now specifically rejecting any role for ACIP decisions in establishing AAP vaccine or related policy recommendations that it promotes or requires of its Guild members.

While ACIP provides expert input that has historically served as the basis for most U.S. vaccine policies, decision-making authority rests entirely with the CDC Director and HHS, making ACIP's advice influential but optional. The CDC Director and HHS leadership are free to set Federal vaccine policy without seeking advice from the ACIP.

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