Vaccines have become so contentious that the American Academy of Pediatrics boycotted and strongly criticized the June 25-26 meeting of the Advisory Committee on Immunization Practices, which I chaired. This public health committee advises the Centers for Disease Control and Prevention on vaccine recommendations.
What warrants this dissatisfaction? At the advisory committee meeting, we voted for two changes in the immunization schedule. First, as an alternative to maternal respiratory syncytial virus or RSV vaccination during pregnancy, we voted to recommend the use of a monoclonal antibody, clesrovimab, to prevent RSV infections in infants. To be ready for the next virus season, this was done in record time, as the Food and Drug Administration had just approved it 17 days earlier.
Clesrovimab is not part of the American Academy of Pediatrics-endorsed immunization schedule. Is the organization opposed to this decision to protect infants? If not, why did it criticize rather than praise the committee? Is politics more important than public health?
In three separate votes for children, pregnant women and other adults, the advisory committee also stopped recommending seasonal influenza vaccines that have a mercury-containing preservative. In the course of criticizing our work, the American Academy of Pediatrics defended these mercury-containing vaccines, even though there are many mercury-free alternatives available.
Mercury is a well-known toxin. Its removal from vaccines is a pro-vaccine position. American Academy of Pediatrics members are supposed to advocate for and vaccinate children, and having mercury in their products is not a great marketing strategy. Mercury has been removed from all cosmetic products, and vaccines are more important than cosmetics.
The American Academy of Pediatrics argues that there is no scientific proof that the mercury-containing vaccines cause harm. That is an unscientific red herring. Let’s do a thought experiment. Suppose we randomize people into two groups, to have dinner with calamari that either contains or does not contain a small amount of mercury. Even if there would be no statistically significant differences between health outcomes in the two groups, we would still all prefer mercury-free calamari.
In daily life, we cannot completely avoid mercury, but its effect is cumulative, so we should minimize exposure. The same is true for smoking. If we randomize people into two groups, one of which smokes a single pack of cigarettes and the other of which does not, there would be no statistically significant difference in lung cancer between the two groups. We should still avoid smoking that pack of cigarettes.
Practicing pediatricians and family doctors have long had to deal with parents worried about injecting mercury into their children. Their job will be easier when they can assure parents that there are no longer any vaccines with mercury-containing preservatives. Physicians must serve everyone, and removing mercury from vaccines is a small but important step in restoring lost trust.
The American Academy of Pediatrics has a history of arguing against the evaluation of the childhood vaccine schedule, but that is an unscientific position. As one example, Danish research suggests that, with a series of vaccines, it may be better if the last one is a live vaccine, as it is for Danish toddlers, rather than a non-live vaccine, as in the U.S. This research deserves a thorough evidence-based evaluation, which may or may not lead to a change in the CDC-recommended vaccine schedule.
Evidence-based medicine is the key to restoring public trust, and most vaccine scientists agree that we should thoroughly and continuously evaluate vaccines. When patients, parents or vaccine scientists have concerns about vaccines, that should be respected and taken seriously. To dismiss such people as anti-vaxxers or science-deniers is false, derogatory, and counterproductive.
I have done vaccine research for more than two decades, helping develop the CDC and FDA vaccine safety surveillance systems. We mostly do not find a problem, and that’s great. When there is a problem, we must be honest and serious about it, whether it is a detected adverse reaction after the MMRV vaccine, a flawed randomized trial regarding the HPV vaccine, or false CDC claims about the COVID vaccines. Failure to recognize and resolve problems in an honest and evidence-based manner is the root cause of increasing vaccine hesitancy.
The American Academy of Pediatrics also complained about the advisory committee’s new members. When CDC stopped the Johnson & Johnson COVID vaccine in April 2021, during a vaccine shortage and at the height of the pandemic, I was the only vaccine scientist publicly objecting. I argued then that it would lead to unnecessary deaths among high-risk older Americans, and a few days later CDC reversed course. One would expect that AAP would welcome such a pro-vaccine scientist on the committee, but it did not.
The academy has a liaison representative on our committee to make its voice heard, yet it chose to boycott the June meeting. That’s unfortunate. Public health cannot thrive without open and rigorous discussions. Having failed to show up, I invite the organization to a live public debate regarding the June meeting they criticized. The public should not trust an organization that is unwilling to openly debate other scientists, so I hope they accept.
Martin Kulldorff, Ph.D., chaired the June 2025 meeting of the Advisory Committee on Immunization Practices at the Center for Disease Control and Prevention. He is a former professor of medicine at Harvard University and Brigham and Women’s Hospital.
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