The United States’ primary vaccine advisory group, the Advisory Committee on Immunization Practices (ACIP), is reportedly reconsidering every existing vaccine recommendation, stated its chair, Kirk Milhoan. This comprehensive review signals a notable departure from decades of practice, positioning the committee under new leadership with a skeptical view of routine immunization schedules. The context for this reassessment appears linked to the broader policy direction of the Department of Health and Human Services (HHS) under Secretary Robert F. Kennedy Jr.
Milhoan, a pediatric cardiologist, informed the New York Times last week that the committee is “reevaluating all of the vaccine products including risks and benefits,” though he suggested recommendations might not universally become optional. In interviews, Milhoan framed the debate as a conflict between individual autonomy and collective public health, a dichotomy health policy experts dispute. Jason Schwartz of the Yale School of Public Health noted that vaccination inherently provides benefits to both the individual and the community they interact with.
Concerns have been raised regarding the approach taken by Milhoan and several handpicked advisers, who reportedly emphasize rare side effects over proven benefits against severe illness. Milhoan specifically questioned the necessity of older vaccines like those for polio, citing modern sanitation improvements—a talking point often associated with Kennedy. However, experts emphasize that vaccination campaigns are the primary reason for the suppression of diseases like polio and the containment of recent measles outbreaks.
Data from the US Centers for Disease Control and Prevention (CDC) indicates a concerning rise in measles cases, with 416 confirmed already this year, approaching one-fifth of the total cases seen in 2025. Milhoan reportedly suggested using the current measles spread among unvaccinated populations as a real-world study to assess hospitalization and death rates. Elizabeth Jacobs, a founding member of Defend Public Health, characterized this stance as dangerously experimental and approaching criminality.
Milhoan has also expressed opposition to vaccine requirements, which are set by states and localities, not ACIP, framing recommendations that lead to mandates as “medical battery.” ACIP’s role has historically been to provide evidence-based guidance, which the CDC subsequently adopts or declines. Schwartz noted that the current committee views the very act of recommending a vaccine, a 60-year charge, as an infringement on parental freedom.
Further complicating the situation, a report by the health policy non-profit KFF indicates that a majority of states are actively decoupling their local immunization requirements from federal guidance. While all states permit medical exemptions, an increasing number allow philosophical exceptions, a trend experts suggest raises the risk of disease resurgence.
Milhoan stated a desire to promote “medical freedom,” but critics argue this approach curtails the rights of the majority, including immunocompromised children. Jacobs countered that medical freedom must encompass the right “to not contract a potentially fatal infectious disease against your will,” noting the vast majority of families support immunization.
The review appears rooted in a fundamental disagreement over scientific consensus, as Milhoan rejected the term “established science,” asserting that safety can only be observed, not proven through rigorous study. Jacobs countered that established science is precisely what has allowed society to control these diseases for centuries, marking an ideological divergence from previous public health consensus.
