News
Ensuring Access to Vaccines
Chaos and controversy have surrounded vaccines for the past year as a result of administrative action. From a public health perspective, vaccines are an essential part of prevention and care of cancer patients and their families. For example, vaccination for human papillomavirus (HPV) and hepatitis B (HBV) can prevent cancers caused by these viruses. Also, “community immunity,” when enough people in a community are vaccinated against a disease, is especially important for protecting cancer patients, including children, who may have weakened immune systems, and are unable to be vaccinated or a vaccine may be less effective for them. In particular, patients with blood cancers and those getting chemotherapy, long courses of corticosteroids, certain types of immunotherapies, or stem cell or bone marrow transplants need community immunity to allow them to safely attend medical appointments and other activities. In addition, vaccines can be used to treat certain cancers by triggering the immune system to attack tumor cells. Finally, researchers are finding improved ways to identify targets for new therapeutic cancer vaccines in clinical trials that could improve treatments for lung, breast, prostate, melanoma (skin), pancreatic, and brain cancers.
Beginning in May of 2025 through January of 2026, a number of actions by the government have discredited the safety and effectiveness of U.S. Food and Drug Administration (FDA)-approved vaccines and affected access to them. The Secretary of Health and Human Services (HHS) terminated all of the Advisory Committee on Immunization Practices (ACIP) members, then appointed new ones, many of whom have been criticized for lacking the qualifications and expertise typically expected under the ACIP charter. ACIP recommendations greatly affect access to care as they dictate which immunization schedules must be covered by private insurance and government programs. ACIP recommendations are also embedded in nearly 600 statutes and regulations across 49 states, three territories, and Washington, DC, such as which vaccines children must have to attend school.
The most significant changes took place on January 5, when HHS altered the childhood and adolescent immunization schedule, bypassing the traditional ACIP process. The changes included reducing the number of vaccines universally recommended for all children from 17 vaccines to 11 vaccines and reclassifying several vaccines from routine to shared clinical decision-making or recommending respiratory syncytial virus (RSV), hepatitis A, HBV, and meningococcal vaccines to only high-risk groups rather than all children. The actions were not based on new evidence or studies, marking a stark contrast with previous changes.
Litigation is underway. The most prominent case is American Academy of Pediatrics v. Kennedy. It challenges HHS actions under the Administrative Procedure Act (APA) and the Federal Advisory Committee Act (FACA). Plaintiffs argue that recent vaccine policy changes were arbitrary and capricious under the APA, and that ACIP was improperly reconstituted with unqualified members, undermining its statutory role under FACA. On March 16, US District Judge Murphy stayed 1) the changes made to the immunization schedule by HHS on January 5; 2) the appointments of the new ACIP members; and 3) all votes taken by the new ACIP. The government has appealed only one issue to the First Circuit on an expedited basis: the validity of the appointments of the new ACIP members. ACS CAN led an amicus brief for 24 public health organizations that focuses heavily on the importance of ACIP being comprised of individuals with relevant scientific expertise, the importance of vaccines to patient health, and ACIP's unique role in patient access to vaccines.