Health Secretary Robert F. Kennedy Jr.’s reshaping of the expert committee that advises on vaccines is complicating state efforts to stop measles outbreaks around the country.
In the face of the worst measles outbreak in the United States in 35 years, the Advisory Committee on Immunization Practices, the federal group that makes vaccine recommendations, has not met in over 10 months.
Last year, Kennedy fired all its members and installed a new panel, including several with vaccine-skeptical views. The new committee’s attempt to reduce the recommended childhood vaccine requirements from 17 to 11 spurred lawsuits. The Centers for Disease Control and Prevention’s website says ACIP’s meetings have been cancelled “due to ongoing litigation.”
Historically, the committee has met three times a year. During the COVID-19 pandemic, it met three times a week to review vaccine safety data and issue dosage recommendations. In the absence of guidance now, states have had to fill in the gaps themselves.
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In New York, where Gov. Kathy Hochul declared a state of emergency earlier this month over a measles outbreak, the state health department is relying on new legislation setting school vaccine standards as “an alternative to the standards set by the Advisory Committee on Immunization Practices,” the agency told The Washington Sun.
Pennsylvania Gov. Josh Shapiro signed an executive order last year that said in light of ACIP’s actions, the state would follow advice from national medical associations, which the state’s Department of Health called “trusted medical experts” in a statement to The Sun.
And South Carolina, which saw a surge of nearly 1,000 measles cases earlier this year, is also relying on outside medical groups for guidance. Dr. Melissa Nolan, a professor of epidemiology who advises the state’s public health department, said “for the first time in our lifetime, the medical scientific community has published their own vaccine guidelines which are different than the federal guidelines.”
The outbreak coincided with an increase in delayed childhood vaccines in the state, Nolan said.
“The state responded in a traditional manner,” Nolan said. “They sent trucks to do mobile vaccine units. But if you don’t engage and address underlying sentiments and have preexisting, built trust with the community, people aren’t going to show up and get vaccinated.”
ACIP’s former executive secretary Melinda Wharton, who resigned in 2025, said that “if ACIP were meeting, there likely would be some discussion about needing stronger language in terms of an actual public health response.”
ACIP would normally review evidence collected by states and the CDC to determine how to alter vaccine guidance and stop an infectious disease outbreak. Public health officials were able to address the most recent severe measles outbreak in 1991 in part because of ACIP’s recommendation for two shots of the measles vaccine instead of the previously recommended single dose.
Outside experts have stressed the need for a stronger federal response, particularly from ACIP. Dr. Paul Offit, the director of the vaccine education center at Children’s Hospital of Philadelphia and a vocal critic of Kennedy’s, says, “It’s gotten harder to treat these outbreaks. We don’t have an ACIP or a CDC that anyone trusts, including myself.”
Typically with this kind of outbreak, Kennedy and the head of the CDC would “be giving briefings in front of the CDC every day,” Offit said.
In a statement to The Washington Sun, Health Department spokesperson Grace Jamison touted the administration’s efforts to address the measles outbreak.
Kennedy and CDC Director Dr. Erica Schwartz have “mounted an aggressive response to measles outbreaks across the country” and “continue to make clear that the MMR vaccine is the most effective way to prevent measles,” Jamison said.
The CDC announced on Tuesday that it would send support to Pennsylvania to investigate its growing outbreak. Earlier this month, the administration unlocked an additional $100 million in funds to help states handle immunization support and surveillance. Jamison said Texas, South Carolina, Virginia, Kansas, New Mexico, and Wisconsin “worked alongside federal teams to help bring their outbreaks rapidly and successfully under control.”
Kennedy has long caveated his support of the measles vaccine. He told CNN on Aug. 2 that he has “never questioned the efficacy of the MMR [measles, mumps and rubella] vaccine,” and that he does not take responsibility for the current measles outbreak. He also told Fox News in 2025 that “if people don’t want it, they shouldn’t be — the government shouldn’t force them to do it.”
Now, measles infections countrywide have surpassed 4,000 cases. Pennsylvania has reported more than 1,200 cases. Two other states have reported more than 500 cases this year.
Measles is a highly contagious virus that hospitalizes about one in five unvaccinated people who become infected in the U.S. Measles had been considered eliminated in the U.S. since 2000. However, vaccination rates among kindergarten-age children have dropped nearly 3 percentage points since 2020, signaling that the disease could become endemic.
“It just feels like agency leadership is not really advocating for the agency, not really supporting good public health decision-making, and it breaks my heart for my former agency as well as for the country,” Wharton said.
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