That the Louisiana senator is speaking out is a welcome development — but this sort of standoff was also entirely foreseeable. 

Months after they met in a high-profile nomination battle, Senator Bill Cassidy (R., La.) is still dealing with the complications from Health and Human Services Secretary Robert F. Kennedy Jr.’s confirmation. As chairman of the Senate Committee on Health, Education, Labor and Pensions, Cassidy, a physician, cast the deciding vote in February to advance Kennedy’s nomination to the floor. Cassidy, however, is now worried that the advisory committee on vaccines that Kennedy recently purged and partially restaffed might not be prepared to issue recommendations.

The Advisory Committee on Immunization Practices (ACIP) is a panel within the Centers for Disease Control and Prevention vested with enormous influence over the vaccines that Americans receive, meeting regularly to vote on recommendations for routine immunizations. As the Washington Post explains, the committee’s recommendations inform a host of policies at both the federal and state levels. Health insurers are required by law to cover only ACIP-recommended vaccinations without patient cost-sharing. The committee also effectively decides which vaccines are included in federal programs that fund immunizations for tens of millions of children. State governments rely on the ACIP’s guidance to determine which vaccinations schools must require for enrollment and which vaccines pharmacists can legally administer.

Two weeks before ACIP was scheduled to meet this month, Secretary Kennedy fired all 17 members of the committee and announced eight handpicked replacements in what he called a “clean sweep.” The reconfigured ACIP, despite having nine empty seats, is supposed to meet tomorrow to update its recommendations. Yesterday on X, however, Senator Cassidy urged that the committee’s meeting be delayed.

Cassidy warns that, “although the appointees to ACIP have scientific credentials, many do not have significant experience studying microbiology, epidemiology or immunology.” Moreover, he fears that some of the committee’s new members “lack experience studying new technologies such as mRNA vaccines, and may even have a preconceived bias against them.” Given the “relatively small panel” — by which he means more than half vacant — its “meeting should be delayed until the panel is fully staffed with more robust and balanced representation — as required by law — including those with more direct relevant expertise.” Cassidy also noted that no CDC director has been confirmed to formally approve the committee’s recommendations. Not mentioned is that this vacancy effectively leaves Kennedy with the final say.

Previously, Cassidy had seemed more sanguine about the HHS secretary’s push to remake ACIP. To help justify the vote that advanced his nomination, the senator held up a promise that he secured from Kennedy that, “if confirmed, he will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without changes.” One might think that firing every member of the committee simultaneously would qualify as a “change.” But after Kennedy did just that, Cassidy told reporters that their agreement merely applied to the committee’s structure as opposed to its membership. 

The problem with the new iteration of ACIP, of course, is that Kennedy has populated the committee with supposed medical experts who either know little about vaccines or think they know many things about vaccines that are wildly false. That Cassidy is speaking out is a welcome development, but this sort of standoff was also entirely foreseeable. 

Robert F. Kennedy Jr., for all of his character flaws, is not coy. He has never been shy about telling people what he thinks about vaccines. In fact, he is probably the most prominent anti-vaccine advocate of the past half century, who has done more than anyone else to popularize the pernicious claim that childhood vaccinations cause autism. Bill Cassidy, in contrast, is an experienced doctor who knows why vaccines are indispensable tools of modern medicine, as he has seen the difference between vaccinated and unvaccinated patients up close. He must have at least suspected what Kennedy would do if put in charge of federal vaccination policy but was persuaded to go along with his confirmation based, in part, on an unenforceable pledge.