Hi, I'm Andy Meyers, CEO of HealthDay. Thanks for joining us for HealthDay Now.
On June 9th, the U.S. Department of Health and Human Services took what they call the bold step in restoring public trust by totally reconstructing the Advisory Committee for Immunization Practices, ACIP.
They removed 17 of their existing members, placing them shortly thereafter with eight new members.
Today, we are extremely pleased to have with us Bonnie Maldonado. She is Senior Associate Dean for Faculty Development and Diversity, Taube Professor of Global Health and Infectious Diseases, Professor of Pediatrics and Epidemiology, Interim Chair of the Department of Medicine, Medical Director, Infection Prevention at Stanford University School of Medicine.
In addition, she holds the distinctive honor of being one of the 17 members recently removed from ACIP. Thank you so much for joining us today. So, if we could start, if you could just give us a little background. What exactly is ACIP and why should anyone care about it?
Yvonne (Bonnie) Maldonado, MD, Sr. Assoc. Dean, Faculty Development and Engagement, Taube Prof. of Global Health and Infectious Diseases, Prof. of Pediatrics and Epidemiology at Stanford University School of Medicine
It's a congressionally mandated committee that is supposed to advise the Centers for Disease Control and Prevention on vaccine recommendations for clinical use for the primary provider and for the public to understand how vaccines should be used.
The process that vaccines go through is: first, they go through years and years of testing, and then they come to the Food and Drug Administration over, again, a course of years, to be reviewed.
And then when they are approved by the FDA or licensed by the FDA, then the ACIP within 60 days, by law, must review any new vaccine that is licensed by the FDA for approval.
The ACIP then reviews the vaccine, all the data around that vaccine, safety number one, efficacy, is the ability of the vaccine to protect against certain diseases, side effects, dosages, all of the details.
Andy Meyers, CEO, HealthDay
So, Secretary Kennedy has pledged radical transparency for all health advisory committees, including ACIP. So, I'd like to just get your thoughts on how you consider the process used to select these new eight members?
Yvonne (Bonnie) Maldonado, MD, Stanford University School of Medicine
So, the ACIP has, first of all, in their charter, it is said that you have to stagger the appointments. That is, the membership cannot all be stepped down at the same time because you need continuity in the committee as they're deliberating about different diseases and vaccine products.
And then when there are terms that are going to be expiring, the CDC actually puts out a public call for nominations and asks people to nominate experts in their field around vaccines, epidemiology, public health, immunology, all of the areas that are important in vaccines.
Two weeks ago, we found out all 17 members of the ACIP, the voting members, all 17 of us found out by reading a Wall Street Journal article that we had been terminated effective immediately by the Secretary of Health and Human Services.
Now, two days later, 48 hours later, the secretary appointed eight new members, and I don't know anything about the process of how they were selected.
Andy Meyers, CEO, HealthDay
The first test of the committee, as we say, is going to be June 25th, 26th. And one of the topics under discussion is thimerosal and the use of thimerosal in influenza vaccine in particular. Can you help us understand the context of this issue and why you think this topic is being brought up now in this meeting?
Yvonne (Bonnie) Maldonado, MD, Stanford University School of Medicine
Thimerosal is an ethylmercury. It's a preservative. It keeps products from getting bacterial contamination. Now, in the 90s, some vaccine products had ethylmercury, very minute amounts of ethylmercury, which is non-toxic; it's been demonstrated to be non-toxic.
And the confusion was that there is a toxic mercury product called methylmercury that is not contained in any vaccine.
In fact, that's the kind of mercury that you can see people eating in fish, for example, and that is a highly toxic mercury component.
But people were confusing methyl and ethylmercury and so in the nineties, ethylmercury or thimerosal was removed from virtually all vaccine products. So, we haven't been using them for probably 30 years or more.
Now there is maybe one vaccine product… it's a multi-dose influenza vaccine because multi-dose, again, you might open it and leave it for another use and therefore there may be a risk of contamination.
And so, for that product, there is some ethylmercury, again, not found to be in toxic levels at all and rapidly eliminated by the body after vaccination. In one, I think, a multi-dose flu vaccine product for children.
Otherwise, there are no thimerosal containing vaccines on the market at this time. And I don't know what the discussion about thimerosal will be. I can only imagine that it will be about removing that product.
The other thing that's happened with ethylmercury, there's been a lot of misinformation from alternative sources that talk about ethylmercury causing autism or thimerosal causing autism that has, despite numerous studies, and I'm talking about dozens and dozens of studies involving hundreds of thousands of children, if not more than a million children around the world, there has never been a study that demonstrated with good scientific methods, a link between autism and vaccines in particular or with thimerosal. So that link has never been proven, but out of an abundance of caution, thimerosal has been taken out of virtually every vaccine.
Andy Meyers, CEO, HealthDay
Another topic on the agenda is the MMRV vaccine, the measles, mumps, rubella, or varicella vaccine. What do think they'll be talking about?
Yvonne (Bonnie) Maldonado, MD, Stanford University School of Medicine
So, MMR and MMRV are measles, mumps, and rubella vaccine and there's a more recent vaccine combination called measles, mumps, rubella, and varicella. So that actually includes the chickenpox vaccine in it. And I think that those vaccines have been in use for decades now. The measles vaccine has been used since the 1960s. It's highly safe, incredibly effective. It's over 95%-plus effective in preventing measles.
So, I don't know why it came up as an agenda item because we did not have any discussions about MMRV. But I do know that the secretary's former affiliation with the Children's Defense Fund has really had some concerns about MMR. Again, the issue of autism continues to come up by that group without any real evidence.
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