| When Robert F. Kennedy Jr., who has repeatedly espoused a debunked link between routine shots and autism, took the reins as US health secretary, experts around the country issued a warning: He’s coming after childhood vaccines. At first, he appeared to promise he wasn’t going to do that. In his confirmation hearing, Kennedy said he wouldn’t tamper with the CDC’s advisory group on vaccine policy. Yet earlier this month, he fired all 17 members and replaced them with many vaccine skeptics and one self-proclaimed “anti-vaxxer.” A stray remark at a government meeting Wednesday provided the clearest evidence yet that those fears could come true. The Advisory Committee on Immunization Practices will formally investigate the list of recommended vaccines for kids, the group’s chairman said, looking into the cumulative effect of routine shots for diseases including measles, hepatitis B and rotavirus. “The number of vaccines that our children and adolescents receive today exceed what children in most other developed nations receive, and what most of us in this room received when we were children,” said Martin Kulldorff, a biostatistician appointed by Kennedy to lead ACIP. The idea that vaccines are overwhelming the immune systems of American children has been an anti-vaccine talking point for years. But the truth is that costs determine the volume of vaccines a country offers. “It has to do with what the national health systems in those other developed countries believe they could afford,” said Paul Offit, who directs the Vaccine Education Center at the Children’s Hospital of Philadelphia. The US is just one of roughly 89 countries with mandatory childhood vaccine policies. Vaccine schedules vary from country to country. The US and Canada recommend that everyone 6 months of age and older get the flu vaccine, while the UK recommends flu shots for special groups like children over the age of 2, the elderly, and pregnant women. To many in the public health world, Kulldorff’s comments were an obvious dog whistle for vaccine critics who want to chip away at US health policy. “It’s a little worse than the nightmare scenario,” Offit said. “These folks aren't even pretending to be other than anti-vaccine.” Kennedy has now reshaped ACIP to more closely reflect his anti-establishment views on vaccines. The concern is that the panel will recruit a group of vaccine skeptics to examine the childhood schedule, giving the group cover to change federal recommendations and revoke access to free shots for millions of children in the US. Offit said that other groups, like the American Academy of Pediatrics, could break with Kennedy’s new panel and issue their own recommendations. The AAP did just that on Wednesday, announcing it would publish its own immunization schedule “guided by science.” Yet the AAP’s move likely won’t solve the problem, since insurers aren’t compelled to follow its advice. — Damian Garde and Michelle Amponsah | 
