Scoop: “Nobody in senior leadership at NCIRD saw the revised vaccine schedule," CDC scientist says.
Plus, an exclusive look at the slide deck an NCIRD scientist presented comparing the US pediatric vaccine schedule with those of peer nations. Spoiler: Denmark is the outlier.
We have some breaking news that I believe we are first to report, right here in Inside Medicine, thanks to the HHS employees, past and present, who continue to bravely speak out. You can help me amplify them by reading, sharing, and supporting this work. Thanks!
On Monday, the Trump administration suddenly overhauled the national vaccine schedule, reducing the number of diseases the CDC routinely recommends vaccinating children against from 17 to 11. While the administration says that CDC scientists were consulted during the development of the new vaccine schedule, Inside Medicine was told by a current CDC official yesterday that key scientists at the agency’s National Center for Immunization and Respiratory Diseases (NCIRD) were not consulted during the decision-making phase of the process.
“Nobody in senior leadership at NCIRD saw the revised vaccine schedule, nor the supporting document until the administration released them on January 5th,” the official said. (While the official does not work at the NCIRD, he described conversations he has had in the last 24-36 hours with those who do. He was granted anonymity to protect his job at the agency.)
A break from the CDC’s established process. (Again.)
The change in the United States’ pediatric vaccine schedule occurred outside the usual processes, which normally involves votes by the CDC’s Advisory Committee on Immunization Practices (ACIP), and comes at the conclusion of a longer process that includes input from experts and the public, thereby typically prioritizing transparency and thoroughness over efficiency. In this case, however, “the lack of transparency is obvious,” the CDC official told me.
Defending the move, Andrew G. Nixon, an HHS spokesperson, responded to Inside Medicine’s request for comment by reiterating that “CDC experts were consulted.” He characterized the claim that NCIRD leadership and subject matter experts had not been involved in the decision-making process around the new recommendations as “false.” When pressed on whether NCIRD scientists had specifically been involved (as opposed to “CDC experts” generally) in anything other than presenting data, he declined to comment further.
Earlier in the day (during our Substack Live), former Director of the NCIRD, Dr. Demetre Daskalakis, also said he has heard that his former colleagues provided data and input during the process, but that they “never got any sort of chance to provide input on the final product.” Similar to the current CDC employee I spoke to, Daskalakis believes NCIRD scientists had neither seen nor evaluated the revisions to the pediatric vaccine schedule until yesterday, the day the administration announced the changes. The current CDC employee I spoke to said that NCIRD scientists had heard rumors that the changes were coming, but did not know the specifics until they were released by HHS on Monday. He also added that NCIRD scientists were unlikely to speak out directly, which in part drove him to do so. “They are extraordinary public servants and they believe in what they do,” he said. Even when under duress, “they don’t want things said against their agency.”
A “long formal assessment” that remains unseen.
One thing that Nixon, Daskalakis, and the current CDC official I spoke to all do agree on is that NCIRD scientists had indeed been assigned to present some information to agency leadership during the run-up to these changes, including a request to summarize how the US pediatric vaccine schedule compares to some peer nations. The results of that “landscape” review were presented to political appointees at the agency on December 18. The slides from that presentation were obtained by Inside Medicine from another source (their authenticity was confirmed by two others with knowledge of the situation.) Here, for the first time in public, are the slides that the current Acting Director of the CDC’s NCIRD presented to political leaders at the agency.1
In an interview on Monday, Acting CDC Director Jim O’Neill said that “a lot of our scientists wrote a long formal assessment.” Asked whether O’Neill was referring to the January 2 document authored by Dr. Tracy Beth Høeg and Dr. Martin Kulldorff, Nixon told me, “no, that’s not what he was referring to.” This suggests that other HHS experts (whether from within CDC or elsewhere) wrote at least one other assessment of the relevant data, but that such documents are not public. Moreover, while the existence of a “long formal assessment” written by HHS scientists within HHS must be taken seriously, it is unknown what such a document might have said or concluded on the matters discussed.
Indeed, Daskalakis believes that his former NCIRD colleagues would not have supported many or most of the changes to the vaccine schedule—and most certainly would not have supported them outside of the normal ACIP process, which includes careful adjudication and grading of all available evidence and public comments. Referring to the slide deck, Daskalakis noted that while the presentation “does not make recommendations, it steers in the direction that it’s untrue to say every country has fewer vaccines than we do.”
For example, one slide in the deck shows that, until Monday, the US targeted pediatric vaccines against 17 pathogens, the same number as Canada. Meanwhile, Germany, Australia, and Japan target 16, 15, and 14 pathogens, respectively. Denmark targets only 10. So rather than giving credence to the notion that Denmark is an exemplar, the data presented in the deck more strongly suggest that the nation is both an outlier and, in other parts of the deck, one whose features (such as universal healthcare and its demography) make it ill-suited for a comparison with the US.
Why process matters here.
This all matters. While career CDC scientists’ conclusions wouldn’t alone be sufficient to direct changes under the normal processes—indeed, that’s why ACIP exists, meets, and votes—the reasoning behind their recommendations has historically been an important part of the process.
In fact, for many pro-science observers who are today unsure whether to trust new CDC policies since it has abandoned its usual practices under Secretary Kennedy, such transparency would especially be welcome.
If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.
While I never comment on the identity of unnamed sources, I will in this case say that the author of this slide deck was not my source, and I did not reach her while preparing this article. I mention this only because her name is front-and-center on the deck and it would be unfair to leave this question unresolved.
Thank you for this extraordinary and deeply disturbing piece of reporting. This confirms what many of us feared but could not yet prove. That this overhaul occurred without NCIRD senior leadership ever seeing the revised schedule or its justification is not a procedural misstep. It is a fundamental breach of how public health governance is supposed to work.
What is especially infuriating is the continued reliance on vague assurances that “CDC experts were consulted” while avoiding any specificity about who was involved, when, and in what capacity. Providing data is not the same as participating in decision making. Being asked for a landscape comparison is not the same as endorsing a final policy.
Your reporting makes clear that the Denmark comparison was not only selectively invoked but contradicted by the very data NCIRD scientists presented. That information was then used as rhetorical cover to justify a predetermined outcome reached outside the ACIP process.
This is not about disagreement over vaccine policy. It is about the deliberate sidelining of expertise, the misuse of institutional credibility, and the erosion of transparency that public trust actually depends on. Thank you for bringing the facts into the open and for protecting the voices of career scientists who are being silenced precisely because they are principled public servants.
So who are the "CDC experts" they consulted? The ones brought in by Kennedy? That would leave a whole lot of truly career relevant experts who weren't consulted. It seems to me decisions are being engineered to fit Kennedy's anti-vax agenda. He's doing so much harm to government trust, which is probably the point. I'm afraid he'll ultimately stop all vaccines. The MRNA research defunded, the ongoing research to make vaccines better at how they protect in peril. There's nothing like making *polio* great again (*insert any nearly eradicated disease). Maybe I'm so disheartened because of my grandkids, one of whom has health issues. 🥺