The Department of Health and Human Services has long advocated vaccination as a key component of public health. Before Robert F. Kennedy, Jr. was confirmed as secretary of the nation’s top public health agency, the longtime vaccine skeptic said he would follow the science on vaccines. But Kennedy’s tenure so far has the pharmaceutical industry, clinicians, and other healthcare industry stakeholders watching for policy changes.
Kennedy’s public comments amid the ongoing measles outbreak in Texas have inconsistencies. He made headlines for stating on social media that vaccination is the most effective way to prevent measles. But in a subsequent CBS interview, he undermined vaccination by stating that “the vaccine wanes very quickly.”
Another red flag was the abrupt resignation of Peter Marks as director of the FDA’s Center for Biologics Evaluation and Research, whose oversight included vaccines. In his resignation letter, Marks alleged that Kennedy is not interested in truth and evidence, but rather “subservient confirmation of his misinformation and lies.” In a subsequent interview with The Associated Press, Marks said he was pushed out after refusing to allow Kennedy’s team to edit data in the Vaccine Adverse Event Reporting System (VAERS), a database of vaccine safety events. Speaking at an event this week, Kennedy said he is planning changes to VAERS, STAT reported.
Vaccine makers aren’t saying anything publicly about Kennedy’s statements or Marks’s comments. Pfizer, GSK, Sanofi, and Moderna did not respond to messages seeking comment. This week, the CDC’s Advisory Committee on Immunization Practices (ACIP) met for the first time since Kennedy became head of HHS. This committee is important because payers use ACIP recommendations to guide their coverage decisions for vaccines. The meeting, which was originally scheduled for February, was postponed in order to gather public comment, HHS said. Financial analysts are watching ACIP and the CDC for signs of changes in the government’s vaccine policies.
“The fact that this meeting took place after originally being postponed with minimal notice is a small sign of promise for the vaccine space and future of the ACIP, which has been under major scrutiny since the appointment of RFK Jr. as HHS head,” William Blair analyst Myles Minter wrote in a note sent to investors.
Anti-vaccine rhetoric did not take over the meeting. Vaccine presentations and discussions proceeded in the same manner as previous ACIP meetings. Respiratory syncytial virus (RSV) vaccines Arexvy, from GSK, and Abrysvo, from Pfizer, received affirmative ACIP votes for use in adults age 50 to 59 who are at increased risk of RSV disease, expanding the target population for the products. GSK also secured an ACIP recommendation for its new meningococcal vaccine, Penmenvy.
In chikungunya vaccines, Bavarian Nordic’s Vimkunya received an affirmative ACIP vote. But Valneva’s chikungunya vaccine, Ixchiq, has been under review due to a small number of cases with adverse effects. The committee voted to recommend a precaution noting this risk in people age 65 and older. All of these votes are just recommendations. The CDC director can accept or reject these recommendations. The agency is currently led by acting director Susan Monarez. President Trump nominated her to formally take on the leadership role after withdrawing the nomination of Dave Weldon, a physician and former congressman who has expressed anti-vaccine views.
So far, ACIP is continuing to make science-based vaccine recommendations. But Steven Lupo, partner in the life sciences practice at consultancy West Monroe, said vaccine messaging and strategy needs to come from multiple places. Clinicians have a responsibility to explain how the umbrella effect of immunity protects against unforeseen disease. Insurers should make vaccines readily available and easy to access. Pharmaceutical companies need to be more transparent about the science of their vaccines and the clinical data supporting them.
“Each one has a responsibility in terms of messaging and making the public understand in the long run, it’s easier to prevent than it is to treat,” Lupo said.
All healthcare industry stakeholders can improve their messaging by adjusting to new ways that people consume information. That means moving away from drug commercials with people dancing, Lupo said. While the U.S. is different from most of the world in terms of permitting pharmaceutical advertising, Lupo noted that these commercials are aimed at clinicians as well as consumers. But pharma companies can also reach these audiences in new ways, such as social media, he said.
Some companies have been changing their messaging outreach. Speaking during the World Medical Innovation Forum in Boston last September, Moderna CEO Stephane Bancel said the mRNA company’s outreach includes social media. For example, Tik Tok videos provide interviews and local stories about people being vaccinated, Bancel said. This approach takes advantage of localization that’s part of the Tik Tok algorithm. Moderna has also been educating clinicians with data on hospitalization rates and death rates from Covid-19 and influenza with localized data.
“We’ve used literally zip code by zip code data, on the hospitalization rate, death rate of Covid, flu, to make people realize the fact, which is, and doctors realize, that [Covid-19 infection is] three times higher risk of hospitalization than flu,” Bancel said. “So it makes no sense from a public health standpoint to give someone a flu shot and not have that discussion about Covid.”
However, drug companies face steeper messaging challenges than others because public perception of the pharma industry is low, Lupo said. One way they can overcome that is by making the messaging simpler and more accessible.
“I think we need to make things very relatable to people who are not scientists, who are not doctors, who are not clinicians, so that they can understand how these vaccines work from a very rudimentary perspective,” Lupo said.
The next ACIP recommendations to watch for are for the Covid-19 vaccines. Since they became available, the committee has recommended universal use of these vaccines. ACIP this week discussed changing that recommendations to focus on people in high-risk groups. That narrower scope could reduce vaccination rates, cutting deeper into Covid vaccine revenue that has been falling for Pfizer and Moderna since the end of the pandemic. The next ACIP meeting is scheduled for June 25 and 26.
Photo: Francesco Carta Photographer, Getty Images
