Hey, MedPage Today: No, It Wasn’t a “Public Health Purge” — It Is a Long-Overdue Realignment of Power, Integrity and Accountability

A Response to Stacy B. Buchanan’s Essay in MedPage Today. The irony is thick, her own COI speaks volumes. She will have to work with people who use words like "risk" and "injury" BEFORE the vote.

Dr. Stacy B. Buchanan, writing from the position of a ACIP liaison representing the National Association of Pediatric Nurse Practitioners (NAPNAP), casts the recent removal of 17 CDC ACIP members as a “purge,” suggesting it was a politically motivated, unjustified dismissal of expert volunteers. She offers her own role as a liaison to ACIP as am authoritative lens through which to frame the decision as damaging, disruptive, and baseless. Ironically, Buchanan’s article omits disclosure of certain income she enjoys, and the very context that justifies the action she decries: decades of regulatory capture, a persistent failure to police conflicts of interest, and public outrage at a system that confuses allegiance to pharmaceutical products with public service.

In fact, Buchanan’s protest is precisely what underscores the need for reform.

For a moment, let us accept the premise that vaccine guidance must be free of undue influence. From this starting point, it becomes untenable to ignore the conflicts that have saturated not only ACIP voting members, but also its liaison community—Buchanan included. In public disclosures, Buchanan reported being a paid consultant to Seqirus. As Sequiris’s products include AFLURIA® TRIVALENT, Influenza Vaccine Suspension for Intramuscular Injection FLUAD® TRIVALENT (Influenza Vaccine, Adjuvanted) Suspension for Intramuscular Injection FLUCELVAX® TRIVALENT (Influenza Vaccine) Suspension for Intramuscular Injection), they are a major influenza vaccine manufacturer source.

Buchana has also accepted honoraria from the American Nurses Association for participating in their COVID-19 vaccine promotional “provider education” campaign. Her advisory role on the Scientific Committee for Vaccinate Your Family connects her to a nonprofit that receives significant funding from pharmaceutical interests, but no direct information on financial compensation for that vaccine advocacy work is available.

These facts, among others you’ll find represented in the COI heatmap I’ve developed, make it difficult to accept her premise that ACIP was a pristine forum of untainted volunteers.

Former ACIP Member’s Self-Reported COI by Vaccine Maker

Data are from: https://www.cdc.gov/acip/disclosures/by-member.html

Reporting COIs is not transparency. Acting on them is.

Despite the apparent transparency Buchanan gestures toward—such as meeting transcripts, public comments, and conflict-of-interest declarations—ACIP has, in practice, long tolerated the participation of financially entangled advisors. The 2009 Office of Inspector General report on the CDC’s ethics program found that 64% of advisors had conflicts that were either not resolved or not addressed properly (HHS OIG Report, 2009). Later, my own analysis revealed ALL BUT ONE had a COI - the military participant. Conflicted individuals often involved themselves in the discussion and only recused themselves from the vote, and some voted anyway. And with the rise of vaccine risk awareness, in spite of the systemic, entrenched denialism, the public, slowly but surely, noticed.

What Buchanan calls “shock and concern” over the cancellation of ACIP’s January 2025 meeting was, in reality, the predictable discomfort that follows a necessary interruption and derailment of a captured process. That pause enabled Secretary Kennedy’s team to evaluate whether those crafting U.S. vaccine policy had the independence their role demands. His stated goal was not retribution, but restoration. To paraphrase Kennedy: “The public must know that unbiased science guides the recommendations from our health agencies.”

Buchanan seeks to insulate ACIP from criticism by romanticizing its history. She characterizes the committee as apolitical, describing its members as humble stewards of public health. But the record contradicts her: Buchanan’s advocacy began in March 2021—after interim Phase III data were available but before full, long-term data sets and full FDA licensure. She promoted COVID-19 vaccines based on EUA review data, which included initial safety and efficacy results, but while still awaiting more comprehensive and mature evidence.

ACIP has also, while she was advising, recommended COVID-19 vaccine boosters before long-term trial data were published, relying heavily on manufacturer-provided summaries. They have accepted surrogate endpoints as definitive without independent validation. They have approved pediatric vaccine recommendations despite active trials being underpowered to detect serious adverse events.

We all now know how that turned out.

These were not trivial oversights—they are signs of a system willing to look past methodological red flags to preserve institutional momentum.

To portray this as apolitical is to deny the ideological capture at play: the unspoken assumption that to question a vaccine’s benefit-risk profile is to be “anti-science.” But Kennedy has never rejected germ theory, nor denied that vaccines can save lives. His position—and the broader demand now resounding across scientific communities—is that no product, no matter how sacrosanct, should be shielded from scrutiny by the people tasked with reviewing it. And no person profiting from a product should be seated at the table where its approval is debated.

Buchanan repeats a now-familiar slander—that Kennedy’s past leadership of Children’s Health Defense makes him responsible for measles outbreaks, specifically citing an unverified allegation in Samoa. This narrative collapsed under even mild scrutiny. I was involved in his trip; I help make it happen, and I have a copy of his formal invitation. Kennedy went there to see if they needed help to do a study to find out why kids were dying from measles. The temporary drop in vaccination uptake in Samoa followed the death of two children after being administered improperly prepared MMR vaccines—not because of advocacy from abroad, but because of gross medical error within the system. To blame that tragedy on CHD or Kennedy is to fail to understand the requirements for temporal causality, and, worse, to engage in emotional scapegoating rather than factual debate. At this point, Buchanan has likely committed slander, specifically libel, of a sitting US Presidential cabinet member.

What is perhaps most revealing about Buchanan’s article is not what it says, but what it presumes: that the public should trust systems that have failed them, simply because the participants say they meant well. We will not soon forget the debacle of the HHS’s response. We know that trust is not restored by repetition of mantras. It is restored by evidence of change.

Kennedy’s removal of entrenched ACIP members was not an attack on science. It was an act of rescuing science from the grip of consensus-by-conflict. For those who believe in open data, in clean methods, and in the independence of medical judgment from industrial funding, the dismissal was not a purge. It was a promise.

A new ACIP is being seated. The public is watching. And, finally, we will see science, not salesmanship, take the lead.