ATLANTA—The U.S. antivaccine movement has found a new front for its attacks on scientists and their work: gatherings of the Advisory Committee on Immunization Practices (ACIP), which recommends which vaccines Americans should receive. Since last summer, increasing numbers of vaccine opponents have come to ACIP meetings, held three times a year here at the campus of the Centers for Disease Control and Prevention (CDC), to vent their anger at the 15 buttoned-down experts on the panel during the public comments section—and to lambaste vaccination in general.
“I do not consent to handing over my God-given children to the government of the United States of America,” Sandy Spaetti, who had traveled from Rockport, Indiana, said at ACIP’s meeting on 27 February, to raucous applause from dozens of other activists. “How is a vaccine that caused my son’s intestines to fold in on itself and almost die safe and effective?” asked Nicole Mason, a photographer from Jacksonville, Florida, who said she lost faith in all vaccines when her 4-month-old son developed intussusception, an intestinal obstruction, after receiving the rotavirus vaccine last summer. (The blockage occurs in an estimated one to five of every 100,000 infants vaccinated; it can also be caused by rotavirus infection itself.)
“This may be the new normal. We don’t know. But it certainly is a lot more than we have seen in the past,” says ACIP’s new chair, José Romero, a pediatric infectious disease specialist at the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital in Little Rock who has served on the panel for 4 years.
ACIP members, mostly physicians, review reams of data, then develop and vote on recommendations for vaccines ranging from niche to universal. At last week’s meeting, for instance, they considered tweaks to the schedule for vaccinating travelers to Asia and the western Pacific against Japanese encephalitis. They were also briefed on new studies as they consider whether to recommend that U.S. adults aged 27 through 45 consider getting vaccinated against the cancer-causing human papillomavirus. The 75-minute public comment period came at the end of the technical presentations.
“This is kind of ground zero where these decisions are being made,” says Lynette Barron, a radio talk show host from Pell City, Alabama, who says her 3- and 5-year-old daughters were harmed by vaccines. Barron has attended ACIP meetings since early 2017; back then, “I was here by myself,” she says. But last year, she launched the Facebook page “Inundate the CDC ACIP Meetings.” Some 20 vaccination opponents showed up at ACIP’s June 2018 meeting. The October 2018 meeting drew perhaps 50, she says. That event grew so tense that in January, CDC issued new rules of conduct, warning members of the public to expect metal detectors at the doors and putting them on notice that the chair would eject them for disruptive behavior.
Last week, police guarded the doors as a crowd filled 165 public seats in CDC’s auditorium; at least 80 attendees were vaccine opponents. They came from as far away as Iowa, Massachusetts, and California, Barron says. For the first time, committee members were roped off from the public—a setup that mirrors the vaccination controversy in the country at large, says Bernice Hausman, a cultural theorist at Pennsylvania State University’s College of Medicine in Hershey. “On one side is evidence-based, dispassionate discourse; on the other, citizens making emotional appeals, using alternative evidence, or telling personal stories. … The two don’t seem to meet,” says Hausman, whose book, Anti/Vax: Reframing the Vaccination Controversy, will be published in April.
Forty-five people had asked to offer public comment; only a score, drawn by lottery, could be accommodated. All but two of the speakers attacked vaccinations and the committee. “I can’t explain why suddenly things shifted after so many years with relatively modest public comments,” says ACIP member Kelly Moore, who until recently directed the Tennessee Immunization Program and is an assistant clinical professor of health policy at the Vanderbilt University School of Medicine in Nashville. “But it’s our duty to listen … and to make sure that we are aware of what public sentiment is.”
One reason vaccination opponents have begun to turn out at ACIP may be that they are disappointed in President Donald Trump, says Paul Offit, who directs the Vaccine Education Center at the Children’s Hospital of Philadelphia in Pennsylvania. A “vaccine safety and scientific integrity” commission that Trump promised to set up soon after he was elected never materialized, for example. Offit suggests vaccine opponents felt “they had their man in the White House—that things were gonna happen for them. And they didn’t.”
Despite the emotion and determination of vaccine resisters, U.S. vaccination rates among young children remain robust. A 2017 CDC analysis found more than 90% of toddlers had received most recommended vaccines, and only 1.3% of children born in 2015 had received none of the 14 recommended early-childhood vaccinations—a quadrupling from the 0.3% figure in 2001, but still a tiny fraction. (The refusal rate is higher in some geographical pockets, several of which are now battling measles outbreaks.)
The increasingly vituperative public attacks can be tough on ACIP scientists, however. “How does it feel knowing that your vote killed my son?” one woman asked the panel in October 2018. But Romero doubts the protests will make it tougher to recruit experts to serve on the committee. “It would take a lot to make us not come,” he says, calling the position “the pinnacle of public health impact. … Most of us consider this an extremely high honor to be here.”
*Correction, 12 March, 12:55 p.m.: This story has been updated to reflect Kelly Moore's current affiliation.