COMMENTARY: When the federal vaccine process falters, good science cannot stop
Michael T. Osterholm, PhD, MPHToday at 9:57 a.m.
COVID-19
Influenza Vaccines
Respiratory Syncytial Virus (RSV)
For more than 60 years, Americans benefited from a federal process designed to answer an extraordinarily important question: What does the best available scientific evidence tell us about how immunizations can be used to protect us from viruses that can hospitalize and even kill?
At the center of that process were the Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP). At its best, ACIP brought together leading experts, supported by career CDC scientists, to systematically examine vaccine safety, effectiveness, and disease epidemiology. Its deliberations took place in public, and its recommendations provided physicians and patients with a common source of evidence-based guidance. It was a perpetual machine, (typically) quietly—but vitally—chugging along in the background, while the rest of us went about our daily lives.
Today, that system is no longer functioning.
The federal vaccine-recommendation process is in disarray—to put it mildly—but influenza, COVID-19, and respiratory syncytial virus (RSV) have not stopped circulating. We cannot allow this breakdown to create a vacuum in evidence-based vaccine guidance.
Physicians still have patients to care for. Parents still must make decisions for their children. Older Americans, during pregnancy, and people with underlying health conditions still need reliable information about how best to protect themselves from respiratory viruses.
A thorough review months in the making
That is why the Vaccine Integrity Project at the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), working with the American Medical Association (AMA), began preparing back in February for the 2026-27 respiratory virus season.We collaborated with medical specialty societies and public health organizations to identify the questions clinicians need to answer. As we did last year, our researchers then systematically reviewed the newest scientific evidence on influenza, COVID-19, and RSV immunizations, examining effectiveness and safety and assessing the quality and potential bias of the data.
Those reviews were published in the Journal of the American Medical Association and made available to the public, and a tool on the Vaccine Integrity Project’s website lets you look at every study our researchers reviewed and see the evidence for yourself.
Our work builds on last year’s effort to ensure that changes in federal vaccine policy do not prevent clinicians and Americans from having access to rigorous, current assessments of vaccine evidence.
Tools for doctors and patients
But an evidence review alone is not enough.Evidence must be translated into clinical recommendations that physicians and the public health community can use. That is why the work being done by the nation's leading medical specialty societies and the AMA is so important.
This year, the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and Infectious Diseases Society of America worked together to coordinate the release of their recommendations.
And the AMA has created an online resource center—www.spreadthefacts.org—where clinicians and public health professionals can find information and tools about influenza, COVID-19, and RSV immunization.
Asking key questions, rigorously examining the data
This collaboration is not an attempt to create a rival government vaccine system. I hope it does not need to become one.The United States needs a strong federal vaccine-recommendation process. We need CDC scientists with deep expertise in infectious diseases, epidemiology and vaccine safety. We need independent experts examining evidence in public. And we need a system insulated from political interference, regardless of which party controls the White House.
Until that system is restored, however, the medical and scientific communities have a responsibility to act.
Americans are understandably asking whom they should trust when they hear conflicting messages about vaccines. I would suggest looking beyond the name of the institutions delivering the message and asking how they reached their conclusion.
Was the evidence systematically reviewed? Were qualified experts involved? Were benefits and risks both examined? Were the methods transparent? Can the public see the evidence supporting the recommendations?
Those questions matter because science is not a matter of institutional authority. It is a process for determining what the evidence tells us—and changing our conclusions when the evidence changes.
The Vaccine Integrity Project evaluates that evidence. Medical societies independently determine what it means for clinical practice. Physicians then help patients decide what is appropriate for them.
That separation of responsibilities is intentional. Our role is not to defend vaccines or reach predetermined conclusions. It is to ask important questions, rigorously examine the evidence and report what we find.
At a moment when much of the national conversation about vaccines has become political, what has happened this year offers a different model. Scientists, physicians, public health experts and medical organizations recognized a gap and worked together to fill it.
Whatever happens next in Washington, one principle should endure: Americans deserve vaccine recommendations grounded in the best available science. We must not lower that standard. Our health and the health of our communities depend on it.
Dr. Osterholm is executive director of the Vaccine Integrity Project and director of CIDRAP.