The Contrarian At The CDC Vaccine Policy Meeting
Dr. Tracy Beth Høeg used her time at the critical ACIP meeting to cast doubt on vaccines.
This week, a doctor with a reputation for spreading vaccine misinformation is participating in one of the most important public health events of the year—a meeting that will impact how certain vaccines are used in the U.S.
Tuesday marked the first day of the first annual meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, makes recommendations for vaccine policy. The group holds three scheduled meetings every year at which it reviews vaccine data and votes on the recommendations, which are then passed to the CDC director for final approval.
The committee consists of 19 voting members—independent medical and public health experts—along with six ex officio members from federal agencies that run immunization programs and 30 representatives from liaison organizations. Typically, ACIP’s meetings are attended by qualified experts.
This year one of the ex officio members is raising eyebrows, however. Normally, the Food and Drug Administration sends the director or deputy director of its Office of Vaccines Research and Review to the meeting. This year, its representative is a political appointee: Dr. Tracy Beth Høeg, a sports medicine physician and epidemiologist with a long history of casting doubt on the safety and efficacy of COVID vaccines based on dubious research.
Høeg stands out among her ACIP peers. A right-wing favorite for her advocacy against pandemic mitigation measures, she is an ally of anti-vax activist and Health and Human Services Secretary Robert Kennedy Jr. She was recently chosen to serve as a special assistant to FDA Commissioner Marty Makary, a surgeon who is himself a Kennedy ally with a dubious history of promoting vaccine misinformation. Her limited background on the subject of immunizations includes co-authoring a controversial pre-print on mRNA COVID jabs that used unverified data from the Vaccine Adverse Effect Reporting System.
According to an agenda published online ahead of Tuesday’s meeting, the committee was set to focus on a number of vaccines over the two days including those for COVID, flu, HPV, Mpox, and RSV. While ex officio members do not get a vote, they do get to speak.
Predictably, Høeg used her voice on the first day to cast doubt on vaccines. Regarding a proposed recommendation to extend routine vaccination against mpox with Bavarian Nordic’s Jynneos vaccine to adolescents ages 12 to 17, she questioned the necessity and safety of doing so.
“I just want to point out from an epidemiological standpoint from the risk-benefit ratio with this proposed recommendation…this age group is at very very low risk of even having a monkey pox case—it looks like we had less than 20 in the last year,” Høeg said. “And when you consider the amount of safety data we have from the small number of people who have received the vaccine so far in this age group…I think it’s very challenging I think to say that we know that the benefits of the vaccine will outweigh the potential harms because we just have such a small denominator in terms of number of adolescents who have been vaccinated so far.”
After one of the presentations on flu shots, Høeg raised concerns about bias in a vaccine effectiveness study that the presenters noted had already been accounted for in the design. Following a presentation on COVID vaccines, she took issue with a slide showing the vaccination status of children hospitalized with the disease, which revealed that most were unvaccinated.
”Just a really quick comment on the fact that 90 percent of the children hospitalized with COVID-19 were unvaccinated is not actually really going to tell us much about the effectiveness of the vaccine considering almost 90 percent of children in general are unvaccinated—I believe it’s 87 percent most recently and 86 percent the year before—and the same applies to adults, so it’s important to adjust for the baseline rate of vaccination for the population,” she said.
In response to Høeg’s remarks, the presenters noted that the slide in question was not meant to reflect the efficacy of the jabs and that the design of their vaccine effectiveness study controlled for baseline coverage.
Anticipation was high heading into Tuesday’s meeting with anti-vax activist Robert Kennedy Jr. heading up the Department of Health and Human Services. Observers were paying close attention to see how it would go. Since Kennedy’s nomination, speculation had been swirling for months that critical vaccines might become targets of the new administration. The concern reached fever pitch when the meeting, originally set for February, was rescheduled and a vote on the influenza vaccine was stricken from the agenda.
Some public health experts see Høeg’s involvement with ACIP as a troubling sign of what is to come. Dr. Angela Rasmussen, a virologist and AJI scientific adviser, called Høeg “grossly unqualified to provide expert advice on vaccination.”
“Her only experience with vaccine research includes publishing scientifically unsound preprints and papers overstating risks and minimizing benefits of vaccination to children,” Rasmussen said.
University of California, San Francisco, law professor Dorit Reiss, who specializes in vaccine law and policy, criticized Høeg’s performance at Tuesday’s meeting, explaining “this is not her area, and she comes in with a well-established bias, and her comments tend to reflect that.”
“If her presence reflects significant loss of expertise in FDA, that's concerning; if it reflects desire to inject a bias against vaccines, that's also concerning,” Reiss said.
The ACIP meeting resumed on Wednesday.