This edition of the Pandora Report provides update on this week’s meeting of the Advisory Committee on Immunization Practices, Secretary Kennedy’s announcement that the US will withdraw its funding to Gavi, and more.
Newly-Appointed ACIP Member Withdraws, Citing Conflicts of Interest
Michael Ross, one of eight people appointed to the Advisory Committee on Immunization Practices (ACIP) by Robert F. Kennedy Jr., has reportedly already removed himself from the body following a conflict of interest review. Ross notably also claimed to be a clinical professor of obstetrics and gynecology at both George Washington University and Virginia Commonwealth University, though NBC’s affiliate News 4 Washington found he had not worked at either institution in years.
An HHS spokesperson said of Ross’ departure, “Yesterday, Dr Michael Ross decided to withdraw from serving on ACIP during the financial holdings review.” In his announcement of the removal of all 17 members who previously sat on ACIP, Sec. Kennedy specifically cited conflicts of interest as a key motivation behind his decision to overhaul the body. Notably, other conflicts of interests new ACIP members have, such as leadership positions with anti-vaccine organizations or having been paid expert witnesses against pharmaceutical companies, were not disclosed during the conflict of interest review process.
Further Reading:
- “Vaccine Panel Gutted by Kennedy Loses a Member Ahead of First Meeting,” Apoorva Mandavilli, The New York Times
ACIP Holds First Meeting Since Overhaul
This week, ACIP held its first meeting since Sec. Kennedy dismissed all 17 previous members from the body, stirring up yet more controversy along the way. The controversy began before the meeting was even held on Wednesday when a presentation set to be shared at the meeting was found to cite non-existent studies. The presentation was given to ACIP on the second day of the meeting by Lyn Redwood, president emerita of Children’s Health Defense (the anti-vaccine group RFK Jr. founded), and claimed that the non-existent study found that use of thimerosal in vaccines can have “long-term consequences in the brain.” The presentations reportedly bypassed normal review processes. Interestingly, Redwood is set to be hired to work in CDC’s Immunization Safety Office.
Thimerosal is a preservative that has been used in vaccines since the 1930s, and it is especially useful for its antimicrobial properties, which has allowed it to make multi-dose vaccine vials safer. This is important because thimerosal, by preventing harmful microbe growth inside multi-dose vials, means immunization campaigns can be more effective by delivering more usable, safer product to communities that need it. Use of thimerosal in FDA-licensed vaccines has declined broadly in large part because of reformulation and development of vaccines presented in single-dose containers.
Notably, thimerosal was removed from childhood vaccines in the US in 2001. This was a precautionary measure aimed at growing public trust in vaccines, with there being no evidence of harm caused by the small amount used in some vaccines apart from minor reactions at the injection site. Today, only a handful of vaccines contain thimerosal, including some influenza vaccines (again, specifically multi-dose presentations). Furthermore, the mercury in thimerosal is metabolized or degraded to ethylmercury, which does not accumulate in the body. This is in contrast to methylmercury, which is naturally occurring in different animals (including certain fish like tuna, swordfish, and king mackerel), does accumulate in the body, and is toxic at high levels.
Redwood repeatedly made false or misleading claims during her presentation, including claiming at one point that ethylmercury has a greater potential to be maintained in the brain than methylmercury, which is false. She also emphasized the lack of studies on thimerosal toxicity in humans, demonstrating apparent ignorance of how vaccine safety is evaluated. Thimerosal is just one component of some vaccines. Therefore, relevant studies aim to determine whether vaccines that contain thimerosal are safe, which has been well established in the literature.
However, this was just one part of the ACIP meeting. The meeting was riddled with inaccuracies, apparent mis- or lack of understandings of how vaccines are produced, and arguments or statements that lacked necessary context. Martin Kulldorff, who was appointed ACIP chair, was incorrectly listed as having an MD on the slide deck (Kulldorff holds a PhD) and made multiple misleading comments about MMR/MMRV vaccines, hepatitis B birth doses, and test-negative designs for COVID-19 vaccines. Restef Levi made inaccurate statements about COVID-19 vaccines and spike proteins while also implying that COVID-19 vaccination makes people more likely to need hospitalization if infected. Robert Malone claimed that certain COVID-19 vaccine lots cause more adverse events. Vicky Pebsworth expressed concern about high numbers of VAERS reports for COVID-19 vaccines, seemingly ignoring the higher number of COVID-19 vaccines given in comparison to any other vaccine during the same period of time and other issues. The list goes on and on, with experts with The Evidence Collective documenting 50 falsehoods shared over the course of the meeting.
Ultimately, ACIP did maintain the general flu vaccine recommendation for those over six months old. It did pass three motions recommending single-use vials only for all adults, children 18 years and younger, and pregnant women for flu vaccines. ACIP did also vote to recommend the RSV shot. Specifically, Clesrovimab is a monoclonal antibody created by Merck, and it is recommended for use in infants younger than eight months who are born during or entering their first RSV season. Both Kulldorff and Malone have been paid to serve as expert witnesses in civil litigation against Merck, which they did not disclose during the conflict of interest review. Furthermore, members who voted against recommending this treatment (Levi and Pebsworth) later voted for its inclusion in the Vaccines for Children program.
Amid concerns about what this new version of ACIP might do, professional medical societies, vaccine manufacturers, state health officials, and many others are working to do what they can to protect access to vaccines. Some are discussing the possibility of ordering vaccines directly from manufacturers, ways to give greater weight to vaccine recommendations that come from medical associations, and asking insurance companies to continue providing coverage based on those associations’ recommendations, rather than those of ACIP. Others are looking to create alternative bodies to provide sources of unbiased information it seems ACIP no longer can provide. One such group is the Vaccine Integrity Project, launched by Michael Osterholm at the University of Minnesota’s CIDRAP.
Meanwhile, representatives of the American Academy of Pediatricians (AAP) refused to participate in the ACIP meeting, saying it was “illegitimate.” AAP President Susan J. Kressly, MD, FAAP, said that the creation of federal immunization policy is “no longer a credible process,” and that “We won’t lend our name or our expertise to a system that is being politicized at the expense of children’s health. But we’re not stepping back, we’re stepping up. The AAP will continue to publish our own immunization schedule just as we always have, developed by experts, guided by science, trusted by pediatricians and families across the country.”
While the votes taken by ACIP this week did not end as poorly as they could have, the future of this body is grim, especially as vaccination rates already are lagging and pandemic preparedness continues to erode under the current administration. Predictably, much of the commentary and other content at this meeting did lend credibility to debunked claims about vaccines, their production, and their development.
Further Reading:
- “Vaccine Policy Meeting: The Essentials,” Katelyn Jetelina, Your Local Epidemiologist
- “Six Former CDC Vaccine Advisory Committee Chairs Warn: U.S. Risks Losing Access to Life-Saving Immunizations,” Grace Lee, Nancy Bennett, Jonathan Temte, Carol Baker, Myron Levin, and José Romero, STAT News
- “AAP Will Continue to Publish Its Own Vaccine Recommendations After CDC Advisers Sow Distrust,” American Academy of Pediatrics
- “4 in 5 Americans Support Childhood Vaccine Requirements, Poll Finds,” Jim Wappes, CIDRAP
- “The Good News (154 Million Deaths Avoided) and Bad News About Childhood Vaccines,” Gabrielle Emanuel, NPR
- “Childhood Vaccination Coverage was Falling Across the Globe Even Before Covid,” Veronica Paulus, STAT News
- “The World’s Only Twice-a-Year Shot to Prevent HIV Could Stop Transmission — If People Can Get It,” Lauren Neergaard, AP News
US to Withdraw Its Funding for GAVI
In remarks made to a Gavi pledging summit in Brussels, Secretary Kennedy announced that the US will halt all contributions made to the organization, claiming that is has “ignored the science” in its work to vaccinate children globally. Kennedy further accused Gavi’s leadership of being selective in their use of science in choosing vaccines, and that “When vaccine safety issues have come before Gavi, Gavi has treated them not as a patient health problem, but as a public relations problem.” Kennedy neglected to provide evidence or examples for these claims.
Kennedy says that the US will not provide the $1.2 billion it has pledged to Gavi unless the organization changes its practices. Gavi issued a statement rejecting Kennedy’s claims. While the organization will not implode without US funding, there are concerns about Gavi’s ability to maintain its operations at their current scale. Fewer vaccines in low- and middle-income countries will impact everyone, including the United States, especially as the US withdraws so much of its other commitments to global health and international aid.
Further Reading:
- “The Costs to Global Health,” Carrie Arnold, Hopkins Bloomberg Public Health
- “Missteps, Confusion and ‘Viral Waste’: The 14 Days That Doomed U.S.A.I.D.,” Christopher Flavelle, Nicholas Nehamas, and Julie Tate, The New York Times
- “What Remains of U.S.A.I.D.?,” Amy Schoenfeld Walker, Malika Khurana, and Christine Zhang, The New York Times
“Assessing Readiness of International Investigations into Alleged Biological Weapons Use”
Brackmann et al. published this article in Emerging Infectious Diseases: “Without clarity if an outbreak is natural, accidental, or deliberate, infectious disease outbreaks of unknown or ambiguous origin can lead to speculation of a purposeful biological attack. Outbreaks in conflict settings are particularly prone to suspicions and allegations. In an increasingly confrontative global geopolitical landscape and with active information manipulation, outbreaks of ambiguous origin are likely to increase concerns of the deliberate use of biological agents. The United Nations General Assembly has agreed on and the United Nations Security Council has endorsed a mechanism to investigate allegations of deliberate use titled the United Nations Secretary-General’s Mechanism for Investigation of Alleged Use of Chemical or Biological Weapons. A recent full-scale field exercise evaluated the deployment readiness of the mechanism and found it is well placed to investigate suspicious disease outbreaks, with room for continual improvement.”
“Dismantling CDC’s Global Work is Dismantling Our First Line of Biodefense”
Stephanie Psaki and Nikki Romanik authored this Just Security article, in which they write, “Over the last few months, the Trump administration has weakened or eliminated the layers of the U.S. biodefense system – dismantling the U.S. Agency for International Development’s programs around the world, eroding the National Security Council’s real-time coordination capability during threats, eliminating the White House pandemic office, and most recently, cancelling proactive investments in safeguards like pandemic influenza vaccines. Amid those changes, one of our strongest defenses against biological threats abroad has been the enduring partnerships and systems maintained by the CDC. However, with the release of President Trump’s budget request earlier this month, the administration signaled an intent to weaken — if not entirely dismantle — this critical safeguard that allows the U.S. to detect outbreaks at their source, leaving Americans and the world more vulnerable to biological threats.”
“Health Emergency Research Preparedness: An Analysis of National Pre‑COVID Research Activity and COVID Research Output”
Peter H. Kilmarx and Shirley Kyere published this article in Annals of Global Health: “Background: Research capacity is a critical element of health emergency preparedness, but metrics are not readily available for many countries. The COVID‑19 pandemic provided an opportunity to use publicly available data to assess correlations between national pre‑pandemic research activity, pandemic research response, and other national socioeconomic characteristics.”
“Methods: National pre‑pandemic (2018–19) research activity was defined as the average of percentile rankings of (1) the average annual number of health science publications in Scopus and (2) the average annual number of clinical trials in the International Clinical Trials Research Platform (ICTRP). National pandemic research response (2020–21) was defined as the average of percentile rankings of (1) average annual number of COVID‑19‑related publications in Scopus and (2) average annual number of COVID‑19‑related clinical trials in ICTRP.”
“Findings: During 2018–19, the median (interquartile range [IQR]) of national annual average health science publications was 415 (108–3,398) and of clinical trials was 21 (4–273). During 2020–21, the median (IQR) of national annual average COVID‑19‑related publications was 85 (18–798) and that of COVID‑19‑related clinical trials was 1.5 (0–11). National COVID‑19‑related research output was strongly correlated with pre‑pandemic research activity (R‑squared 0.89) and much less correlated with Human Development Index (0.26), COVID‑19 case number (0.16), case rate (0.14), gross domestic product (0.11), or population (0.10). In a multivariable linear regression analysis, national pre‑COVID‑19 research activity was the only factor with substantial or statistically significant contribution to explaining variations in COVID‑19‑related research output.”
“Interpretation: National pandemic research responses were most strongly correlated with pre‑pandemic research activity, much more so than with other country characteristics. These findings strongly support global efforts to strengthen research capacity as a critical element of preparedness for health emergencies.”
“Behind Shuttered Borders: A view into North Korea’s COVID-19 experiences”
Victor Cha, Katrin Fraser Katz, and Seiyeon Ji recently published this CSIS report: “This report by the Center for Strategic and International Studies, in cooperation with the George W. Bush Institute, is to our knowledge the first published review of human rights abuses inside North Korea associated with the Covid-19 global pandemic. Between January 2020 and August 2023, the regime imposed one of the world’s most extreme lockdowns—sealing its borders and halting all exchanges related to trade, tourism, diplomacy, and humanitarian aid, and enforcing rigid internal travel restrictions—under the guise of “anti-epidemic” measures. With no independent reporting possible during this period, the regime claimed a flawless record, denying any Covid-19 cases for the first two years and reporting only 74 deaths when it finally acknowledged an outbreak in May 2022.”
“This report is based on the voices of 100 ordinary North Korean residents amplified through micro-surveys conducted in the second half of 2023, just as the country’s lockdown restrictions and border controls were lifted. While the report’s findings should not be interpreted as a complete representation of views in North Korea, they still provide rare insights into the lived experiences of ordinary North Koreans and expose key patterns of government culpability and negligence in managing the pandemic. Drawing on these findings, the authors discuss policy implications and offer recommendations for governments and international organizations seeking to improve the welfare of the North Korean people.”
“5 Years Later: America Looks Back at the Impact of COVID-19”
From Pew: “The most significant pandemic of our lifetime arrived as the United States was experiencing three major societal trends: a growing divide between partisans of the left and right, decreasing trust in many institutions, and a massive splintering of the information environment. COVID-19 did not cause any of this, but these forces fueled the country’s divided response. A Pew Research Center survey conducted in October 2024 found that nearly three-quarters of U.S. adults (72%) say the pandemic did more to drive the country apart than to bring it together. Fundamental differences arose between Americans over what we expect from our government, how much tolerance we have for health risks, and which groups and sectors to prioritize in a pandemic. Many of these divides continue to play out in the nation’s politics today.”
Read more here.
“Fostering Better Science by Releasing Biomedical Research and Innovation from the Grip of Rich Nations”
Nathalie J. Arhel recently published this opinion piece in PLOS Global Public Health, in which she discusses efforts to decolonize biomedical research and how they can reinforce existing inequities, and paths toward inclusive and equitable governance of biomedical research. She writes in her introduction, “In early 2025, the new US administration took unprecedented actions to axe funding to federal science and agencies and suspend foreign aid programs. Beyond the evident toll on global health – such as the closure of clinics that support vulnerable communities and interruptions in epidemiological surveillance – the erosion of US foreign aid presents a potential opportunity to redress long-standing inequities in biomedical research. The call for change is not new: the COVID-19 pandemic exposed the vulnerabilities of global health systems, highlighting the importance of national and regional self-sufficiency in research and innovation. Moreover, there is a growing acknowledgement of the need to dismantle systemic power imbalances and confront historical injustices…By addressing the inequities in biomedical research and considering how these can be redressed, this opinion piece aims to contribute to a broader effort to centre marginalized voices and knowledge systems.”
ICYMI: Paris Conference on Risks from Mirror Life
“This Conference is the first in a series of international meetings that will bring together a wide range of stakeholders to discuss and address the feasibility and risks of efforts to develop mirror life. The Conference will commence on 12th June with a publicly-streamed Symposium sharing the state of scientific understanding on these topics with a broad audience. On 13th June, a series of expert workshops will be held to begin addressing outstanding questions.”
Watch the event recording here, and read about the conference here.
NEW: Synthetic Biology for Biomanufacturing and Predictable Engineering
From NASEM: “Advances in biotechnology and biomanufacturing are essential for the United States to maintain global leadership as well as for supporting economic and national security interests. Biology provides the basis for innovations from medicine, health, and agriculture, to defense, energy, and manufacturing.”
“Join the National Academies on July 1 from 8:30 AM to 5:00 PM ET for a workshop session that will explore innovations in biomanufacturing technologies that can make scale-up predictable, rapid, and cost-competitive. Participants will discuss the need for public-private collaborations to drive sustained improvements in biomanufacturing, while also looking at ways to make biotechnology predictably engineerable with emerging technologies such as synthetic cells and AI/machine learning integrations.”
Learn more and register here.
NEW: CTD–SPECTRE Symposium, “Tropical and Emerging Infectious Diseases for Clinicians and Translational Scientists”
“The CTD-SPECTRE Symposium on Tropical and Emerging Infectious Diseases for Clinicians and Translational Scientists 2025 offers a unique opportunity to connect with global experts, gain cutting-edge insights, and collaborate with peers dedicated to infectious disease research and treatment.”
“Taking place September 16 -19, 2025, at the historic Grand Galvez in Galveston, TX, this immersive symposium will unite clinicians, translational investigators, and trainees to explore the latest breakthroughs in tropical and emerging infectious diseases.”
“Hosted by the Division of Infectious Diseases at UTMB, Center for Tropical Diseases (CTD) and Special Pathogens Excellence in Clinical Treatment, Readiness, & Education (SPECTRE) Program.”
Learn more and register here.
International Pandemic Sciences Conference
“Representatives from academia, industry, civil society and policy are invited to gather in Oxford, UK, and online from 30 June – 1 July 2025 for the International Pandemic Sciences Conference 2025.”
“This year’s conference theme, Getting Ahead of the Curve, will explore how we can work together to predict, identify and control epidemic and pandemic threats globally. ”
“Over two days of plenary, parallel and networking sessions, stakeholders from different sectors and communities will have the opportunity to share ideas, experiences and strategies on prediction, early detection and control of pandemic threats. ”
“The International Pandemic Sciences Conference 2025 is hosted by the Pandemic Sciences Institute at the University of Oxford.”
Learn more here.
Biodefense in Crisis: Danger and Opportunity
“This Commission meeting, Biodefense in Crisis: Danger and Opportunity, will be held on July 22, 2025. As a new Administration begins to develop its policy priorities and realigns federal offices and programs, the government must maintain and strengthen federal capabilities to address the biological threat. The focus of this meeting will be to provide the Bipartisan Commission on Biodefense with a better understanding of (1) core requirements for effective national biodefense; (2) Administration biodefense priorities; (3) impacts of department and agency realignment; and (4) strategies for addressing future biological threats. More information will be provided as the event date approaches.”
This event will take place on July 22, 10 am-4 pm ET in Washington, DC. Register here.
SBA.4 International Synthetic Biology and Biosecurity Conference in Africa
From SynBio Africa: “The SBA 4.0 conference will serve as a platform for fostering connections among industry, academia, community groups, and policymakers. It will showcase innovative applications of synthetic biology and AI, and highlight ongoing efforts in biomathematics, biomanufacturing, one-health, biosafety and biosecurity. It will also facilitate networking and information exchange. Key focus areas include tackling agriculture, health, environmental management, and industry challenges. In Africa, synthetic biology is poised to drive the national development agenda by promoting a sustainable bioeconomy, supporting health and agricultural systems, and aiding environmental conservation and restoration. This event will provide a vital opportunity for stakeholders to discuss and strategize the integration of synthetic biology innovations, address policy, legal frameworks, and communicate the benefits of the technology.”
This conference will take place July 23-25 in Kigali. Learn more and register here.
CTD-SPECTRE 2nd Annual Symposium
“The CTD-SPECTRE Symposium on Tropical and Emerging Infectious Diseases for Clinicians and Translational Scientists 2025 offers a unique opportunity to connect with global experts, gain cutting-edge insights, and collaborate with peers dedicated to infectious disease research and treatment.”
“Taking place September 16 -19, 2025, at the historic Grand Galvez in Galveston, TX, this immersive symposium will unite clinicians, translational investigators, and trainees to explore the latest breakthroughs in tropical and emerging infectious diseases.”
Learn more and register here.
Applied Biosafety Call for Papers
“The Editors of Applied Biosafety are pleased to announce a forthcoming Special Issue focused on the myriad of topics associated with global biosafety management. This special issue will showcase examples of innovative approaches, creative solutions, and best practices developed and used around the world for managing risks associated with the handling, use, and storage of infectious biological agents, toxins, and potentially infectious materials in research and clinical settings.”
Learn more and submit by November 1 here.
Request for Proposals: Biosafety and Biosecurity Capacity Strengthening in Support of the 100 Days Mission
From CEPI: “This Request for Proposals (RfP) will support the establishment of a group of implementation partners to enable successful implementation of CEPI’s Biosecurity Strategy, focused on objectives associated with capacity strengthening, equity, and health-security partnerships, as described in CEPI’s Biosecurity Strategy Implementation Plan. The selected applicants will sign a Framework Agreement under which CEPI can make “call-offs”, i.e. requests for services, related to specific tasks. At CEPI’s direction, services rendered under this Framework Agreement may be provided to CEPI internally, or to a partner organization (e.g. partner countries, affiliates within CEPI’s laboratory and manufacturing networks particularly in the Global South, international organisations, etc.); such partners may govern aspects of the content of the work, but the legal agreement remains with CEPI.”
Learn more and submit proposals by July 30 here.
Call for Applications: Mid-Career Biodefense Bootcamp Fellowship (2025)
“…the Council on Strategic Risks (CSR) is continuing to develop and cultivate creative solutions to help address biological threats, including a particular focus on reducing risks of the deliberate misuse of infectious diseases and other biological materials, processes, and products. As part of this work, CSR is announcing an open call for applications for our new Mid-Career Biodefense Bootcamp Fellowship, which follows an early-2024 beta run of the program.”
“In this “bootcamp” fellowship, successful applicants will learn from leading experts committed to biological threat reduction and biosecurity, including current and former government officials who helped dismantle Cold War-era biological weapons capabilities, advance international biological cooperation, and drive policy progress. They will interact with leading current and former experts as well as public and private sector innovators.”
Learn more and apply by July 7 here.
The Pandora Report 