Health and Human Services Secretary Robert F. Kennedy Jr. has had his way with federal vaccine policy over the past 13 months. He personally fired every member of a key vaccine committee and packed the body with allies, vaccine skeptics, and public health iconoclasts. The panel quickly rolled back longstanding vaccine recommendations and aired anti-vaccine views that previous committee members and major medical associations have lambasted as untethered to reality.
In January, the secretary sidelined his handpicked members of the Advisory Committee on Immunization Practices (ACIP) to unilaterally implement a bulk revision to the childhood vaccine schedule, cutting the number of routine vaccination recommendations from 17 to 11.
On Monday, a federal court ruling put all of that on hold, at least temporarily. District Court Judge Brian Murphy issued a stay on the January schedule revisions, the guidance changes ACIP adopted last year, and any further votes by the committee. ACIP was scheduled to meet this week, but the gathering has now been postponed.
The ruling came in a suit brought by medical associations to challenge the sweeping changes. They heralded the ruling, but public health observers fear any legal victory—whether temporary or after the suit makes its way through the courts—cannot undo the confusion and anti-vaccine messaging already promulgated by the Trump administration.
What is the case about?
Six major medical organizations, including the Infectious Diseases Society of America and the American Academy of Pediatrics (AAP), filed the lawsuit last July, objecting to Kennedy’s unilateral decision to no longer recommend the COVID vaccine for healthy children and pregnant women. After the secretary remade ACIP and the committee began changing long-standing vaccine guidance, the plaintiffs updated their complaint to challenge those actions, and last month, they broadened the case further to address the January revisions to the childhood schedule.
The key legal issues fall into two buckets. The first is a challenge to the current ACIP makeup. The plaintiffs argue that Kennedy’s June reconstitution of the committee violated the requirements of the Federal Advisory Committee Act (FACA) and ACIP’s own established procedure for appointing new members—namely, that the committee have a “fairly balanced” membership of people who are experts regarding immunization practices, public health, and vaccine safety and efficacy. Most of the new members lack experience or credentials in those areas and appear to have been selected mainly for their ties to Kennedy and/or general skepticism toward vaccines.
The challengers also argue those same shortcomings mean Kennedy’s reconstitution of the committee constitutes an “arbitrary and capricious” action that the Administrative Procedure Act (APA) requires courts to invalidate.
The second issue involves the schedule changes earlier this year. On January 5, Jim O’Neill, then the acting director of the Centers for Disease Control and Prevention (CDC), adopted a historic paring-down of the childhood schedule less than a month after a presidential directive charged officials with aligning guidance to match countries like Denmark that recommend fewer routine vaccinations. (The Department of Health and Human Services (HHS) Office of General Counsel reportedly stopped Kennedy from moving earlier to adopt the Danish schedule in December, warning of a legal challenge if the administration ignored normal procedures.)
The schedule change followed a brief review memo produced by two officials, but ACIP was not consulted, nor did the panel vote on any of the revisions. The lack of ACIP involvement also runs afoul of the APA, the plaintiffs argue. The CDC director has the power to go against ACIP recommendations for the schedule but cannot ignore ACIP’s role in making the recommendations in the first place.
The government mainly argued that the CDC has authority to set vaccine recommendations independent of ACIP and that such recommendations fall under discretionary action that is “unreviewable” by the court and not subject to APA requirements. Congress did not create ACIP or pass any laws explicitly requiring the CDC director to consult with ACIP. They also argued that the plaintiffs lacked standing to bring the challenge in the first place.
Dorit Reiss, a law professor at the University of California-San Francisco whose work focuses on legal issues related to vaccines, thinks the administration’s responses to the merits of the challenge are weak. She said the government’s best chance is if a higher court agrees that the conduct in question is not subject to judicial review.
In a 45-page ruling, Murphy largely sided with the challengers, writing that the government’s disregard of procedure “undermined the integrity of its actions.” He rejected the idea that the CDC could sideline ACIP, pointing to multiple federal statutes that reference the committee’s role in vaccine guidance—the Affordable Care Act, for example, requires insurers to cover vaccines recommended by the committee. The ruling effectively puts ACIP and the January changes on hold while the case proceeds to trial or until the government appeals the decision and a higher court overrules Murphy.
“This is a process decision that has a substantive outcome, which is rolling back recommendations that were made by people who shouldn’t have made them in the first place,” Nicole Huberfeld, a Boston University health law professor who filed an amicus brief supporting the plaintiffs in the case, told The Dispatch.
The AAP’s president praised the ruling in a statement Monday, saying it “represents a critical step to restoring scientific decision-making to federal vaccine policy.” The administration has said it intends to challenge the ruling, though as of this publication, an appeal has yet to be filed. The Department of Health and Human Services (HHS) did not respond to The Dispatch’s request for comment on the timeline for an appeal. When asked about the future of the case, Richard Hughes IV, one of the lead attorneys for the plaintiffs, told The Dispatch, “We are confident that we will prevail on the merits.”
What happens in the interim?
The immediate practical results of the ruling are not entirely clear. ACIP meetings have been postponed for now, and the stay should technically revert the vaccine schedule to its previous form before Kennedy and the committee changed the guidance for COVID and Hepatitis B vaccines and before the CDC slashed other routine vaccination recommendations including for respiratory syncytial virus (RSV), meningitis, and rotavirus. But the CDC has yet to adjust the schedule on its site and did not respond to The Dispatch’s request for comment about whether it intends to do so.
“We’re all a little bit uncertain about what’s coming next,” Sara Rosenbaum, a professor at George Washington University’s Milken Institute School of Public Health who also joined an amicus brief supporting the challengers.
It’s also unclear how the stay of ACIP’s decisions last year will affect vaccine access. In addition to vaccine recommendations, the committee is also tasked with passing resolutions that determine which immunizations are covered under the Vaccines for Children (VFC) Progra—VFC provides millions of uninsured and underinsured children with vaccines at no cost. At its June 2025 meeting, for example, the committee greenlit VFC coverage of a new monoclonal antibody shot for preventing RSV in infants, a move that Murphy’s ruling could potentially invalidate. “It does create substantial uncertainty about VFC coverage,” Reiss told The Dispatch. ACIP’s current vice chair, Dr. Robert Malone, has suggested the ruling rescinds VFC coverage for the RSV therapy.
Will it matter?
While ACIP’s decisions remain significant for vaccine access, the ruling comes at a point when the committee has become almost entirely discredited by the public health community and largely sidelined by HHS. “In the short run, what this committee does is increasingly at the margins of how vaccines are used in the United States,” Jason Schwartz, a professor at the Yale School of Public Health who researches vaccine policymaking, told The Dispatch.
ACIP once set the standard for both state and federal vaccine policy. But after nearly a year of chaos and confusion about what shots it recommends and for whom, 30 states no longer use ACIP as their benchmark for some or all childhood vaccine recommendations.
“This particular issue about ACIP and how its members were constituted and whether adequate processes were [followed] won’t reverse or undo all of the damage that has been done, and very likely will continue to be done by our federal health officials with respect to stewarding the vaccination program,” Schwartz said.
Public trust in vaccine information and recommendations coming from federal health agencies has plummeted in the last year. Fearful of a voter backlash in this year’s midterm elections, the White House has decided to pivot away from vaccine issues, according to numerous media reports in recent weeks.
But even if legal or political constraints force a halt to some of Kennedy’s agenda, many observers don’t expect the administration to repair the damage. “I don’t see any world in which they’re going to start undoing the instability they created,” Rosenbaum said. “They may not let Kennedy do more at the moment, but I don’t think they’re going to suddenly clean up their act.”
Regardless of how the court case proceeds, the burden of enduring vaccine skepticism will continue to be borne by communities around the country suffering from outbreaks of measles, whooping cough, and other vaccine-preventable illnesses and doctors navigating a chaotic vaccine information environment.
“If you talk to pediatricians, they’re really, really worried about what’s happening,” Huberfeld said. “Frankly, they’re not satisfied that this [ruling] will do enough to get people back into pediatricians’ offices having open conversations about the merits of vaccination, because the damage is done. People already think that the federal government doesn’t support vaccines.”
