The CDC’s Advisory Committee on Immunization Practices (ACIP) is about to make an important decision that could impact millions of Americans—and this time, it could be good news. Later this month, ACIP is expected to vote on whether to lower the age for routine pneumococcal vaccination from 65 to 50. This move could save lives, expand healthcare access, and, most importantly, restore goodwill between the American people and the public health establishment.
Vaccines have been one of the greatest success stories in public health. They have helped eliminate diseases, protect vulnerable populations, and increase life expectancy across the globe. In the 20th century, the U.S. worked feverishly to develop vaccines for various deadly diseases, including polio, smallpox, and measles. Thanks to mass immunization campaigns, by the year 2000, measles, once a common childhood illness with severe complications, was declared eliminated in the U.S. This achievement underscores how widely administered vaccines can nearly eradicate even the most contagious diseases, safeguarding future generations.
The role of ACIP in this success cannot be overstated. They are a group of medical and public health experts who meet regularly to develop recommendations for using vaccines and immunizations in clinical practice. Moreover, this committee serves a unique role, focusing on clinical use and practical applications, not regulating safety and efficacy, which is the job of the Food and Drug Administration (FDA). Their work impacts millions, shaping public health recommendations, insurance coverage, and physician practices. In short, ACIP plays a vital role in keeping Americans healthy.
From a policy standpoint, ACIP’s move to lower the age recommendation for pneumococcal vaccinations from 65 to 50 makes perfect sense. Pneumonia can be deadly, particularly for older adults and those with underlying health conditions. Vaccination rates among older adults are not as high as they should be, and by extending the recommendation to younger adults, there is an opportunity to increase awareness and uptake of the vaccine. Along the same line, the CDC is also holding out on a recommendation for the RSV vaccination. ACIP could further increase senior health by voting on whether the RSV vaccine should be given to all adults ages 60 and up and to those aged 50-59 with certain high-risk health conditions. CDC’s waiting on a recommendation for RSV vaccine puts high-risk individuals in limbo. Think about high-risk individuals with COPD and how they are waiting for new recommendations regarding approved vaccines to make their day-to-day lives safer. While the vaccine is FDA-approved, without the CDC’s stamp, insurers won’t cover it. And that delay is unfortunate because more people protected means fewer hospitalizations, less strain on our healthcare system, and ultimately, lower healthcare costs for everyone. And let’s face it—preventing disease is always cheaper than treating it.
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Now, while lowering the age for pneumococcal vaccines is a step in the right direction, ACIP needs to take this policy a step further by avoiding the bureaucratic trap of picking “winners and losers.” Currently, two FDA-approved vaccines for pneumococcal disease—PCV13 and PPSV23—are both effective and historically government-recommended for certain populations. When it comes to deciding which vaccine to recommend for adults aged 50 and older, ACIP should not choose one over the other. Patients, in consultation with their doctors, should decide which vaccine is best for them, not government agencies.
This is where good public policy meets common sense. By allowing both vaccines to be part of the recommendation, ACIP would promote choice, foster competition, and respect the physician's role. More competition and choice between vaccines means lower costs for patients and insurers and will ensure that patients have access to the right vaccine at the right time for their unique circumstances.
After the public health debacles of the COVID-19 pandemic, many Americans are distrustful of government agencies like the CDC. We saw how politicization of public health can backfire and how top-down mandates eroded trust in institutions that were supposed to keep us safe. By recommending both vaccines and lowering the age threshold, ACIP would send a powerful message that they are putting science, choice, and patient care at the forefront of their decision-making.
ACIP’s upcoming decision on pneumococcal vaccinations is a critical opportunity for the CDC to do the right thing, improve public health outcomes, and help rebuild trust in our public health institutions.
Vaccines are among medicine's most powerful tools. Their power comes from their scientific efficacy and the public's trust in those who recommend them. ACIP has the chance to strengthen that trust by making a decision that is both pro-patient and pro-science. Let’s hope they don’t squander this opportunity. The health of millions of Americans depends on it.
Andrew Langer is Executive Director of the Coalition Against Socialized Medicine
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