Senator and Insurers Cast Doubt on U.S. Vaccine Panel as It Readies Review

The chairman of the Senate health committee on Wednesday cast doubt on the trustworthiness of a federal advisory panel on vaccines, and major insurers said they would continue to cover routine shots even if the panel tried to limit their use.

Both developments pointed to an accelerating distrust of what had been a widely respected scientific body, the Advisory Committee on Immunization Practices, whose members recommend vaccination policy to the director the Centers for Disease Control and Prevention.

The panel is set to meet on Thursday and Friday to review recommendations for three childhood vaccines: those for Covid-19, hepatitis B and measles, mumps, rubella and varicella. Some of the advisers have expressed doubts that the vaccines are safe and should be used so widely.

“It’s a very positive step that the insurance industry is calling this travesty for what it is, rather than accepting the current A.C.I.P. will be able to protect the health of the patients they are responsible for,” said Dr. Richard Besser, chief executive of the Robert Wood Johnson Foundation and a former acting director of the C.D.C.

Health Secretary Robert F. Kennedy Jr. dismissed the committee’s 17 members in June and replaced them with new advisers, many of whom, like the secretary, have voiced skepticism of vaccines.

On Wednesday, Senator Bill Cassidy, Republican of Louisiana and chairman of the Senate health committee, said that if the new committee panelists were to make changes to the childhood vaccine schedule, Americans should not have confidence in their decisions.

At a Congressional hearing earlier in the day, Susan Monarez, who was fired as director of the C.D.C. in August, told the senators that Mr. Kennedy had said he intended to revise the standard vaccination schedule for children.

Mr. Cassidy, a physician and liver specialist, has worried publicly that the advisory body is losing legitimacy under Mr. Kennedy. He noted that vaccinating newborns against hepatitis B, for example, had brought the number of children with liver disease from 20,000 cases annually to around 20.

Mr. Kennedy and some conservative politicians have cast doubt on whether babies should receive the vaccine on the day they are born, despite the advisory panel recommending the shot for decades.

Mr. Cassidy said that if the panel removed the shot from the recommended childhood vaccines, patients would have to pay out of pocket for the hepatitis B shot. Many would choose not to.

“The challenge of this is that insurance won’t cover it, so it becomes a financial hardship,” the senator said, adding, “You always have to balance the patient’s pocketbook with their health.”

Andrew G. Nixon, a spokesman for the Department of Health and Human Services, rejected the idea that the advisory committee would rework the vaccine recommendations without sound evidence.

He said that any decision would be approved by the acting C.D.C. director, Jim O’Neill, and “be based on the latest available science.”

Mr. O’Neill was brought in after Dr. Monarez was fired. A former Silicon Valley executive, he has no medical or scientific training.

The announcement from AHIP, a major trade group for health insurers, that insurers would continue to cover vaccines even if they were not recommended by the C.D.C. was aimed at reassuring people who typically get vaccinated or get their children vaccinated in the fall.

“Health plans are committed to maintaining and ensuring affordable access to vaccines,” the insurers said in a statement.

“While health plans continue to operate in an environment shaped by federal and state laws, as well as program and customer requirements, the evidence-based approach to coverage of immunizations will remain consistent,” the association added.

The decision by the insurers follows a wave of similar moves by states and medical organizations to potentially ignore the committee’s recommendations because of concerns they are not evidence based.

The insurers’ “announcement is a huge vote of no confidence,” said Tom Frieden, a former C.D.C. director, who said it reflected a desire by insurers to avoid the cost of these illnesses by having their customers vaccinated.

“No one has done anything like this before,” he said.

The insurers, which also own private Medicare plans, said they would continue covering vaccines recommended by the federal committee as of Sept. 1, 2025.

UnitedHealthcare, the nation’s largest insurer and not a member of AHIP, declined to comment on the trade group’s actions. It issued its own statement, saying the company “is committed to enabling access to safe, effective and affordable care, including coverage for vaccinations.”

United said its customers should check the details of their individual plans, but commercial plans typically would “continue to cover claims for Covid-19 vaccines and many of the typical school vaccines, such as M.M.R., tetanus, diphtheria and polio with no cost share.”

Although the major insurers are likely to continue their coverage, some employers and insurers may still base their decisions on the updated recommendations of the committee, which could be more restrictive.

The insurers’ stance toward Covid vaccines will most likely reflect the changed federal guidance, but many people will still be able to have their immunizations covered.

Parents, in consultation with physicians, can have their children vaccinated against Covid, and the insurers will pay for it and charge no out-of-pocket costs.

Medicaid plans, which serve low-income individuals and rely on a combination of federal and state funding, may also have starkly different requirements depending on the state. Children who depend on the government’s Vaccines for Children Program may not be covered.

States are among those groups that are starting to go their own way. Their recommendations already vary widely, with state officials in New York and elsewhere signing executive orders to ensure the availability of Covid vaccines, and a group of Western states forming a health alliance to offer their own recommendations.

The alliance has issued its own recommendations for a host of respiratory illnesses. A group of Northeastern states, including New York, have formed a similar alliance.