Updated at 4:50 p.m. ET on June 29, 2025
下午4:50更新美国东部时间于2025年6月29日
The past three weeks have been auspicious for the anti-vaxxers. On June 9, Health Secretary Robert F. Kennedy Jr. purged the nation’s most important panel of vaccine experts: All 17 voting members of the CDC’s Advisory Committee on Immunization Practices (ACIP), which sets recommendations for the use of vaccines and determines which ones must be covered through insurance and provided free of charge to children on Medicaid, were abruptly fired. The small, ragtag crew of replacements that Kennedy appointed two days later met this week for the first time, amid lots of empty chairs in a conference room in Atlanta. They had come to talk about the safety of vaccines: to raise concerns about the data, to float hypotheses of harm, to issue findings.
过去三周对抗vaxxers吉祥。6月9日，卫生部长罗伯特·肯尼迪（Robert F. Kennedy Jr.肯尼迪（Kennedy）两天后任命的小型杂乱无章的船员本周第一次见面，在亚特兰大的一间会议室中有很多空椅子。他们开始谈论疫苗的安全性：引起对数据的担忧，浮动危害假设，以发出调查结果。
The resulting spectacle was set against a backdrop of accelerating action from the secretary. On Wednesday, Kennedy terminated more than $1 billion in U.S. funding for Gavi, a global-health initiative that supports the vaccination of more than 65 million children every year. Lyn Redwood, a nurse practitioner and the former president of Children’s Health Defense, the anti-vaccine organization that Kennedy used to chair, was just hired as a special government employee. (She presented at the ACIP meeting yesterday.) A recently posted scientific document on the ACIP website that underscored the safety of thimerosal, an ingredient in a small proportion of the nation’s flu vaccines, had been taken down, a committee member said, because the document “was not authorized by the office of the secretary.” (A spokesperson for the Department of Health and Human Services told me in an email that this document was provided to the ACIP members in their meeting briefing packets.)
由此产生的景象是在秘书加速行动的背景下设置的。周三，肯尼迪（Kennedy）终止了超过10亿美元的美国为加维（Gavi）提供的资金，加维（Gavi）是一项全球健康计划，每年支持超过6500万儿童的疫苗接种。肯尼迪（Kennedy）曾担任主席的反疫苗组织儿童健康防御机构，护士从业人员，前总裁儿童卫生防御部门的前总裁林·雷德伍德（Lyn Redwood）被聘为特别政府雇员。（她在昨天的ACIP会议上发表了。）最近在ACIP网站上发布了一份科学文档，该文件强调了硫梅罗斯（Thimerosal）的安全性，这是一小部分国家流感疫苗的成分，被取消了，因为该文件“没有由秘书办公室授权”。（卫生与公共服务部发言人在一封电子邮件中告诉我，该文件已在会议简报包中提供给ACIP成员。）
What’s clear enough is that, 61 years after ACIP’s founding, America’s vaccination policy is about to be recooked. Now we’ve had a glimpse inside the kitchen.
很明显的是，在ACIP成立61年后，即将重新启发美国的疫苗接种政策。现在，我们在厨房内瞥见了。
The meeting started with complaints. “Some media outlets have been very harsh on the new members of this committee,” said Martin Kulldorff, a rangy Swedish biostatistician and noted COVID contrarian who is now ACIP’s chair. (Kuldorff was one of the lead authors of the Great Barrington Declaration, a controversial proposal from the fall of 2020 to isolate seniors and other vulnerable people while reopening the rest of society.) In suggesting that he and Kennedy’s other appointees are opposed to vaccination, Kulldorff said, journalists were misleading the public, weakening trust in public health, and fanning “the flames of vaccine hesitancy.”
会议始于投诉。“一些媒体对该委员会的新成员非常苛刻，”瑞典生物统计学家，著名的Covid Contranian说，他现在是ACIP的主席。（Kuldorff是《大巴灵顿宣言》的主要作者之一，这是一项有争议的提议，即2020年秋天，在重新开放社会的同时，在重新开放社会的同时，孤立了老年人和其他弱势群体。）他和肯尼迪的其他任命是疫苗接种的，kulldorff表示，kulldorff却误导了公众的fean狂，又弱化了疫苗。犹豫。”
This was, in fact, the most pugnacious comment of the two-day meeting, which otherwise unfolded in a tone of fearmongering gentility. Robert Malone, a doctor and an infectious-diseases researcher who has embraced the “anti-vaccine” label and published a conspiracy-theory-laden book that details government psyops against the American people, was unfailingly polite in his frequent intimations about the safety of vaccines, often thanking CDC staff for their hard work and lucid presentations. With his thick white beard, calm affect, and soldierly diction—Malone ended many of his comments by saying “Over” into the microphone—he presented less as a firebrand than as, say, the commanding officer of a submarine.
实际上，这是为期两天的会议中最挑剔的评论，否则这是一种令人恐惧的绅士语调。罗伯特·马龙（Robert Malone）是一名医生，也是一位接受“抗疫苗”标签的研究人员，并出版了一本阴谋理论的书，详细介绍了针对美国人民的政府psyops，他经常对疫苗的安全无意识，通常对CDC员工的辛勤工作和清醒的表现表示感谢。他的浓密的白胡子，平静的情感和士兵的词典 - 马龙结束了他的许多评论，因为他说“过度”麦克风的言论 - 他作为火力少了，而不是潜艇的指挥官。
When Malone alluded to the worry, for example, that spike proteins from the mRNA-based COVID vaccines linger in the body following injection, he did so in respectful, even deferential, language, suggesting that the public would benefit from greater study of possible “delayed effects” of immune-system activation. The CDC’s traditional approach—its “world-leading, rigorous” one, he clarified—might be improved by examining this question. A subject-matter expert responded that the CDC has been keeping tabs on real-world safety data on those vaccines for nearly five years, and has not detected any signs of long-term harm.
例如，当Malone提到担忧时，注射后，从基于mRNA的Covid疫苗中升高了蛋白质，他以尊重的，甚至是尊严的语言进行了这种蛋白质，这表明公众将受益于对免疫系统激活的可能“延迟效应”的更多研究。他澄清了CDC的传统方法 - “世界领先，严格”的方法，可以通过检查这个问题来改善。一位受试者专家回答说，疾病预防控制中心一直在近五年内对这些疫苗的现实安全数据保留现实的安全数据，并且尚未发现任何长期危害的迹象。
Later, Malone implied that COVID or its treatments might have, through some unspecified, bank-shot mechanism, left the U.S. population more susceptible to other illnesses. There was a “paradoxical, sudden decrease” in flu cases in 2020 and 2021, he noted, followed by a trend of worsening harm. A CDC staffer pointed out that the decrease in flu during those years was not, in fact, a paradox; well-documented shifts in people’s health behavior had temporarily reduced the load of many respiratory illnesses during that same period. But Malone pressed on: “Some members of the scientific community have concern that they’re coming out of the COVID pandemic—exposure to the virus, exposure to various countermeasures—there may be a pattern of broad-based, uh, anergy,” he said, his eyes darting up for a moment as he invoked a term for a diminished immune response, “that might contribute to increased severity of influenza disease.” He encouraged the agency to “be sensitive to that hypothesis.”
后来，马龙（Malone）暗示，通过一些未指定的银行摄影机制，库维德（Covid）或其治疗方法可能使美国人口更容易受到其他疾病的影响。他指出，在2020年和2021年的流感病例中，有“矛盾的，突然的降低”，随后危害了伤害的趋势。CDC工作人员指出，那几年的流感减少实际上不是悖论。在同一时期，有据可查的人的健康行为转变暂时减轻了许多呼吸道疾病的负担。但是马龙（Malone）强迫：“科学界的一些成员担心他们是从共证的大流行中出来的 - 暴露于病毒，暴露于各种对策的模式中 - 基于广泛的，呃，消极的态度，他说，他的眼睛逐渐提高了一会儿，因为他曾在一次性疾病中提高了一种免疫反应的术语，“这可能会导致造成的疾病，“这可能会导致造成的疾病，以造成造成的疾病，以造成贡献，造成了贡献的症状。他鼓励该机构“对该假设敏感”。
Throughout these and other questions from the committee members, the CDC’s subject-matter experts did their best to explain their work and respond to scattershot technical and conceptual concerns. “The CDC staff is still attempting to operate as an evidence-based organization,” Laura Morris, a professor at the University of Missouri School of Medicine, who has attended dozens of ACIP meetings in the past and attended this one as a nonvoting liaison to the committee from the American Academy of Family Physicians, told me. “There was some tension in terms of the capacity of the committee to ask and understand the appropriate methodological questions. The CDC was trying to hold it down.”
在委员会成员的这些问题和其他问题中，疾病预防控制中心的主题专家尽了最大的努力来解释他们的工作并应对Scattershot的技术和概念问题。密苏里大学医学院的教授劳拉·莫里斯（Laura Morris）过去曾参加过数十个ACIP会议，并以美国医师学院的委员会的非投票联络人士告诉我：“ CDC员工仍在试图作为循证组织运作。”“在委员会提出和理解适当的方法论问题的能力方面存在一些紧张关系。疾病预防控制中心试图阻止它。”
That task became more difficult as the meeting progressed. “The new ACIP is an independent body composed of experienced medical and public health experts who evaluate evidence, ask hard questions, and make decisions based on scientific integrity,” the HHS spokesperson told me. “Bottom line: This process reflects open scientific inquiry and robust debate, not a pre-scripted narrative.” The most vocal questioner among the new recruits—and the one who seemed least beholden to a script—was the MIT business-school professor Retsef Levi, a lesser-known committee appointee who sat across the table from Malone. A scruffy former Israel Defense Forces intelligence officer with a ponytail that reached halfway down his back, Levi’s academic background is in data modeling, risk management, and organizational logistics. He approached the proceedings with a swaggering incredulity, challenging the staffers’ efforts and pointing out the risks of systematic errors in their thinking. (In a pinned post on his X profile, Levi writes that “the evidence is mounting and indisputable that mRNA vaccines cause serious harm including death”—a position entirely at odds with copious data presented at the meeting.)
随着会议的进行，这项任务变得更加困难。HHS发言人告诉我：“新的ACIP是一个独立的机构，由经验丰富的医学和公共卫生专家组成，他们评估证据，提出棘手的问题并基于科学完整性做出决定。”“最重要的是：这个过程反映了开放的科学询问和强大的辩论，而不是预先录制的叙述。”新兵中最有声的发问者，也是看上去最少的剧本的人，是麻省理工学院的商业学校教授Retsef Levi，他是一个鲜为人知的委员会任命的人，他坐在马龙对面。列维（Levi）的学术背景是一位舒适的前以色列国防部队情报官，马尾辫向后一半，在数据建模，风险管理和组织后勤方面。他以令人难以置信的难以置信的是，挑战了员工的努力，并指出了他们的思维系统错误的风险。（Levi在他的X个人资料上的一篇文章中写道：“证据是持续的，无可争议的是mRNA疫苗会造成严重伤害，包括死亡” - 这与会议上的大量数据完全不符。）
Shortly before the committee’s vote to recommend a new, FDA-approved monoclonal antibody for preventing RSV in infants, Levi noted that he’d spent some time reviewing the relevant clinical-trial data for the drug and another like it, and found some worrying patterns in the statistics surrounding infant deaths. “Should we not be concerned that maybe there are some potential safety signals?” he asked. But these very data had already been reviewed, at great length, in multiple settings: by the FDA, in the course of drug approval, and by the dozens of members of ACIP’s relevant work group for RSV, which had, per the committee’s standard practice, conducted its own staged analysis of the new treatment before the meeting and reached consensus that its benefits outweighed its risks. Levi was uncowed by any reference to this prior work. “I’m a scientist, but I’m also a father of six kids,” he told the group; speaking as a father, he said, he personally would be concerned about the risk of harm from this new antibody for RSV.
在委员会投票后不久，李维斯（Levi）提出了一种新的，由FDA批准的单克隆抗体，用于预防婴儿的RSV，并指出，他花了一些时间审查该药物的相关临床审核数据，并发现了其他类似的药物，并发现了围绕婴儿死亡的统计数据令人担忧的模式。“我们不应该担心可能有一些潜在的安全信号吗？”他问。但是，在多种情况下，已经对这些数据进行了详尽的审查：在FDA，在毒品批准的过程中，以及ACIP相关工作组的数十名RSV工作组成员，根据委员会的标准实践，根据委员会的标准实践，对新疗法进行了对新待遇的分期分析，并在会议前并达成了其益处，其福利超过了风险。Levi毫无疑问地参考了这项先前的工作。他对小组说：“我是科学家，但我也是六个孩子的父亲。”他说，作为父亲，他个人会担心这种新抗体对RSV的伤害风险。
In the end, Levi voted against recommending the antibody, as did Vicky Pebsworth, who is on the board of an anti-vaccine organization and holds a Ph.D. in public health and nursing. The five other members voted yes. That 5–2 vote aside, the most contentious issue on the meeting’s schedule concerned the flu shots in America that contain thimerosal, which has been an obsession of the anti-vaccine movement for the past few decades. Despite extensive study, vaccines with thimerosal have not been found to be associated with any known harm in human patients, yet an unspecified vote regarding their use was slipped into the meeting’s agenda in the absence of any work-group study or presentation from the CDC’s staff scientists. What facts there were came almost exclusively from Redwood, the nurse who used to run Kennedy’s anti-vaccine organization. Earlier this week, Reuters reported that at least one citation from her posted slides had been invented. That reference was removed before she spoke yesterday. (HHS did not address a request for comment on this issue in its response to me.)
最后，李维斯（Levi）投票反对推荐抗体，而Vicky Pebsworth也是反疫苗组织的董事会成员，并拥有博士学位。在公共卫生和护理方面。另外五名成员投票赞成。撇开5-2的投票，会议日程安排上最有争议的问题涉及含有硫柳汞的美国流感镜头，这在过去几十年中一直对反疫苗运动的痴迷。尽管进行了广泛的研究，但尚未发现具有硫柳汞的疫苗与人类患者的任何已知危害有关，但是在没有CDC员工科学家的任何工作组研究或介绍的情况下，就其使用的未指定投票被逐渐减少到会议的议程中。曾经经营肯尼迪反疫苗组织的护士Redwood几乎完全来自Redwood。本周早些时候，路透社报道说，她的张贴幻灯片中至少发明了一次引用。该参考文献在她昨天讲话之前已被删除。（HHS在对我的回应中没有解决有关此问题的评论请求。）
The only one of Kennedy’s appointees who had ever previously served on the committee—the pediatrician Cody Meissner—seemed perplexed, even pained, by the proceedings. “I’m not quite sure how to respond to this presentation,” he said when Redwood finished. He went on to sum up his concerns: “ACIP makes recommendations based on scientific evidence as much as possible. And there is no scientific evidence that thimerosal has caused a problem.” Alas, Meissner’s warnings were for nought. Throughout the meeting, he came off as the committee’s last remaining, classic “expert”—a vaccine scientist clinging to ACIP’s old ways—but his frequent protestations were often bulldozed over or ignored. In the end, his was the only vote against the resolutions on thimerosal.
肯尼迪唯一以前曾在委员会任职的人（儿科医生科迪·米斯纳（Cody Meissner））似乎对诉讼感到困惑，甚至感到痛苦。“我不太确定如何回应这个演示文稿，”红木结束时说。他继续总结了他的担忧：“ ACIP尽可能根据科学证据提出建议。而且没有科学证据表明硫胺造成了问题。”las，迈斯纳的警告是徒劳的。在整个会议期间，他是委员会最后剩下的经典“专家”（一名疫苗科学家，坚持ACIP的旧方式），但他的频繁抗议经常被推迟或忽略。最后，他是唯一反对有关硫柳汞的决议的投票。
Throughout the two-day meeting, Kuldorff kept returning to a favorite phrase: evidence-based medicine. “Secretary Kennedy has given this committee a clear mandate to use evidence-based medicine,” he said on Wednesday morning. “The purpose of this committee is to follow evidence-based medicine,” he said on Wednesday afternoon. “What is important is using evidence-based medicine,” he said again when the meeting reached its end. All told, I heard him say evidence-based at least 10 times during the meeting. (To be fair, critics of Kuldorff and his colleagues also love this phrase.) But the committee was erratic in its posture toward the evidence from the very start; it cast doubt on CDC analyses and substituted lay advice and intuition for ACIP’s normal methods of assessing and producing expert consensus. “Decisons were made based on feelings and preferences rather than evidence,” Morris told me after the meeting. “That’s a dangerous way to make public-health policy.”
在为期两天的会议期间，库尔多夫一直回到最喜欢的短语：循证医学。他在周三上午说：“肯尼迪部长赋予了该委员会的明确任务，要求使用循证医学。”他在周三下午说：“该委员会的目的是遵循循证医学。”“重要的是使用循证医学，”会议结束时，他再次说。总而言之，我听到他在会议期间至少说基于证据的10次。（公平地说，库尔多夫及其同事的批评者也喜欢这句话。）但是委员会从一开始就对证据的态度不稳定。它对CDC分析和替代了ACIP评估和产生专家共识的正常方法的质疑和直觉。莫里斯在会议结束后告诉我：“决定性的是基于感受和偏好而不是证据。”“这是制定公共卫生政策的危险方式。”
