Debate Over COVID-19 Vaccines Raises Alarms for Infection Prevention and Public Health

Reports that the Trump administration is weighing whether to remove COVID-19 vaccines from the US market have sent shockwaves through the infection prevention and public health communities. The discussion follows public comments from members of the Advisory Committee on Immunization Practices calling for mRNA vaccines to be pulled entirely. While no formal action has been taken, the implications of such a move would extend far beyond COVID-19 alone.

“This is the kind of moment where we need to slow down and return to the evidence,” said Jeffery Goad, PharmD, MPH, the president of the National Foundation for Infectious Diseases and a professor of pharmacy practice at Chapman University in Irvine, California, said in an interview with Infection Control Today^®. “The evidence is clear from both CDC data and the published literature that COVID-19 vaccines are safe and effective, and nothing has changed.”

A key source of confusion has been the role and authority of federal advisory bodies. Goad emphasized that ACIP does not have the power to mandate or remove vaccines from the market.

“The [Food and Drug Administration (FDA)] is focused on safety and efficacy and determines whether a vaccine is approved,” Goad explained. “The CDC can only make recommendations after that approval, and ACIP is an advisory committee to the CDC. Neither [the Advisory Committee on Immunization Practices (ACIP)] nor the CDC makes mandates. That authority rests with the states.”

Even if CDC recommendations were modified, FDA approval would still allow clinicians to use vaccines. The most immediate consequences would likely affect coverage and payment rather than access itself. “If ACIP no longer recommends a vaccine, then questions arise about who pays for it,” Goad said. “That is where things become complicated.”

From a regulatory standpoint, withdrawing an FDA-approved vaccine would require compelling safety evidence. According to Goad, that threshold has not been met.

“There have never been any severe safety signals from government-run surveillance systems that would suggest the COVID-19 vaccine is unsafe and should be removed from the market,” he said. “The FDA has the authority to remove a vaccine, not the CDC, and there is no evidence to support that action.”

For infection preventionists, the stakes are high. Goad warned that restricting or removing COVID-19 vaccines would have devastating consequences for high-risk populations.

“It would be catastrophic if we lost the use of this technology,” he said. “These vaccines saved millions of lives and continue to save lives. COVID-19 killed over 1,000 people just this January alone. COVID-19 is not done with us.”

He also stressed that mRNA technology extends beyond COVID-19. “This platform has been studied for decades,” Goad said. “It was a perfect match for SARS-CoV-2, but it also holds promise for other devastating diseases. Removing it would have ripple effects we cannot fully contemplate.”

Healthcare system readiness would also suffer. Today’s vaccine distribution infrastructure is far more robust than during the early pandemic years. “Having vaccines in the commercial supply chain gives us a level of readiness we never had in 2020,” Goad noted. “I would hate to see that lost over misunderstandings.”

The debate also threatens vaccine confidence among both health care workers and patients. Goad urged infection prevention teams to proactively counter misinformation.

“Nothing has changed,” he said. “The vaccine is still safe. It is still effective. COVID-19 is still killing people. We cannot control how the virus evolves, but we can control our preparation and readiness, and that starts with vaccination.”

As uncertainty continues, Goad emphasized the importance of trusted sources. “Professional organizations are still providing credible, transparent information,” he said. “That is where health care workers and the public should turn.”