For the past 60 years, a committee of independent experts has advised the federal government on vaccine policy, providing guidance on which shots people should get and when. Government public health officials have almost always followed the panel’s recommendations, all but making it the final word on public health policy in the US for most of its existence. And over those decades, the United States has made tremendous health gains over that time through mass vaccination campaigns.

But on Monday, Health Secretary Robert F. Kennedy Jr. fired every sitting member of the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), a move that stunned doctors and scientists across the country. And it means that the CDC’s days as the clear and unchallenged authority on US vaccine policy appear numbered.

“Up until today, ACIP recommendations were the gold standard for what insurers should pay for, what providers should recommend, and what the public should look to,” Noel Brewer, a health behavior professor at the University of North Carolina, who was a member of the panel until this week, told the Associated Press. “It’s unclear what the future holds.”

New committee members will be announced at some point, but as of Tuesday morning, even top US senators did not know who the replacements would be. The panel is supposed to hold one of its periodic public meetings in late June to discuss the Covid-19 vaccine, as well as shots for RSV and HPV, among others.

This is a watershed moment in US public health, one that seems sure to sow confusion among patients and health care providers. The deepening divide between Kennedy’s Make American Healthy Again (MAHA) movement and mainstream medicine could make it harder for people who want vaccines to get them, while encouraging more doubt about the value and safety of shots among the general public. Here’s what you need to know.

Why is Kennedy doing this?

The vaccine advisory committee was first convened by the surgeon general in 1964, but it is not enshrined in federal law. That means that Kennedy — as the top official at the US Department of Health and Human Services, which contains the CDC — can change its membership or dissolve the panel entirely if he so desires.

Kennedy framed his decision to clear out the members as necessary to restore public trust in the government’s vaccine recommendations. In a Wall Street Journal op-ed, Kennedy asserted the committee “has been plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine.”

It may be a little “hot dog guy meme” that the man who may have done more than any other person to erode public trust in vaccines is now complaining about the problem of eroding public trust in vaccines. But it fits with........

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