With CDC in chaos, scientists and physicians piece together replacements for agency’s lost work

By MIKE STOBBE Associated Press Physiological Writer NEW YORK AP The CDC is in chaos and various groups are starting to step in and take over work the agency was doing The moves come in response to Wellbeing Secretary Robert F Kennedy Jr s extensive and several say illegal restructuring and downsizing of the Atlanta-based Centers for Complaint Control and Prevention Plenty of masses medical veterans see an agency wracked by a leadership emergency staff cuts budget cuts and unprecedented levels of political meddling The concern hit a crescendo when the White House moved to oust the agency s director and a few top CDC leaders resigned in protest Related Articles Fed governor Cook to seek court order blocking her firing by Trump China criticizes US senators Taiwan visit calls it a threat to sovereignty Trump proposed getting rid of FEMA but his review council seems focused on reforming the agency Trump fires Democratic member of Surface Transportation Board ahead of huge rail merger decision DC Man seen throwing sandwich at agent charged with misdemeanor after grand jury declines indictment But even before CDC Director Susan Monarez was fired selected organizations started pursuing new procedures to do jobs formerly handled by the CDC A few are working to preserve longstanding vaccination recommendations Several are trying to release information that CDC has stopped providing Others aim to maintain fitness material collections at menace of being lost But these outside efforts don t have the federal funding tools legal mechanisms or platform that have been the underpinning of the nation s general fitness system As noble as they are these patchwork efforts ostensibly won t cut it specific experts say There may be a few workarounds explained Dr Megan Ranney dean of the Yale School of Society Physical condition But I m not sure it s fair or appropriate that people feel like they have to turn to private groups instead of the establishment Vaccination guidance tops the list For decades the CDC has set the nation s standards on vaccines which ones are recommended and who should get them The recommendations were guidance not law But they were automatically adopted by doctors school systems strength insurers and others They were the product of a lengthy information review process involving a panel of outside experts the Advisory Committee on Immunization Practices But in May Kennedy a longtime leader in the anti-vaccine movement communicated COVID- vaccines would no longer be recommended for healthy children and pregnant women He made the decision without input from the ACIP In June he abruptly dismissed the entire panel accusing them of being too closely aligned with manufacturers He replaced them with a handpicked group that included several vaccine skeptics and then shut the door to several doctors groups that had long helped form ACIP recommendations It s not clear what other changes are in store for ACIP but a number of health groups say Kennedy can t be counted on to make decisions based on robust therapeutic evidence The moves sparked a group of general wellness researchers and others to form the Vaccine Integrity Project based at the University of Minnesota which is aims to become the kind of compiler and reporter of curative evidence that the CDC and ACIP have been in the past A committee meeting without CDC In mid-August the group held an ACIP-like Zoom meeting in which subject-matter experts presented lengthy reviews of new research about the safety and effectiveness of COVID- flu and RSV vaccines for children pregnant women and people with weakened immune systems It also featured a four-person panel of experts including the editor-in-chief of the New England Journal of Medicine Like ACIP members they appealed presenters questions about their analyses Presenters made clear that they had to base their presentations on what had appeared in curative journals and was publicly available they weren t privy to unpublished surveillance and safety information that CDC collects The group is not making vaccination recommendations itself But it is working with doctors organizations that are One is the American College of Obstetricians and Gynecologists which has noted pregnant women should continue to get COVID- shots counter to what Kennedy stated Another is the American Academy of Pediatrics continuing to recommend them for children ages months to years But as therapeutic societies split from CDC it s not yet clear which recommendations insurers will heed when making coverage decisions And there remain a number of other questions such as What will happen in states that have vaccination policies tied to ACIP recommendations In Massachusetts Democratic Gov Maura Healey included language in a billion supplemental budget bill that gives the fitness department authority to set its own recommendations and requirements if the federal executive fails to maintain a robust schedule of vaccine recommendations Several other efforts now underway Vaccine finders During the COVID- pandemic the CDC teamed up with researchers at Boston Children s Hospital and Harvard Curative School on www vaccines gov The website described about newly developed vaccines recommended to protect against the coronavirus and served as a search engine to help people find nearby pharmacies that had the shots in stock But the site gradually dropped information about vaccines and why they were recommended and this year became a stripped-down version that absolutely stated Find a pharmacy near you and a box to type in your zip code When the authorities s contract with Boston Children s Hospital ended in late July the site stopped working altogether Researchers at Boston Children s Hospital this month restarted a version of the site that existed before the pandemic www vaccinefinder org We re turning back to what it was explained John Brownstein of Boston Children s who founded the site Obviously as a executive site it carries more weight But if that isn t in the cards we re very happy to carry the torch Dental safety Last month the Association for Dental Safety launched a new institute for dental safety that was designed to pick up specific of the work done by the CDC s Division of Oral Vitality which was eliminated in the spring The new institute is first focused on updating infection controls guidelines for dental offices which the CDC last updated in Without a doubt ADS is the best choice to continue oversight of dental infection prevention and control guidelines ensuring recommendations are current scientifically sound translated into lay terms and disseminated to those who need them on a daily basis noted Nicole Johnson former associate director in the CDC s Division of Oral Healthcare in a press report Pregnancy information The CDC s Pregnancy Danger Assessment Monitoring System which annually surveys women across the country lost its entire staff about people in layoffs this year It was the majority of comprehensive collection of information on the wellbeing behaviors and outcomes before during and after childbirth Researchers have been using its figures to investigate the nation s maternal mortality challenge Specific states that have the money and motivation might decide to run similar surveys just within their borders California runs its own PRAMS-like survey But if states are doing their own thing then we don t have national comparable information across jurisdictions and across time meaning its not feasible to see where problems are majority of severe and which policies to reduce maternal deaths are working commented Jamie Daw a Columbia University soundness framework researcher focused on pregnancy Violence prevention Kennedy in recent times fired about CDC staffers who provided training tuition and advice to state and local violence prevention programs and evaluate how well they were working What s the point in knowing the about the rates of violence if you re not going to do anything about it noted Sarah DeGue one of the laid-off CDC researchers But existing programs still need technical guidance and expertise In May DeGue founded Violence Prevention Solutions a consulting firm to help society organizations develop and evaluate programs It s us trying to rebuild what we had somewhere else in a different way so that all the knowledge and experience and tools that we had can still be available she declared AP reporter Michael Casey in Boston contributed The Associated Press Medical and Science Department receives sponsorship from the Howard Hughes Health Institute s Science and Educational Media Group and the Robert Wood Johnson Foundation The AP is solely responsible for all content