When it comes to vaccines, there are two kinds of parents coming into Dr. Megan Prior’s office in Washington, D.C., these days.

One set are parents who pepper the pediatrician with increasingly panicked questions about the future availability of vaccines and whether their children can get any shots early. Then there are the parents who feel vindicated in their decision not to vaccinate their kids, despite vaccines’ overall safety and record of disease prevention. 

“It’s almost like I have these two groups of diverging patients, where some are really, really worried about their access and want to get things done as soon as possible,” she said. “And then others are sort of in this vaccine hesitant category.”

Both groups have been spurred by Health and Human Services Secretary Robert F. Kennedy Jr. 

Kennedy’s HHS shakeups could have huge implications for vaccine policy in America. Earlier this month, he fired all 17 members of a key vaccine panel and replaced them with a smaller group of people who in some cases lack relevant experience and who, like him, have been skeptical of vaccines. He claims the vaccine panel firings were aimed at addressing members’ conflicts of interest, even though they worked under a comprehensive policy. 

Physicians who treat both children and families say they’re frustrated with Kennedy’s unprecedented firing of the panel known as the Advisory Committee for Immunization Practices (ACIP) — and they’re concerned about what it might mean for the future availability of safe and effective vaccines.

For now, doctors are figuring out as a medical community how they can keep their patients healthy with evidence-based guidelines. They’re turning to each other — through membership in trusted organizations that are taking joint actions — and figuring out how to give patients reliable information amid uncertainty about the government’s next steps.

ACIP’s review of vaccines and subsequent guidance, under the Centers for Disease Control and Prevention, helps insurance companies determine vaccine coverage. A change to ACIP recommendations could have the ripple effect of making a vaccine more expensive to obtain, or more difficult to access through doctors’ offices and pharmacies. The new panel has not taken any actions yet, but its members are scheduled to next week. Vaccine experts say they’re watching closely to see what policy changes, if any, might emerge.

“If I were a mom, and I’m thinking, ‘What do I do for my kid right now?’ I want to be confident that my primary care physician, my family doctor or my pediatrician was making recommendations based on what we know from science and not based on what the insurance company will or will not pay for, or what politics is saying,” said Dr. Jen Brull, a longtime family physician who is now president of the American Academy of Family Physicians (AAFP). “I think it’s very safe to say that you can look to your primary care physician for that kind of recommendation, and that’s what you should be looking for.”

Prior, who has long used ACIP and CDC guidance on vaccines to answer questions from parents, said she recently downloaded a version of the current children’s vaccination schedule that includes recommendations made by the fired vaccine panel, “just in case there are any changes, so I can remember exactly how wording looked.” She is creating a list of trusted sources, including the American Academy of Pediatrics (AAP) and AAFP, so she can monitor how they mirror or pivot from future government actions.

Other vaccine experts have announced their own initiative to protect the integrity of vaccine policy, information and access.

“Clearly, there’s a lot of us who are super interested in evidence-based science that will ensure that physicians and families have access to the right recommendations, no matter how politicized things get,” Prior said.

Around the same time that news about Kennedy’s ACIP firings broke, hundreds of doctors were gathered in Chicago for a key meeting of the American Medical Association (AMA), the largest association of physicians, representing more than 190 state and specialty medical societies. Within hours after the firings were public, Brull and representatives from several major medical groups drafted an emergency resolution that called on Kennedy to reverse his actions on the vaccine panel and also requested a Senate investigation into the firings. The resolution passed.

“The emotion in the room was that everyone who was there cared about this — but we wanted to make sure that the AMA, that our individual organizations, were speaking truth,” Brull said.

Dr. David Higgins, a pediatrician and spokesperson for AAP, said the recent dismantling of expertise on ACIP threatens a clarity that has developed over decades within the medical community when it comes to vaccinations.

AAP has been issuing vaccine guidance since 1935, nearly three decades before ACIP was created. To help reduce confusion, both entities officially began publishing harmonized guidance on vaccines in 1995. The consistency helped streamline care for families and reduced discrepancies as combination vaccines became more widely available, according to Higgins.

AAP still maintains its own expert review process for its vaccine schedule, and Higgins said the organization plans to keep issuing recommendations that are “grounded in science and committed to child health.” He worries about potentially conflicting recommendations in the future, and how that might raise public confusion and distrust.

“Parents we talk with are understandably anxious and unsure,” he said in an email. “Our parents and families have a lot of questions, and as pediatricians, we welcome those questions. Pediatricians want to partner with parents and meet them where they are with compassion, clarity, and credible information.”

Brull also wanted to emphasize that point from the lens of family physicians, who sometimes see generations of one family and can be a key source of evidence-based medical information, especially in rural areas with more limited health coverage options.

“My foundational advice to parents and kids who are old enough to have these conversations on their own is that the best thing most people can do is reach out and talk to their primary care doctor — whether that’s their pediatrician or their family physician, and have a conversation,” she said.

Prior, who shares her views on health policy news on social media, does not want to minimize the implications of ACIP’s new membership and what it could mean if they pull a safe vaccine from the immunization schedules for adults or children. She still distinctly remembers her constant worry about whether her young child could access a COVID-19 vaccine, and the transition to in-person schooling and re-entering more public spaces.

“If we live in a world where measles is incredibly common, where whooping cough is incredibly common, where these really infectious diseases are just part of our lives again, parents will have to go through those decisions again,” she said. “I think that piece of it makes me so frustrated. I know how frustrating it was to be a parent in COVID, and I do not wish that stress on anyone. It’s doubly frustrating that this stress we would be putting on ourselves is 100 percent preventable.”