The chair of the Advisory Committee on Immunization Practices (ACIP), Kirk Milhoan, confirmed in recent interviews that the committee is re-examining all vaccines, including their benefit–risk balance. He also stressed that future recommendations do not necessarily imply maintaining the current childhood vaccination schedule, and that the committee’s approach is increasingly shifting toward individual decision-making by patients and physicians rather than population-level public-health considerations. This change comes at a time when US vaccine policy is under the direct oversight of Health Secretary Robert F. Kennedy Jr., who has long been known for his controversial views on vaccination.
According to Milhoan, the committee does not “necessarily” intend to make all vaccinations purely voluntary, but is conducting a comprehensive review of all products. In public statements, the ACIP chair has framed the debate over vaccination as a conflict between individual autonomy and public health, and has questioned the notion of “established science” with regard to vaccine safety. He has paid particular attention to polio and measles vaccines, suggesting that improvements in sanitation should be taken into account when assessing whether current recommendations should continue.
Experts argue, however, that this line of reasoning overlooks a fundamental fact: the decline in infectious diseases in the United States has been directly linked to high vaccination coverage. In the case of polio, the risk of new outbreaks rises as vaccination rates fall, and the current epidemiological situation for measles already illustrates the scale of the problem. In 2026, the United States has recorded 416 confirmed measles cases so far, compared with 2,255 cases in all of 2025. After just three weeks of the new year, the number of cases has already reached roughly one-fifth of last year’s total, which was the worst measles year in three decades.
Milhoan’s remarks have also drawn criticism after he described the rapidly rising number of measles cases as an opportunity to observe how often unvaccinated patients are hospitalized and how frequently deaths occur. Some experts interpret this as effectively endorsing a population-level “experiment” at a time when decades of epidemiological research have already demonstrated the effectiveness of vaccination in preventing hospitalizations and deaths.
Milhoan has also publicly criticized the very mechanism of vaccine recommendations, portraying it as a form of coercion against families, even though the US federal government does not mandate childhood vaccinations and decisions on school requirements are made by individual states and local authorities. According to public-health specialists, current members of ACIP increasingly treat the act of recommending vaccines itself as an infringement on parental freedom, representing a fundamental departure from the role the committee has played for the past 60 years. At the same time, a new report by KFF shows that a growing number of states are separating their regulatory decisions from federal guidance.
Public-health leaders expect that the committee will continue to challenge the existing scope of federal vaccine recommendations and emphasize potential — and very rare — adverse events, while downplaying their well-documented population-level benefits. As a result, an increasing share of responsibility for maintaining public trust in vaccination is likely to fall on state and local health authorities and medical organizations.
