Appeals court presses Trump administration on frozen vaccine panel picks

A three-judge panel of the U.S. Court of Appeals for the First Circuit spent nearly an hour on Tuesday questioning whether a lower-court judge went too far in freezing Health and Human Services Secretary Robert F. Kennedy Jr.'s picks for the federal government's chief vaccine advisory committee, the latest turn in a year-long legal fight that has left the country without an official flu-shot recommendation heading into the current respiratory virus season.

The hearing, held at Boston's John Joseph Moakley U.S. Courthouse, centered on a March 16 order by U.S. District Judge Brian E. Murphy that blocked 13 of Kennedy's appointees to the Advisory Committee on Immunization Practices (ACIP) and voided the votes the reconstituted panel had already cast. A Justice Department attorney, Matthew Zorn, told the appellate judges the injunction had left ACIP "without a quorum" and asked them to "vacate the order on the appointments so the secretary can reconstitute the committee and get it back to work." Lawyers for the American Academy of Pediatrics and its co-plaintiffs urged the court to leave the freeze in place while the underlying case, tracked on the appellate docket, proceeds.

The numbers

The dispute traces back to June 2025, when Kennedy dismissed all 17 sitting members of ACIP and replaced them with 15 appointees of his own choosing, nearly all aligned with skepticism of the existing vaccine schedule. Judge Murphy's injunction found that most of those appointees were "distinctly unqualified" under the statute governing the committee, noting that only six of the 15 had any meaningful background in vaccines. ACIP needs at least eight eligible voting members present to take official action, a threshold the panel has been unable to meet since the order took effect.

Plaintiffs' fourth amended complaint, filed in the U.S. District Court for the District of Massachusetts, challenges four final agency actions:

• Kennedy's June 2025 dismissal of all 17 sitting ACIP members and appointment of 15 replacements
• A December 5, 2025 committee vote eliminating the recommendation that newborns receive a hepatitis B vaccine dose within 24 hours of birth
• A September 19, 2025 vote reclassifying COVID-19 vaccination as "shared clinical decision-making" for people under 65
• A January 5, 2026 "decision memo" cutting the recommended childhood immunization schedule from 17 vaccines to 11

Judge Murphy's March order set aside all four actions and froze the committee's disputed membership while the underlying case proceeds.

Court filings illustrate why the plaintiffs say the new panel fell short of the "fairly balanced" standard Congress set for federal advisory committees. According to the complaint, two of Kennedy's most recent additions to ACIP, announced in January 2026, were obstetrician-gynecologists who had each publicly reversed long-held professional positions on vaccines shortly before their appointments; one, practicing in Florida, said of her own past stance, "I was not anti-vaccine. I am now," while the other, in the Boston area, has said publicly that "the science is not 'long-settled' regarding vaccines." Plaintiffs cited those statements as evidence the committee no longer reflected mainstream clinical consensus.

How the committee unraveled

ACIP has advised the Centers for Disease Control and Prevention on immunization policy for more than six decades, typically reviewing clinical evidence in public meetings before voting on recommendations that shape insurance coverage, school-entry rules and physician guidance nationwide. The American Academy of Pediatrics and several other medical and public-health groups first sued in July 2025, days after Kennedy's mass dismissal of the committee's prior members, arguing the shake-up violated the Federal Advisory Committee Act's requirement that such panels remain "fairly balanced" and free of "inappropriate" influence. The complaint has been amended four times since, most recently in February, as plaintiffs added each new ACIP vote and HHS policy change to the case recorded on the district court's docket.

Murphy ruled in March that the plaintiffs were likely to prevail on the merits and issued a preliminary injunction covering both the committee's membership and its votes. HHS and Kennedy appealed to the First Circuit the following month, arguing the district court lacked authority to second-guess the secretary's personnel choices and that the stay was obstructing legitimate public-health work.

Who is affected

The practical effect has been a federal vaccine-policy vacuum during the fall respiratory virus season. With ACIP unable to convene, the committee has issued no official 2026-27 influenza vaccine recommendation, leaving pediatricians, pharmacists and state health departments to lean on guidance from outside medical societies instead. The American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the Infectious Diseases Society of America have each published their own schedules to fill the gap this season.

Insurance coverage has so far been less disrupted. The insurance trade group AHIP has said member plans, including Aetna, Cigna, Humana, Elevance Health and Blue Cross Blue Shield affiliates, will keep covering, without cost-sharing, any vaccine that carried an ACIP recommendation as of September 1, 2025, through the end of 2027 regardless of how the litigation ends. That commitment has shielded most patients from immediate coverage disputes even as the underlying recommendations remain legally unsettled.

The stakes extend beyond insurance paperwork. ACIP recommendations also feed the federal Vaccines for Children program, which supplies free immunizations to roughly half the country's children, and inform the school-entry requirements that most states set by referencing the federal schedule rather than writing their own. A prolonged vacancy at the top of that system leaves state health officials, rural clinics and uninsured families with less certainty than the large commercial insurers that negotiated their own stopgap.

What the judges said

During Tuesday's argument, Chief Judge David Barron pressed Zorn on what harm the government was actually trying to remedy by restoring the disputed appointees, telling him bluntly:

"It's hard to know precisely what harm this relief was designed to address."

Andrew Pincus, arguing for the medical groups, told the panel that Murphy's order provided "important protection for America's public health" and should remain in force until the case is resolved on the merits. The panel gave no indication of when it would rule, and a wire account of the hearing noted that appeals courts typically take weeks or months to issue a decision after oral argument.

What happens next

A previously scheduled ACIP meeting for October 21-23 is widely expected to be canceled again absent a ruling restoring the committee's membership, extending the advisory vacuum into the winter vaccination push. Whatever the First Circuit decides on the narrower question of the appointments, the broader fight over Kennedy's policy changes continues in Judge Murphy's courtroom, where the fourth amended complaint remains pending. For now, the committee that for decades set the federal government's vaccine guidance remains sidelined, and the country is heading deeper into flu season without one.