By MIKE STOBBE and LAURAN NEERGAARD

ATLANTA (AP) — U.S. Health Secretary Robert F. Kennedy Jr.’s new vaccine advisers began their first meeting Wednesday under intense scrutiny from medical experts worried about Americans’ access to lifesaving shots.

First on the agenda is an awkward scenario: Kennedy already announced COVID-19 vaccines will no longer be recommended for healthy children or pregnant women, and his new advisers aren’t scheduled to vote on whether they agree. Yet government scientists prepared meeting materials calling vaccination “the best protection” during pregnancy — and said most children hospitalized for COVID-19 over the past year were unvaccinated.

COVID-19 remains a public health threat, resulting in 32,000 to 51,000 U.S. deaths and more than 250,000 hospitalizations since last fall, according to the Centers for Disease Control and Prevention. Most at risk for hospitalization are seniors and children under 2 — especially infants under 6 months who could have some protection if their mom got vaccinated during pregnancy, according to the CDC’s presentation.

It’s one signal that this week’s two-day meeting of the Advisory Committee on Immunization Practices isn’t business as usual.

Another sign: Shortly before the meeting, a Virginia-based obstetrician and gynecologist stepped down from the committee, bringing the panel’s number to just seven. The Trump administration said Dr. Michael Ross withdrew during a customary review of members’ financial holdings.

The meeting opened as the American Academy of Pediatrics announced that it will continue publishing its own vaccine schedule for children but now will do so independently of the ACIP, calling it “no longer a credible process.”

The panel, created more than 60 years ago, helps the CDC determine who should be vaccinated against a long list of diseases, and when. Those recommendations have a big impact on whether insurance covers vaccinations and where they’re available, such as at pharmacies.

Earlier this month, Kennedy abruptly dismissed the existing 17-member expert panel and handpicked eight replacements, including several anti-vaccine voices. And a number of the CDC’s top vaccine scientists — including some who lead the reporting of data and the vetting of presentations at ACIP meetings — have resigned or been moved out of previous positions.

The highly unusual moves prompted a last-minute plea from a prominent Republican senator to delay this week’s meeting. Sen. Bill Cassidy of Louisiana, a physician who chairs the chamber’s health committee, said Monday that many of Kennedy’s chosen panelists lack the required expertise and “may even have a preconceived bias” against new vaccine technologies.

In a House hearing Tuesday, Kennedy defended his purge, saying the old panel had been “a template for medical malpractice.”

Rep. Kim Schrier, a pediatrician and Democrat from Washington state, told Kennedy: “I will lay all responsibility for every death from a vaccine-preventable illness at your feet.”

Committee will vote on RSV protections

The two-day meeting’s agenda on was abruptly changed last week.

Discussion of COVID-19 shots will open the session on Wednesday. Later in the day, the committee will take up RSV, with votes expected. On Thursday, the committee will vote on fall flu vaccinations and on the use of a preservative in certain flu shots.

RSV, or respiratory syncytial virus, is a common cause of cold-like symptoms that can be dangerous for infants.

In 2023, U.S. health officials began recommending two new measures to protect infants — a lab-made antibody for newborns and a vaccine for pregnant women — that experts say likely drove an improvement in infant mortality.

The committee will discuss another company’s newly approved antibody shot, but the exact language for the vote was not released prior to the meeting.

“I think there may be a theme of soft-pedaling or withdrawing recommendations for healthy pregnant women and healthy children,” even though they are at risk from vaccine-preventable diseases, said Lawrence Gostin, a public health law expert at Georgetown University who co-authored a recent medical journal commentary criticizing the COVID-19 vaccination decision.

Flu shot recommendations to be debated

At its June meetings, the committee usually refreshes guidance for Americans 6 month and older to get a flu shot, and helps greenlight the annual fall vaccination campaign.

But given the recent changes to the committee and federal public health leadership, it’s unclear how routine topics will be treated, said Jason Schwartz, a Yale University health policy researcher who has studied the committee.

Thursday also promises controversy. The advisory panel is set to consider a preservative in a subset of flu shots that Kennedy and some antivaccine groups have falsely contended is tied to autism. In preparation, the CDC posted a new report confirming that research shows no link between the preservative, thimerosal, and autism or any other neurodevelopmental disorders.

Gostin said the agenda appears to be “a combination of what we would normally expect ACIP to cover along with a mixture of potential conspiracy theories,” he said. “We clearly are in a new normal that’s highly skeptical of vaccine science.”

The committee’s recommendations traditionally go to the Centers for Disease Control and Prevention director. Historically, nearly all are accepted and then used by insurance companies in deciding what vaccines to cover.

But the CDC currently has no director, so the committee’s recommendations have been going to Kennedy, and he has yet to act on a couple recommendations ACIP made in April.

The CDC director nominee, Susan Monarez, is slated to go before a Senate committee on Wednesday.

Neergaard reported from Washington.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.