There have been a lot of federal vaccine announcements lately. I am having trouble figuring out how all the pieces fit together, and I follow this stuff fairly closely. Maybe some of you feel the same way. So, let me try to explain it to myself, out loud, and hopefully it will make sense to all of us.

First, a recap of where the executive order left things

I wrote about the Gold Standard executive order the President signed on August 10. https://rickjaffeesq.com/2026/08/11/against-the-advice-of-counsel-trump-takes-the-shot/ The order recommends universal childhood immunization against eleven diseases, puts a second group into a high-risk category, moves a third group to shared clinical decision-making, and asks that the MMR be given as three separate single-disease shots once such products exist.

What the order does not do is change anything on its own. It directs HHS to come back with a plan. Judge Murphy’s preliminary injunction in AAP v. Kennedy still freezes the January schedule revision and still stays the reconstituted ACIP. School mandates are state law, and a presidential order does not touch them. So as of today the operative question is what machinery exists to carry out whatever plan Kennedy eventually delivers.

That is where the committees come in.

Three committees, three different jobs

HHS filed a rewritten charter for the National Vaccine Advisory Committee on July 7, refiled the charter for the Advisory Commission on Childhood Vaccines on July 21, and this week published a Federal Register notice soliciting nominations for a new NVAC. A lot of people are reading this as a way around the ACIP injunction. Understanding why it is not, requires understanding what each of these bodies actually does, because they are three different things that get talked about as if they were interchangeable.

ACIP

ACIP advises the CDC on who should get which vaccine. Here is the odd part. Congress never created ACIP. It exists under section 222 of the Public Health Service Act, 42 U.S.C. § 217a, which is the general provision letting the Secretary set up an advisory committee on more or less anything. What gives ACIP its power is that Congress later wrote it into other statutes by name. Private health plans must cover, with no cost sharing, immunizations that have an ACIP recommendation adopted by CDC. 42 U.S.C. § 300gg-13(a)(2). The Vaccines for Children program buys off the ACIP list. 42 U.S.C. § 1396s. And the states generally point their school requirements at the CDC schedule, (or they used to) which is built from ACIP votes. So ACIP is the committee that reaches into insurance coverage, federal vaccine purchasing, and school enrollment.

NVAC

NVAC was created by Congress in the 1986 Vaccine Act, 42 U.S.C. § 300aa-5. It sits at HHS and reports to the Assistant Secretary for Health, who serves as Director of the National Vaccine Program. It has nothing to do with CDC. That is the whole design. NVAC gives advice directly to senior HHS leadership, bypassing the CDC apparatus entirely. Congress gave it four jobs: vaccine supply, research priorities for safety and efficacy, advising on implementation of the National Vaccine Program, and an annual report identifying where governmental and non-governmental cooperation ought to go. Over the years it has produced the National Vaccine Plan, adult immunization standards, and a substantial pile of white papers. What it has never produced is anything with legal consequence. No insurer’s obligation changes because of an NVAC report. No state statute changes. No vaccine gets purchased or stops getting purchased.

So if the question is will the changes made to the NVAC charter have any immediate or direct effect of what vaccines your child will have to take to go to school in the few states that do not have a religious exempntion. The answer is a hard no.

ACCV (and that’s the one I had to look up)

ACCV was also created by the 1986 Act, 42 U.S.C. § 300aa-19. Nine members, housed at HRSA (another damm acronym, Heath Resource and Services Administation which is a separate division of HHS), which runs the NVICP. ACCV’s jurisdiction is the National Vaccine Injury Compensation Program and nothing else. It advises the Secretary on running the compensation program, it reviews the Vaccine Information Statements, and it recommends changes to the Vaccine Injury Table. If you are trying to figure out what ACCV means for the childhood schedule, the answer is that it means nothing, because ACCV is about what happens after a child is injured, not about which shots a child gets.

In short, the two committees Congress actually wrote into the vaccine statute have no authority over the schedule, and the committee Congress left out of that statute is the one that drives what the federal government thinks a child needs to receive, but as explained in the the Gold Standard EO post, the federal government doesn’t have any direct say in what vaccinations are necessary for a child to attend a school in any state, unless that state specifically incorporated either the ACIP recommended schedule (and no state recommends the full 18 ACIP recommended immunizations) or the state incorporates the ACIP contraindication and precautions tables, which many states do in whole or in part by state statutre or regulation.

Next post I will go into the details of the changes.

Rick Jaffe, Esq.