My opinion, not speaking on behalf of USG, CDC leadership, or ACIP.
CDC has had decades of mission creep, and has lost focus in core mission. It is now being restructured, redirected and dismantled. The international component is being transferred to the State department. There will be turbulence during this period. The opportunity and gift is for the ACIP to help guide the rebuilding and restructuring towards greater rigor, objectivity, transparency and integrity. But this will take years. In my opinion. And that job will be difficult, contentious and subject to intense criticism.
CDC has had decades of mission creep, and has lost focus in core mission. It is now being restructured, redirected and dismantled. The international component is being transferred to the State department. There will be turbulence during this period. The opportunity and gift is for the ACIP to help guide the rebuilding and restructuring towards greater rigor, objectivity, transparency and integrity. But this will take years. In my opinion. And that job will be difficult, contentious and subject to intense criticism.
CDC must have rigorous external peer review and scrutiny. For far too long it has been an insular, self-reinforcing culture prone to chronic and pervasive confirmation bias.
If you want to rebuild a corporate culture, you need a transformative leader, widespread cuts in FTE, followed by a surge of hiring of new FTE that are not caught up in the same cultural biases that you seek to replace.
The other model is to allow the dysfunctional culture to continue for a period while creating a new organization, and then collapse the original and replace it with the new one.
I have been writing for years now that many agencies including CDC are compromised by having dual competing functions. In the case of the CDC, one example is holding responsibility for both vaccine advocacy and vaccine safety/effectiveness monitoring/reporting. Similar competing dual function conflicts exist in many other agencies. And the budget for promoting industry interests seems to always vastly exceed oversight budget . I strongly recommend that these functions of vaccine advocacy and oversight must be split into different silos.
Whether those silos both report to CDC director is a policy decision.
A case could be made that post marketing surveillance of drugs, devices and biologics should be pulled out of FDA and CDC. ACIP is experiencing the consequences of split monitoring mandates between FDA and CDC. This leads to the game of "not our monkey, talk to the other guy".
For example the issue of the lot consistency and lot release data query for the COViD vaccines
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