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The first meeting of HHS Secretary Robert F. Kennedy Jr.'s handpicked vaccine advisory board yesterday featured plenty of anti-vaccine talking points — and its proceedings didn't stick to the script.

State of play: It was revealed that one of Kennedy's eight appointees withdrew during the required financial review, leaving the board with only seven members.

• The leading professional association of pediatricians publicly boycotted the proceedings.
• And planned votes on recommendations for RSV vaccines were postponed when the committee ran out of time.

The big picture: The events underscored how the Advisory Committee on Immunization Practices is on a less predictable course under Kennedy, who maintains he isn't against vaccines but is pro-safety.

• The ramifications could be huge if the panel upends decades of vaccine policy. ACIP's recommendations not only influence insurance coverage decisions but what physicians tell patients.

Driving the news: The committee quickly served notice that it will create new subgroups to look into the "cumulative effect" of current federal childhood and adolescent vaccine schedules, and to study vaccines that haven't been reviewed in more than seven years.

Panel members voiced skepticism about mRNA vaccines during presentations on COVID-19 vaccine safety and efficacy and questioned the way the CDC they now advise designed past studies and analyzed data.

• Chair Martin Kulldorff said in his opening remarks that classifying panelists as pro- or anti-vaccine undermines scientific integrity and "further feeds the flames of vaccine hesitancy."

What's next: The committee will start voting today on recommendations for infant and maternal RSV vaccines, influenza vaccines and thimerosal-containing influenza vaccines.

• That last agenda item will follow a presentation on the mercury compound given by Lyn Redwood, president emerita of Children's Health Defense, the anti-vaccine group with close ties to Kennedy. The presentation reportedly cites a research paper that doesn't exist.

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CDC director nominee Susan Monarez tried not to contradict Trump administration policies, while still touting her credentials as a scientist, during her confirmation hearing before the Senate health committee yesterday, Peter Sullivan wrote first on Pro.

Why it matters: Monarez is a career government researcher who's regarded as a more mainstream nominee than President Trump's first pick, Dave Weldon, whose nomination was pulled amid concern from senators about his experience and vaccine views.

• She's the first CDC director-designate to face Senate confirmation under a law Congress passed in 2023.

Driving the news: Monarez tried to show her commitment to more established science while also not contradicting some of Kennedy's more controversial views.

• "I have not seen a causal link between vaccines and autism," she said under questioning from Sen. Bernie Sanders (I-Vt.), noting that "vaccines save lives."
• But when asked repeatedly by Democratic Sens. Andy Kim of New Jersey and Maggie Hassan of New Hampshire, she declined to directly give an example of an area where she disagreed with Kennedy.
• "The secretary is doing the important work of leading a complex agency," she told Kim.

Health committee Chair Bill Cassidy (R-La.), who had called for the ACIP meeting to be delayed over concerns with the new members, called on Monarez to make the panel more balanced, if confirmed.

If you need smart, quick intel on health care policy for your job, get AxiosProPolicy.

Kids and teens consumed fewer calories from fast foods over the decade that ended in mid-2023, according to newly published CDC data.

Why it matters: It showed the country may have been heading toward healthier food options well before Kennedy took office and made cleaning up America's diet a priority.

Where it stands: Kids ages 2 through 19 consumed an average of 11.4% of their daily calories from fast food on a given day between August 2021 and August 2023, according to data from the CDC's National Health and Nutrition Examination Survey.

• That's down from an average of nearly 14% in 2013 and 2014, per CDC data.
• For adults age 20 and up, average calories from fast food fell from about 14% in 2013 and 2014 to 11.7% during mid-2021 to mid-2023.

Zoom out: About 30% of youth ages 2 through 19 ate fast food on any given day between August 2021 and 2023. That figure exceeded 36% between 2015 and 2018, the CDC found.

• The team working on the National Health and Nutrition Examination Survey team was not impacted by mass employee terminations at HHS this year, and its work continues, a CDC spokesperson told Axios.

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A national survey found that 86% of American voters are more likely to support congressional candidates who will:

• Hold Big Pharma accountable.
• Lower the price of prescription Rx drugs.

Learn more.

Federal officials and health workers are practicing a deadly disease response this week at Washington Dulles International Airport, using a new portable biocontainment unit and a Boeing 747 to simulate the transfer of four patients with an unknown condition between Toronto and D.C.-area hospitals.

The big picture: The Ebola outbreak underscored the importance of isolating and repatriating Americans with lethal viruses from hot zones, and transporting them between specially equipped hospitals, John Knox, principal deputy assistant secretary at HHS, told Axios.

• The unit is essentially a movable hospital room that can transport up to 10 patients at a time and be converted into ER use with features such as negative pressure, Knox said.
• Dozens of federal, international and local agencies are taking part in the drills, which featured ambulances waiting on the apron to safely transport the patients.
• "We live in an era of emerging diseases with global travel," Knox said. "This really bolsters national security."