type: timeline_event Dr. Kirk Milhoan, the newly appointed chair of the CDC's Advisory Committee on Immunization Practices (ACIP), tells fellow panel member Dr. Cody Meissner during a lunch break that committee members feel like "puppets on a string" rather than an independent advisory group, according to a transcript captured on the meeting's audio feed. The extraordinary admission, overheard by medical associations and health care providers attending the December 4-5 meeting remotely, publicly exposes concerns about political manipulation of the nation's premier vaccine advisory panel under HHS Secretary Robert F. Kennedy Jr.'s control.
According to a transcript obtained by The Washington Post and confirmed by POLITICO, Milhoan stated: "You know, I feel like, you know, it's, sort of like we feel like a little bit like puppets on a string as opposed to really being an independent advisory panel." The comment was made on what participants believed was a private conversation but was actually broadcast over the videoconferencing sound feed used by liaison representatives from medical associations, pharmaceutical industry representatives, and health care providers participating remotely in the meeting.
Two sources who were on the call confirmed Milhoan's "puppet" remark to POLITICO. The remarks were captured by the videoconferencing software and viewed by multiple major news outlets including The Washington Post, The Wall Street Journal, and POLITICO. The inadvertent public disclosure reveals internal concerns about committee independence that panel leadership had not previously acknowledged publicly.
When asked about the remarks by reporters, Milhoan clarified via text message: "There are pressures from many organizations: federal, industry, medical organizations that are trying to influence by ad hominem attacks, when we are trying to look at and ask for data." He stated he was "not referring to the administration" and claimed he has not faced pressure from Kennedy. An HHS spokesperson later stated that Milhoan was referring to treatment of the committee by liaison representatives who criticized the panel during the two-day meeting.
However, the context of Milhoan's appointment and the committee's composition directly contradicts claims of independence from the administration. Kennedy personally selected Milhoan and every other ACIP member after firing all 17 sitting members in June 2025, an unprecedented purge that Kennedy justified by claiming a "clean sweep is necessary to reestablish public confidence in vaccine science." Milhoan, a pediatric cardiologist and former Air Force flight surgeon, became chair on December 2, 2025, just days before the meeting.
The "puppets on a string" admission occurred during the most controversial ACIP meeting in the committee's history. The same day, the panel voted 8-3 to end universal hepatitis B vaccination at birth, reversing a 34-year policy that reduced pediatric infections by 99%. The meeting was characterized by what STAT News described as "incompetence, bias, and procedural chaos," with concerns that most committee members "don't understand their job."
Major medical organizations had already expressed alarm about the panel's lack of independence and credibility before Milhoan's admission. The American Academy of Pediatrics boycotted the December meeting entirely, with AAP President Dr. Susan Kressly stating "it is no longer a credible process" and "We won't lend our name to a system that is being politicized at the expense of children's health." The American Medical Association warned that excluding physician liaisons from ACIP work groups is "irresponsible, dangerous to our nation's health and will further undermine public and clinician trust in vaccines."
Dr. Cody Meissner, the only panel member with prior ACIP service before Kennedy's June purge, voted against the hepatitis B policy change and warned: "We are doing harm by changing this wording." Meissner is the sole remaining connection to the committee's previous scientific expertise and independence. His presence on the panel makes him a particularly significant audience for Milhoan's admission, as Meissner represents the institutional knowledge of how ACIP functioned before political reconstitution.
The new ACIP composition includes individuals described by NBC News as having "largely expressed skepticism of vaccines" and by PBS as "noted vaccine skeptics and conspiracy theorists." Panel members include Dr. Robert Malone, a prominent vaccine critic, and were selected by Kennedy despite his history of promoting debunked theories linking vaccines to autism. A lawsuit filed in July 2025 by a coalition of medical professional groups alleged that Kennedy barred registered Democrats from serving on the panel and that candidates would not be allowed to join if they previously criticized Trump.
Scientific analysis of ACIP's functioning under the new leadership confirms deteriorating standards. Between April and September 2025, ACIP's policymaking maturity rating fell from an overall score of 100% to 58%, according to research published in a peer-reviewed journal. Three former CDC leaders who resigned in protest warned that ACIP "appears poised to raise vaccine risks while burying their benefits" and that "loosely defined sessions" for the December meeting "could invite misapplied risk framing."
The "puppets on a string" comment reveals what public health experts have warned about since Kennedy's June purge: that the committee no longer functions as an independent scientific body. Dr. Jonathan Temte, former ACIP chair from 2012-2015, warned after the June firings that "we are heading in the direction of U.S. vaccine policy becoming the laughing stock of the globe." The Infectious Diseases Society of America called Kennedy's allegations about the previous committee's integrity "completely unfounded" and labeled the reconstitution "reckless, shortsighted and severely harmful."
During the December meeting, the panel heard a presentation from Aaron Siri, a vaccine lawsuit attorney with no medical training, representing a significant departure from ACIP's traditional reliance on peer-reviewed scientific evidence and medical expertise. Epidemiologist Jennifer Nuzzo criticized the committee's reliance on "personal stories" rather than epidemiological evidence, noting that "anecdotes may be misleading." STAT News reported that public health experts expressed concerns that many committee members operate on "a very steep learning curve" lacking vaccine expertise.
The American College of Physicians warned that "individuals appointed to ACIP serve overlapping terms that are not tied to specific presidential administrations" and that "children born under one presidential administration should not be better protected from death and serious illness than children who happen to be born under the next." The organization demanded "the preservation of ACIP's independence, valuing the voices of experienced liaisons, resisting political interference, and reinforcing the role of the CDC as a scientific, not a political, institution."
Milhoan's admission that panel members feel manipulated comes as the broader medical community has already lost confidence in ACIP's credibility. The AAP's instruction to its 67,000 members to ignore ACIP's hepatitis B recommendation and continue vaccinating all newborns represents an extraordinary breach in the traditional relationship between federal health authorities and medical professional organizations. Multiple states including New York announced they will not follow ACIP guidance, an unprecedented rejection of CDC vaccine recommendations.
The "puppets on a string" comment also emerged amid reports of personal retaliation against Milhoan for his ACIP service. According to his wife, Milhoan was dismissed from his pediatric cardiology practice shortly before the panel voted on hepatitis B policy, allegedly "solely because of his service as Chair of ACIP." This raises additional questions about the pressures facing panel members and the professional risks of serving on Kennedy's reconstituted committee.
Public health experts view Milhoan's inadvertent admission as confirmation of their concerns about political control over vaccine policy. The comment reveals that even committee leadership selected by Kennedy recognizes the panel lacks independence, contradicting official claims that the reconstituted ACIP represents evidence-based decision-making free from political interference. The fact that such concerns were expressed privately but captured on an open audio feed demonstrates the disconnect between the committee's public posture and internal reality.
The exposure of ACIP members feeling like "puppets on a string" represents a crisis of scientific integrity at the nation's most influential vaccine advisory body. By personally selecting every member after an unprecedented purge, Kennedy created conditions where panel members lack genuine independence regardless of their individual intentions. Milhoan's admission validates warnings from the broader medical community that ACIP has been compromised as a credible scientific institution, replaced by a politically controlled body that prioritizes anti-vaccine ideology over evidence-based public health policy.
The incident crystallizes the broader pattern of expertise purges and political interference in public health institutions under the Trump administration. When the chair of a reconstituted advisory panel admits members feel manipulated, it exposes the fundamental corruption of the scientific advisory process and confirms that vaccine policy decisions are now driven by political objectives rather than independent medical expertise and child safety.