Public health experts raise alarm over 'fundamental violation of the integrity of the CDC'

In an editorial in JAMA, public health experts called for the FDA to take steps to reassure the public and clinical community about the scientific review and approval of a COVID-19 vaccine. (JAMA)

Recent allegations of political interference into Centers for Disease Control and Prevention (CDC) guidelines regarding COVID-19 testing could erode public trust in future vaccines against the novel coronavirus, top medical experts said in a discussion hosted by the Journal of the American Medical Association.

Last week, The New York Times reported controversial testing guidelines posted to the CDC website were not actually written by the CDC. By Friday, the CDC reversed those guidelines, saying that asymptomatic individuals should be tested if they'd been exposed to someone who had the virus.

In a video chat hosted Friday by JAMA Editor-in-Chief Howard Bauchner, M.D., experts raised alarm about the implications of the appearance of political meddling in federal scientific agencies' work.

"There's the fact that there was a political layer of review over the articles in Morbitiy and Mortality Weekly Reports, which is the scientific journal of the CDC and really considered the core scientific communication the agency has with practitioners," said Joshua Sharfstein, M.D., who is vice dean for public health practice and community engagement at Johns Hopkins University. "And then you have, for the public, the idea that the agency could draft something and it could get totally rewritten with errors and posted to the CDC website as if it were a CDC document. It's just a fundamental violation of the integrity of the CDC."

RELATED: Americans see hospitals as more trustworthy than FDA or CDC on COVID-19 vaccine information, poll finds

Sharfstein is former FDA deputy commissioner and former Maryland health secretary under former Democratic Governor Martin O'Malley.

"Now, why does the integrity of the CDC matter?" Sharfstein said. "We're in a pandemic. The CDC is the lead public health agency in the country, and people should—when they see the CDC—believe they are getting what the CDC actually thinks and not what a political layer of review has added and not, certainly, statements by others that haven't even been seen by the CDC. It just makes the CDC brand, the CDC mark, stand for nothing if it can be violated like that."

Preeti Malani, M.D., who is the chief health officer and a professor of medicine in the infectious diseases division at the University of Michigan, echoed his concerns.

"For me, the CDC holds such a special place as an infectious disease doctor. Even going to visit the CDC is a very special experience," Malani said. "Having handled several papers from there over the years and even been involved in different workshops, the level of scrutiny that happens whether they are submitting a paper or making a recommendation is part of the review process that makes the CDC trustworthy. To understand what is happening now, how there are shortcuts being made and overridden—it sounds like—for political reasons is heartbreaking and concerning. The lack of trust that is going to emerge from this situation that is already there could have implications well beyond COVID."

The two public health experts, along with Bauchner, published an editorial last week in JAMA calling on the Food and Drug Administration (FDA) to reassure the public and clinical community about the scientific review and approval of a COVID-19 vaccine. 

"A lack of clarity about the agency's approach—coupled with a stream of announcements from various federal agencies and pharmaceutical companies—has led to confusion and concern," they wrote. "Greater clarity and transparency about the review process as well as the full engagement of the relevant federal advisory committees can inspire understanding and trust."

Their comments also come on the heels of a recent Harris Poll that found only 73% of Americans said they saw the CDC as somewhat or very trustworthy, and 72% said they saw the FDA as highly trusted. That was just ahead of drug companies that work on vaccines in general, as well as those that are specifically working on COVID-19 vaccines (71%).