Citing a survey called “Killer Jab?,” which found that nearly 1 out of 4 Americans reported knowing someone who died from a covid vaccine, a federal work group is calling for sweeping changes to how the medical establishment tracks and treats injuries from the shots. The changes are proposed in a confidential report obtained by The New York Times.

The work group’s report — “written with a sense of urgency,” it said — was drafted for the federal Advisory Committee on Immunization Practices, a panel that advises the government on vaccine policy. In the report, the authors propose creating a diagnostic category specifically for covid vaccine injuries, new diagnostic guidelines and a network of research centers to study long-term harms from covid vaccines and the illness itself.

Its opening paragraph cites two polls, one of them the “Killer Jab?” an online and telephone survey of 1,110 American adults conducted in 2023 by Rasmussen Reports, a conservative-leaning polling firm, which asked “Do you know someone personally who died from side effects of the covid-19 vaccine?”

Thousands of people believe that they were harmed by covid vaccines, citing a wide variety of neurological, cardiovascular and immune symptoms they say were caused by the shots. But many say that their complaints have been dismissed by federal agencies as psychosomatic and that they have been unfairly branded as being anti-vaccine.

Billions of people worldwide have received covid vaccines. Most studies have not found widespread reports of deaths or severe side effects related to the shots. And in June 2025, when Health Secretary Robert F. Kennedy Jr. overhauled the vaccine committee, the Centers for Disease Control and Prevention told the new members its databases had found no increased risk of death after covid vaccination.

Dr. Sean O’Leary, head of the pediatric infectious disease committee for the American Academy of Pediatrics, said the covid work group’s report misrepresented the body of work already available on side effects from the covid vaccine. (The academy is one of six organizations that has sued the Health Department, with a goal of preventing ACIP members from meeting.)

The report cherry-picks studies of poor quality that support its thesis and omits work that does not, O’Leary said, adding, “It is straight out of the anti-vaccine handbook.”

The work group’s proposals come at the same time as the group has abandoned the idea of holding separate votes on whether to rescind recommendations for certain covid vaccines.

The vaccine committee is scheduled to consider the work group’s recommendations at a meeting on Wednesday, but a federal court could upend those plans. A judge is expected to rule before Wednesday on whether the vaccine panel’s members are qualified to meet and make vaccine recommendations for Americans.

The committee’s decision to press ahead with discussing vaccine injuries, without proposing to withdraw the recommendations for the shots, reflects a delicate balancing act inside the Trump administration over how much emphasis to place on vaccine policy — an issue unpopular with voters in both parties — in advance of the November midterm elections.

But it also reflects an intensifying focus within federal agencies on harms from vaccines, food and medicines. The Food and Drug Administration announced a new database last week to track vaccine injuries; it would merge several existing systems and begin collecting data on harms from food and supplements.

The covid work group initially proposed that ACIP should vote on whether to rescind its current recommendations for the mRNA covid shots made by Pfizer and Moderna, at least for children, pregnant women and people under 40, according to two people with knowledge of the events. The group suggested that ACIP could instead recommend the more traditional vaccine made by Novavax.

The retreat on that recommendation was reported earlier by The Washington Post.

Still, at the ACIP’s scheduled meeting this week, members of the covid work group may present data to the panel purporting to show that the mRNA covid vaccines are contaminated with fragments of DNA that can cause dangerous inflammatory reactions. Regulatory agencies worldwide, including the FDA, have examined and dismissed such claims.

Polls have found that Kennedy’s vaccine skepticism is unpopular, even among Republicans and others who support his Make America Healthy Again agenda. A recent survey by Republican pollster Tony Fabrizio concluded that supporting the elimination of vaccine recommendations posed “electoral downsides” for members of both parties.

The Trump administration has made it clear that it wants Kennedy to pivot away from vaccines and toward his healthy eating agenda, which has bipartisan support. Federal officials have said privately that they have accomplished what they wanted to on vaccines, and that they are putting the issue behind them. Kennedy has so far complied.

But the panel members he appointed — including its chair, Retsef Levi, an applied mathematician at the Massachusetts Institute of Technology; and its vice chair, Dr. Robert Malone, a biochemist who has been sharply critical of covid vaccines — share Kennedy’s vaccine skepticism and are determined to press on with his agenda.

Vaccine experts note that even the safest of vaccines and drugs have side effects, and that the covid vaccines have side effects that are still poorly understood.

“We know that some people experience prolonged and debilitating symptoms after vaccination, and this warrants further clinical, epidemiological and mechanistic studies to better understand what causes these illnesses,” said Akiko Iwasaki, an immunologist at Yale who studies post-vaccine syndrome and its similarity to long covid.

“At the very least, patients deserve compassionate, evidence-based care,” she said.

The covid work group’s report details three planned votes, one recommending that any harms from covid vaccines be awarded a distinct diagnostic code that could be used for insurance reimbursement. The report refers to harms caused by the vaccines as post-acute-covid-19-vaccination syndrome, or PACVS.

The group also plans to recommend that the CDC develop formal diagnostic guidelines for clinicians to recognize and manage patients with long-term symptoms after covid vaccination or illness. And it plans to suggest that the CDC collaborate with other agencies, such as the National Institutes of Health, to set up a research network that would study the syndromes and develop potential tests and treatments.

All these actions are outside the usual purview of the vaccine committee, which typically advises the CDC on which vaccines should be given and when.

ACIP’s foray into diagnostic guidelines is “well outside the committee’s remit,” said Noel T. Brewer, a vaccine expert who was removed from the committee by Kennedy last June.

In fact, a separate branch of the CDC already plans to review at a meeting this week whether adverse effects of covid vaccines should be added to the compendium of diagnostic codes used by doctors nationwide.

But Stefanie Spear, deputy chief of staff for the Department of Health and Human Services and a longtime adviser to Kennedy, said, “It is fully under ACIP’s purview to ask what we know and need to know about long covid and covid vaccine injuries.” She declined to comment further.

The committee’s charter does include discussion of vaccine safety, but in the context of informing its “deliberations on use of vaccines.” The charter makes no mention of the committee’s involvement in clinical guidelines or diagnostic criteria for vaccine injuries.

“Vaccine policy in the U.S. has become increasingly incoherent,” Brewer said. “This strange side quest is yet another example.”

ACIP’s guidelines have historically informed insurance coverage of the shots, as well as which vaccines states require for entry into schools and day care.

But it has lost much of its influence since Kennedy fired all of its members and appointed new ones, most of whom share his skepticism of vaccines.

Some of the committee’s recent decisions have not been embraced by states or insurance companies. Kennedy himself has circumvented the committee by making vaccine policy announcements, including on covid vaccines, on social media. In January, he and his appointees bypassed the committee and announced a new childhood vaccination schedule that cut the number of diseases prevented by routine immunizations to 11 from 17.

Dr. Debra Houry, who was the CDC’s chief medical officer before she resigned in August, said she was surprised by the committee’s continued focus on covid vaccines instead of on the nation’s current measles outbreaks or on newer vaccines the members could be discussing.

“It is always fine and welcome to look at concerns around vaccines and new evidence,” she said. “However, this committee seems to be hyperfocused on finding only the negatives and not benefits.”

The committee and its covid work group had previously discussed long covid at length and ultimately determined that the constellation of symptoms included in the syndrome were too broad to inform vaccine policy, according to Brewer, the former member of the work group.

“The basis of supposed covid vaccine injury syndrome is even less persuasive and thus even less directly relevant to vaccine policy,” he said.

Similar syndromes based on loose clusters of symptoms, such as Gulf War syndrome or lingering symptoms of Lyme disease, “have been clinical dead ends,” he said, adding, “These patients are sick, but it’s unclear what the cause is or how to best help them heal.”