| During his first term, President Donald Trump oversaw one of the greatest modern efforts to bring a new vaccine to the world. In his second term, his administration has greatly reduced public access to — and potentially trust in — safe, effective vaccines and public health in general. “I’ve never seen such an anti-health agenda,” Alexandra Phelan, an expert in global health law and a senior scholar at Johns Hopkins University’s Center for Health Security, said in an interview earlier this year. “It’s an agenda that is intent on threatening the health of Americans.” Here’s what’s going on. Kennedy casts widespread doubt about established science on vaccines In the wake of the pandemic, the political right became much more skeptical of public health. When he won the White House again, Trump put vaccine skeptic Robert F. Kennedy Jr. in charge of the nation’s health departments, telling him to “go wild.” Kennedy quickly dismantled vaccine safety committees and upended the Centers for Disease Control and Prevention, the agency designed to protect Americans against infectious and chronic diseases. The government dropped recommendations for healthy pregnant people and babies to get coronavirus vaccines, and his team is reviewing whether to keep giving newborns vaccines for RSV, a respiratory infection that can be life-threatening for infants; hepatitis B, which can cause liver failure and cancer; rubella, a vaccine that causes congenital birth defects; and the common practice of getting flu and coronavirus vaccines together. “We at [the Department of Health and Human Services] are enacting a once-in-a-generation shift from a sick-care system to a to a true health care system that tackles the root causes of chronic disease,” Kennedy told Congress in a hearing Thursday. Public health experts vehemently disagree. They say the worst measles outbreak in decades is a direct result of Kennedy’s vaccine skepticism. “If the nation is truly going to be healthier, the best path would be to double down on these proven strategies, not dismantle them,” Debra Houry, who resigned from her role as the CDC’s chief medical official last week, wrote in The Washington Post on Wednesday. “I’m a doctor. Vaccines work,” said Sen. John Barrasso (R-Wyoming), countering Kennedy on Thursday. “Secretary Kennedy, in your confirmation hearings, you promised to uphold the highest standards for vaccines. Since then, I’ve grown deeply concerned.” It’s harder to get vaccines now and could soon be even harder The federal government can’t ban vaccines, but it can make them more difficult to access and less likely that insurance will cover them. In more than a dozen states, you now need a prescription to get a coronavirus vaccine at CVS. “Effectively, we’re denying people a vaccine,” Sen. Bill Cassidy (R-Louisiana), a doctor, asserted Thursday. That means more children, in particular, could get really sick because they tend to have lower immunity to diseases, experts say. “There will be some otherwise healthy kids who get quite sick from covid who haven’t been vaccinated,” said Jennifer Kates, the senior vice president and director of the global health and HIV policy program at KFF. Public health experts warn that polio could even come back in a world where it’s harder to get vaccines and people are more skeptical of science. “We will not be able to stop polio at its source before it lands on American soil,” Houry warned. “We are not ready for emerging health threats, and it’s only getting worse.” Vaccines may depend on where you live One of the only places in society where vaccines are mandated is in public schools, and until Kennedy and Trump’s reversal on immunizations, every state had required the shots to go to school (allowing for exemptions). Florida this week became the first state to move to eliminate vaccine mandates for school. Western states — Washington, Oregon and California — announced a coalition to make vaccine recommendations based on stances of national medical organizations such as the American Academy of Pediatrics, which has split with Kennedy on vaccines. Vaccines are popular, but confidence in public health is wavering Confidence in public health has declined since the pandemic. Kates says KFF polling has found that a majority of people don’t have confidence in public health agencies, most don’t plan to get a coronavirus vaccine, and many have questions about vaccines in general. Yet overall, vaccines are an accepted part of public health. Parents across the political spectrum overwhelmingly support school vaccination requirements, according to a Washington Post-KFF poll conducted in July and August. On Thursday, multiple senators accused Kennedy of taking away parents’ freedom to choose to vaccinate their children. “This is the last thing our parents need when our kids are going back to school is to have this kind of confusion and expense and scarcity you are creating as a result of your ideology,” Sen. Michael Bennet (D-Colorado) said. Kennedy frames all of this as a pursuit to “end the chronic disease epidemic.” “We are going to devote thousands of studies,” he told Congress. Public health experts say that they also want to tackle chronic disease but that Kennedy is sweeping aside almost all well-established science on health in the process and conflating vaccines with chronic disease. “The data on vaccines are scientifically valid,” Kates said. “There is not new information or hidden information that would change what we would know.” Kennedy’s “Make America Healthy Again” agenda worries public health experts beyond the vaccine issue. The Trump administration also rolled back regulations that try to limit forever chemicals and air pollution. It’s made rural hospitals less viable and also cut a program many tribes rely on for whole, healthy foods — undermining priorities that Kennedy says are his. Kates said there’s a scenario that keeps her up at night: A future pandemic that is especially harmful to children hits the country, with pockets of the population still unwilling to give public health officials the benefit of the doubt — and a public health sector dismantled by Kennedy and Trump. “Most people were not around when kids were dying,” she said. “Remembering what it was like when people could get measles or polio, it’s not in the consciousness. So the idea you would take something preventively to stave off the worst illness or greater spread, it’s not something people are familiar with.” | 
