Save America from the MAHA Movement
Scientists, clinicians, and public health professionals will not stand by while MAHA puts our children at risk of injury and death to enrich themselves and destroy democracy
Over the past two weeks, it has become abundantly clear that President Donald Trump and Health and Human Services Secretary Robert F. Kennedy, Jr. have redoubled their efforts to block access to as many vaccines as possible. The organizing principle of the Make America Healthy Again (MAHA) movement remaking American biomedical science and public health is a deep, unwavering opposition to vaccination. Since Kennedy was confirmed in February, he has been chipping away at the policies and infrastructure of our public health system, particularly those that enable and promote immunization. MAHA efforts to interfere with vaccine access and vaccination have been accelerating recently. These efforts have unfortunately been successful.
Kennedy has attacked vaccines across agencies and disciplines, cutting funding for vaccine research and redirecting it to MAHA cronies, slashing staff and expertise at federal health agencies, installing the least qualified, most unsuitable leaders across HHS, replacing scientific processes with political ones, flooding media with blatant anti-vaccine and anti-science propaganda, and attempting to make unilateral, scientifically unjustified policy changes. There is now momentum behind these efforts.
As more vaccines are removed from the childhood vaccination schedule, fewer and fewer children will be vaccinated. More and more children are going to get the diseases that these vaccines prevent. We won’t notice at first. Some of these diseases, like HBV, take a long time to develop. We won’t even know the full extent of more acute, clinically obvious diseases, like measles and pertussis (whooping cough), because our capacity for detecting, monitoring, and responding to outbreaks has been so depleted across the federal government. But more and more people are going to get sick. More and more people are going to die. The only reason for these deaths will be the furtherance of the MAHA agenda. By the time that most people realize what is happening, it will be too late to stop it.
That is why we need to stop it now. My colleagues and I came together to speak out against this. The American people deserve to know that MAHA is endangering us all by dismantling our public health system. Americans need to know what MAHA is really promising our children: preventable suffering and death. Speaking out is the first step in what I hope will become a call to action to fight back against a government that is threatening our children’s lives.
Make America have hepatocellular carcinoma again
At last week’s meeting of the Advisory Committee for Immunization Practices (ACIP), Team MAHA managed to score another critical hit on the childhood vaccination schedule. They voted to recommend delaying the birth dose of the hepatitis B virus (HBV) vaccine. HBV causes an incurable, chronic infection, which is often silent until years later when it causes liver cancer or liver failure. ACIP voted to recommend that parents delay protecting their babies against this completely preventable, incurable, deadly cancer-causing disease for no justifiable reason.
ACIP is an independent external advisory panel convened by the Centers for Disease Control and Prevention (CDC) that develops official recommendations for vaccination: who should get vaccines, when they should be vaccinated, and what vaccines should be covered by insurance, Medicare and Medicaid, and government immunization programs like Vaccines for Children (VFC) that provide free vaccines to low-income kids.
Kennedy fired the entire ACIP in June and replaced them with a roster of mostly anti-vaccine activists and medical contrarians. Although ACIP’s performance as a scientifically competent advisory board has quantifiably declined, they have done the work they were appointed by Kennedy to do. So far, ACIP has issued recommendations that successfully descheduled multi-dose flu vaccines and the measles-mumps-rubella-varicella (MMRV) combination vaccine for children under four. Now, they have added the birth dose of HBV to their trophy case of “MAHA wins.” None of these decisions have been made using the standard ACIP frameworks for evidence-based evaluation. None of these decisions have been scientifically justified.
In fact, delaying the HBV birth dose will gradually subject American children to profound suffering. For an idea of what it was like before the vaccine, hepatologist Brian McMahon’s written comment to ACIP1 describes how he helplessly watched children as young as 8 years old die from hepatocellular carcinoma (HCC; liver cancer) when he was a physician in the Public Health Service. McMahon showed in 1985 that HBV was frequently transmitted to children in endemic communities through non-sexual and non-injection-related routes, so maternal HBV testing is insufficient to prevent the virus from spreading to children after they are born through other types of household exposure (sports, play, hygiene, shared personal tools, etc). McMahon writes that implementing a universal birth dose of the HBV vaccine resulted in complete elimination in endemic communities that previously had the highest rates of HBV in the US, with no new cases of HBV occurring in people under age 20 since 1993. No new cases of HCC occurred since 1995. The HBV vaccine—especially when the series is begun within 24 hours of birth—is so good at stopping new cases that it has driven HBV to the threshold of elimination nationwide.
“If the ACIP decides to recommend against the birth dose are the members willing to take responsibility when HCC reappears years from now in unvaccinated children?” McMahon asks in his comment. The answer is no. The ACIP members desire this outcome. They will cheer themselves on for putting millions of babies at risk rather than assess their own accountability.
The anti-vaccine calls are coming from the White House
Excited by the success of the ACIP meeting, Trump issued a presidential memorandum ordering Kennedy to review the US childhood vaccination schedule and revise it to be more like other countries. Specifically, Trump demands that America catch up with “peer, developed countries,” such as Denmark, Japan, and Germany. Never mind that none of these countries are comparable to the US in terms of vaccine uptake, health systems, disease prevalence, population, geography, economic productivity, immigration policy, or government.
ACIP is not the only game in town at HHS when it comes to determining vaccine access. The Food and Drug Administration (FDA) is charged with evaluating and licensing vaccines and drugs. The two top officials in charge of regulating all drugs (Tracy Beth Høeg) and vaccines (Vinay Prasad) have lengthy histories of anti-vaccine activism, as does FDA Commissioner Marty Makary. They have wasted no time imposing their agenda on our national system for regulating medicine, including by making unilateral decisions in defiance of expert recommendations to withhold approval of COVID boosters and announcing a complete, non-transparent restructuring of vaccine safety monitoring and the licensure process.
Høeg has also been busy manufacturing pretext to overhaul the vaccination schedule, through unsupported assertions that COVID-19 vaccines killed children, demanding that we adopt Denmark’s immunization schedule for no other reason than she is wild for Danish public health (except for Danish government scientists using national data to show that vaccines do not cause autism, which she ignores), and making false or misleading claims about various vaccine regimens and formulations.
The presidential memo ordering the vaccine schedule refresh reads like it was written by Høeg, who presented her ode to Danish vaccine policies a few hours before the memo was released. Since these ideas passed straight from Høeg’s ACIP presentation to the White House, it suggests that FDA has Trump’s blessing to begin regulating vaccines into oblivion.
Vaccine court may be adjourned…permanently
Even more concerning, the ACIP presentation from vaccine injury lawyer and close Kennedy ally Aaron Siri indicated his intentions to go after the National Vaccine Injury Compensation Program (VICP), sometimes called “vaccine court.” The VICP was established as a no-fault, government-funded venue allowing people who believe they have suffered a vaccine injury to file a claim and receive compensation faster than if they sued in civil court. It also allows manufacturers to make vaccines without incurring existential liability.
The VICP was created by the 1986 National Childhood Vaccine Injury Act (NCVIA). There were adverse events associated with the whole-cell pertussis component of the diphtheria-tetanus-pertussis (DTP) vaccine. The pertussis component was made of inactivated whole Bordetella pertussis bacteria, which increased the likelihood of side effects. A new formulation with an acellular pertussis component—DTaP—was introduced in the 1990s (I got my DTaP booster in October and had no noticeable side effects) and this has greatly reduced adverse events.
However, in the 1980s, so many lawsuits were filed that vaccine manufacturers stopped making pertussis vaccines at all. Childhood vaccines are deeply unprofitable products: they are only used a few times throughout life, and in some cases are not used after childhood. People usually do not need a polio booster as an adult because the vaccine provides lifelong protection. Since pharmaceutical companies don’t see repeat customers from childhood vaccines, making them isn’t a blockbuster business strategy. Thus, manufacturers cannot sustain high litigation costs—win or lose—and remain in the business. The government passed the NCVIA to offer remedies for the vaccine injured and to incentivize manufacturers to keep making vaccines. However, the NCVIA imposes limitations as to the amount of compensation paid out by claims in VICP, so lawyers like Siri and Kennedy would like to see it removed from their path to billion dollar damage awards.
It is not yet clear how or whether Kennedy will attempt to end the VICP, but if he succeeds, manufacturers will once again flee the US market. Whether or not vaccine access is reduced by ACIP or FDA actions, it will be completely gone if manufacturers stop making vaccines.
It’s up to us to take action
There’s not enough time in a short video to discuss concrete actions, but I hope this serves as a call to action for the people who watch it. A big action item is simply making people aware of what is happening. The stakes could not be higher: delaying or descheduling essential vaccines will result in millions of sick or dead children. However, the mechanisms used to take these vaccines away are not very exciting or interesting. Kennedy is most successful when using administrative and legal trickery to attack vaccines, rather than science.
Most people don’t want to hear the details of ACIP meetings, no matter how clownish the proceedings get. Most people don’t have time or bandwidth to learn about evidence-based frameworks, the ins and outs of FDA licensure, how the VICP works, or any of the other administrative loopholes Kennedy jumps through to effect the MAHA agenda. That’s very understandable, since I wouldn’t choose to know these things if it weren’t my job to do so. Kennedy exploits the administrative obscurity of his bureaucratic methods to conceal the damage from the public. However, we are very nearly across the event horizon where the damage to public health will be irreversible.
This presents a serious communication challenge in showing how boring administrative processes are profoundly consequential. The boring administrative processes in question here will result in dead kids at national scale. One reason why Kennedy and his MAHA loyalists have made progress is that the public largely doesn’t know that the groundwork for making America sicker than it has been in more than 70 years is being laid right now. Making people aware of what those consequences will be and how the MAHA movement is carrying them out is absolutely critical for more organized action down the road.
With my colleagues in science, public health, and medicine, as well as the incredible people at The Save America Movement, I am answering the call. Now.
Credits
Angela Rasmussen, PhD, virologist, vaccine researcher, co-Editor-in-Chief, Vaccine
The Save America Movement Steering Committee (Science and Public Health)
Twitter/X: @angie_rasmussen
Bluesky: @angierasmussen.bsky.social
Instagram: @drangierasmussen
Substack: Dr. Angela Rasmussen
Kristian Andersen, PhD, Scripps, evolutionary virologist and infectious disease researcher
Bluesky: @kgandersen.bsky.social
Demetre Daskalakis, MD, MPH, physician, public health official, former Director of the CDC National Center for Immunization and Respiratory Diseases
Twitter/X: @dr_demetre
Bluesky: @drdemetre.bsky.social
Instagram: @drdemetre
Jeremy Faust, MD, Harvard Medical School and Brigham and Women’s Hospital, emergency medicine physician and epidemiologist
Twitter/X: @jeremyfaust
Bluesky: @jeremyfaust.bsky.social
Instagram: @jeremysamuelfaust
Substack: Inside Medicine
Gregg Gonsalves, PhD, Yale School of Public Health, infectious disease epidemiologist
Bluesky: @gregggonsalves.bsky.social
Gigi Gronvall, PhD, Johns Hopkins Bloomberg School of Public Health, immunologist, biodefense and health security
Twitter/X: @ggronvall
Bluesky: @ggronvall.bsky.social
Substack: Gigi Gronvall
Elizabeth Booker Houston, JD, MPH, public health policy analyst, attorney, and comedian
Twitter/X: @booker_squared
Instagram: @bookersquared
TikTok: @bookersquared
Substack: Elizabeth Booker Houston
Taylor Nichols, MD, UCSF, emergency medicine and addiction medicine physician
Bluesky: @tnicholsmd.com
TikTok: @tnicholsmd
Medium: tnicholsmd.medium.com
Anita Patel, MD, critical care pediatrician
Twitter/X: @anitakpatelmd
Bluesky: @anitakpatelmd.bsky.social
Instagram: @anitakpatelmd
Vincent Racaniello, PhD, Columbia University, virologist
Twitter/X: @profvrr
Bluesky: @microbetv.bsky.social
Instagram: @microbe.tv
Website: microbe.tv
Dorit Rubinstein Reiss, LLB, PhD, UC San Francisco Law, vaccine law and policy
Twitter/X: @doritmi
Bluesky: @doritreiss.bsky.social
Jessica Malaty Rivera, MS, infectious disease epidemiologist and science communicator
Twitter/X: @jessicamalaty
Bluesky: @jessicamalaty.bsky.social
IG: @jessicamalatyrivera
Substack: Jessica Malaty Rivera, MS
Gavin Yamey, MD, MPH, MA, Duke University, physician, global health policy
Bluesky: @gavinyamey.bsky.social
Footnote
Personal disclosure: Brian McMahon is my uncle. Since I am not a hepatologist and my experience with viral hepatitis concerns hepatitis C virus (which is very different from HBV despite them both causing chronic infections and progressive disease), I frequently reach out to him with questions about HBV. He is very generous with his expertise. He is devastated to see his life’s work about to be undone.
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