Today US Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. quietly removed multiple vaccines from the childhood immunization schedule as part of his ongoing quest to Make America Healthy Again (MAHA). Well, not removed, but shifted to “shared clinical decision-making.” In theory, this means you consult a health care professional and decide if you want a vaccine or not. The MAHA regime suggests that you do not.
In theory, this also means that you would have access to vaccines, should you make the shared clinical decision that you want one. You have always been able to make the decision that you don’t. You have always been free to grant or deny informed consent. The vaccine schedule is a recommended timeline for safely immunizing your child against preventable diseases that could kill or disable them. You have always been able to practice shared clinical decision-making.
Normally, recommendations are made individually for each vaccine by the Advisory Committee for Immunization Practices (ACIP), who follow a standardized framework to conduct extensive evidence reviews. The ACIP was conceived as an external, independent advisory panel that would objectively review data to determine whether or not a particular vaccine regimen provided benefits that outweighed the risks. They’ve done that since the first meeting in 1964.
Although ACIP’s performance has been steadily on the decline since Kennedy fired them all last June and replaced them with mostly anti-vaxxers and space occupiers, this announcement circumvents the need for ACIP recommendations altogether.
It’s hard to stay if this will stick, but it does further chip away at public confidence in vaccines and access to them. It is very unclear how this will impact insurance, something of particular concern considering millions of Americans just lost it and many more never had it to begin with. With health infrastructure failing in the US and globally due to Trump divesting from everything that made America great and our entire cohort of senior health officials tacitly discouraging everyone from immunization by encouraging “shared clinical decision-making” vaccination rates will continue to decline.
What is perhaps most difficult to believe is that this is all based on the bizarre reality that President Donald Trump has ordered Kennedy to align the US vaccine schedule with the far less populous nation of Denmark, which has a socialist economic structure and a nationalized health system and is, actually, nothing like the US.
He appears to have gotten this idea from the combined brain trust of Martin Kulldorff (former ACIP Chair and the newly minted Chief Science Officer of the newly invented HHS think tank that Kennedy started) and Tracy Beth Høeg (Acting Director of the FDA Center for Drug Evaluation and Research—she is the top US drug regulator), who circulated a memo that supposedly supports this decision. I’ll have more on that tomorrow.
As you might imagine, it was an unhappy day for public health enthusiasts and vaccine researchers. I got two of my favorite colleagues together to talk about why you need to know about the most recent MAHA assault on your family’s safety and well-being, and what the consequences will be.
Jessica Malaty Rivera, MS: epidemiologist and science communicator, mother of three
Saskia Popescu: epidemiologist, infection preventionist, global health security and biodefense expert
Dr. Angela Rasmussen (me): virologist and marginally competent Substack Live administrator
It seemed like this was well-received so we are going to do it again and take questions next time. See you then! And get your flu shot.
