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      Trump’s former surgeon general urges president to fire RFK Jr

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      The surgeon general from the first Trump administration on Saturday said that the US president should “absolutely” fire health secretary Robert F Kennedy Jr over his “dangerous” policies on vaccines and the Centers for Disease Control and Prevention (CDC).Jerome Adams, who has become a pointed critic of the public health decisions being swiftly rolled out in the second Trump administration, made his most fierce attack yet on what has been unfolding.“He’s putting us at risk,” Adams said of RFK Jr, adding that Kennedy is “endangering America at large” with moves to limit access to vaccines, such as shots to protect against the deadly Covid-19 virus.In an interview with CNN on Saturday morning, anchor Victor Blackwell asked Adams, who served as Donald Trump’s surgeon general from 2017 to 2021, including through the height of the coronavirus pandemic, whether Kennedy should resign.“Well, he’s not going to resign,” Adams said.Asked whether, therefore, Trump should fire his health secretary, Adams said: “I absolutely believe that he should, for the sake of the nation.”Kennedy was praised by the president after a stormy committee hearing in the US Senate on Thursday where Democrats called for his resignation or firing and accused him of ignorance and “reckless disregard for science and the truth”.Although more muted, a select few Republicans were critical, including Republican senator Bill Cassidy of Louisiana, who had been a crucial vote to confirm Kennedy to his post, who said the secretary was “effectively denying people the vaccine” with his policy positions. Kennedy snapped back: “You’re wrong.”Adams said he was “flabbergasted” by new restrictions from the Food and Drug Administration (FDA) last month on who is eligible to receive the latest version of the Covid-19 vaccination and hoped that Trump “will begin to see the danger … to America” of Kennedy’s leanings and will not be “in thrall” of his health secretary.On Friday, Adams was a co-author of a bipartisan opinion piece published in USA Today from three former surgeons general that said that Kennedy’s actions to shake up the CDC were actions that “jeopardize not only the institution’s integrity but also the health and well-being of millions of Americans”.The other authors were Jocelyn Elders, surgeon general in Democrat Bill Clinton’s administration, and Richard Carmona, surgeon general under Republican George W Bush’s presidency.The CDC erupted in chaos in late August when the Trump administration fired the center’s director Susan Monarez, who had been in the post for mere weeks, in an apparent divide over vaccine policy – although she is refusing to leave. Several senior CDC leaders quit in protest at Kennedy’s move to oust her. This followed his June firing of all 17 members of the CDC’s advisory committee on immunization practices (ACIP) and his replacing them with some who publicly hold anti-vaccine views.The three former surgeons general wrote that they were “gravely concerned” for the CDC as a “cornerstone of public health in America and across the world” that had saved countless lives through its science-driven approach, earning public trust.skip past newsletter promotionafter newsletter promotion“The recent turbulence at the CDC threatens to undermine this legacy, and we feel this is not just a bureaucratic or political issue. It’s truly a matter of life and death,” the article said.Adams said in the CNN interview that organizations such as the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the American Medical Association have lost trust in the CDC under Kennedy’s leadership.He warned that Kennedy could effectively destroy the CDC and was “putting lives at risk by doing so”.Adams at times clashed with Trump when he was his surgeon general, including over policies over public masking during the pandemic.On Saturday, he warned that Kennedy’s policies threatened public health in general but that Covid vaccine restrictions were “specifically endangering Black, Hispanic and Native American communities, who experienced death rates during the pandemic that were twice as high as white Americans”.The day after the Senate hearing, former Massachusetts Democratic representative Joe Kennedy III, RFK Jr’s nephew, posted a statement on X calling the health secretary “a threat to the health and wellbeing of every American” and urging him to resign.Echoing that call to resign was one of the secretary’s siblings, Kerry Kennedy, who also posted on X and decried what she called “the decimation of critical institutions, like the [National Institutes of Health] and the CDC”. More

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      RFK Jr accused of ‘reckless disregard for science and the truth’ in Senate hearing

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      The US health secretary, Robert F Kennedy Jr, faced the Senate finance committee in a tense and combative hearing on Thursday, during which lawmakers questioned his remarks expressing vaccine skepticism, claims that the scientific community is deeply politicized and the ongoing turmoil plaguing the Centers for Disease Control and Prevention (CDC).In a hearing lasting more than three hours and ostensibly about the Trump administration’s healthcare agenda, Kennedy defended his leadership at the Department of Health and Human Services (HHS), claiming that his time at the agency will be focused on “unbiased, politics-free, transparent, evidence-based science in the public interest”.Senate Democrats on the committee began the hearing calling for Kennedy’s resignation. “Robert Kennedy’s primary interest is taking vaccines away from Americans,” ranking member Ron Wyden, a Democratic senator from Oregon, said in his opening remarks. “People are hurt by his reckless disregard for science and the truth in this effort. I hope the very least, Robert Kennedy has the decency to tell the truth this morning.”Raphael Warnock, also a Democrat, called Kennedy a “hazard to the health of the American people”, repeating calls for him to step down or for Donald Trump to fire him.Last week, Kennedy fired the CDC director, Susan Monarez, less than a month after she was confirmed to her position. She is now mounting a legal case challenging her removal.Shortly after Monarez’s termination, several leading public health officials at the CDC resigned from their positions, citing frustration with Kennedy’s approach to vaccines and his management style.Kennedy said Monarez was “lying” about her claims that she was fired for refusing to sign off on the secretary’s new vaccine policies. Instead, Kennedy said that she was removed after admitting to being untrustworthy.The Democratic senator Elizabeth Warren, of Massachusetts, was unconvinced – citing Kennedy’s prior characterization of the former CDC director as “unimpeachable”.“You had full confidence in her and you had full confidence in her scientific credentials, and in a month she became a liar?” she asked. Thom Tillis, the outgoing Republican senator of North Carolina, asked about the same contradiction in his questioning.Monarez’s lawyers responded in a statement to Kennedy’s comments, calling them “false” and “at times, patently ridiculous”. They added that Monarez would repeat her published claims “under oath”.Kennedy also justified wider firings at the CDC , calling them “absolutely necessary”.“We are the sickest country in the world,” he said. “That’s why we need to fire people at CDC. They did not do their job. This was their job to keep us healthy.”In June, Kennedy fired all 17 members of the CDC’s vaccine advisory committee – a move that defied a promise he made during his confirmation hearing to Republican senator Bill Cassidy, a physician who chairs the Senate health committee. Many of Kennedy’s replacements for the advisory panel have a history of vaccine skepticism.When asked about the changes to the advisory committee, and how that will change vaccine recommendations and scheduling, Kennedy said he didn’t anticipate changes to the MMR (measles, mumps and rubella) vaccine.In an exchange with Kennedy, Cassidy noted the possible conflict of interest with some of the panel’s new members who are involved in ongoing litigation with vaccine manufacturers.Cassidy cast a critical vote to confirm Kennedy earlier this year. He had previously expressed a number of concerns about the health secretary’s historic comments that undermined vaccine efficacy. The senator has since been critical of a number of Kennedy’s policies, including his decision to cut half a billion dollars worth of mRNA vaccine funding – calling the move “unfortunate”.skip past newsletter promotionafter newsletter promotionLast month, the Food and Drug Administration (FDA) approved the new batch of Covid-19 vaccines, but placed restrictions on who would be able to access them. The agency has authorized shots for people 65 and older, who are known to be more at risk from serious illnesses from Covid infections. Younger people will only be eligible if they have an underlying medical condition that makes them vulnerable. Infectious disease experts say that this policy could prove extremely dangerous, particularly for young children.On Tuesday, Kennedy defended HHS’s handling of the measles outbreak that affected several states in an opinion piece. While the secretary branded his agency’s response as effective, public health experts said Kennedy’s own messaging around vaccines was muddied and confusing.Cassidy concluded his remarks at the hearing by telling Kennedy that his policies were “effectively denying people the vaccine”, sharing an email from a doctor friend who expressed confusion about Covid inoculation eligibility given the FDA’s new recommendation policies.Kennedy snapped back: “You’re wrong.”The Republican senator John Barrasso, of Wyoming, also a doctor, expressed similar concerns about Kennedy’s policies. “In your confirmation hearing you promised to uphold the highest standard for vaccines,” Barrasso said. “Since then, I’ve grown deeply concerned.”During a back and forth with the Virginia senator Mark Warner, a Democrat, Kennedy falsely claimed that there are “no cuts to Medicaid” under the One Big Beautiful Bill Act – Trump’s hallmark domestic policy legislation that was signed into law in July.The congressional budget office estimates that around 7.8 million people stand to lose their health insurance over a decade, due to Medicaid changes under the law.Multiple Democrats on the committee had heated exchanges with the health secretary. Many of them pointed out the inconsistency between Kennedy’s recent support for the president’s “Operation Warp Speed” and his disparagement of the Covid-19 shot. He has previously called it the “deadliest” vaccine ever manufactured.At the hearing, Kennedy refused to acknowledge the wealth of data that shows that the Covid-19 vaccine has saved lives.“Trump has said the vaccine works, and has saved millions of lives. Your own process, on the other hand, has not been transparent,” said the Democratic senator Maggie Hassan, of New Hampshire. “You repeatedly choose to ignore data because it doesn’t match your preconceived notions and lies.” More

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      Texas bill allowing residents to sue out-of-state abortion pill providers reaches governor

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      A measure that would allow Texas residents to sue out-of-state abortion pill providers advanced to the desk of the governor, Greg Abbott, on Wednesday, setting up the state to be the first to try to crack down on the most common abortion method.Supporters say it’s a key tool to enforce the state’s abortion ban, protecting women and fetuses.Opponents see it not only as another way to rein in abortion but as an effort to intimidate abortion providers outside Texas who are complying with the laws in their states – and to encourage a form of vigilantism.If the measure becomes law, it’s nearly certain to spark legal challenges from abortion rights supporters.Under the measure, Texas residents could sue those who manufacture, transport or provide abortion-inducing drugs to anyone in Texas for up to $100,000. Women who receive the pills for their own use would not be liable.Under the bill, providers could be ordered to pay $100,000. But only the pregnant woman, the man who impregnated her or other close relatives could collect the entire amount. Anyone else who sued could receive only $10,000, with the remaining $90,000 going to charity.Lawmakers also added language to address worries that women would be turned in for seeking to end pregnancies by men who raped them or abusive partners. For instance, a man who impregnated a woman through sexual assault would not be eligible.The measure has provisions that bar making public the identity or medical details about a woman who receives the pills.It wasn’t until those provisions were added, along with the limit of a $10,000 payment for people who aren’t themselves injured by the abortion, that several major Texas anti-abortion groups backed the bill.The idea of using citizens rather than government officials to enforce abortion bans is not new in Texas. It was at the heart of a 2021 law that curtailed abortion there months before the US supreme court cleared the way for other state bans to take effect.In the earlier law, citizens could collect $10,000 for bringing a successful lawsuit against a provider or anyone who helps someone obtain an abortion. But that measure didn’t explicitly seek to go after out-of-state providers.Pills are a tricky topic for abortion opponents. They were the most common abortion method in the US even before the 2022 supreme court ruling that overturned Roe v Wade and allowed states to enforce abortion bans.They’ve become even more widely used since then. Their availability is a key reason that the number of abortions has risen nationally, even though Texas and 11 other states are enforcing bans on abortion in all stages of pregnancy.The pills have continued to flow partly because at least eight Democratic-led states have enacted laws that seek to protect medical providers from legal consequences when they use telehealth to prescribe the pills to women who are in states where abortion is illegal.Anna Rupani, executive director of Fund Texas Choice, said the measure is intended to threaten those out-of-state providers and women in Texas.“This is about the chilling effect,” she said. “This is yet another abortion ban that is allowing the state to control people’s health care lives and reproductive decisions.”Earlier this year, a Texas judge ordered a New York doctor to pay more than $100,000 in penalties for providing abortion pills to a Dallas-area woman.The same provider, Dr Maggie Carpenter, faces criminal charges from a Louisiana prosecutor for similar allegations.New York officials are invoking their state’s shield laws to block extradition of Carpenter and to refuse to file the civil judgment.If higher courts side with Louisiana or Texas officials, it could damage the shield laws.Meanwhile, the attorneys general of Texas and Florida are seeking to join Idaho, Kansas and Missouri in an effort to get courts to roll back US Food and Drug Administration approvals for mifepristone, one of the drugs usually used in combination for medication abortions, contending that there are safety concerns. They say it needs tighter controls because of those concerns.If the states are successful, it’s possible the drug could be distributed only in person and not by telehealth.Major medical organizations including the American College of Obstetricians and Gynecologists say the drug is safe. More

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      Why Trump’s undermining of US statistics is so dangerous | Daniel Malinsky

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      In 1937, Joseph Stalin commissioned a sweeping census of the Soviet Union. The data reflected some uncomfortable facts – in particular, the dampening of population growth in areas devastated by the 1933 famine – and so Stalin’s government suppressed the release of the survey results. Several high-level government statistical workers responsible for the census were subsequently imprisoned and apparently executed. Though the Soviet authorities would proudly trumpet national statistics that glorified the USSR’s achievements, any numbers that did not fit the preferred narrative were buried.A few weeks ago, following the release of “disappointing” jobs data from the Bureau of Labor Statistics (BLS), Donald Trump fired the commissioner of labor statistics, Dr Erika McEntarfer, and claimed the numbers were “rigged”. He also announced his intention to commission an unprecedented off-schedule census of the US population (these happen every 10 years and the next one should be in 2030) with an emphasis that this census “will not count illegal immigrants”. The real goal is presumably to deliver a set of population estimates that could be used to reapportion congressional seats and districts ahead of the 2026 mid-term elections and ensure conditions favorable to Republican control of Congress – though it is not clear there is sufficient time or support from Congress to make this happen. The administration is also reportedly “updating” the National Climate Assessments and various important sources of data on topics related to climate and public health have disappeared. In addition to all this, Trump’s justice department launched an investigation into the crime statistics of the DC Metropolitan police, alleging that the widely reported decline in 2024 DC violent crime rates – the lowest total number of recorded violent crimes city-wide in 30 years – are a distortion, fueled by falsified or manipulated statistics. One might say that the charge of “fake data” is just a close cousin of the “fake news” and all of this is par for the course for an administration that insists an alternate reality is the truth. But this pattern may also beget a specifically troubling (and quintessentially Soviet) state of affairs: the public belief that all “political” data are fake, that one generally cannot trust statistics. We must resist this paradigm shift, because it mainly serves to entrench authoritarianism.It was eventually a common sentiment in the Soviet Union that one could never trust “the official numbers” because they were largely manipulated to serve political interests. (At least, this is the sentiment reported by my parents, who grew up in the Soviet Baltic states during the 1960s and 1970s – I was an infant when we left in the late 80s so I cannot report much first-hand.) One upshot of this kind of collective belief, if it were to take hold, is that it can make one’s informational world quite small: if you can only trust what you can verify directly, namely what you experience yourself or hear from trusted friends and family, it is difficult to broaden your view to include experiences of people in circumstances very different from yours. This kind of parochial world with few shared reference points is bad for democracy and building solidarity across groups. It also makes it easier for an oppressive state to plant false and divisive “facts” to serve its goals; we’ll have a fake crime wave here and a booming economy there, and though maybe most people disbelieve this they do not quite believe the opposite either. No one can credibly claim or contest any socially relevant trends because all numbers are fake, so the activities of claiming and contesting things become pointless – just do what you can get away with.A political culture with no trust in data or statistics is also one that will rely more heavily on opaque decisions made by elites behind closed doors. In his influential historical study of the rise of quantitative bureaucracy, the historian Thomas Porter points out that basing policy decisions on calculated numerical costs and benefits reduces the role of “local” discretion and can have a homogenizing effect, which can strengthen centralized state control. The flip side of this coin is that it also divests people in power from part of their authority by enabling a degree of public transparency and scrutability: if a huge government project must be justified by reference to some cost-benefit calculations, these calculations can be cross-checked and challenged by various parties. If a government agency requires documentation of progress on initiatives, proof that public funds are being spent appropriately, and evidence on who benefits and by how much, there is substantially less room for plain corruption and mismanagement provided that independent parties have access to the relevant information. Without credible data that reflects the facts on the ground, how can the public push back against an invented “crisis” narrative, concocted to justify the invocation of emergency powers?Anyone who spends any time working with data is acutely aware that there are lots of choices to be made in the collection or processing of data – there are numerous “decision points” about what to include, how to precisely define or measure things, and so on. Indeed, insofar as data is used to tell stories about complex things such as the state of the economy or the health of a population, different data collection or analysis choices can to some extent lend support to different narratives, including predetermined narratives if an unscrupulous analyst is set on it. But it does not follow from this that “anything goes” or that statistics are meaningless. There are better and worse ways to collect and analyze data, both reasonable and preposterous ways to answer empirical questions such as “are crime rates in DC going up or going down?” Most importantly, when government statistics are managed by qualified and non-partisan officials and the relevant numbers can be challenged, debated and contested, then we have a democratic basis for guiding our institutions to better policy decisions. Data of public importance must be publicly accessible, not hidden from view.Trump’s assault on the integrity of data is not the worst of his ongoing abuses – the public should be more immediately outraged by the masked agents disappearing people on the streets and the national guard occupying city centers – but this pattern of actions vis-a-vis official statistics should be extremely alarming. It is a slow boil: if we reach the point where nobody trusts numbers because it’s all “fake data”, it will be too late to resist and too difficult to undo the damage. The opposition must block appointments of unqualified and clearly biased nominees to lead the BLS and other agencies responsible for data stewardship. We must resist undue interference in data gathering, whether that is at the level of the US census or at the level of city government. On the contrary, we should be investing in initiatives that strengthen public trust in and understanding of the social, economic and environmental data that can be used to guide decisions that affect our communities’ wellbeing.

      Daniel Malinsky is an assistant professor of biostatistics in the Mailman School of Public Health at Columbia University More

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      Former CDC leaders slam RFK Jr for endangering Americans’ health

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      Nine former officials at the Centers for Disease Control and Prevention have said that Robert F Kennedy Jr’s leadership of the US health and human services department is “unlike anything our country has ever experienced” and “unacceptable”. They also warned that Kennedy’s leadership “should alarm every American, regardless of political leanings”.In a guest essay for the New York Times, the former CDC leaders said Kennedy’s actions were “unlike anything we have ever seen at the agency”.The letter comes days after Kennedy sought to dismiss Susan Monarez, the CDC director he appointed just months earlier. Monarez refused to leave her post, and was later fired by Donald Trump. Monarez said through lawyers the clash came after she refused to sign off on Kennedy’s directives.In the essay, titled We Ran the C.D.C.: Kennedy Is Endangering Every American’s Health, the former leaders, including Rochelle P Walensky, Mandy Cohen and Tom Frieden, said they were concerned Kennedy is “focusing “on unproven ‘treatments’ while downplaying vaccines” and cancelling medical research “that will leave us ill prepared for future health emergencies”.The former officials accused Kennedy of replacing “experts on federal health advisory committees with unqualified individuals who share his dangerous and unscientific views”.The letter comes as the Trump administration is pushing back on criticism of Kennedy’s leadership.The White House said last week that Trump and Kennedy aim to make the agency “more public-facing” and “more accountable,” and that they would be “strengthening our public health system and restoring it to its core mission of protecting Americans from communicable diseases, investing in innovation to prevent, detect and respond to future threats”.The arguments over the direction of the CDC center in part on disagreements over vaccination policies.Monarez was reportedly fired after clashing with Kennedy over vaccine policy.In a sign that it is a debate even Trump can’t escape, the president on Monday in a Truth Social post called on pharmaceutical companies to “justify” the success of the Covid vaccines that were initiated during his first term.“Many people think they are a miracle that saved Millions of lives. Others disagree! With CDC being ripped apart over this question, I want the answer, and I want it NOW.”Trump added that while the drug companies “go off to the next ‘hunt’ and let everyone rip themselves apart, including Bobby Kennedy Jr. and CDC”, they should “figure out the success or failure” of Covid drugs.The White Househas named deputy health secretary Jim O’Neill to serve as acting CDC director. O’Neill is a biotech investor and former speechwriter for the health department during the George W Bush administration. He can only serve as an interim leader of the agency until a permanent director is confirmed by the Senate.Following Monarez’s firing, hundreds of CDC staffers rallied outside the agency’s headquarters in Atlanta in protest. Three senior CDC leaders, Debra Houry, Demetre Daskalakis and Daniel Jernigan, resigned from their posts.In Monday’s Times editorial, the nine former CDC officials stepped in to Covid vaccine dispute, saying Operation Warp Speed “produced highly effective and safe vaccines that saved millions of lives” during the pandemic.“During our respective CDC tenures, we did not always agree with our leaders, but they never gave us reason to doubt that they would rely on data-driven insights for our protection, or that they would support public health workers,” they added. More

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      Former CDC official ‘only sees harm’ to public health under RFK Jr’s leadership

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      The former immunizations director of the Centers for Disease Control and Prevention has warned of the future of American health under the leadership of Donald Trump’s health secretary, Robert F Kennedy Jr.In an interview on Sunday with ABC, Demetre Daskalakis – who resigned this week in protest over the White House’s firing of CDC director Susan Monarez – said: “From my vantage point as a doctor who’s taken the Hippocratic Oath, I only see harm coming.”He went on to add: “I may be wrong, but based on what I’m seeing, based on what I’ve heard with the new members of the Advisory Committee for Immunization Practices, or ACIP, they’re really moving in an ideological direction where they want to see the undoing of vaccination.”Daskalakis’s interview comes amid growing chaos across US health agencies and rare bipartisan pushback towards the White House’s firing of Monarez, which came amid steep budget cuts to the CDC’s work as well as growing concerns of political interference.There have also been growing public calls for Kennedy to resign, particularly as he has continued to make questionable medical and health claims – and be lambasted in response by experts and lawmakers alike.Explaining his resignation, Daskalakis said: “I didn’t think that we were going to be able to present science in a way free of ideology, that the firewall between science and ideology has completely broken down. And not having a scientific leader at CDC meant that we wouldn’t be able to have the necessary diplomacy and connection with HHS to be able to really execute on good public health.”Daskalakis also criticized Kennedy’s recent changes to the childhood Covid-19 vaccine schedule, noting that the vaccine is currently approved only for people aged 65 and older, as well as for children and adults with underlying health conditions.“That’s not what the data shows. Six months old to two years old, their underlying condition is youth. 53% of those children hospitalized last season had no underlying conditions. The data say that in that age range, you should be vaccinating your child. I understand that not everybody does it, but they have limited access by narrowing that recommendation. Insurance may not cover it,” Daskalakis said.He also cast doubt on Jim O’Neill, the new CDC chief who was a top aide to Kennedy and has no training in medicine or infectious disease science.In response to whether or not he trusts O’Neill saying that he is in favor of vaccines, Daskalakis said: “Honestly, I really want to trust it … But based on the very first post that I’ve seen from him on X where he says that CDC scientists manipulated data to be able to follow an ideology or an agenda in the childhood schedule, makes me think that I know what leader he serves, and that leader is one that does not believe in vaccination.”In a Saturday op-ed for the New York Times, Vermont senator Bernie Sanders accused Kennedy of “endangering the health of the American people now and into the future”, adding: “He must resign.”Since he assumed leadership over the health department, Kennedy – a longtime anti-vaccine advocate – has fired health agency workers and entertained conspiracy theories. Last week, more than 750 current and former employees at US health agencies signed a letter in which they criticized Kennedy as an “existential threat to public health”.The health agency workers went on to accuse the health secretary of being “complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information”.The letter comes after a deadly shooting at the CDC headquarters in Atlanta earlier this month, when a 30-year-old gunman fired more than 180 rounds into the buildings, killing a police officer before dying from a self-inflicted gunshot wound. The shooter had been struggling with mental health issues and was influenced by misinformation that led him to believe the Covid-19 vaccine was making him sick, according to the gunman’s father. More

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      RFK Jr says he’ll ‘fix’ a vaccine program – by canceling compensation for people with vaccine injuries

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      While unrest and new vaccine restrictions have kept US health agencies in headlines, there’s one vaccine program in particular that Robert F Kennedy Jr, secretary of the US Department of Health and Human Services (HHS), recently vowed to “fix”, which experts say could further upend the vaccine industry and prevent people experiencing rare side effects from vaccines from getting financial help.While some changes to the National Vaccine Injury Compensation Program (VICP), which compensates people who suffer very rare side effects from vaccination, must come from Congress, Kennedy could take several actions to reshape or affect the program’s operations.Kennedy “seems to be pursuing two opposite theories” on changing VICP, said Anna Kirkland, a professor at the University of Michigan and author of Vaccine Court.“Make it easier and compensate more, versus blow it all up. And then maybe there’s a third way of, foment skepticism, undercut recommendations,” she said.The moves represent the latest battle in “the war on vaccines that he’s been waging for decades”, Art Caplan, head of the division of medical ethics at New York University’s Grossman School of Medicine said. Kennedy, an anti-vaccine activist for about two decades, has reported more than $2.4m in income for referring vaccine-related cases to a law firm, for instance.Making major changes to the program may open up vaccine makers to more litigation, making it difficult for them to keep existing vaccines on the market or to produce new ones.In 1980, there were 18 companies in the US producing vaccines; a decade later, there were four. Congress passed a law in 1986 leading to the establishment of the VICP to prevent further instability in the vaccine market.By making changes to the program, Kennedy “can scare the manufacturers”, and the market is “pretty fragile”, said Caplan.Dorit Reiss, professor of law at University of California College of the Law, San Francisco, said that “VICP was adopted … because manufacturers were leaving the market over litigation” and that “this would mean manufacturers will pull out of the market and we’ll have less vaccine accessible”.There aren’t many vaccine makers left in the US. Most vaccines are not very lucrative – either for the manufacturers or the doctors who administer them. Most routine vaccines are covered under the VICP.Caplan said any vaccines could be vulnerable and these actions have major consequences for uptake even if vaccines remain on the market.“The biggest problem is still undermining trust in mainstream science,” Caplan said.Changing or even eliminating the program would also likely make it more difficult for patients to have their cases addressed. Yet a bill that would abolish the VICP entirely, introduced by the representative Paul Gosar, a Republican from Arizona, is gaining traction in anti-vaccine circles.Reiss noted that “undoing VICP might mean there’s no vaccines available”.A website about Gosar’s bill features a quote from Kennedy: “If we want safe and effective vaccines, we need to end the liability shield.”HHS did not respond to the Guardian’s questions on whether Kennedy knows about this use of his quotation, or what his plan to “fix” the compensation program involves.There are several actions Kennedy can take to “make vaccine availability much more difficult”, Caplan said.Kennedy has mentioned two concrete plans: adding discovery to existing compensation claims, and removing the backlog of claims. The program rules already allow discovery at the discretion of the adjudicators, called special masters. Adding special masters could help speed up claim processing, but the number of special masters was set by Congress, not HHS.In addition, the special masters answer to the US Department of Justice (DoJ), not HHS – though they represent the secretary in claims.“The first thing [Kennedy] said he was doing was working with Pam Bondi at DoJ,” Kirkland said. “Bondi could certainly direct her own employees to stop contesting a lot of things, and just let as much as possible go through, because they represent the secretary against the petitioners. So they could certainly change the softer ways that they operate, try to be easier, try to be faster.”In that case, Kennedy could ask the special masters to concede – effectively approving automatically – any claims about, for instance, diagnoses of autism or allergies after vaccination, Reiss said.One way to argue that a vaccine caused severe side effects under VICP is to present in a causation hearing a preponderance of evidence demonstrating it’s more than 50% likely – a metric known as “50% and a feather” – that the vaccine is the cause of a side effect.But “there doesn’t have to be existing literature that shows this connection. If you have a credible expert with a convincing theory, that’s enough” under VICP, Reiss said.Reiss noted that the “program was intentionally and consciously designed to make it easy to compensate”.“It increases vaccine trust when we have a quick, generous compensation program – when we can tell people: ‘Look, if the worst happens, if you’re the one in the million where things actually go wrong, you can be quickly and generously compensated, whereas if you instead get a vaccine-preventable disease, you don’t have any compensation.’ I think that can help trust. It’s also the right thing to do,” she said.The other way to settle a claim is the table of injuries, which lists the vaccines included in ACIP [the Advisory Committee on Immunization Practices], potential injuries and time periods.“If the injury occurs within that time, then causation is presumed,” Reiss said.Kennedy could change the table, adding more or different side effects. This would require publishing public notice and accepting comments. If a new injury is added to the table, cases are allowed to be submitted for the past eight years, rather than the usual three years.The table is “the one that’s the most straightforwardly under his control”, Kirkland said. The last time a government agency tried to change the table, it failed. “That’s got to mean something,” she added.If the ACIP no longer recommends a routine vaccine, it may be removed from the table. Claims would then need to go through the regular court system.There is a higher bar in the regular courts, where claimants have to show fault, demonstrating a defective product or negligence, for instance. The rules of evidence are stricter. Claimants also have to hire a lawyer and pay the lawyer costs and the experts.With the private US healthcare market, “if you don’t win your case, you’re going to then get stuck with gigantic medical bills”, Caplan said.In a country like the US, where the burden is on the individual to pay their medical bills, VICP is a safety net for people having medical events after vaccination, he said.Many of the claims now handled under VICP are for relatively low amounts of money that law firms – especially the rare firms with the expertise to take on large pharmaceutical companies – might not find worthwhile in representing.There are aspects of VICP that need reform, Reiss said. The program needs more special masters, the caps on payments need to be updated from original levels set in the 1980s, and the statute of limitations should be expanded beyond three years – especially because it is difficult to diagnose side effects in young children in that amount of time, she said.“The statute of limitations, special masters and caps need to be changed, and there have been efforts to do that,” she said. “They just, I think, didn’t get enough attention, and that’s probably not what he’s focusing on.” More

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      Bernie Sanders demands that RFK Jr step down as health secretary

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      Bernie Sanders has joined in on growing public calls for Donald Trump’s health secretary, Robert F Kennedy Jr, to resign, after recent chaos across US health agencies.In an op-ed published in the New York Times on Saturday, the Vermont senator accused Kennedy of “endangering the health of the American people now and into the future”, adding: “He must resign.”“Mr Kennedy and the rest of the Trump administration tell us, over and over, that they want to Make America Healthy Again. That’s a great slogan. I agree with it. The problem is that since coming into office President Trump and Mr Kennedy have done exactly the opposite,” Sanders wrote.Sanders pointed to the White House’s firing of Susan Monarez, the director of the Centers for Disease Control and Prevention, as well as four other top CDC officials who resigned in protest this week after Monarez “refused to act as a rubber stamp” for Kennedy’s “dangerous policies”.“Despite the overwhelming opposition of the medical community, secretary Kennedy has continued his longstanding crusade against vaccines and his advocacy of conspiracy theories that have been rejected repeatedly by scientific experts,” Sanders wrote.“Against the overwhelming body of evidence within medicine and science, what are secretary Kennedy’s views? … He has absurdly claimed that ‘there’s no vaccine that is safe and effective’… Who supports secretary Kennedy’s views? Not credible scientists and doctors. One of his leading ‘experts’ that he cites to back up his bogus claims on autism and vaccines had his medical license revoked and his study retracted from the medical journal that published it.”Sanders went on to add: “The reality is that secretary Kennedy has profited from and built a career on sowing mistrust in vaccines. Now, as head of [the Department of Health and Human Services] he is using his authority to launch a full-blown war on science, on public health and on truth itself.”Pointing to what he described as “our broken health care system”, Sanders said that Kennedy’s repeated attacks against science and vaccines will make it more difficult for Americans to obtain lifesaving vaccines.“Already, the Trump administration has effectively taken away Covid vaccines from many healthy younger adults and kids, unless they fight their way through our broken health care system. This means more doctor’s visits, more bureaucracy and more people paying higher out-of-pocket costs – if they can manage to get a vaccine at all,” he wrote.The senator warned that Kennedy’s next target may be the childhood immunization schedule, which involves a list of recommended vaccines for children to protect them from diseases including measles, chickenpox and polio.“The danger here is that diseases that have been virtually wiped out because of safe and effective vaccines will resurface and cause enormous harm,” Sanders said.skip past newsletter promotionafter newsletter promotionIn recent days, the Trump administration has faced rare bipartisan pushback following its firing of Monarez, which came amid steep budget cuts to the CDC’s work as well as growing concerns of political interference.Meanwhile, Kennedy has continued to make questionable medical and health claims – and has been lambasted in response by experts and lawmakers alike.Since he assumed leadership over the health department, Kennedy – a longtime anti-vaccine advocate – has fired health agency workers and entertained conspiracy theories. Last week, more than 750 current and former employees at US health agencies signed a letter in which they criticized Kennedy as an “existential threat to public health”.The health agency workers went on to accuse the health secretary of being “complicit in dismantling America’s public health infrastructure and endangering the nation’s health by repeatedly spreading inaccurate health information”.The letter comes after a deadly shooting at the CDC headquarters in Atlanta earlier this month, when a 30-year-old gunman fired more than 180 rounds into the buildings, killing a police officer before dying from a self-inflicted gunshot wound. The shooter had been struggling with mental health issues and was influenced by misinformation that led him to believe the Covid-19 vaccine was making him sick, according to the gunman’s father. More