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    RFK Jr grilled on vaccine policies and healthcare fraud in bruising House hearing

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    Robert F Kennedy Jr, the US health secretary, faced a bruising day on Capitol Hill on Tuesday, including being forced to retract accusations against a Democratic congressman after claiming the lawmaker’s vaccine stance was bought by $2m in pharmaceutical contributions.In a hearing held by the House health subcommittee, Kennedy was met with hours of contentious questioning over budget cuts, massive healthcare fraud and accusations he lied to senators to secure his confirmation.Kennedy launched his attack on representative Frank Pallone after the New Jersey Democrat hammered him over vaccine policy reversals. “You’ve accepted $2m from pharmaceutical companies,” Kennedy said. “Your enthusiasm for supporting the old [vaccine advisory committee] seems to be an outcome of those contributions.”The accusation appeared to reference Pallone’s shift from raising concerns about mercury in FDA-approved products in the 1990s to later supporting mainstream vaccine policy – a change Kennedy suggested was motivated by industry money rather than science.After a point of order, the Republican chair ordered Kennedy to retract the remarks after lawmakers accused him of impugning Pallone’s character. But the pharma attack was overshadowed by accusations that Kennedy lied his way into office. Representative Kim Schrier, a pediatrician, asked Kennedy: “Did you lie to senator [Bill] Cassidy when you told him you would not fire this panel of experts?”Two weeks ago, Kennedy axed all 17 members of the CDC’s vaccine advisory committee, despite assurances to Cassidy during confirmation hearings.“You lied to senator Cassidy. You have lied to the American people,” Schrier said. “I lay all responsibility for every death from a vaccine-preventable illness at your feet.”Kennedy denied making promises to Cassidy.The hearing exposed the deepening fractures in Kennedy’s relationship with Congress, even among Republicans who initially supported his confirmation. What began as a routine budget hearing devolved into accusations of dishonesty, conflicts of interest and fundamental questions about whether Kennedy can be trusted to protect public health.In one moment, representative Alexandria Ocasio-Cortez pressed Kennedy about his ignorance to the Trump administration’s reported investigation of UnitedHealthcare, the nation’s largest health insurer, for criminal fraud in Medicare Advantage plans.“You are not aware that the Trump Department of Justice is investigating the largest insurance company in America?” Ocasio-Cortez asked again after suggesting he couldn’t confirm that it was happening.When she said that for-profit insurers such as UnitedHealthcare defraud public programs of $80bn annually, Kennedy appeared confused about the scale: “Did you say 80 million or billion?”“80 with a ‘B’,” Ocasio-Cortez said.For Democrats, Tuesday’s performance confirmed their worst fears about a vaccine-skeptical activist now controlling the nation’s health agencies. For Kennedy, it marked an escalation in his battle against what he calls a corrupt public health establishment pushing back on his radical vision.But behind the political theater lay a fundamental reshaping of America’s public health architecture. Kennedy’s cuts have eliminated entire offices and centers, leaving them unstaffed and non-functional. While he defended the reductions as targeting “duplicative procurement, human resources and administrative offices”, he hinted that some fired workers might be rehired once court injunctions on the layoffs are resolved.Kennedy recently replaced the fired vaccine advisers with eight new appointees, including known spreaders of vaccine misinformation. The move alarmed even supportive Republicans such as Cassidy, who called Monday for delaying this week’s advisory meeting, warning the new panel lacks experience and harbors “preconceived bias” against mRNA vaccines.Kennedy has long promoted debunked links between vaccines and autism, raising fears his appointees will legitimize dangerous anti-vaccine theories.He also explained why he was pulling Covid-19 vaccine recommendations for pregnant women, claiming “there was no science supporting that recommendation” despite extensive research showing the vaccines’ safety during pregnancy.“We’re not depriving anybody of choice,” Kennedy insisted. “If a pregnant woman wants the Covid-19 vaccine, she can get it. No longer recommending it because there was no science supporting that recommendation.”In another sidebar, Kennedy unveiled his vision for America’s health future: every citizen wearing a smartwatch or fitness tracker within four years. The ambitious scheme, backed by what he promised would be “one of the biggest advertising campaigns in HHS history”, would see the government promoting wearables as a possible alternative to expensive medications.“If you can achieve the same thing with an $80 wearable, it’s a lot better for the American people,” Kennedy said. More

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      Who are the eight new vaccine advisers appointed by Robert F Kennedy?

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      Robert F Kennedy Jr, the US health secretary, named eight new vaccine advisers this week to a critical Centers for Disease Control and Prevention (CDC) panel after firing all 17 experts who had held the roles.New members of the panel include experts who complained about being sidelined, a high-profile figure who has spread misinformation and medical professionals who appear to have little vaccine expertise. Kennedy made the announcement on social media.“All of these individuals are committed to evidence-based medicine, gold-standard science, and common sense,” Kennedy said in his announcement. “They have each committed to demanding definitive safety and efficacy data before making any new vaccine recommendations.”Formally called the Advisory Committee on Immunization Practices (ACIP), the panel advises the CDC on how vaccines should be distributed. Those recommendations in effect determine the vaccines Americans can access. This week, Kennedy also removed the career officials typically tasked with vetting ACIP members and overseeing the advisory group, according to CBS News.Kennedy is a widely known vaccine skeptic who profited from suing vaccine manufacturers, has taken increasingly dramatic steps to upend US vaccine policy.“ACIP is widely regarded as the international gold standard for vaccine decision-making,” said Helen Chu, one of the fired advisers, at a press conference with Patty Murray, a Democratic US senator.“We cannot replace it with a process driven by one person’s beliefs. In the absence of an independent, unbiased ACIP, we can no longer trust that safe and effective vaccines will be available to us and the people around us.”Robert W MaloneArguably the most high-profile new member, Robert W Malone catapulted to stardom during the Covid-19 pandemic, appearing across rightwing media to criticize the Biden administration while describing himself as the inventor of mRNA technology.Messenger RNA technology powers the most widely used Covid-19 vaccines. While Malone was involved in very early experiments on the technology, researchers have said his role was limited.Malone’s star rose quickly after appearing on the Joe Rogan podcast in 2022, where he and Rogan were criticized for spreading misinformation. On the show, Malone promoted the idea that both ivermectin and hydroxychloroquine could be possible treatments for Covid-19, but said research on the drugs was being suppressed. Ivermectin and hydroxychloroquine have not been shown to improve outcomes from Covid-19.“Malone has a well-documented history of promoting conspiracy theories,” said Dr Jeffrey D Klausner, an epidemiologist and infectious disease expert at the University of Southern California, who recently told the New York Times he was in touch with Kennedy about his appointments.Martin KulldorffKulldorff is a former Harvard professor of biostatistics and an infectious disease epidemiologist originally from Sweden. He said in an essay for the rightwing publication City Journal that he was fired because he refused to be vaccinated in line with the school policy.Like Malone, he rose to prominence during the pandemic as a “Covid contrarian” who criticized the scientific consensus – views he said alienated him from his peers in the scientific community. He voiced his opposition to Covid-19 vaccine mandates and, in his essay, complained of being ignored by media and shadow-banned from Twitter.Kulldorff co-authored the Great Barrington Declaration, which called for limited closures instead of pandemic lockdowns before vaccines were available. The document became a touchstone for the American political right.Before the pandemic, Kulldorff studied vaccine safety and infectious disease, including co-authoring papers with members of CDC staff, such as on the Vaccine Safety Datalink. He was a member of the CDC’s Covid Vaccine Safety Working Group in 2020, but said later he was fired because he disagreed with the agency’s decision to pause Johnson & Johnson’s Covid-19 vaccine and with Covid-19 vaccine mandates. He served on the Food and Drug Administration’s (FDA) drug safety and risk management advisory committee around the same time.He has since enjoyed support from people already within the administration, including the Great Barrington Declaration co-author Dr Jay Bhattacharya, current head of the National Institutes of Health (NIH), and Dr Vinay Prasad, head of the Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research, which handles vaccines.Cody MeissnerMeissner is a professor of pediatrics at the Geisel School of Medicine at Dartmouth. He previously held advisory roles at the FDA and CDC, including ACIP from 2008-2012.In 2021, Meissner co-wrote an editorial with Dr Marty Makary, now the head of the FDA, which criticized mask mandates for children. In April, he was listed as an external adviser to ACIP on the respiratory syncytial virus (RSV) committee.Notably, Meissner is listed in a new conflicts of interest tool launched by the health department in March. Kennedy had criticized the fired ACIP members as “plagued with persistent conflicts of interest”.“He’s a card-carrying infectious disease person who knows the burden of these diseases, and he knows the risk and the benefit,” Dr Kathryn Edwards told CBS News. Edwards previously served as chair of the FDA’s vaccine advisory panel.Vicky PebsworthPebsworth is a nurse and the former consumer representative on the FDA’s vaccine advisory committee. She is also the Pacific regional director for the National Association of Catholic Nurses, according to Kennedy’s announcement.In 2020, Pebsworth spoke at the public comment portion of an FDA advisory panel meeting on Covid-19 vaccines. There, she identified herself as the volunteer research director for the National Vaccine Information Center (NVIC), “and the mother of a child injured by his 15-month well-baby shots in 1998”.The NVIC is widely viewed as an anti-vaccine advocacy organization “whose founder Barbara Lou Fisher must be considered a key figure of the anti-vaccine movement”, according to an article from 2023 on how to counter anti-vaccine misinformation.Retsef LeviLevi is a professor of operations management at the MIT Sloan School of Management who Kennedy described as an “expert in healthcare analytics, risk management and vaccine safety”.In 2021, he opposed Covid-19 booster shot approval during the public comment portion of an FDA advisory committee hearing. In 2022, he wrote an article calling for EMS calls to be incorporated into vaccine safety data, arguing that cardiovascular side-effects could be undercounted – an article that later required correction. The potential effects of Covid-19 vaccines on heart health have been a focal point of right-leaning criticism.Last month, Levi was criticized for publishing a pre-print paper – a paper without peer review – that he co-authored with Dr Joseph Ladapo, the Florida surgeon general, a vaccine skeptic. The paper alleged that people who took the Pfizer Covid-19 vaccine were more likely to die than those who received the Moderna vaccine.Michael A RossKennedy described Ross as “a Clinical Professor of Obstetrics and Gynecology at George Washington University and Virginia Commonwealth University, with a career spanning clinical medicine, research, and public health policy”.However, as first reported by CBS News, Ross’s name does not appear in faculty directories for either school. A spokesperson for George Washington University told the outlet that Ross did work as a clinical professor, but “has not held a faculty appointment … since 2017”.A spokesperson for Virginia Commonwealth University described Ross as “an affiliate faculty member” at a regional hospital system in the Capitol region.He is also listed as a partner at Havencrest Capital Management, as a board member of “multiple private healthcare companies”.Joseph R HibbelnHibbeln is a California-based psychiatrist who previously served as acting chief for the section of nutritional neurosciences at the NIH. He describes himself as an expert on omega-3, a fatty acid found in seafood.He also serves on the advisory council of a non-profit that advocates for Americans to eat more seafood. He practices at Barton Health, a hospital system in Lake Tahoe, California. His work influenced US public health guidelines on fish consumption during pregnancy.Dr James PaganoPagano is an emergency medicine physician from Los Angeles “with over 40 years of clinical experience”, and a “strong advocate for evidence-based medicine”, according to Kennedy. More

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      RFK Jr to remove all members of CDC panel advising on US vaccines

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      The health secretary, Robert F Kennedy Jr, is getting rid of all members sitting on a key US Centers for Disease Control and Prevention panel of vaccine experts and reconstituting the committee, he said on Monday.Kennedy is retiring and replacing all 17 members of the CDC’s advisory committee for immunization practices, he wrote in piece published in the Wall Street Journal.“Without removing the current members, the current Trump administration would not have been able to appoint a majority of new members until 2028,” Kennedy wrote.More details soon … More

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      RFK Jr drops Covid-19 boosters for kids and pregnant women from CDC list

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      The US health secretary, Robert F Kennedy Jr, announced that the federal Centers for Disease Control and Prevention (CDC) would remove Covid-19 booster shots from its recommended immunization schedule for healthy children and pregnant women.Legal experts said the Trump administration appointee’s decision, which Kennedy announced on social media, circumvented the CDC’s authority to recommend such changes – and that it is unprecedented for a health secretary to unilaterally make such a decision.“I couldn’t be more pleased to announce that as of today, the Covid vaccine shot for healthy children and healthy pregnant women has been removed from the CDC’s recommended immunization schedule,” Kennedy said in the announcement.Kennedy claimed Joe Biden’s administration last year “urged healthy children to get yet another Covid shot despite the lack of any clinical data to support the repeat booster strategy in children”.The secretary was flanked by Food and Drug Administration (FDA) commissioner – Dr Marty Makary – and the head of the National Institutes of Health (NIH), Dr Jay Bhattacharya. Neither the head of the FDA nor of the NIH would typically be involved in making vaccine administration recommendations.Bhattacharya said the announcement was “common sense and good science”.Removing the booster shot from the recommended immunization schedule could make it more difficult to access – and it could affect private insurers’ willingness to cover the vaccine. About half of Americans receive healthcare through a private insurance company.Such a unilateral change is highly unusual if not unprecedented for a typical US Department of Health and Human Services (HHS) secretary. And it could leave the HHS department open to litigation, said one vaccine law expert.“The secretary has never been involved in making Covid-19 vaccine recommendations – any vaccine recommendations,” said Dorit Reiss, a law professor at the University of California San Francisco who has closely followed attempts to circumscribe access to Covid-19 vaccines.It is not clear whether the social media announcement was accompanied by formal documentation of the change. Annual Covid-19 booster shots were still recommended for children on the CDC’s website Tuesday morning. It is unclear how Tuesday’s announcement could affect federal programs, such as Vaccines for Children, which provides shots to uninsured and under-insured children.“I am surprised at the open contempt they are showing to the process and not even pretend to do it in a substantive and deliberative way,” Reiss said. “If only because I would think they want to make it as litigation-proof as they can.”The change further sends conflicting messages about the importance of Covid-19 vaccination during pregnancy. The CDC says people are at increased risk of severe illness if they contract Covid-19 during pregnancy, including heightened risk of hospitalization and the need for intensive care.That evidence was acknowledged by Makary in a similarly unprecedented article in the New England Journal of Medicine, which announced changes to the way the FDA would license Covid-19 vaccines. In that article, pregnancy and recent pregnancy were listed among “underlying medical conditions that can increase a person’s risk of severe Covid-19”.Further, there is evidence that mothers who are vaccinated pass protective immunity to infants. Infants younger than six months are at the highest risk of severe disease among children, with the risk to children younger than four years old on par with that of 50-64-year-old adults, according to the Journal article.Typically, changes to vaccine administration recommendations are first considered by the CDC’s advisory committee on vaccine practices (ACIP), a group of independent vaccine experts. ACIP meetings are public, meaning in a normal process Americans can watch experts debate the validity of different approaches in real time before a vote. Although the CDC does not always take the group’s advice, it often does. The CDC was without a permanent director as of Tuesday, a little more than four months into Donald Trump’s second presidency.ACIP recommendations are then counter balanced by recommendations from the FDA’s vaccine and related biologics products advisory committee, which has a similar structure and transparency measures. That group met five days earlier to recommend strains to include in this fall’s Covid-19 booster shot, settling on the JN.1 lineage.Kennedy’s announcement comes as the Trump administration has packed HHS with “Covid contrarians” – a colloquial term used by researchers to describe people, typically critics, who do not accept mainstream public health’s recommendations to prevent Covid-19.Congressional Republicans allied with Trump have also continued to flog the Biden administration’s response to the pandemic in hearings. Vaccine hesitancy has become much more common among Republican party voters than it once was, a Gallup poll has found. More

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      Trump is ‘fully fit’ and manages high cholesterol, says White House physician

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      Donald Trump – the oldest person to ever be elected US president – controls high cholesterol with medication and has elevated blood pressure but is “fully fit”, White House physician Sean Barbella said in a report released on Sunday.The US navy captain’s report was published two days after Trump underwent a routine physical. It also said he was up to date on all recommended vaccines – despite his national health secretary Robert F Kennedy Jr having spent years sowing doubt about the safety and efficacy of vaccination.Trump himself has previously spread debunked claims about links between vaccines and autism often invoked by Kennedy.Barbella’s report is the most detailed information on the health of Trump, 78, since he returned to the White House in January for a second presidency.“President Trump exhibits excellent cognitive and physical health and is fully fit to execute the duties of the Commander-in-Chief and Head of State,” Barbella wrote in his report.The report noted that Trump’s high cholesterol is “well-controlled” with two medications addressing it.The medicines are rosuvastatin and ezetimibe, generic names of the branded drugs Crestor and Zetia. They have improved Trump’s cholesterol over time.Ideally, total cholesterol should be less than 200. At his physical in January 2018, his total cholesterol was 223. In early 2019, the reading came in at 196 and it stood at 167 in 2020. In Sunday’s report, it was listed as 140.Trump’s blood pressure was 128 over 74. That is considered elevated. And people with elevated blood pressure are likely to develop high blood pressure – or hypertension – unless they take steps to control the condition.The report also noted that Trump has scarring on his right ear, the result of a gunshot wound he suffered when a would-be assassin fired at him during a campaign rally in Pennsylvania last year.A secret service sniper killed the attacker, who fatally shot one spectator while wounding two others.Barbella’s report also references Trump’s history with Covid-19. Trump was hospitalized during a serious bout with the virus in October 2020 during a run for re-election that ended in defeat to Joe Biden.Amid questions about his age and mental acuity, Biden then dropped out of an electoral rematch with Trump in November 2024 and endorsed his vice-president, Kamala Harris, to succeed him. Trump won the popular and electoral votes against Harris to return to the presidency.skip past newsletter promotionafter newsletter promotionAfter the exam preceding the report, Trump told journalists on Air Force One: “It went, I think, well … Every test you can imagine, I was there for a long time, the yearly physical.“I think I did well.”Trump also told reporters he took a cognitive test. Barbella’s report gave Trump a 30 out of 30 on what is known as the Montreal Cognitive Assessment.The screening takes about 10 minutes to administer, according to information online. One version available online asks those undergoing the screening to draw a clock, repeat words, name animals and count backwards from 100 at intervals of seven, among other tasks.Trump’s resting heart rate was 62 beats per minute, in line with previous tests. A normal resting heart rate for adults ranges from 60 beats to 100 beats per minute. And generally, a lower rate implies better cardiovascular fitness.Reuters and the Associated Press contributed reporting More

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      Second child dies of measles in Texas amid rising outbreak

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      A second child with measles has died in Texas amid a steadily growing outbreak that has infected nearly 500 people in that state alone.The US health and human services department confirmed the death to NBC late Saturday, though the agency insisted exactly why the child died remained under investigation. On Sunday, a spokesperson for the UMC Health System in Lubbock, Texas, said that the child had been hospitalized before dying and was “receiving treatment for complications of measles” – which is easily preventable through vaccination.The family of the child in question had chosen to not get the minor vaccinated against the illness.Michael Board, a news reporter at Texas’s WOAI radio station, wrote on Sunday that official word from the state’s health and human services department was that the child died from “measles pulmonary failure” while having had no underlying conditions.Citing records it had obtained, the New York Times described the child as an eight-year-old girl.That marked the second time a child with measles had died since 26 February. The first was a six-year-old girl – also hospitalized in Lubbock – whose parents had not had her vaccinated.The Trump administration’s health secretary, Robert F Kennedy Jr, on Sunday identified the two children to have died with measles as Kayley Fehr and Daisy Hildebrand. Daisy was the one who died more recently, and Kennedy said in a statement that he traveled to her funeral on Sunday to be with her family as well as the community in its “moment of grief”.Kennedy for years has baselessly sowed doubt about vaccine safety and efficacy. He sparked alarm in March among those concerned by the US’s measles outbreak when he backed vitamins to treat the illness and stopped short of endorsing protective vaccines, which he minimized as merely a “personal choice” rather than a safety measure that long ago was proven effective.In his statement on Sunday, Kennedy said: “The most effective way to prevent the spread of measles is the MMR vaccine,” which also provides protection against mumps and rubella. He also said he would send a team to support Texas’s local- and state-level responses to the ongoing measles outbreak.A third US person to have died after contracting measles was an unvaccinated person in Lea county, New Mexico, officials in that state announced in early March.Dr Peter Marks, who recently resigned as the Food and Drug Administration’s vaccine while attributing that decision to Kennedy’s “misinformation and lies”, blamed the US health secretary and his staff for the death of the child being buried on Sunday.“This is the epitome of an absolute needless death,” Marks said Sunday during an interview with the Associated Press. “These kids should get vaccinated – that’s how you prevent people from dying of measles.”Marks also told the AP that he had warned US senators that the country would endure more measles-related deaths if the Trump administration did not more aggressively respond to the outbreak. The Senate health committee has called Kennedy to testify before the group on Thursday.One of that committee’s members is the Louisiana Republican and medical doctor Bill Cassidy, who frequently speaks about the importance of getting vaccinates against diseases but joined his Senate colleagues in voting to confirm Kennedy as the US health secretary.Cassidy on Sunday published a statement saying: “Everyone should be vaccinated.”There is “no benefit to getting measles”, Cassidy’s statement added. “Top health officials should say so unequivocally [before] another child dies.”Measles, which is caused by a highly contagious, airborne virus that spreads easily when an infected person breathes, sneezes or coughs, had been declared eliminated from the US in 2000. But the virus has recently been spreading in undervaccinated communities, with Texas and New Mexico standing among five states with active outbreaks – which is defined as three or more cases.The other states are Kansas, Ohio and Oklahoma. Collectively, as of Friday, the US had surpassed 600 measles cases so far this year – more than double the number it recorded in all of 2024. Health officials and experts have said that they expect the measles outbreak to go on for several more months at least – if not for about a year.Texas alone was reporting 481 cases across 19 counties as of Friday, most of them in the western region of the state. It registered 59 previously unreported cases between Tuesday and Friday. There were also 14 new hospitalizations, for a total of 56 throughout the outbreak.More than 65% of Texas’s measles cases are in Gaines county, which has a population of just under 23,000, and was where the virus started spreading in a tightly knit, undervaccinated Mennonite community.Gaines has logged 315 cases – in just over 1% of the county’s residents – since late January.The Associated Press contributed reporting More

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      Mehmet Oz confirmed by US Senate to lead Medicare and Medicaid

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      Former heart surgeon and TV pitchman Dr Mehmet Oz was confirmed on Thursday to lead the Centers for Medicare and Medicaid Services (CMS).Oz became the agency’s administrator in a party-line 53-45 vote.The 64-year-old will manage health insurance programs for roughly half the country, with oversight of Medicare, Medicaid and Affordable Care Act coverage. He steps into the new role as Congress is debating cuts to the Medicaid program, which provides coverage to millions of poor and disabled Americans.Oz has not said yet whether he would oppose such cuts to the government-funded program, instead offering a vision of promoting healthier lifestyles, integrating artificial intelligence and telehealth into the system, and rethinking rural healthcare delivery.During a hearing last month, he told senators that he did favor work requirements for Medicaid recipients, but that paperwork shouldn’t be used to reaffirm that they are working or to block people from staying enrolled.Oz, who worked for years as a respected heart surgeon at Columbia University, also noted that doctors dislike Medicaid for its relatively low payments and some don’t want to take those patients.He said that when Medicaid eligibility was expanded without improving resources for doctors, that made care options even thinner for the program’s core patients, which include children, pregnant people and people with disabilities.“We have to make some important decisions to improve the quality of care,” he said.Oz has formed a close relationship with his new boss, Robert F Kennedy Jr. He’s hosted the health secretary and his inner circle regularly at his home in Florida. He’s leaned into Kennedy’s campaign to “make America healthy again” (Maha), an effort to redesign the nation’s food supply, reject vaccine mandates and cast doubt on some long-established scientific research.The former TV show host talks often about the importance of a healthy diet, aligning closely with Kennedy’s views.skip past newsletter promotionafter newsletter promotionWhile Oz has faced some criticism for promoting unproven vitamin supplements and holistic treatments – staples of the “Maha movement” – he’s regularly encouraged Americans to get vaccinated.Oz will take over the CMS days after the agency was spared from the type of deep cuts that Kennedy ordered at other public health agencies. Thousands of staffers at the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes for Health are out of a job after mass layoffs that started on Tuesday.The CMS is expected to lose about 300 staffers, including those who worked on minority health and to shrink the cost of healthcare delivery. More

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      ‘The goal is to disassemble public health’: experts warn against US turn to vaccine skepticism

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      As vaccine hesitancy increases in the US, isolated, tight-knit and religious communities have frequently been at the center of high-profile outbreaks.Such is the case in west Texas, where a rural community is the center of an expanding measles outbreak that has already claimed the lives of two Americans – the first deaths from the disease in nearly a decade.However, as the conspiracy theories of Maga conservatism marry the bugbears of the US health secretary and vaccine skeptic Robert F Kennedy Jr, the one-time fringe view of vaccines has become increasingly mainstream – with activists in right-leaning population centers taking lessons learned from the Covid-19 pandemic into the realm of childhood inoculations.One need look no further than Sarasota, Florida, for a full-throated political denunciation.“Generally, people are weak, lazy,” said Vic Mellor, an activist based near Sarasota, and a close ally of former Trump national security adviser Michael Flynn.Mellor owns the We the People Health and Wellness Center in nearby Venice. Mellor, in a shirt that shouts “VIOLENCE MIGHT BE THE ANSWER”, is a self-professed attendee of the January 6 insurrection at the US Capitol.“And that lazy part just makes them ignorant … Covid has proven that obviously this is true. I mean, all the facts are starting to come out on Covid now – that it was a hoax. That is just an extension of where this hoax began decades earlier with the vaccines, OK? This is all a money grab, this is all a power grab.”The pandemic was real, and it started Mellor down the road of questioning vaccines. Where he once opposed only the Covid-19 shots, he now opposes vaccines entirely – arguing they harm children despite experts on vaccines considering them one of mankind’s greatest medical achievements.“This is not an isolated, rural, religious community, which I think is what a lot of people associate with an anti-vaccine mentality,” said Kathryn Olivarius, the author of Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom, and a historian of disease at Stanford University. “This is in the heart of everything.”Sarasota has become a proving ground for the Maga right. Among nail salons, mom-and-pop Cuban restaurants and roadside motels lining US 41, known locally as the Tamiami Trail, a visitor can find the gates of New College. This was once a public university prized for its progressive liberal arts education. Now it is part of the new conservative experiment in remaking higher education led by activists aligned with Donald Trump and the Republican Florida governor, Ron DeSantis.Along the same road is the Sarasota memorial hospital, an aberration in American healthcare – it is publicly owned with open board elections. The normally sleepy election became contentious when insurgent “health freedom” candidates, supported in part by Mellor, entered the race. Three won seats on the nine-member board in 2022.Even the name of this stretch of sun-bleached asphalt is up for debate. This year, a state Republican lawmaker – who has also introduced bills to limit vaccine requirements – briefly proposed changing its name to the “Gulf of America Trail” – a nod to Trump’s renaming of the Gulf of Mexico.Arguably the most salient artifact of this activism in Sarasota is the least visible: vaccination rates against measles.Measles vaccination rates for kindergarteners have plummeted over the last two decades – from 97% in 2004 to 84% in 2023, according to state health records. Sarasota is roughly on par with the vaccination rates in rural Gaines county, Texas – the center of the ongoing measles outbreak that sickened 279 people in in that state alone. Notably, both Gaines county and Sarasota have large home-schooling communities, meaning vaccination rates could in fact be lower.It is well known in research circles that right-leaning states across the US south and west have worse health metrics – from obesity to violence to diseases such as diabetes. That reality was supercharged during the pandemic; as vaccine mandates became a fixation on the right, Republican-leaning voters became more skeptical of vaccines. In turn, places with politically conservative leaders experienced more Covid-19 deaths and greater stress on hospitals.Measles is one of the most contagious diseases known to medicine. At least 95% of the population needs to be vaccinated to prevent outbreaks of the disease. But despite a supremely effective vaccine that eliminated the disease from the US in 2000, vaccine hesitancy has increasingly taken hold.skip past newsletter promotionafter newsletter promotionConservative activism alone can’t be blamed for declining measles vaccination rates. The measles vaccine in particular has been subject to a sustained firehose of misinformation stemming from a fraudulent paper linking the vaccine to autism in 1999. For years, this misinformation was largely nonpartisan. And Florida’s anti-vaccine movement was active even before the pandemic – with a vocal contingent of parents arguing against strengthening school vaccine standards in 2019.What appears new in Sarasota is how local conservative activists have brought opposition to vaccines into the heart of their philosophy. By Mellor’s telling, he and a loosely affiliated group of Maga activists began to adopt anti-vaccine beliefs as the pandemic wore on – helping organize major health protests in the area in recent years, such as mask mandate opt-outs and the “health freedom” campaign for hospital board seats.Mellor said his nearby property, the Hollow, was a gathering place during the pandemic (it is also a part-time gun range). He cites ivermectin, an anti-parasitic drug that became a fascination of the right, as the reason “we didn’t lose people at all” during the height of the pandemic. Available clinical evidence shows it is not effective against Covid-19.Kennedy has fit neatly into this realignment. He enjoys trust ratings among Republicans nearly as high as Trump, according to polling from the health-focused Kaiser Family Foundation. Kennedy has already spread dubious information about measles vaccines in public statements (notably: from a Steak ’n Shake in Florida) – a response one vaccine expert said “couldn’t be worse”.“While children are in the hospital suffering severe measles pneumonia, struggling to breathe, [Kennedy] stands up in front of the American public and says measles vaccines kill people every year and that it causes blindness and deafness,” said Dr Paul Offit, the director of the Vaccine Education Center and an attending physician in the division of infectious diseases at the Children’s Hospital of Philadelphia. Severe side effects from the vaccine are possible, but they are much rarer than disability and death from measles.“This is what happens when you have a virulent anti-vaccine activist, a science denialist, as the head of the most important public health agency in the United States,” said Offit. “He should either be quiet or stand down.”The same poll found trust in public health agencies has fallen precipitously amid Republican attacks. More than a quarter of Republican parents report delaying childhood vaccines, the poll found, a rate that has more than doubled since 2022. There is no analogous trend among Democratic parents. Despite how claims espoused by vaccine skeptics can be easily refuted, their power has not been undercut.“The anti-vaccine business is big business,” said Offit, pointing to the myriad unproven “treatments” offered by promoters of vaccine misinformation, some of which are offered at Mellor’s We the People health center. “We have been taken over by a foreign country, and the goal of that foreign country is to disassemble public health.”The misery of measles did not take long to appear in Texas – measles-induced pneumonia has already led pediatricians to intubate children, including at least one baby, according to the Associated Press. About one to three people out of 1,000 who are infected by measles die from the infection, and one in 1,000 suffer severe brain swelling called encephalitis, which can lead to blindness, deafness and developmental delays.“We actually don’t have the perspective people in the past had on these diseases,” Olivarius. “I have spent many, many, many years reading letters and missives from parents who are petrified of what’s going to happen to their children” if there are outbreaks of yellow fever, polio or measles, Olivarius said about diseases now largely confined to history – thanks to vaccines.“The lesson from history is these are not mild ailments,” she said. “These are diseases that have killed hundreds of millions of people – and quite horribly too.” More

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      ‘It’s back to drug rationing’: the end of HIV was in sight. Then came the cuts

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      This year the world should have been “talking about the virtual elimination of HIV” in the near future. “Within five years,” says Prof Sharon Lewin, a leading researcher in the field. “Now that’s all very uncertain.”Scientific advances had allowed doctors and campaigners to feel optimistic that the end of HIV as a public health threat was just around the corner.Then came the Trump administration’s abrupt cuts to US aid funding. Now the picture is one of a return to the drugs rationing of decades ago, and of rising infections and deaths.But experts are also talking about building a new approach that would make health services, particularly those in sub-Saharan Africa, less vulnerable to the whims of a foreign power.The US has cancelled 83% of its foreign aid contracts and dismantled USAid, the agency responsible for coordinating most of them.Many fell under the President’s Emergency Plan for Aids Relief (Pepfar) programme, which has been the backbone of global efforts to tackle HIV and Aids, investing more than $110bn (£85bn) since it was founded in 2003 and credited with saving 26 million lives and preventing millions more new infections. In some African countries it covered almost all HIV spending.View image in fullscreenThere is a risk, says Lewin, director of Melbourne University’s Institute for Infection and Immunity and past president of the International Aids Society, of “dramatic increases in infections, dramatic increases in death and a real loss of decades of advances”.There is no official public list of which contracts have been cancelled, and which remain. It appears that virtually no HIV-prevention programmes funded by the US are still in operation, save a handful principally providing drugs to stop pregnant women passing on the infection to their babies. Countries report disruption to the most basic measures, such as condom distribution.Some treatment programmes have been spared, but not those whose focus conflicted with the Trump administration’s war on “gender ideology” or diversity, equity and inclusion (DEI), such as those working with transgender communities. Doctors, nurses and other healthcare workers have been laid off, while worried patients are hoarding drugs or stretching supplies, according to UNAids surveillance. UNAids itself has lost more than half of its funding.Even programmes that have survived the cull have faced turmoil since February, with instructions to stop work rescinded but with no certainty that funding will continue.View image in fullscreenIn only one example, the Elizabeth Glaser Paediatric Aids Foundation says it has had to halt HIV treatment for 85,000 people in Eswatini, including more than 2,000 children, and tests for thousands of pregnant women and babies to prevent transmission and begin life-saving medication.Access to drugs represents an “immediate crisis”, Lewin says. “If people with HIV stop the medications, then not only do they get sick themselves, which is tragic, but they also then become infectious to others.”As clinics on the frontline of treating the disease scrabble to secure access to basic drugs, scientists at this month’s Conference on Retroviruses and Opportunistic Infections in San Francisco were hearing that HIV might soon be preventable with a once-a-year injection.The drug lenacapavir was already generating huge excitement in the field, after trial results showed that a six-monthly jab could prevent HIV. New results from the manufacturer Gilead suggest that a tweak to the formula and how it is given could see its protective effects last even longer.Nevertheless, Lewin says, the mood at the meeting, packed with many of the world’s leading HIV specialists, was “dire”.As well as programme cancellations, there are “huge concerns around science and what’s going to happen to the [US] National Institutes of Health, [whose] funding of science has been so significant on every level”, she says.Some scientists in receipt of US funding have been told to remove their names from DEI-linked research, she says, even though DEI is fundamental to the HIV response.View image in fullscreen“I don’t mean that in a sort of touchy-feely way, I mean that’s what we need to do: you need to actually get those treatments to these diverse communities.”In 2022, 55% of all new HIV infections were within “key populations”, such as gay men, other men who have sex with men, sex workers, transgender people, prisoners and people who inject drugs.Prof Linda-Gail Bekker, of South Africa’s Desmond Tutu Health Foundation, has seen US funding for three trials of potential HIV vaccines involving eight countries cancelled and only reinstated after an appeal to the US supreme court.“We’re running around like chickens without heads to at least get one going, because the vaccines are sitting in the fridge and will expire,” she says.She led the lenacapavir trial that showed it offered 100% protection to young women in sub-Saharan Africa, but now worries about HIV/Aids prevention “falling off the radar completely”.The global community had been making headway towards the United Nations’ goal of ending Aids by 2030, she says, with a five-year plan to use “amazing new innovative tools and scale them up”, which would have led to “less dependence on foreign aid and more self-reliance” as new infections fell and attention shifted to maintaining treatment for people with HIV.“All of that is hugely at risk now because, without these funds, our governments will have to step up but they will concentrate on treatment,” she says. “We know they will do that, because that is what we did for the first 30 years.”Efforts to control Aids were entering “the last mile”, which was always likely to be more expensive, she says. “The people who were happy to come into health facilities, they would have come into health facilities.”It would be difficult to rely on government funding to reach the remaining groups, she says, not only because of fewer resources but also because in some countries it means targeting groups whose existence is illegal and unrecognised, such as sex workers or sexual minorities, and young girls may be reluctant to use government clinics if they are not supposed to be sexually active.“I feel like the odds are very stacked against us,” says Bekker, adding: “We’re obviously going to have to re-programme ourselves [and] formulate a different plan.”Pepfar had pledged funding to the Global Fund to Fight Aids, Tuberculosis and Malaria, to deploy 10m doses of lenacapavir in low-income countries. While the Global Fund has promised to maintain its commitment, it might receive fewer than the planned number of doses, Bekker fears.“Six months ago, I was saying the best thing we can do with lenacapavir is offer it to everybody in a choice environment. [Now] I think we’re gonna have to say who needs [injectable] prep,” she says, “and the rest have to do the best they can.“How do we make that decision? And what does that look like? It is back to sort of rationing.“When we started ARVs [antiretroviral drugs] way back in 2000,” Bekker recalls, “you would go, ‘you get treatment; you don’t, you don’t, you don’t’.“It feels terrible … but you have to get over that. You have to say it will be infection-saving for some people. And we’ve got to make it count.”View image in fullscreenFor Beatriz Grinsztejn, president of the International Aids Society, the disruption is critical and threatens many vulnerable people. But, she adds, it could present “an important opportunity for ownership – otherwise we are always left in the hands of others”.She worries about the impact of cuts to funding on younger scientists, with their potential loss from the research field “a major threat for the next generation”. But, she adds, the HIV community is “powerful and very resilient”.There have already been calls for new ways of doing things. It is “time for African leadership”, members of the African-led HIV Control Working Group write in the Lancet Global Health. There are now plans for Nigeria to produce HIV drugs and tests domestically.Christine Stegling, deputy director of UNAids, says it began “a concerted effort” last year to develop plans with countries about how their HIV programmes could become more sustainable domestically “but with a longer timeframe … now we are trying to do some kind of fast-tracking”.Governments are determined, she says, but it will require fiscal changes either in taxation or by restructuring debt.The goal of ending Aids by 2030 is still achievable, Stegling believes. “I think we have a very short window of opportunity now, in the next two, three months, to continue telling people that we can do it.“I keep on reminding people, ‘look, we need to get back to that same energy that we had when people were telling us treatment can’t be available in the global south, right?’ And we didn’t accept it. We made it happen.“We have national governments now who are also very adamant, because they can see what can happen, and they want to make it happen for their own populations.” More