The CDC's Ideological Takeover
The systematic dismantling of scientific leadership at the Centers for Disease Control and Prevention (CDC) under Health Secretary Robert F. Kennedy Jr. represents more than bureaucratic reshuffling. The firing of CDC Director Susan Monarez after just three weeks in office, followed by the resignation of four senior officials in protest, suggests we have reached a point of no return: the subordination of scientific evidence to predetermined ideological conclusions. This transformation threatens decades of progress in disease prevention and raises a troubling question for public health advocates: have we abandoned scientific rigor for the comfort of confirmation bias?
The numbers tell a story of institutional collapse. Since April 2025, the CDC has lost nearly 2,400 employees, representing 20% of the agency's workforce. More than 1,000 HHS workers have signed letters demanding Kennedy's resignation. When Monarez refused to "rubber-stamp unscientific, reckless directives and fire dedicated health experts," according to her legal team, she chose protecting public health over political expediency, and was terminated for that choice.
The Architecture of Predetermined Conclusions
History suggests Kennedy's approach follows a troubling pattern: conclusions first, “evidence” later. In June 2025, Kennedy fired all 17 members of the CDC's Advisory Committee on Immunization Practices (ACIP), replacing them with vaccine skeptics and anti-vaccine activists. Among his appointments is David Geier, a discredited proponent of the long-debunked vaccine-autism connection who lost his medical license for practicing without proper credentials.
The ideological nature of Kennedy's decision-making became even clearer when STAT reported that Monarez had submitted a confidential reform plan that closely mirrored Kennedy's subsequent proposals for CDC modernization. Her July 20 memo called for upgraded infrastructure, workforce investments, enhanced disease surveillance, and stronger firewalls against political influence—priorities Kennedy later claimed as his own in his Wall Street Journal defense. Yet Kennedy fired her anyway, not for opposing reform, but for refusing his ultimatum to "approve all recommendations from the vaccine advisory committee" and "fire top CDC officials." The revelation exposes Kennedy's public rationale about "replacing leaders who resisted reform" as fundamentally dishonest.
This pattern of predetermined conclusions reached its most explicit expression during a Cabinet meeting when Kennedy promised to reveal in September "interventions that are clearly, almost certainly causing autism," with Trump speculating that "something artificial" must be the cause. Announcing conclusions before conducting research represents the antithesis of scientific inquiry and is nothing more than predetermined outcomes masquerading as hypothesis testing.
Dr. Demetre Daskalakis, former director of the National Center for Immunization and Respiratory Diseases who resigned in protest, captured the gravity of this shift: "I only see harm coming. 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."
The Human Cost of Ideological Public Health
The dismantling of CDC expertise creates cascading consequences that disproportionately impact vulnerable populations. The agency's budget has been cut nearly in half, from $9.1 billion to $4.2 billion. Chronic disease prevention funding, which provided $16-20 million per state annually, faces elimination. The agency now has 750 fewer "ready responders" available for health emergencies.
For people living with HIV and other vulnerable populations, these cuts represent a direct assault on health equity. The CDC's HIV surveillance systems, prevention programs, and outbreak response capabilities depend on the institutional knowledge and scientific expertise that Kennedy has systematically eliminated. When flu sample submissions from abroad decreased by 70% due to the administration's withdrawal from the World Health Organization, the United States lost crucial early warning systems for pandemic preparedness.
Dr. Debra Houry, the former chief medical officer who resigned, warned that "we are not ready for emerging health threats, and it's only getting worse." Rural communities and people with chronic conditions—populations already facing significant health disparities—will bear the greatest burden of this institutional collapse.
Bipartisan Alarm and the Need for Oversight
The crisis has prompted rare bipartisan concern from lawmakers. Sen. Bill Cassidy (R-LA), who provided a crucial vote for Kennedy's confirmation, called for the postponement of the September ACIP meeting, stating that "any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership." Sen. Susan Collins (R-ME) found "no basis" for Monarez's removal.
The tension within Republican ranks became evident in a public Twitter exchange between Cassidy and Sen. Rand Paul (R-KY), where Cassidy pointedly noted that "MAHA starts with preventing vaccine preventable diseases." The comment raises a fundamental question: is Secretary Kennedy aware of this starting point for his own Make America Healthy Again agenda? Paul's defense of Kennedy's vaccine skepticism highlights the fracture between evidence-based public health Republicans and those embracing anti-vaccine ideology.
Even more telling, nine former CDC directors spanning both Republican and Democratic administrations condemned Kennedy's actions as "unlike anything we had ever seen at the agency and unlike anything our country had ever experienced." When career public servants who have served under multiple administrations express such unified alarm, the threat to institutional integrity cannot be dismissed as partisan politics.
The American Medical Association issued a statement expressing deep concern about CDC's destabilization at "a challenging moment for public health," while the American Nurses Association warned that the changes "could potentially pose a direct risk to the safety and security of our nation."
The Broader Questions: Science vs. "Vibes" in Public Health Policy
The CDC crisis illuminates a broader erosion of evidence-based decision-making in public health policy. When scientific conclusions are predetermined and evidence is selectively marshaled to support ideological positions, we abandon the fundamental principles that underpin effective public health practice.
This shift toward policy by "vibes" rather than evidence gains particular momentum from social media influencer culture and the wellness industry, a $6.3 trillion global market that dwarfs pharmaceuticals' $1.65 trillion. Research from the Center for Countering Digital Hate reveals that Kennedy belongs to the "Disinformation Dozen" - 12 individuals responsible for 65% of anti-vaccine content on major platforms. These “wellness” influencers, with millions of collective followers, promote alternative health products while spreading vaccine misinformation that platforms fail to control despite documented public health harms.
The regulatory disparity amplifies this problem. While pharmaceutical drugs require 10-15 years of clinical trials costing billions, dietary supplements face no pre-market approval requirements under the 1994 Dietary Supplement Health and Education Act. This creates an ecosystem where unsubstantiated wellness claims flourish on social media while rigorously tested medical interventions face increasing skepticism from audiences primed by influencer misinformation.
The pattern extends beyond vaccines to encompass the entire architecture of public health surveillance and response. When Kennedy restricts COVID-19 vaccine access based on ideology rather than epidemiological evidence, when he eliminates chronic disease programs without data supporting their ineffectiveness, when he replaces career scientists with political appointees lacking relevant expertise, he transforms public health agencies into instruments of social engineering rather than evidence-based medicine.
One current CDC employee described this as "the beginning of the end of objective science." The consequences extend far beyond CDC headquarters in Atlanta—they reach into every community clinic serving people living with HIV, every state health department tracking disease outbreaks, every family seeking evidence-based guidance about their health decisions.
The Stakes for Health Equity and Patient Access
The response from state governments illustrates the severity of the federal abdication. California, Oregon, and Washington announced the formation of a West Coast Health Alliance to "uphold scientific integrity in public health as Trump destroys CDC's credibility." When states feel compelled to create alternative public health infrastructure, the federal system - and its leadership - have fundamentally failed.
While some states move to protect science-based public health, others are abandoning it entirely. On the same day the West Coast Health Alliance was announced, Florida declared plans to become the first state to end all vaccine mandates, including for schoolchildren. The stark contrast—three states forming an alliance to preserve scientific integrity while another dismantles evidence-based protections—illustrates how Kennedy's assault on federal public health expertise is fracturing the nation's disease prevention infrastructure.
The elimination of scientific expertise at the CDC represents a direct threat to health equity and evidence-based patient care. For advocates working to expand access to HIV prevention and treatment, for policymakers crafting evidence-based health legislation, for people relying on public health guidance to make informed decisions about their care, the stakes could not be higher.
Congress must exercise its oversight authority to protect the institutional integrity that underpins effective public health practice. This responsibility transcends partisan politics—it represents a fundamental obligation to ensure that public health decisions are grounded in scientific evidence rather than ideological predetermination. The alternative is a public health system that serves political ends rather than human health, where predetermined conclusions masquerade as scientific inquiry, and where the most vulnerable populations pay the highest price for our collective abandonment of evidence-based decision-making.
America's Vaccination Problem
Politics Trump Public Health
The United States is confronting a serious resurgence of vaccine-preventable diseases, exemplified by the measles outbreak in Texas and New Mexico that has now infected over 124 people and claimed the life of an unvaccinated child. This crisis coincides with multiple failures in public health leadership and unprecedented political interference in evidence-based practice.
Recent Centers for Disease Control and Prevention (CDC) analysis reveals that the percentage of children with a vaccine-hesitant parent varies dramatically by vaccine type — from 56% for COVID-19 vaccines to 12% for routine childhood vaccines. This growing hesitancy has created dangerous gaps in community protection across the country.
In a rapid succession of alarming developments within a single week, we've witnessed a new confirmed measles case in Kentucky from an international traveler, Health and Human Services (HHS) Secretary Robert F. Kennedy (RFK) Jr.'s cancellation of a multimillion-dollar project to develop an oral COVID-19 vaccine, and the FDA's abrupt cancellation of a critical advisory committee meeting on next season's flu vaccine formulation. During his first cabinet meeting appearance, Kennedy incorrectly stated there had been two measles deaths (there was one) and downplayed the outbreak as "not unusual" — a claim physicians immediately contradicted.
This confluence of declining vaccination rates, active disease outbreaks, and systematic dismantling of public health infrastructure represents a crisis entirely of our own making. It’s 2025 and children are dying from diseases we've known how to prevent for decades, not because of scientific limitations, but because of a collective failure to prioritize evidence over ideology.
A Dismantling in Real Time
At the February 27 cabinet meeting, HHS Secretary Kennedy made several troubling statements about the ongoing measles outbreak. "Measles outbreaks are not unusual," Kennedy claimed, an assertion quickly refuted by medical experts.
"Classifying it as 'not unusual' would be inaccurate," said Dr. Christina Johns, a pediatric emergency physician. "Usually an outbreak is in the order of a handful, not over 100 people that we have seen recently with this latest outbreak in West Texas."
Dr. Philip Huang, director of Dallas County Health and Human Services, was more direct: "This is not usual. Fortunately, it's not usual, and it's been because of the effectiveness of the vaccine."
Kennedy's statement that two people had died from measles was also incorrect – Texas officials confirmed there has been one death, an unvaccinated school-aged child. His claim that patients were hospitalized "mainly for quarantine" was astonishingly false. Local health officials reported that most patients required treatment for serious respiratory issues, including supplemental oxygen and IV fluids.
Meanwhile, in just his first two weeks in office, Kennedy has taken several actions that threaten to undermine vaccine development and public health guidance:
The FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting scheduled for March was abruptly canceled. This annual meeting is crucial for selecting the strains to be included in next season's flu vaccines. A wise move in the middle of the worst flu season in 15 years. Norman Baylor, former director of the FDA's Office of Vaccine Research and Review, told NBC News: "I'm quite shocked. The VRBPAC is critical for making the decision on strain selection for the next influenza vaccine season."
Kennedy halted a $460 million contract with Vaxart to develop a new COVID-19 vaccine in pill form, just days before 10,000 people were scheduled to begin clinical trials.
Just days earlier, Kennedy indefinitely postponed a meeting of the CDC's Advisory Committee on Immunization Practices (ACIP), which helps determine vaccine recommendations for states and insurers.
Dr. Paul Offit, a member of VRBPAC and vaccine expert at Children's Hospital of Philadelphia, expressed his dismay: "I feel like the world is upside down. We aren't doing the things we need to do to protect ourselves."
Evidence of Vaccine Success Amid Political Attacks
In striking irony, the CDC Morbidity and Mortality Weekly Report (MMWR) just published new data demonstrating the remarkable success of the human papillomavirus (HPV) vaccination program in preventing cervical cancer. During 2008–2022, cervical precancer incidence decreased 79% among screened women aged 20–24 years, the age group most likely to have been vaccinated. Higher-grade precancer incidence decreased 80% in the same group.
This success story illustrates what effective vaccination programs can achieve when supported by consistent policy and healthcare provider recommendations. The HPV vaccine has prevented countless future cancers in a generation of young people, with similar potential for other vaccines when politics doesn't interfere with public health.
The contrast between this evidence of vaccine success and the current administration's assault on public health infrastructure could not be more glaring. At the very moment when scientific data confirms vaccines' life-saving impact, political appointees are systematically dismantling the systems designed to implement and monitor vaccination programs.
The False Promise of "Informed Consent"
Kennedy has justified halting vaccine promotion by claiming he wants future campaigns to focus on "informed consent" instead. However, experts warn this framing misrepresents the concept and creates dangerous misperceptions about vaccines (which, to be fair, would make it right in RFK Jr.’s wheelhouse—if only that were the actual job description).
Mark Navin, Lainie Friedman Ross, and Jason A. Wasserman explained in STAT News: "True 'informed consent' requires an understanding of how people process information about risks, and public health must promote collective benefits rather than focus entirely on individual autonomy."
Simply listing potential vaccine side effects without context creates predictable cognitive biases, similar to hearing about a shark attack and becoming afraid to swim despite the infinitesimal risk. As these experts note, "It is more like handing someone a list of everything that could go wrong on an airplane without mentioning that flying is far safer than driving."
The CDC's canceled 'Wild to Mild' campaign appropriately conveyed what matters most: vaccines' ability to turn severe, potentially deadly disease cases into manageable, mild illnesses—reducing hospitalizations, complications, and deaths. Replacing this messaging with uncontextualized risk information isn't enhancing informed consent — it's promoting fear and hesitancy.
The Expanding Measles Threat
Measles is making a dangerous comeback. The Kentucky Department of Health confirmed its first case since 2023 in an adult who recently traveled internationally. While contagious, the individual visited a Planet Fitness gym, potentially exposing others—a not-so-subtle reminder that wiping down equipment is more than just good manners.
This case adds to outbreaks in nine states, including Texas, New Mexico, Alaska, Georgia, New Jersey, New York, and Rhode Island. The most severe remains in West Texas’ Gaines County, where nearly 14% of schoolchildren have religious exemptions from required vaccinations.
On February 26, an unvaccinated child in that Texas community became the first U.S. measles fatality since 2015 and the first pediatric death since 2003. Before vaccines, measles killed 400 to 500 Americans annually.
These outbreaks are particularly tragic given that the MMR vaccine is exceptionally safe and effective. Two doses provide 97% protection against a disease that, without vaccination, would infect nearly every child by age 15. Among 10,000 measles cases, 10 to 30 children will die, 2,000 will require hospitalization, and over 1,500 will suffer serious complications, some with lifelong consequences.
By contrast, severe vaccine side effects are extraordinarily rare—fewer than four in 10,000 people experience fever-related seizures, blood clotting issues, or allergic reactions. As beloved children’s author Roald Dahl wrote after losing his daughter Olivia to measles encephalitis in 1962: "I think it is almost a crime to allow your child to go unimmunized."
Roald Dahl and the open letter he wrote in 1986, encouraging parents to vaccinate their children against measles. (Credit: Ronald Dumont/Daily Express/Getty Images)
Declining Vaccination Rates
Vaccination rates for measles and other preventable diseases have been trending downward, creating dangerous gaps in community protection. According to research from the Center for American Progress, kindergarten MMR vaccination rates have fallen below the critical 95% threshold needed for herd immunity. Since the 2019-20 school year, coverage has dropped from 95% to approximately 93% nationwide, leaving over 250,000 children vulnerable to infection.
This decline is even more concerning at the state level. Thirty-nine states saw vaccination rates fall below the 95% threshold in the 2023-24 school year, an increase from 28 states during the 2019-20 school year. Overall, less than 93% of kindergarten children were up to date on their state-required vaccines in 2023-24, compared with 95% four years earlier.
COVID-19 and influenza vaccination rates show similar concerning trends. According to the CDC's vaccination tracking data, only 23.1% of adults have received the 2024-25 COVID vaccine, while 45.3% have received the seasonal flu vaccine. For adults 65 and older, these rates are somewhat higher but still insufficient – 44.4% for COVID and 70.2% for flu.
A 2022 modeling study estimated that over 9.1 million children (13.1%) in the United States are currently susceptible to measles infection. If pandemic-level vaccination declines persist without catch-up efforts, that number could rise to over 15 million children (21.7%), significantly increasing the risk of larger and more frequent outbreaks.
When Vaccines Become Political Identifiers
Vaccine-preventable diseases disproportionately impact vulnerable communities. Flu vaccination rates vary significantly by race, with 49% of White adults vaccinated, compared to 42% of Black adults and 35% of Hispanic adults. These disparities stem from access barriers, medical mistrust, and inconsistent provider recommendations.
The politicization of vaccines exacerbates these challenges. Support for school vaccine mandates has dropped from 82% in 2019 to 70% in 2023, driven by a sharp decline among Republicans (79% to 57%), while Democratic support remains stable at 85-88%. Similar trends appear among White evangelical Protestants, where support for school vaccine requirements fell from 77% to 58%. This geographic clustering of under-vaccinated populations fuels outbreaks—exactly what’s unfolding in West Texas.
Partisan divides extend beyond COVID-19. Republicans report lower annual flu vaccination rates than Democrats (41% vs. 56%), and among those fully vaccinated against COVID-19, Democrats are nearly three times as likely to have received a recent booster (32% vs. 12%). Vaccine hesitancy also correlates with education levels, further compounding risks in communities with both lower socioeconomic status and conservative political leanings.
Addressing these disparities requires public health strategies that acknowledge political polarization while working beyond it. Culturally tailored messaging, trusted community voices, and policies that eliminate access barriers are essential to counteract the social and ideological forces shaping vaccine decisions today.
State-Level Assaults: Louisiana's Ban on Vaccine Promotion
Federal attacks on vaccine policy are now playing out at the state level. In February 2025, the Louisiana Department of Health announced it would no longer promote mass vaccination through health fairs or media campaigns—a directive from Surgeon General Dr. Ralph Abraham that drew immediate backlash from the medical community.
Nine state medical organizations, including the Louisiana State Medical Society, issued a joint letter condemning the move: "Immunizations should not be politicized. Healthcare should not be politicized. Public health should not be politicized. Your relationship with your physician should not be politicized."
Dr. Vincent Shaw, president of the Louisiana Academy of Family Physicians, called the opposition unprecedented and warned that halting vaccine promotion could bring back diseases he's "only seen in textbooks, like measles and rubella." Meanwhile, Abraham has misrepresented his credentials, falsely identifying as a board-certified family medicine physician—raising serious concerns about the expertise guiding public health policy.
The consequences are already surfacing. Dr. Mikki Bouquet, a Baton Rouge pediatrician, reports growing parental skepticism about routine vaccinations. "Now parents are asking which vaccines are really necessary. That's absurd—it’s like asking which vitamin matters most. You need them all."
Even Republican Senator Bill Cassidy, despite voting to confirm RFK Jr. as HHS Secretary, has criticized the policy, warning that cutting vaccine outreach ignores the reality of parents' lives.
This shift underscores a troubling trend: political ideology overriding evidence-based public health, with the most vulnerable populations poised to suffer the consequences.
The Fight for Evidence-Based Solutions
This past week has marked a dangerous escalation of political interference in public health. The cancellation of vaccine advisory meetings, the halting of innovative vaccine development, and the downplaying of a deadly measles outbreak signal a fundamental shift away from science-based policy.
Healthcare professionals can no longer afford to stay on the sidelines. Beyond their clinical roles, they must become active policy advocates by:
Contacting state and federal representatives to oppose policies that undermine vaccination
Engaging with professional organizations to develop unified advocacy efforts
Providing expert testimony at legislative hearings on vaccine-related bills
Writing op-eds and speaking to media about vaccine safety and efficacy
Countering misinformation as trusted community voices
Supporting candidates who prioritize evidence-based public health policies
Medical organizations must also wield their influence more effectively. The recent joint statement from nine Louisiana medical groups demonstrates the power of unified action, while hospital systems—often major employers—hold political capital that should be used to safeguard public health infrastructure.
Community advocates play a critical role, too. Parents, faith leaders, and business owners can amplify vaccine messaging and reinforce public health norms. Even conservatives who support science-based medicine must speak out. As Senator Bill Cassidy’s rebuke of Louisiana’s vaccine policy shows, principled advocacy can transcend partisan divides when children's health is at stake.
The choice is clear: we either defend decades of vaccination progress or risk a return to the preventable suffering of the pre-vaccine era. Healthcare providers willing to advocate beyond clinic walls will determine which path we take.