Vaccine misinformation pushed by Secretary of Health and Human Services Robert F. Kennedy Jr. could put American lives at risk. (Eric Harkleroad/KFF Health News)

President Donald Trump’s administrations have been notorious for an array of “alternative facts” — ranging from the relatively minor (the size of inaugural crowds) to threats to U.S. democracy, such as who really won the 2020 election.

And over the past six months, the stakes have been life or death: Trump’s health officials have been endorsing alternative facts in science to impose policies that contradict modern medical knowledge.

It is an undeniable fact — true science — that vaccines have been miraculous in preventing terrible diseases from polio to tetanus to measles. Numerous studies have shown they do not cause autism. That is accepted by the scientific community.

Yet Secretary of Health and Human Services Robert F. Kennedy Jr., who has no medical background or scientific training, doesn’t believe all that. The consequences of such misinformation have already been deadly.

For decades, the vast majority Americans willingly got their shots — even if a significant slice of parents had misgivings. A 2015 survey found that 25% of parents believed that the measles, mumps, and rubella (MMR) vaccine could cause autism. (A 1998 study that suggested the connection has been thoroughly discredited.) Despite that concern, just 2% of children entering kindergarten were exempted from vaccinations for religious or philosophical objections. Kids got their shots.

But more recently, poor government science communication and online purveyors of misinformation have tilled the soil for alternative facts to grow like weeds. In the 2024-25 school year, rates of full vaccination for those entering kindergarten dropped to just over 92%. In more than a dozen states, the rate was under 90%, and in Idaho it was under 80%. And now we have a stream of measles cases, more than 1,300 from a disease declared extinct in the U.S. a quarter-century ago.

It’s easy to see how both push and pull factors led to the acceptance of bad science on vaccines.

The number of recommended vaccines has ballooned this century, overwhelming patients and parents. That is, in large part, because the clinical science of vaccinology has boomed (that’s good). And in part because vaccines, which historically sold for pennies, now often sell for hundreds of dollars, becoming a source of big profits for drugmakers.

In 1986, a typical child was recommended to receive 11 vaccine doses — seven injections and four oral. Today, that number has risen to between 50 and 54 doses by age 18.

The Advisory Committee on Immunization Practices, which renders judgments on vaccines, makes a scientific risk-benefit assessment: that the harm of getting the disease is greater than the risk of side effects. That does not mean that all vaccines are equally effective, and health officials have done a lackluster job of fostering public understanding of that fact.

Older vaccines — think polio and measles — are essentially 100% effective; diseases that parents dreaded were wiped off the map. Many newer vaccines, though recommended and useful (and often heavily advertised), don’t carry the same emotional or medical punch.

Parents of the current generation haven’t experienced how sick a child could be with measles or whooping cough, also called pertussis. Mothers didn’t really worry about hepatitis B, a virus generally transmitted through sex or intravenous drug use, infecting their child.

That lack of understanding spawned skeptics. For example, since 2010, the vaccine for influenza, which had been around for decades, has been recommended annually for all Americans at least 6 months old. In the 2024-25 season, the rate of flu vaccination was only between 36% and 54% in adults; in other years, it has been lower than that. “I got the flu vaccine, and I still got the flu” has been a common refrain of skeptics.

“Pre-covid, there were people who took everything but flu,” said Rupali Limaye, an associate professor at Johns Hopkins University’s Bloomberg School of Public Health, who studies vaccine demand and acceptance. “Then it became everything but covid. Now it’s everything — including MMR and polio.”

Even as the first Trump administration’s Operation Warp Speed helped develop covid vaccines, conservative media outlets created doubts that the shots were needed: doubts that mRNA technology had been sufficiently tested; doubts that covid-19 was bad enough to merit a shot; concerns that the vaccines could cause infertility or autism.

Trump did little to correct these dangerous misperceptions and got booed by supporters when he said that he’d been vaccinated. Once vaccine mandates came into play, Trump strongly opposed them, reframing belief in the vaccine as a question of personal liberty. And if the government couldn’t mandate the covid shot for school, it followed that officials shouldn’t — couldn’t — mandate others.

Thus 100 years of research proving the virtues of vaccination got dropped into a stew of alternative facts. You were either pro- or anti-vaccine, and that signaled your politics. Suddenly, the anti-vax crowd was not a small fringe of liberal parents, but a much larger group of conservative stalwarts who believed that being forced to vaccinate their kids to enter school violated their individual rights.

Even within the Trump administration, there have been some who (at least partly) decried the trend. While Marty Makary, the Food and Drug Administration commissioner, defended Kennedy’s decision to roll back the recommendation that all Americans get annual covid boosters — saying the benefits were unproven — he noted it should not be a signal to stop taking other shots.

As “public trust in vaccination in general has declined,” he wrote, the reluctance to vaccinate had harmed “vital immunization programs such as that for measles–mumps–rubella (MMR) vaccination, which has been clearly established as safe and highly effective.”

Nonetheless, Makary’s boss, Kennedy, continued to promote bad science about vaccines broadly, even as he sometimes grudgingly acknowledged their utility in cases like a measles outbreak. He has funded new research on the already disproven link between MMR shots and autism. He has halted $500 million in grants for developing vaccines using mRNA technology, the novel production method used for the first covid vaccines and a technique scientists believe holds great promise for preventing deaths from other infectious diseases.

In my 10 years practicing as a physician, I never saw a case of measles. Now there are cases in 40 states. More than 150 people have been hospitalized, and three, all unvaccinated, have died.

Alternative facts have formed what David Scales, a physician and sociologist at Weill Cornell Medical College who studies misinformation, calls “an unhealthy information system.” It is an alternative scientific universe in which too many Americans live. And some die.

This story can be republished for free (details).

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

In this photo illustration, a pharmacist holds a COVID-19 vaccine. States and clinicians are working on getting correct information on vaccines to vulnerable groups amid shifting federal guidance. (Photo illustration by Joe Raedle/Getty Images)

Heading into the respiratory illness season, states and clinicians are working to encourage pregnant patients to get COVID-19 vaccinations, even though the U.S. Department of Health and Human Services no longer recommends that they should.

Along with being older and having an underlying health condition, pregnancy itself is a risk factor. Pregnant women are more vulnerable to developing severe illness from COVID-19. They’re also at high risk for complications, including preterm labor and stillbirth. The vast majority of medical experts say getting the shot is safe and effective — much safer than having the illness.

But HHS Secretary Robert F. Kennedy Jr. announced in May that the agency would no longer recommend that pregnant women get the vaccine. Before testifying before Congress in June, Kennedy circulated a document on Capitol Hill claiming higher rates of fetal loss after vaccination. But the authors of those studies told Politico that their work had been misinterpreted.

Experts say the federal shift puts the onus on state health agencies to ramp up vaccine guidance and outreach. Clinicians and public health organizations are trying to dispel misinformation and make sure information reaches low-income people and people of color, who had higher maternal death rates during the pandemic. During the first two years of the pandemic, the virus contributed to a quarter of maternal deaths, according to federal data.

“We are severely disappointed,” said Dr. Neil Silverman, a professor of clinical obstetrics and gynecology at the University of California, Los Angeles David Geffen School of Medicine. He has studied vaccines and pregnancy for the past 15 years and specializes in high-risk pregnancies.

Silverman called the federal shift a “public health tragedy on a grand scale.”

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Vaccinations against COVID-19 help prevent severe illness in pregnant people as well as their newborns, who are too young to get vaccinated, Silverman said. In what’s called passive immunity, vaccinated mothers pass on antibodies to their babies through the placenta and through breast milk.

“State public health agencies are probably going to have to implement vaccine guidance that differs from the federal recommendations. And that’s going to be an interesting can of worms,” said OB-GYN Dr. Mark Turrentine, a professor of obstetrics and gynecology at the Baylor College of Medicine in Texas.

Turrentine serves on a board of the American College of Obstetricians and Gynecologists that focuses on immunization and infectious diseases. He said his recent pregnant patients who had COVID-19 hadn’t gotten the vaccine.

“The change in guidance on the federal level just really makes a lot of confusion, and it makes it very challenging to try to explain to individuals why all of a sudden the difference,” Turrentine said.

A slew of public health organizations have been making a concerted effort to dispel vaccine myths. They include the Society for Maternal-Fetal Medicine, a Washington, D.C.-based nonprofit organization of maternal-fetal experts. At a news briefing the society held this month, clinicians stressed the safety and long-standing science behind COVID-19 vaccines, as well as the shots for RSV and the flu. Cases of RSV and the flu tend to peak in the winter months, while in recent years COVID-19 cases have spiked in the summer and the winter.

Dr. Brenna Hughes, an OB-GYN who chairs the organization’s infectious diseases and emerging threats committee, pointed to survey data from the federal Centers for Disease Control and Prevention showing that less than a third of eligible pregnant patients received COVID-19 shots, and only 38% received RSV shots for the 2023 to 2024 season. Less than half — 47% — received flu shots, and 59% received TDAP (whooping cough) vaccines.

CDC data shows that for last year’s and this year’s season, only between 12% and 14% of pregnant patients got the COVID-19 vaccine.

“The complications from the infection are so much greater than the complications and the very few and typically minor adverse events that might occur from the vaccine,” said microbiologist Sabra Klein, a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.

In June, the American College of Obstetricians and Gynecologists and 30 other professional health organizations signed a letter urging insurers to continue covering the COVID-19 shot for pregnant women, and have continued to urge coverage since then.

CVS Caremark, one of the nation’s three major pharmacy benefit managers, told Stateline it will continue covering the vaccine for pregnant women. The Arizona, California and North Carolina state Medicaid agencies also told Stateline they are still currently covering COVID-19 vaccines for pregnant women.

Doulas, midwives and lawmakers challenge erasure of Black women in maternal health care

Dr. Kimberly Fortner, president-elect of the Infectious Diseases Society for Obstetrics and Gynecology, said during the maternal-fetal medicine briefing that she hopes medical groups’ joint messaging will bolster insurers.

“Hopefully by us linking arms, that can then help develop consistency so that insurers will continue to pay for the vaccine,” she said.

Exacerbating disparities

Dr. Ayanna Bennett, director of the District of Columbia Department of Health, said the federal government’s new stance has upended “a system that’s been stable for a very long time.”

Bennett said her agency used federal pandemic aid to shore up vaccine outreach efforts to communities of color. Now that flow of money is ending.

The changes in federal guidance and funding will “almost certainly exacerbate” maternal health disparities, said Marie Thoma, a perinatal epidemiologist and an associate professor in the University of Maryland Department of Family Science who researches pregnancy and COVID-19.

Black and Indigenous women died at higher rates. The virus exacerbated existing racial disparities in maternal health — and created new ones: Latina mothers, who generally see low rates of maternal mortality, saw deaths surge to 28 per 100,000 in 2021. Their rate was about 12 per 100,000 in 2018, according to federal data.

“We are going in with some exposure already that we didn’t have during the start of the pandemic. So, there will be some protection, but now that will erode,” said Thoma. “If we’re not getting vaccines, or if people are hesitant to take them, we could see some increase.”

Silverman said the administration’s efforts to strip mentions of race from government policies makes it difficult for institutions to reach populations at greatest risk. He called the dismissal of decades of data “saddening and infuriating.”

“The politicization of the vaccine process, or access to it, is what concerns me the most,” said Dr. Yvette Martas, a Connecticut OB-GYN who chairs the board of directors of the Hispanic Health Council.

Many women “are trying to navigate an economic system that’s not always in their favor in terms of also providing access to the kind of educational material that they need,” she said.

Not just COVID-19

In June, Kennedy ousted all 17 members of the CDC’s vaccine advisory committee, replacing them with some members who are vaccine skeptics.

The change is creating chaos. Some states have vaccine laws, such as mandates for kids and coverage statutes, that are specifically tied to the committee’s decisions.

The Vaccine Integrity Project at the University of Minnesota called on frontline health workers, health officials and professional societies to “counter the spread of inaccurate and confusing vaccine information.”

At a news briefing this month held by the Association of State and Territorial Health Officials, representatives from Alabama, Connecticut and Washington, D.C., said they will continue to recommend vaccines.

Alabama’s state health officer, Dr. Scott Harris, said clinicians will be instrumental in getting correct vaccination information to patients.

“We don’t think that we necessarily have the same authoritative voice that we might have had a decade ago in trying to guide people in what to do, but we do believe that people trust their health care providers in most cases and are certainly willing to listen to them,” he said at the briefing.

Bennett said she is hopeful that strong, consistent messaging from respected medical organizations will help combat confusion.

“Having established groups like the American Academy of Pediatrics or the American College of Obstetrics and Gynecology make very firm recommendations that keep us essentially not changed from where we have been, I think, should reassure families,” she said.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

Susan Monarez, President Donald Trump’s nominee to be the director of the Centers for Disease Control and Prevention, testifies during her confirmation hearing before the Senate Committee on Health, Education, Labor, and Pensions on June 25, 2025. (Photo by Kayla Bartkowski/Getty Images)

WASHINGTON — The U.S. Senate voted to confirm Susan Monarez as director of the Centers for Disease Control and Prevention on Tuesday.

Monarez — whom the Senate confirmed on a party-line vote, 51-47 — will now be responsible for the national public health agency within the Department of Health and Human Services. The Atlanta-based agency has faced backlash as HHS Secretary Robert F. Kennedy Jr. pursues a vaccine-skeptical agenda.

GOP Sens. Bill Hagerty of Tennessee and Dan Sullivan of Alaska did not vote.

Monarez was the acting director of the CDC between January and March. She previously served as the deputy director of the Advanced Research Projects Agency for Health, which is part of HHS.

Monarez, who has a Ph.D. in microbiology and immunology, will be the first person without a medical degree to hold the title since 1953.

The White House originally selected former Florida U.S. Rep. Dave Weldon to lead the CDC but withdrew the nomination in March.

Monarez’s confirmation followed a procedural vote earlier Tuesday that saw her advance, 52-47, along party lines.

Kennedy continues to face scrutiny after he fired all 17 members of the Advisory Committee on Immunization Practices, or ACIP, in June and named eight new members — a number of whom are viewed as skeptical of vaccines.

Vermont independent Sen. Bernie Sanders, ranking member of the Senate Committee on Health, Education, Labor and Pensions, launched an investigation alongside seven Democratic members of the committee Tuesday regarding Kennedy’s firings and replacements within the critical vaccine panel.

“By removing all 17 of ACIP’s members and replacing them with eight individuals handpicked to advance your anti-vaccine agenda, you have put decades of non-partisan, science-backed work — and, as a result, Americans’ lives — at risk,” the senators wrote in a letter to Kennedy.

Those seven Democratic committee members include Sens. John Hickenlooper of Colorado, Lisa Blunt Rochester of Delaware, Angela Alsobrooks of Maryland, Ed Markey of Massachusetts, Maggie Hassan of New Hampshire, Andy Kim of New Jersey and Tim Kaine of Virginia. 

A medical worker prepares to vaccinate people at a pop-up COVID-19 vaccination clinic in a rural Delta community in April 2021 in Leland, Miss. The Mississippi State Department of Health, like other state health departments, is concerned about the potential loss of federal funding. (Photo by Spencer Platt/Getty Images)

Between 2016 and 2022, as congenital syphilis cases rose nationally and especially in the South, Mississippi saw a one thousand percent increase — from 10 to 110 — in the number of newborn babies who were hospitalized after contracting the disease, known to cause developmental issues, intellectual disabilities, and even death.

So in 2023, the state Department of Health mandated that all medical practitioners screen for the disease in pregnant mothers, and it has been running advertisements to spread awareness.

Annual congenital syphilis cases in Mississippi rose from 62 in 2021 to 132 in 2023, according to state data. The number fell to 114 last year. There have been 33 cases so far this year.

That work won’t stop despite potential budget cuts, Dr. Daniel Edney, Mississippi’s state health officer, said in an interview. “We’re going to keep doing what we have to do, you know, to keep it under control.”

State by state, public health departments take a similar approach: They monitor, treat and try to stem preventable diseases, alongside their host of other duties. But in the coming year, health department officials — with their agencies already strapped for cash — fear they’ll find it much more difficult to do their jobs.

President Donald Trump’s budget proposal for fiscal year 2026 would cut the federal Centers for Disease Control and Prevention budget by more than half, from $9.3 billion to $4.2 billion. The proposal serves as a wish list from the administration, a blueprint for the Republican-controlled Congress as it works through upcoming spending legislation.

If lawmakers hew to Trump’s vision, then state and county public health departments would be hit hard. States contribute to their own health departments, but a lot of them rely heavily on federal funding.

And around half of local public health department funding comes from federal sources, primarily the CDC, as noted in a 2022 report from the National Association of County & City Health Officials.

Medicaid cuts are likely to worsen mental health care in rural America

“The federal government provides a lot of funding, but the actual implementation of public health programs happens at the state and local level,” said Josh Michaud, associate director of global health policy at KFF, a health policy research group. “Each state has its own approach, in many ways, to how public health programs are overseen, how they’re funded, how they are implemented.”

In announcing his department’s share of the proposed budget, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. said Trump’s goals align with “new priorities in reversing the chronic disease epidemic.”

But many local health leaders point to the longtime mission of state public health departments in preventing the spread of disease.

“Local public health is on the front lines preventing communicable disease, operating programs to prevent chronic disease, ensuring our septic and well water systems are safe,” said Dr. Kelly Kimple, acting director of North Carolina’s Division of Public Health within the Department of Health and Human Services.

“I’m very concerned,” Kimple said, “especially given the magnitude of funding that we’re talking about, as we can’t keep doing more with less.”

Clawing back COVID-era grants

Other federal budget cuts also have states worried.

Many state public health departments grew alarmed when the Trump administration announced in March that it would be clawing back $11.4 billion in COVID-era funding for grants that were slated to extend into 2026.

Twenty-three states and the District of Columbia sued. A federal district court in Rhode Island temporarily blocked the cuts, and the case remains tied up in court.

The court’s preliminary injunction may not protect temporary staff or contractors, though. Public health departments have been laying off staff, cutting lab capacity and reducing immunization clinics, said Dr. Susan Kansagra, chief medical officer for the Association of State and Territorial Health Officials.

Historically, public health departments receive funding in “boom and bust” cycles, meaning they tend to get more federal support during emergencies, said Michaud, of KFF. But “since the Great Recession of 2008, there was a general decline in public health support funding until the COVID pandemic.”

For example, KHN and The Associated Press reported that between 2010 and 2019, spending on state public health departments declined by 16% per capita and spending for local health departments fell by 18%.

Nationally, syphilis cases reached historic lows in the 2000s, thanks to robust prevention efforts and education from public health officials. By 2022, however, cases reached their highest numbers nationally since the 1950s.

“In the wake of the COVID emergency, you’ve seen a sort of backlash to what people had been calling the overreach of public health and imposing vaccination requirements and lockdowns and other public health measures,” Michaud told Stateline.

Smallpox, cholera and typhoid

Public health departments and officials go back to the 19th century, when there was a greater emphasis on sanitation efforts to prevent spread of diseases such as smallpox, cholera and typhoid, which were rampant at the time.

By the end of the century, 40 states had established health departments, which to this day are responsible for water sanitation, tracking the spread of disease, administering vaccinations, furnishing health education, providing screenings for infants and some prenatal care for moms at local clinics, offering family planning services, and tracking and treating sexually transmitted infections, among other things.

Kimple pointed to measles as a current example of a disease that’s spreading fast. When North Carolina’s health department detected a case in the state, she said, the department “identified and contacted everyone who might have been exposed, helped people get tested, worked with doctors to make sure they knew how to respond.”

That’s the legacy of local public health, Michaud said.

“The federal government cannot decide, ‘This public health program will happen in this state, but not that state,’ that kind of thing. And cannot declare a national lockdown. The COVID pandemic tested a lot of those boundaries. It really is a state and local responsibility to protect public health. And that’s always been the case, since the beginning of our country,” Michaud said.

“And what we’re seeing now is a complete upheaval of the funding going into public health.”

A major cut in services

Kimple said she’s seen recent progress in her state in the support for funding public health.

“North Carolinians viewed our work as highly important to improving health and well-being in the state, and appreciated the local presence, the reliable information, the role in prevention and efforts to protect, in particular, vulnerable communities,” she said.

Similarly, Edney said that Mississippi state lawmakers were showing more support, despite some setbacks in 2016 and 2017. New federal cuts could throw a wrench in the health department’s economic plans and its ability to reach small communities.

“Now the federal rug is being pulled out from under us,” he said.

Edney said he expects the federal share of his department’s public health funding to fall from its current 65% to around 50%.

Edney said he’s been trying to strengthen Mississippi health department’s longevity by diversifying its revenue streams by, for example, accepting private donations.

The state will not stop doing its “core” work, he said, regardless of federal funding.

“We’re not going to cut back on services at the county health department, because what we do now is all mission critical,” Edney said.

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

Susan Monarez, President Donald Trump’s nominee to be the director of the Centers for Disease Control and Prevention, testifies during her confirmation hearing before the Senate Committee on Health, Education, Labor, and Pensions in the Dirksen Senate Office Building on June 25, 2025 in Washington, D.C. (Photo by Kayla Bartkowski/Getty Images)

WASHINGTON — President Donald Trump’s candidate to lead the Centers for Disease Control and Prevention advanced out of a Senate committee Wednesday following a party-line vote, moving her one step closer to confirmation.

Susan Monarez’s nomination now goes to the floor, where she will likely secure the backing needed to officially take on the role of CDC director after garnering support from Republicans across the political spectrum during the committee’s 12-11 vote.

Senate Majority Leader John Thune, R-S.D., will be in charge of scheduling that vote, though if it isn’t held during the next few weeks, Monarez will have to wait until after the chamber’s August recess.

Chairman Bill Cassidy, R-La., said during the Health, Education, Labor and Pensions Committee’s markup he believes Monarez is a strong candidate for CDC director and that he hopes she will help get the nation’s ongoing measles outbreak under control.

“The United States needs a CDC director who makes decisions rooted in science, a leader who will reform the agency and work to restore public trust in health institutions,” Cassidy said. “With decades of proven experience as a public health official, Dr. Monarez is ready to take on this challenge.”

Sanders criticizes Monarez on vaccine safety

Every Republican senator on the committee, including Maine’s Susan Collins and Alaska’s Lisa Murkowski, voted to advance Monarez’s nomination.

Vermont independent Sen. Bernie Sanders, ranking member on the panel, opposed Monarez’s advancement along with the Democrats on the committee.

Sanders argued that during Monarez’s time as acting director of the CDC, she didn’t do enough to counter Secretary of Health and Human Services Robert F. Kennedy Jr., especially on the safety of vaccines. 

“Today, the United States is reporting the highest number of measles cases in 33 years,” Sanders said. “In my view, we need a CDC director who will defend science, protect public health and repudiate Secretary Kennedy’s dangerous conspiracy theories about safe and effective vaccines that have saved, over the years, millions of lives.”

Second CDC choice from Trump

Monarez testified before the Health, Education, Labor and Pensions Committee in June, a standard part of the confirmation process.

Trump originally selected former Florida U.S. Rep. Dave Weldon to run the Atlanta-based CDC shortly after he secured election to the Oval Office in November. But the White House pulled Weldon’s nomination in March, after it appeared he couldn’t secure the votes needed for confirmation.

Later that month, Trump announced his plans to nominate Monarez in a social media post.

“Dr. Monarez brings decades of experience championing Innovation, Transparency, and strong Public Health Systems,” Trump wrote. “She has a Ph.D. from the University of Wisconsin, and PostDoctoral training in Microbiology and Immunology at Stanford University School of Medicine.

“As an incredible mother and dedicated public servant, Dr. Monarez understands the importance of protecting our children, our communities, and our future. Americans have lost confidence in the CDC due to political bias and disastrous mismanagement. Dr. Monarez will work closely with our GREAT Secretary of Health and Human Services, Robert Kennedy Jr. Together, they will prioritize Accountability, High Standards, and Disease Prevention to finally address the Chronic Disease Epidemic and, MAKE AMERICA HEALTHY AGAIN!”

Susan Monarez, President Donald Trump’s nominee to be the director of the Centers for Disease Control and Prevention, testifies during her confirmation hearing before the U.S. Senate Committee on Health, Education, Labor, and Pensions on June 25, 2025. (Photo by Kayla Bartkowski/Getty Images)

WASHINGTON — Members of the U.S. Senate Committee on Health, Education, Labor and Pensions pressed President Donald Trump’s nominee to lead the Centers for Disease Control and Prevention about vaccine recommendations Wednesday after the Health and Human Services secretary fired members of a critical vaccine panel this month.

Trump’s pick, former acting CDC Director Susan Monarez, said that she trusted vaccines while defending HHS Secretary Robert F. Kennedy Jr.’s decision this month — widely seen as part of a vaccine-skeptical agenda — to fire all 17 members of the Advisory Committee on Immunization Practices, or ACIP, and recommend eight new members.

“Part of the secretary’s vision in restoring public trust is making sure that the American people can be confident in the way the evidence and science is driving decision-making,” she told senators.

The panel’s seven members — one dropped out this week — will meet Wednesday and Thursday to review data and vote on new vaccine recommendations. The recommendations carry significant weight as insurance providers and federal health programs like Medicaid use them to determine if shots are covered and schools rely on them for immunization mandates.

Cassidy questions

Louisiana Sen. Bill Cassidy, who chairs the committee, said he was concerned about ACIP, especially as a non-CDC staff member is scheduled to give a presentation to the committee about thimerosal, a mercury-based preservative. The panel is expected to vote on approving flu shots that contain the compound.

Lyn Redwood, the former head of Children’s Health Defense, the anti-vaccine group that Kennedy founded, is giving the presentation arguing that thimerosal causes autism. The CDC’s own research shows that thimerosal does not cause autism. 

Cassidy said that while Monarez had no part in this week’s ACIP meeting, or the agenda, he said that “if the ACIP hearing today is being used to sow distrust, I would ask that going forward, that you would make sure that there really was a balanced perspective.”

“Yes, someone can speak as a critic, but there should be someone who is reviewing the overwhelming evidence of the safety of vaccines,” Cassidy, who is a physician, said.

Monarez, who was the agency’s acting director from January to March, said that she trusted vaccines and that immunization was important to save lives.

If Monarez is confirmed by the Senate, she would be the first director of the CDC without a medical degree in nearly 70 years. She has a Ph.D. in microbiology and immunology.

More concerns about vaccine panel

Cassidy was not the only Republican on the panel concerned about the firing of all the members of ACIP.

Alaska Republican Sen. Lisa Murkowski said she was concerned about the backgrounds of the seven new panelists.

“I would hope that one of the things that you would all be looking into is to make sure that these individuals are going to be looking at the science in front of them, (and) leave their political bias at home,” Murkowski said.

Democratic Sens. Patty Murray of Washington state and Angela Alsobrooks of Maryland also pressed Monarez about Kennedy’s actions to fire everyone on the panel.

Murray asked Monarez if the new members of the panel voted to not recommend vaccines, if she would listen to that recommendation.

Monarez sidestepped the question and said the roles at ACIP were difficult to fill and that members needed to pass an ethics process.

“If they have not gone through an ethics approval process they shouldn’t be participating in the meetings,” she said.

Alsobrooks asked Monarez if she believed the 17 members fired from ACIP lacked qualifications.

Monarez did not answer the question, but said Kennedy’s reasoning for “resetting the ACIP to a new cohort was going to be on the path of restoring public trust.”

Grant funding and layoffs

Senators also raised concerns about grants that had been canceled, even though Congress already approved the funds.

Maine GOP Sen. Susan Collins, who is the chairwoman of the Senate Committee on Appropriations, said that her state is suffering from a high level of Lyme disease and as a result a vaccine was in the works at a research institute in Maine.

“This vaccine is very promising and I want to make sure that it is allowed to continue to its conclusion,” Collins said.

Monarez agreed and said if she is confirmed, she will specifically work to make sure funding for that vaccine continues.

“It’s ironic that our dogs can get a vaccine to protect them against tick-borne illnesses like Lyme disease but we humans can’t and I hope we can remedy that,” Collins said.

Sen. Tim Kaine, Democrat of Virginia, pressed Monarez about the elimination of the Office on Smoking and Health at the CDC. He asked if she was involved in laying off all the staff in April, the month after her brief stint as acting director ended.

“I had no participation in (the layoffs) after I left,” she said.

Fluoride in water

Alsobrooks pressed Monarez about Kennedy’s push to have the CDC stop recommending that low levels of fluoride be placed in public drinking water.

Fluoride is added in drinking water to help prevent cavities, tooth decay and other dental health issues.

Alsobrooks asked Monarez, who is her constituent, if the public water supply that contains fluoride in Potomac, Maryland, where Monarez lives, was safe to drink.

“I believe the water in Potomac, Maryland, is safe,” Monarez said. 

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Since January, Milwaukee has been dealing with dangerous levels of lead dust in some public schools, resulting in nine school closures.

On Tuesday, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. told a Senate committee there was a federal “team” in the city from the CDC’s Childhood Lead Poisoning Prevention Program — though the positions were cut in April.

“We are continuing to fund the program in Milwaukee, we have a team in Milwaukee, we’re giving laboratory support to the analytics in Milwaukee, and we’re working with the health department in Milwaukee,” Kennedy said when questioned by Sen. Jack Reed, a Rhode Island Democrat, during a hearing before the Senate Committee on Appropriations.

The Milwaukee Health Department disputed Kennedy’s statement.

“There is no team from HHS or CDC in Milwaukee assisting with the MPS lead hazard response,” department spokesperson Caroline Reinwald wrote in an email.

Kennedy has previously suggested the childhood lead program would be reinstated and told U.S. Sen. Tammy Baldwin last week that lead poisoning in children is an “extremely significant” concern. Reed had asked Kennedy about the program’s fate in light of those comments.

“If the secretary had information that hasn’t been proffered to myself or my team yet, I would welcome, again, continued support from the CDC,” said Milwaukee Health Commissioner Mike Totoraitis on Wednesday.

“Admittedly, I was wondering if they potentially got stuck in traffic in Chicago and didn’t make it to Milwaukee,” he said of Kennedy’s statements about a “team.”

Federal experts were part of Milwaukee’s lead crisis response

Childhood lead poisoning experts from the CDC communicated with the Milwaukee Health Department at the start of the city’s school lead crisis, Totoraitis told WPR.

“They validated our concerns about the testing results that we were finding in the schools,” he said.

He said federal experts recommended school closures as a response, which the city’s health department had originally avoided, not wanting to disrupt learning.

“But given the significant threat of permanent brain damage from lead poisoning, we had to rely on our federal partners to make that decision,” Totoraitis said.

In March, the city requested that a CDC Epi-Aid team come to Milwaukee, hoping to beef up the city’s school lead crisis response.

But in early April, Totoraitis learned that the experts who would’ve managed that team had been laid off. His request was denied.

The team would’ve expanded the city’s testing capacity, he said, and could’ve used its lead specialization to detect trends city officials wouldn’t catch.

But even without a special team, losing the ability to remotely consult CDC experts had an impact. Totoraitis said they had helped his department make investigation plans for lead-contaminated schools and do “epidemiological, long-term digging” into where kids are getting poisoned.

“Those are the parts that are really lacking now,” Totoraitis said.

After the layoffs, one CDC expert offered to help the city as a volunteer, he said.

Totoraitis said the city might contract with some of the laid-off staff members directly. “We’re really hopeful that I can secure the funding, through one of our grants, to bring some of these former CDC staff on in June,” he said.

But he stressed that his department already has a “really robust” lead poisoning program, handling about 1,000 cases a year.

“We’re continuing our work with or without federal resources,” the Milwaukee Health Department’s Reinwald said.

One CDC laboratory specialist visited Milwaukee

One of Kennedy’s claims was that “we’re giving laboratory support to the analytics in Milwaukee.”

In response to a question from WPR about Kennedy’s contention that a team is working on the issue in the city, a spokesperson from the Department of Health and Human Services said the CDC was assisting on laboratory testing.

“At the request of the Milwaukee Health Department Laboratory (MHDL), CDC is assisting with validating new lab instrumentation used for environmental lead testing. Staff from MHDL are focused on the lead response and other routine testing while CDC will assist with testing validation, laboratory quality management, and regulatory requirement documentation to onboard the new laboratory instrument,” the spokesperson said in an email.

According to Reinwald, a CDC laboratory specialist visited the city for two weeks in May to help the health department set up a new machine.

The machine processes lead samples from across the city — including those related to the school lead crisis.

But that visit was planned before the school lead crisis started, Totoraitis said. He said the city had already been expanding its lead-testing capacity before the crisis.

The lab specialist was “requested independently of the MPS situation,” Reinwald said, and served a “narrow technical role specific to onboarding the equipment.”

“It’s a single person,” Totoraitis said. “I know the secretary had said a team was in Milwaukee helping us, but I don’t know who he’s referring to.”

This story was originally published by WPR.

RFK Jr. claims federal ‘team’ is in Milwaukee for school lead crisis; city says there isn’t is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.