Kennedy is expected to create a task force to recommend possible federal action, according to a former agency official, an internal agency memo obtained by KFF Health News, and a consultant who says he helped with the memo. 

“HHS does not comment on future or potential policy decisions and task forces,” agency spokesperson Emily Hilliard said by email. 

The plans show how rumors and conspiracy theories can gain an air of legitimacy under the Trump administration, where researchers say that unscientific ideas have unusual power to take hold and shape public health policy. 

The concept posits that airplane vapor trails are really “chemtrails” that harm public health. Another version alleges planes or devices are being deployed by the federal government, private companies, or researchers to trigger big weather changes, such as hurricanes, or to alter the Earth’s climate, emitting hazardous chemicals in the process. 

HHS is expected to appoint a special government employee to investigate climate and weather control, according to Gray Delany, former head of the department’s Make America Healthy Again agenda. He said he drafted the internal agency memo. HHS has interviewed applicants to lead a “chemtrails” task force, said Jim Lee, a blogger focused on weather and climate who Delany said helped edit the memo, which Lee confirmed. 

Delany, who was ousted in August from HHS, said Kennedy has expressed strong interest in chemtrails. The memo alleges that “aerosolized heavy metals such as Aluminum, Barium, and Strontium, as well as other materials such as sulfuric acid precursors, are sprayed into the atmosphere under the auspices of combatting global warming,” through a process of stratospheric aerosol injection. 

“That is a pretty shocking memo,” said Daniel Swain, a climate scientist at the University of California. “It doesn’t get more tinfoil hat. They really believe toxins are being sprayed.” 

Deploying chemtrails to poison people is just one of many baseless conspiracy theories that have found traction among Trump administration health policy officials led by Kennedy, a longtime anti-vaccine activist before entering politics who embraces a range of such ideas. 

In April, Kennedy was asked on “Dr. Phil Primetime” about chemicals being sprayed into the stratosphere to change the Earth’s climate. “It’s done, we think, by DARPA,” Kennedy said, referring to a Department of Defense agency that develops emerging technology for the military’s use. “And a lot of it now is coming out of the jet fuel. Those materials are put in jet fuel. I’m going to do everything in my power to stop it. We’re bringing on somebody who’s going to think only about that.” 

DARPA officials didn’t return a message seeking comment.

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He shared his concern with reporters, acknowledging it sounded a little like “The X Files,” a science fiction television show.

Academics cite Wallace’s story as one of the catalysts behind a fringe concept that has spread among adherents to the Make America Healthy Again, or MAHA, movement and is gaining traction at the highest levels of the federal government. Its treatment as a serious issue underscores that under President Donald Trump, unscientific ideas have unusual power to take hold and shape public health policy.

The concept posits that airplane vapor trails, or contrails, are really “chemtrails” containing toxic substances that poison people and the terrain. Another version alleges planes or devices are being deployed by the federal government, private companies, or researchers to trigger big weather changes, such as hurricanes, or to alter the Earth’s climate, emitting hazardous chemicals in the process.

Several GOP lawmakers and leaders in the Trump administration remain convinced the concepts are legitimate, though scientists have sought to discredit such claims.

Health and Human Services Secretary Robert F. Kennedy Jr. is planning to investigate climate and weather control, and is expected to create a task force that will recommend possible federal action, according to a former agency official, an internal agency memo obtained by KFF Health News, and a consultant who helped with the memo.

The plans, along with comments by top GOP lawmakers, show how rumors and conspiracy theories can gain an air of legitimacy due to social media and a political climate infused with falsehoods, some political scientists and researchers say.

“When we have low access to information or low trust in our sources of information, a lot of times we turn to our peer groups, the groups we are members of and we define ourselves by,” said Timothy Tangherlini, a folklorist and professor of information at the University of California-Berkeley. He added that the government’s investigation of conspiracy theories “gives the impression of having some authoritative element.”

HHS is expected to appoint a special government employee to investigate climate and weather control, according to Gray Delany, former head of the agency’s MAHA agenda, who said he drafted the memo. The agency has interviewed applicants to lead a “chemtrails” task force, said Jim Lee, a blogger focused on weather and climate who Delany said helped edit the memo, which Lee confirmed.

“HHS does not comment on future or potential policy decisions and task forces,” agency spokesperson Emily Hilliard said in an email.

The memo alleges that “aerosolized heavy metals such as Aluminum, Barium, and Strontium, as well as other materials such as sulfuric acid precursors, are sprayed into the atmosphere under the auspices of combatting global warming,” through a process of stratospheric aerosol injection, or SAI.

“There are serious concerns SAI spraying is leading to increased heavy metal content in the atmosphere,” the memo states.

The memo claims, without providing evidence, that the substances cause elevated heavy-metal content in the atmosphere, soil, and waterways, and that aluminum is a toxic product used in SAI linked to dementia, attention-deficit/hyperactivity disorder, asthma-like illnesses, and other chronic illnesses. The July 14 memo was addressed to White House health adviser Calley Means, who didn’t respond to a voicemail left by a reporter seeking comment.

High-level federal government officials are presenting false claims as facts without evidence and referring to events that not only haven’t occurred but, in many cases, are physically impossible, said Daniel Swain, a climate scientist at the University of California.

“That is a pretty shocking memo,” he said. “It doesn’t get more tinfoil hat. They really believe toxins are being sprayed.”

Kennedy has previously promoted debunked chemtrail theories. This spring, he was asked on “Dr. Phil Primetime” about chemicals being sprayed into the stratosphere to change the Earth’s climate.

“It’s done, we think, by DARPA,” Kennedy said, referring to a Department of Defense agency that develops emerging technology for the military’s use. “And a lot of it now is coming out of the jet fuel. Those materials are put in jet fuel. I’m going to do everything in my power to stop it. We’re bringing on somebody who’s going to think only about that.”

DARPA officials didn’t return a message seeking comment.

Federal Messaging

Deploying chemtrails to poison people is just one of many baseless conspiracy theories that have found traction among Trump administration health policy officials led by Kennedy, a longtime anti-vaccine activist before entering politics. He continues to promote a supposed link between vaccines and autism, as well as make statements connecting fluoride in drinking water to arthritis, bone fractures, thyroid disease, and cancer. The World Health Organization says fluoride is safe when used as recommended.

Delany, who was ousted in August from HHS, said Kennedy has expressed strong interest in chemtrails.

“This is an issue that really matters to MAHA,” said Delany, referring to the informal movement associated with Kennedy that is composed of people who are skeptical of evidence-based medicine.

The memo also alleges that “suspicious weather events have been occurring and have increased awareness of the issue to the public, some of which have been acknowledged to have been caused by geoengineering activities, such as the flooding in Dubai in 2024.” Geoengineering refers to intentional large-scale efforts to change the climate to counteract global warming.

“It is unconscionable that anyone should be allowed to spray known neurotoxins and environmental toxins over our nation’s citizens, their land, food and water supplies,” Delany’s memo states.

Scientists, meteorologists, and other branches of the federal government say these assertions are largely incorrect. Some points in the memo are accurate, including concerns that commercial aircraft contribute to acid rain.

But critics say the memo builds on kernels of truth before veering into unscientific fringe theories. Efforts to control the weather are being made, largely by states and local governments seeking to combat droughts, but the results are modest and highly localized. It isn’t possible to manipulate large-scale weather events, scientists say.

Severe flooding in the United Arab Emirates in 2024 couldn’t have been caused by weather manipulation because no technology could create that kind of rainfall event, Maarten Ambaum, a meteorologist at the University of Reading who studies Gulf region rainfall patterns, said in a statement on the floods. Similar debunked claims emerged this year after central Texas experienced devastating floods.

The Government Accountability Office concluded in a 2024 report that questions remain as to the effectiveness of weather modification.

Research into changing the climate has been conducted, including work by one private company that engaged in field tests. Still, federal agencies say no ongoing or large-scale projects are underway. Study of the concept remains in the research phase. The Environmental Protection Agency says there are no large-scale or government efforts to affect the Earth’s climate.

“Solar geoengineering is not occurring via direct delivery by commercial aircraft and is not associated with aviation contrails,” the agency says on its website.

Widespread Misinformation

Misperceptions about weather, climate control, and airplane contrails extend beyond the Trump administration, scientists said.

In September, a congressional House committee hearing titled “Playing God With the Weather — A Disastrous Forecast” involved two hours of debate on the once-fringe idea. Rep. Marjorie Taylor Greene (R-Ga.), who chaired the hearing, has introduced legislation to ban weather and climate control, with a fine of up to $100,000 and up to five years in prison.

Some Democrats objected to the nature of the discussion. Rep. Melanie Stansbury (D-N.M.) accused Greene of using “the platform of Congress to proffer anti-science theories, to platform climate denialism.”

Frequently citing chemtrails, GOP lawmakers have introduced legislation in about two dozen states to ban weather modification or geoengineering. Florida passed a bill to establish an online portal so residents can report alleged violations.

“The Free State of Florida means freedom from governments or private actors unilaterally applying chemicals or geoengineering to people or public spaces,” GOP Florida Gov. Ron DeSantis said in a press statement this spring.

Meanwhile, the chemtrail conspiracy has permeated popular culture. The title track on singer Lana Del Ray’s seventh studio album is entitled “Chemtrails Over the Country Club.” Bill Maher dove into the chemtrail myth on his podcast “Club Random,” saying, “This is nuts. It’s just nuts.” And “Chemtrails,” a psychological thriller, wrapped filming in July.

Social media has given wing to the chemtrails concept and other fringe ideas involving public health. They include an outlandish belief that Anthony Fauci, who advised both Trump and President Joe Biden on the government response to the covid-19 pandemic, created the AIDS epidemic. There is no evidence of such a link, public health leaders say.

Researchers say another false belief by those on the far right holds that people who received covid vaccines could shed the virus, causing infertility in the unvaccinated. There is no evidence of such a connection, scientists and researchers say.

More severe weather events due to global warming may be driving some of the baseless theories, scientists say. And risks occur when such ideas take hold among the general population or policymakers, some public health leaders say. Climate researchers, including Swain, say they’ve received death threats.

Lee, the blogger, said he disagrees with some of the more far-fetched beliefs and is aware of the harm they can cause.

“There are people wanting to shoot down planes because they think they are chemtrails,” said Lee, adding that some believers are afraid to venture outside when plane vapor trails are visible overhead.

There is also no evidence that plane contrails cause health problems or are related to intentional efforts to control the climate, according to the EPA and other scientists.

The memo and focus at HHS on climate and weather control are alarming because they perpetuate conspiracies, said David Keith, a professor of geophysical sciences at the University of Chicago.

“It’s unmoored to reality,” he said. “I expected there were documents like this, but seeing it in print is nevertheless shocking. Our government is being driven by nonsensical dreck from dark corners of social media.”

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The shutdown centered largely on a disagreement over the Obama-era health law. Democrats want a further extension of enhanced subsidies that reduce ACA health insurance premiums, but GOP lawmakers insist any debate wait until after a budget deal is reached to keep the federal government afloat. 

With the sides far apart, federal funding ran out at midnight Oct. 1 after Congress failed to pass even a stopgap budget. The issue now is how long the deadlock will continue. 

In a KFF poll released today, more than three-quarters — 78% — of the public say they want Congress to extend the enhanced tax credits available to people with low and moderate incomes. That includes more than half of Republicans and “Make America Great Again” supporters. The poll was conducted just prior to the Oct. 1 shutdown. 

The Department of Health and Human Services has said it expects to furlough about 40% of its workforce, which has already been downsized by about 20,000 positions under the Trump administration. Across the federal government, roughly 750,000 employees will be furloughed, according to an estimate by the Congressional Budget Office. While they won’t be working, those employees will get back pay for their missed compensation, totaling about $400 million daily, the CBO estimated. 

The two parties are blaming each other. 

“We’re not going to simply go along to get along with a Republican bill that continues to gut the health care of everyday Americans,” House Minority Leader Hakeem Jeffries said of pressure to reach a budget deal. 

Republicans, meanwhile, have blasted Democrats for holding up funding over the subsidies and say any deal will require concessions. 

“If there were some extension of the existing policy, I think it would have to come with some reforms,” Senate Majority Leader John Thune said Sept. 26. 

In the KFF poll, people supportive of an extension said the blame, if the effort fails, would fall mostly on President Donald Trump (39%) and Republicans in Congress (37%). A smaller share, 22%, say congressional Democrats would deserve the most blame. A Washington Post poll out Thursday also found people were more likely to blame congressional Republicans and the White House. 

Several Republicans have expressed interest in extending the subsidies. Within days, ACA enrollees are expected to get notices from their insurers advising them of steeper premiums.

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Federal funding ran out at midnight on Oct. 1, after Congress failed to pass even a stopgap budget while negotiations continued.

Now the question is how long the deadlock will last, with Democrats pitted against Republicans and a presidential administration that has broken with constitutional norms and regularly used political intimidation and primary threats to achieve its ends. Because Republicans hold only a slim majority in the Senate, any deal will need to attract at least a few Democratic votes.

Ramifications from a shutdown on public health systems and health programs will be felt far beyond Washington, D.C., halting almost all of the federal government’s nonessential functions, including many operations related to public health.

Even on Sept. 30, as the clock ticked toward midnight, President Donald Trump renewed threats about mass firings of federal workers if Democrats didn’t acquiesce to GOP demands. Some people worry that such workforce reductions would further enable the administration to undermine federal government operations and reduce the budget impasse to what’s been described as three-dimensional chess or a game of chicken.

Such threats to fire, rather than temporarily suspend, federal workers are “unprecedented,” said G. William Hoagland of the Bipartisan Policy Center. The lack of negotiations between Capitol Hill Republicans and Democrats in advance of the shutdown is also unprecedented in his experience, said Hoagland, a longtime GOP Senate Budget Committee aide.

The stalemate centers largely on health coverage, with Democrats and Republicans clashing over the Affordable Care Act and Medicaid cuts. For Americans with ACA marketplace plans, government subsidies cap the percentage of household income they must pay toward premiums. Lawmakers expanded the subsidies in 2021 and extended that additional help through the end of 2025, and the looming expiration of those expanded subsidies would increase costs and reduce eligibility for assistance for millions of enrollees.

Democrats want a further extension of the subsidies, but many GOP lawmakers are resistant to extending them as is and say that debate must wait until after a budget deal to keep the federal government afloat. Antagonism has grown, with the parties in a pitched battle to convince voters the other party is to blame for the government’s closure.

Said Senate Minority Leader Chuck Schumer on the Senate floor Sept. 30: “Republicans have chosen the losing side of the health care debate, because they’re trying to take away people’s health care; they’re going to let people’s premiums rise.”

But Senate Majority Leader John Thune accused Democrats of attempting to “take government funding hostage.”

The longer a shutdown lasts, the more impacts could be felt. For example, some community health centers would be at risk of closure as their federal funding dries up.

Long-term projects by the Federal Emergency Management Agency to reduce damage from future natural disasters will stop, for example. Rescue services at national parks that stay open will be limited. And at the National Institutes of Health, many new patients awaiting access to experimental treatments may not be admitted to its clinical center.

Entitlement programs such as Medicaid and Medicare will continue, as will operations at the Indian Health Service. But disease surveillance, support from the Centers for Disease Control and Prevention to local and state health departments, and funding for health programs will all be hampered, based on federal health agencies’ contingency plans.

The Department of Health and Human Services is expected to furlough about 40% of its workforce, which has already been downsized by about 20,000 positions under the Trump administration. Across the federal government, roughly 750,000 employees will be furloughed, according to an estimate released Sept. 30 by the Congressional Budget Office, a nonpartisan agency that calculates the cost of legislation. While furloughed employees won’t be working, eventually they will get back pay, totaling about $400 million daily, the CBO estimated.

At HHS, research is expected to pause on the links between drug prices and the Inflation Reduction Act, the major law enacted under former President Joe Biden to boost the economy. Despite reports that Food and Drug Administration Commissioner Marty Makary said the FDA would basically be untouched, the agency won’t accept new drug applications and food safety efforts will be reduced. Federal oversight of a program that helps hospitals save lives and evacuate individuals in environmental crises is expected to stop.

Fewer federal staff will be available to provide help to Medicaid and Medicare enrollees. CDC responses to inquiries about public health matters will be suspended. And the work of a federal vaccine injury program is also anticipated to stop.

Congressional Democrats insist the ACA subsidies must be renewed now because enrollment for the Obama-era health program opens on Nov. 1. Without the extended subsidies, health insurers are warning of double-digit premium hikes for millions of enrollees.

House Democratic Leader Hakeem Jeffries has argued that a “Republican-caused health care crisis” is hanging over Americans as a result of Trump’s new tax-and-spending bill, which adds restrictions to Medicaid that are expected to kick millions off the program. Republicans have also advanced mass layoffs and funding cuts at the nation’s health department and caused widespread confusion over access to some vaccines.

“We’re not going to simply go along to get along with a Republican bill that continues to gut the health care of everyday Americans,” Jeffries told reporters Sept. 29. “These people have been trying to repeal and displace people off the Affordable Care Act since 2010.”

Republicans, meanwhile, have blasted Democrats for holding up funding over the subsidies and say any deal will require concessions.

“If there were some extension of the existing policy, I think it would have to come with some reforms,” Thune, the Senate Republican leader, said Sept. 26.

Such a deal may involve changes to a policy that caps what consumers have to pay for ACA marketplace plans at 8.5% of their income, no matter how much they earn. It could also alter their ability to obtain plans with no premiums, an option that became more widely available because of the beefed-up subsidies.

Adding restrictions to the ACA subsidies is likely to decrease enrollment in the program, which saw declines during the first Trump administration and did not reach 20 million for the first time until last year, a milestone reached in large part due to the subsidies.

Several Republicans have expressed interest in extending the subsidies, including a group of GOP representatives who proposed legislation to do so last month.

Democrats may be betting that the timing of the shutdown will put pressure on their Republican colleagues to come to the negotiation table on the ACA subsidies.

Within days of the government’s closure, ACA enrollees are expected to get notices from their health insurers advising them of steeper premiums. Insurers have said the expiring subsidies have forced those large premium hikes because the healthiest and youngest people are more likely to opt out of coverage when prices go up.

The White House, meanwhile, ramped up its pressure campaign on Democrats. White House press secretary Karoline Leavitt insisted Sept. 29 that Trump wants to keep the government open.

“Our most vulnerable in our society and our country will be impacted by a government shutdown,” she said.

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The leadership upheavals, which he says will restore trust in federal health agencies, have shaken the confidence many states have in the CDC and led to the fracturing of a national, cohesive immunization policy that’s endured for three decades.

States and medical societies that long worked in concert with the CDC are breaking with federal recommendations, saying they no longer have faith in them amid the turmoil and Kennedy’s criticism of vaccines. Roughly seven months after Kennedy’s nomination was confirmed, they’re rushing to draft or release their own vaccine recommendations, while new groups are forming to issue immunization guidance and advice.

How the new system will work is still being hammered out. Vaccine recommendations from states, medical societies, and other groups are likely to diverge, creating dueling guidance and requirements. Schoolchildren in New York may still generally need immunizations, for example, while others in places such as Florida may not need many vaccines.

There are potential financial ramifications too, because historically, private insurers, Medicaid, and Medicare have generally covered only vaccines recommended by the federal government. If the CDC and its advisory group, which began a two-day meeting Sept. 18 in Atlanta, stop recommending certain vaccines, hundreds of millions of people could wind up paying for shots that previously cost them nothing. Some states are already taking steps to prevent that from happening, which means where people live could determine if they will face costs.

“You’re seeing a proliferation of recommendations, and the recommendations by everybody are different from the CDC,” said Michael Osterholm, a University of Minnesota epidemiologist who launched an ad hoc group that provides vaccine guidance. “States and medical societies are basing their recommendations on science. The recommendations out of CDC are magic, smoke, and mirrors.”

Kennedy has defended changes at the CDC and the revamping of the vaccine committee as necessary, saying previous advisory panel members had conflicts of interest and agency leadership botched its pandemic response.

The CDC is “the most corrupt agency at HHS, and maybe the government,” Kennedy said at a Sept. 4 Senate committee hearing. Susan Monarez, the ousted CDC director, testified Sept. 17 at another Senate hearing about how Kennedy told her to preapprove vaccine recommendations from the advisory panel or be fired.

Kennedy has said HHS also plans to investigate vaccine injuries he says are not thoroughly tracked or investigated. The CDC investigates injuries that are reported by providers or patients, but Kennedy has said he wants to recast the entire program. The Food and Drug Administration is already looking into cases of children who died following covid-19 vaccination.

HHS didn’t return an email seeking comment.

The actions by states, medical societies, and other groups reflect a mounting lack of confidence in federal leadership, public health leaders say, and the break from the CDC is happening at a rapid clip.

The Democratic governors of California, Hawaii, Oregon, and Washington — fashioning themselves as the West Coast Health Alliance — are coordinating to develop vaccine recommendations that won’t necessarily follow those from the CDC. The governors said in a joint statement that the CDC shake-up has “impaired the agency’s capacity to prepare the nation for respiratory virus season and other public health challenges” and this week issued 2025-26 guidance for vaccination against viruses such as covid, influenza, and respiratory syncytial virus.

A group of northeastern states are exploring a similar collaborative.

“The worst thing that could happen is that we have 50 different recommendations for the covid vaccine. That will destroy public health,” said Massachusetts Public Health Commissioner Robbie Goldstein, who has been involved with the effort. He’s also spoken with leaders of the West Coast alliance. “I’m really hopeful that we do come together in larger and larger collaboratives with the same recommendations or very similar recommendations,” he said while speaking to a group of reporters this month.

And medical societies such as the American Academy of Pediatrics are releasing covid vaccine recommendations that diverge for the first time from the CDC’s guidance.

Some states are seizing on the split to ensure access to shots. Massachusetts is requiring insurers to cover vaccines recommended by the state health department rather than paying only for those suggested by the CDC, making it the first state to guarantee such continued coverage. AHIP, a trade group representing insurers, said on Sept. 16 that health plans will cover immunizations, including updated formulations of covid and flu vaccines, that were recommended by the CDC panel as of Sept. 1 with no cost sharing through the end of 2026.

Pennsylvania is allowing pharmacists to give covid vaccines even if they’re not recommended by the federal agency. Instead, they can follow recommendations from the pediatric academy and other medical groups.

Florida, meanwhile, plans to drop requirements for schoolchildren to get immunizations against chickenpox, meningitis, hepatitis B, and some other diseases. State lawmakers would need to take action to end mandates for all vaccines.

Joseph Ladapo, the state’s surgeon general, said in a Sept. 3 press conference that any vaccine requirement is wrong and “drips with disdain and slavery.”

Some doctors criticize the decision as a dangerous step backward.

“This is a terrifying decision that puts our children’s lives at risk,” said Richard Besser, former acting director of the CDC, in an emailed statement.

The first school vaccine mandate was rolled out in the 1850s in Massachusetts, for smallpox. While all states have vaccine requirements for schoolchildren, immunization rates for kindergarten students declined while cases of vaccine-preventable measles and whooping cough surged in 2024 and 2025.

Rochelle Walensky, the Biden administration’s first CDC director, warned of the “polarization” of state-by-state approaches. “It’s like your head is in the oven and your feet are in the freezer and, on average, we’re at 95% vaccination. That doesn’t work in measles — every place has to be at 95% vaccination.” She was referring to the proportion of a population that needs to be vaccinated to provide herd immunity.

Kennedy’s actions have thrust vaccines center stage and made him fodder for comedy. The Marsh Family, a British musical group, released a parody on Sept. 7 of Paul Simon’s “Me and Julio Down by the Schoolyard,” with the chorus, “We’ll see measles and polio down in the schoolyard.”

HBO comedian Bill Maher said the CDC could be known by the title “Disease” during a recent episode of his show. And Stephen Colbert used his monologue on “The Late Show with Stephen Colbert” to weigh in on the revamped vaccine advisory group, calling its new members the “crème de la cuckoo.”

President Donald Trump has defended Kennedy, telling reporters “he means very well,” even as Trump said on Sept. 5 that “you have some vaccines that are so amazing.” Trump has repeatedly expressed pride in Operation Warp Speed, a government initiative during Trump’s previous administration that rapidly developed covid vaccines. But he’s also promoted a discredited theory linking vaccines and autism.

The White House did not respond to a request for comment.

The Trump administration already narrowed recommendations for the covid vaccine despite no new safety risks with the shots, although medical societies are continuing to recommend them for most people. The gulf is expected to widen as the agency’s advisory group reviews whether to change its guidance on a number of pediatric vaccines.

Other groups are also trying to provide vaccine and public health guidance, driven in part by concerns that Kennedy and other federal health leaders will make policy decisions and statements not grounded in science. Kennedy has promoted claims that aluminum, used in many vaccines, is linked to allergies, despite a lack of evidence for the claims. A Danish study, in fact, found aluminum was not linked to chronic disease, but Kennedy said the study’s supplemental data indicated it caused harm. The journal that published the study defended the findings.

Current and former CDC and HHS staffers, along with public health academics and retired health officials, have formed the National Public Health Coalition, a nonprofit to endorse recommendations and provide guidance on policy issues. They plan to partner with state and local health departments.

“A real benefit of the National Public Health Coalition is we are made up of current and former CDC and HHS folks, people who have deep knowledge of what government programs for public health look like, and what improvements are needed,” said Abigail Tighe, the group’s executive director.

Another new group is Grandparents for Vaccines, which bills itself as a volunteer-led effort to raise awareness about vaccines. And the Vaccine Integrity Project was launched in April by the University of Minnesota’s infectious disease center, to review evidence for medical societies on the safety and effectiveness of vaccines.

“We’re going to continue to help wherever we can to address misinformation,” said Osterholm, the center’s leader.

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Hasta este año.

El plan de la administración Trump de retirar más de $550 millones en fondos federales para salud pública y pandemias en Texas hizo que se cancelara el evento, justo antes de su inicio programado para el 21 de julio.

“Hay personas que vienen todos los años y dependen de este evento”, dijo Dairen Sarmiento Rangel, directora del Departamento de Salud y Servicios Humanos del condado de Hidalgo. “Algunas personas incluso acampan afuera de Operación Salud Fronteriza para ser las primeras en recibir servicios. Este evento es muy importante para nuestra comunidad”.

Los gobiernos estatales y locales ya han tenido que hacer dolorosos recortes a sus programas, luego de importantes reducciones en la financiación federal para salud que ya han entrado en vigor. Ahora, se preparan para enfrentar los golpes financieros que están por venir —algunos no ocurrirán hasta finales del próximo año o incluso después— como resultado de la ley fiscal y de gasto aprobada por los republicanos en el Congreso en julio, conocida como la One Big Beautiful Bill, que pone en marcha gran parte de la agenda nacional del presidente Donald Trump.

Texas, por ejemplo, anticipa una reducción de hasta $39.000 millones en fondos federales para Medicaid durante los próximos 10 años debido a nuevas barreras para la inscripción, como revisiones de elegibilidad más frecuentes, según un análisis publicado en julio por KFF.

En conjunto, estas reducciones representan un cambio radical en la forma en que se financian y se ofrecen los programas estatales de salud. En la práctica, la administración está trasladando una parte importante de los costos de salud a los estados. Esto obligará a sus líderes a tomar decisiones difíciles, ya que muchos presupuestos estatales ya están presionados por la disminución en la recaudación de impuestos, la desaceleración del gasto federal por covid y la incertidumbre económica.

Más de una docena de estados han bajado sus proyecciones de ingresos para el año próximo, según un informe publicado en junio por Pew.

“Es casi inevitable que los estados recorten varios servicios de salud debido a la presión fiscal”, dijo Wesley Tharpe, asesor principal en política fiscal estatal del Centro para Prioridades Presupuestarias y Políticas (CBPP), una organización de tendencia progresista.

Algunos estados tratan de suavizar el impacto de forma proactiva.

En Hawaii, los legisladores se han propuesto ayudar a organizaciones sin fines de lucro que ya enfrentan disminución en fondos federales. Repartirán $50 millones en subvenciones a organizaciones de salud, servicios sociales y otras que hayan sufrido recortes. Para acceder a los fondos, deben demostrar que su financiación fue eliminada, reducida o afectada por los recortes.

“No es justo que organizaciones dedicadas a ayudar al pueblo de Hawaii se vean obligadas a reducir sus servicios por los recortes federales”, declaró el gobernador demócrata Josh Green en un comunicado.

Otros estados recortan proyectos para enfrentar la situación.

El gobernador de Delaware, Matt Meyer, demócrata, supo en marzo que la administración Trump retiraría $38 millones en fondos de salud pública al estado. Como consecuencia, un mes después, los líderes legislativos estatales frenaron un proyecto para renovar y ampliar el complejo del Capitolio estatal.

“Reconocimos que los recortes federales irresponsables a la red de protección social de miles de habitantes de Delaware nos obligaban a ahorrar recursos para proteger a los más vulnerables”, dijo David Sokola, presidente temporal del Senado estatal.

En Nuevo México, el estado con el mayor porcentaje de residentes inscritos en Medicaid, un grupo bipartidista de legisladores votó a favor de crear un fondo fiduciario para reforzar el financiamiento del programa. Según algunas estimaciones, aproximadamente el 10% de los más de 800.000 residentes que están cubiertos por Medicaid y el Programa de Seguro Médico para Niños (CHIP, en inglés) podrían perder su cobertura bajo esta nueva ley federal.

Algunos líderes estatales advierten a sus comunidades que lo peor está por venir.

En un evento realizado el 18 de agosto en un hospital del sur del Bronx, en la ciudad de Nueva York, la gobernadora demócrata Kathy Hochul subió al escenario junto a trabajadores de salud para criticar la nueva ley de Trump.

“Lo que los republicanos en Washington han hecho con la ‘Ley Más Horrible’ que he visto es, literalmente, perjudicar a los neoyorquinos”, dijo. El sistema de salud del estado se prepara para enfrentar recortes cercanos a los $13.000 millones al año.

En California, los legisladores analizaron el impacto de los recortes en una audiencia del comité de la Asamblea General el 20 de agosto, donde algunos legisladores demócratas señalaron que programas estatales como los de salud reproductiva estaban en peligro.

“Nos hemos preparado para esta realidad: la llamada ‘Big Beautiful Bill’ del presidente Trump ahora es ley”, dijo el legislador demócrata Gregg Hart durante la audiencia, calificándola como “un ataque directo a los programas fundamentales de California y a nuestros valores”.

“Lamentablemente, la realidad es que el estado no tiene la capacidad para compensar todos estos recortes federales draconianos con el presupuesto actual”, agregó. “No podemos simplemente firmar un cheque y hacer que esto desaparezca”.

La radical ley presupuestaria, que fue aprobada sin apoyo demócrata, reducirá el gasto federal en Medicaid en aproximadamen $1.000 millones durante la próxima década, según estimaciones de la Oficina de Presupuesto del Congreso (CBO). Las reducciones en el gasto vienen en gran medida de la imposición de un requisito laboral para las personas que obtuvieron Medicaid con la expansión promovida por la Ley de Cuidado de Salud a Bajo Precio (ACA), además de otras nuevas barreras para acceder a la cobertura.

Según la CBO, más de 7,5 millones de personas perderán la cobertura de Medicaid y quedarán sin seguro, mientras se extienden recortes fiscales para personas ricas que, según los demócratas, no los necesitan.

Por su parte, los republicanos y el presidente Trump afirman que el paquete fiscal y los recortes en los programas son necesarios para evitar el fraude y el despilfarro, y para garantizar la sostenibilidad de Medicaid, un programa federal-estatal que brinda cobertura a personas con discapacidades y de bajos ingresos.

“La One Big Beautiful Bill elimina a los inmigrantes ilegales, aplica requisitos laborales y protege a Medicaid para los verdaderamente vulnerables”, anunció la Casa Blanca en un comunicado del 29 de junio.

Los recortes a Medicaid no comenzarán hasta después de las elecciones legislativas de mitad de mandato en noviembre de 2026, pero ya se han aplicado otros recortes.

La administración Trump ha intentado recuperar $11.000 millones en fondos federales de salud pública destinados a los estados durante la pandemia, lo que provocó una batalla legal con una coalición de estados gobernados por demócratas. También recortó unos $1.000 millones en subvenciones federales para servicios de salud mental en las escuelas y detuvo los fondos de los Institutos Nacionales de Salud (NIH) que financiaban a más de 90 universidades públicas.

Un análisis de KFF Health News demuestra que las cancelaciones han afectado a todo el país, sin importar la afiliación política o la ubicación geográfica. De las organizaciones que sufrieron recortes en el primer mes, aproximadamente el 40% se encuentran en estados que Trump ganó en noviembre.

La secretaria de prensa del Departamento de Salud y Servicios Humanos (HHS), Emily Hilliard, dijo que la agencia prioriza las inversiones que respalden el mandato de Trump de enfrentar las enfermedades crónicas. Defendió algunos de los recortes y afirmó, erróneamente, que la nueva ley no reduce Medicaid.

“La pandemia de covid-19 ya terminó, y el HHS no seguirá desperdiciando miles de millones de dólares de los contribuyentes en una crisis que los estadounidenses superaron hace años”, dijo.

Líderes estatales señalan que los fondos federales por la pandemia, que la administración busca recuperar, se habían destinado a otras medidas de salud pública, como la vigilancia de enfermedades emergentes, la respuesta ante brotes y la contratación de personal. En mayo, fiscales estatales ganaron una orden de restricción temporal contra la administración.

“Lo que estamos viendo ahora es que los estados anticipan grandes recortes a Medicaid, pero también enfrentan una serie de recortes federales más pequeños, pero significativos, en programas de salud pública”, dijo Larry Levitt, vicepresidente ejecutivo de políticas de salud en KFF. (KFF Health News es uno de los programas de KFF)

Parte del desafío para los estados es simplemente entender los cambios.

“Creo que es justo decir que hay preocupación, confusión e incertidumbre”, afirmó Kathryn Costanza, experta en Medicaid en la Conferencia Nacional de Legislaturas Estatales.

Los estados intentan entenderlo todo, creando grupos asesores para seguir los cambios federales, presentando demandas para intentar bloquear los recortes y reasignando fondos.

En Colorado, los legisladores aprobaron una ley que permite que fondos estatales de Medicaid se usen para servicios de salud —excluyendo abortos— en clínicas de Planned Parenthood of America, después de que la nueva ley de Trump prohibiera la financiación federal para este tipo de atención. Aún está por verse si esa prohibición se mantiene en los tribunales.

La legislatura de Louisiana asignó $7,5 millones a universidades estatales para compensar los recortes en financiación federal para la investigación, gran parte de ella relacionada con temas de salud.

Y en Dakota del Sur, el banco de alimentos más grande del estado pidió a los legisladores que destinen $3 millones para compensar recortes en fondos del Departamento de Agricultura de Estados Unidos.

Los estados deben equilibrar sus presupuestos cada año, por lo que los recortes ponen en riesgo muchos servicios si los legisladores no están dispuestos a aumentar impuestos. El trabajo comenzará en serio en enero, cuando muchos estados inicien sus nuevas sesiones legislativas.

Y es probable que las decisiones difíciles continúen. Los republicanos en la Cámara de Representantes del Congreso consideran nuevas leyes que podrían traer más recortes, como la reducción al generoso financiamiento federal que actualmente reciben 20 millones de adultos inscritos en Medicaid gracias a la expansión de ACA.

Como resultado, algunos estados revertirán sus expansiones de Medicaid y recortarán aún más programas de salud.

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Until this year. The Trump administration’s plan to strip more than $550 million in federal public health and pandemic funds from Texas helped prompt cancellation of the event just before its scheduled July 21 start.

“Some people come every year and rely on it,” said Hidalgo County Health and Human Services Director Dairen Sarmiento Rangel. “Some people even camp out outside of Border Health so they can be the first in line to receive services. This event is very important to our community.”

States and local governments have made painful program cuts in the wake of major reductions in federal health funding that have already taken effect. Now, they’re sizing up the financial hits to come — some not until late next year or beyond — from the “One Big Beautiful Bill Act,” the tax and spending law congressional Republicans passed in July that enacts much of President Donald Trump’s domestic agenda.

Texas, for instance, expects to see its federal Medicaid funds reduced by as much as $39 billion over 10 years due to new barriers for enrollment, such as more frequent eligibility checks, according to a July analysis by KFF.

Taken together, the reductions amount to a seismic shift in how state health programs are provided and paid for. The administration is, in effect, pushing a significant amount of health costs to states. That will force their leaders to make difficult choices, as many state budgets are already strained by declining tax revenues, a slowdown in federal pandemic spending, and economic uncertainty.

Revenue forecasters in more than a dozen states have lowered expectations for the coming year, according to a June report by Pew.

“It’s almost inevitable that states will enact a number of cuts to health services because of the fiscal pressure,” said Wesley Tharpe, senior adviser for state tax policy at the left-leaning Center on Budget and Policy Priorities.

Some are proactively trying to stanch the impact.

Hawaii lawmakers are looking to aid nonprofits that are already contending with federal funding cuts. They’re doling out $50 million in grants to health, social service, and other nonprofits hit by federal funding cuts. To get the money, nonprofits must show a termination or drop in funding, or that they have otherwise been harmed by the cuts.

“It is not fair that organizations dedicated to supporting the people of Hawaii are being forced to scale back due to federal funding cuts,” Democratic Gov. Josh Green said in a statement.

Other states are scaling back projects to contend with cuts. Delaware Gov. Matt Meyer, a Democrat, received notice in March that the Trump administration was cutting $38 million in public health funding from the state. The next month, state legislative leaders halted a planned project to upgrade and expand the Capitol complex as a result.

“We recognized that the reckless federal cuts to the social safety nets of thousands of Delawareans called for us to hold back resources to protect our most vulnerable,” said David Sokola, president pro tempore of the Delaware Senate.

In New Mexico, the state with the highest percentage of residents enrolled in Medicaid, a bipartisan group of lawmakers voted to create a trust fund to boost funding for the program. About 10% of the more than 800,000 state residents covered by Medicaid and the related Children’s Health Insurance Program could lose their health coverage under the federal spending law, based on some estimates.

Some state leaders are warning constituents that the worst may be yet to come.

At an Aug. 18 event at a hospital in the South Bronx section of New York City, New York Gov. Kathy Hochul, a Democrat, stood on stage among health care workers in white coats to skewer Trump’s new law.

“What Republicans in Washington have done through the ‘Big Ugliest Bill’ I’ve ever seen is literally screwing New Yorkers,” she said. The state’s health system is bracing for nearly $13 billion in annual cuts.

And in California, lawmakers weighed the impact of the coming cuts from the federal law at a general assembly committee hearing on Aug. 20, where some Democratic legislators said state efforts to protect reproductive health services and other programs were in jeopardy.

“We’ve been bracing for this reality: President Trump’s so-called ‘Big, Beautiful Bill’ is now law,” Democratic lawmaker Gregg Hart said at the hearing, calling it a “direct assault on California’s core programs and our values.”

“Sadly, the reality is, the state does not have the capacity to backfill all of these draconian federal funding cuts in the current budget,” Hart said. “We cannot simply write a check and make this go away.”

The sweeping budget law, which passed without any Democratic support, will reduce federal spending on Medicaid by about $1 trillion over the next decade, based on estimates from the Congressional Budget Office. The spending reductions largely come from the imposition of a work requirement on people who’ve obtained Medicaid under the Affordable Care Act’s expansion, as well as other new barriers to coverage.

The law will mean more than 7.5 million people will lose Medicaid coverage and become uninsured, according to the Congressional Budget Office, while extending tax cuts for wealthy people who, Democrats say, don’t need them. Republicans and Trump have said the spending package and its accompanying program cuts were necessary to prevent fraud and waste, and to sustain Medicaid, a state-federal program for people with disabilities and lower incomes.

“The One Big Beautiful Bill removes illegal aliens, enforces work requirements, and protects Medicaid for the truly vulnerable,” the White House said in a June 29 statement.

The Medicaid cuts won’t begin until after the midterm elections in November 2026, but other cuts have already hit.

The Trump administration has sought to claw back $11 billion in federal public health funds earmarked to states because of the pandemic, spurring a legal fight with a coalition of Democratic-led states. It also cut about $1 billion in federal grants for mental health services in schools, and halted grants from the National Institutes of Health that provided money to more than 90 public universities.

HHS press secretary Emily Hilliard said the agency is prioritizing investments that advance Trump’s mandate to confront chronic disease. She defended some of the cuts and said, erroneously, that the spending law doesn’t cut Medicaid.

“The covid-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a crisis that Americans moved on from years ago,” she said.

State leaders say the pandemic funding the administration wants returned was earmarked for other public health measures, such as tracking emerging diseases, outbreak responses, and staffing. State attorneys general in May won a temporary restraining order against the administration.

“What we’re seeing now is states anticipating big cuts in Medicaid coming, but they’re also dealing with a whole variety of federal cutbacks in public health programs that are smaller but still quite meaningful,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes KFF Health News.

Part of the challenge for states is simply understanding the changes.

“I think it’s fair to say there is concern, confusion, and uncertainty,” said Kathryn Costanza, a Medicaid expert at the National Conference of State Legislatures.

States are struggling to sort it all out, forming advisory groups that are tracking federal changes, suing to try to block the cuts, and reallocating funding.

In Colorado, lawmakers passed a bill to let state Medicaid dollars pay for non-abortion care at Planned Parenthood of America clinics after Trump’s law banned federal funding for such care. Whether the ban holds up in court remains to be seen.

The Louisiana Legislature sent $7.5 million to state universities to make up for cuts to federal research funding, much of which goes to health-related research.

And in South Dakota, the state’s largest food bank has asked lawmakers to spend $3 million to make up for funding cuts to the U.S. Department of Agriculture.

States must balance their budgets every year, so cuts put many services at risk if state lawmakers are unwilling to raise taxes. The work will begin in earnest in January, when many states begin new legislative sessions.

And the tough choices are likely to continue. Congressional House Republicans are considering legislation that could bring more cuts, including by slashing the generous cost sharing the federal government provides for 20 million adults who enrolled in Medicaid under the ACA’s Medicaid expansion.

Some states will roll back their Medicaid expansions and cut more health programs as a result.

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Kennedy was called to appear this week before the Senate Finance Committee to discuss these events and other vaccine and public health policy developments. 

Kennedy wants to see the Pfizer and Moderna messenger RNA-based covid-19 vaccines pulled from the market, according to two people familiar with the planning who asked not to be identified because they’re not authorized to speak to the press. 

Kennedy has handpicked a vaccine advisory committee for the CDC that is reviewing mRNA-based covid vaccines, which he falsely claimed in 2021 were “the deadliest vaccine ever made.” The covid vaccine review is being led by Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology who has said without evidence that the shots cause serious harm, including death. If the committee recommends against them, Kennedy and the FDA could then begin the process of removing them from the market. 

Taking mRNA-based covid shots off the market would leave consumers with fewer options for protection. Paxlovid, an antiviral medication that treats the infection in high-risk adults, would be available. 

White House spokesperson Kush Desai said Kennedy and Commissioner of Food and Drugs Marty Makary have reiterated that covid shots will remain available for Americans who need and want them. 

The CDC advisory committee reviewing the covid shots is also probing a long-debunked link between aluminum, used in many childhood immunizations such as those for hepatitis A and pneumonia, and autism or allergies. 

The group’s findings are expected to support the erroneous link, some public health officials say. HHS could then require drugmakers to undertake costly reformulations of the shots or stop manufacturing them altogether. 

“That would set up the elimination of all childhood vaccines,” said Richard Besser, former acting CDC director during the Obama administration. 

Kennedy’s move to put his stamp on the CDC means states that have long relied on the agency’s expertise and help in crises such as disease outbreaks will largely be left to fend for themselves, said Ashish Jha, who served as President Joe Biden’s covid response coordinator from 2022 to 2023. 

“States will struggle with the CDC incapable and dysfunctional,” Jha said. “Our system is not designed for states to go it alone.” 

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Health and Human Services Secretary Robert F. Kennedy Jr.’s push to fire CDC director Susan Monarez is more than an administrative shake-up. The firing marks a major offensive by Kennedy to seize control of the agency and impose an anti-vaccine, anti-science agenda that will have profound effects on the lives and health of all Americans, public health leaders say.

Kennedy wants to see the Pfizer and Moderna messenger RNA-based covid-19 vaccines pulled from the market, according to two people familiar with the planning who asked not to be identified because they’re not authorized to speak to the press. He’s also set his sights on restricting or halting access to some pediatric immunizations, some public health leaders say.

His actions have already reduced federal help to states, creating the potential for more infectious disease outbreaks and incidences of foodborne illness. Some public health leaders say they expect Kennedy will use the CDC to publicize health information that isn’t grounded in science.

“It’s crazy season,” said Richard Besser, former acting CDC director during the Obama administration. “People want information they can trust to make critical decisions about their health. Until now, we’ve been able to say look at the CDC. Unfortunately, we’re not able to do that anymore.”

HHS spokesperson Emily Hilliard disputed the criticism.

“Secretary Kennedy remains firmly committed to delivering on President Trump’s promise to Make America Healthy Again, dismantling the failed status quo that fueled a nationwide chronic disease epidemic and eroded public trust in our public health institutions,” Hilliard said in a statement.

White House spokesperson Kush Desai said Kennedy and Commissioner of Food and Drugs Marty Makary have reiterated that covid shots will remain available for Americans who need and want them.

“The Trump administration is restoring Gold Standard Science as the sole guiding principle of health decision-making,” Desai said in an email. “Only the Fake News could ignore these facts to continue pushing Democrat talking points and hysteria.”

Behind the Ouster

The shake-up began last week, when Kennedy sought to fire Monarez, a microbiologist who’d just been confirmed by the Senate in July. She refused to leave the position, and her lawyers said Kennedy sought to oust her because she wouldn’t fire senior staff or follow unscientific directives. Four top career officials at the CDC resigned on Aug. 27 in protest.

Career staffers at the CDC and some public health groups had hoped President Donald Trump would intervene and put the brakes on Kennedy. Instead, the White House backed Kennedy, saying Monarez was fired.

Trump on Sept. 1 demanded that drug companies show that covid vaccines work, in a further sign he’s not set on defending the shots.

“I hope OPERATION WARP SPEED was as ‘BRILLIANT’ as many say it was. If not, we all want to know about it, and why???” Trump said on Truth Social.

Operation Warp Speed was the initiative that Trump himself announced in 2020 to accelerate the development of covid vaccines, including the Pfizer and Moderna shots. The vaccines have proved safe and effective in multiple clinical trials; a study published in JAMA Health Forum estimated that they saved about 2.5 million lives worldwide.

CDC staffers are worried the agency’s next director won’t fight for science, according to an employee who asked not to be identified for fear of professional retaliation.

Trump’s support for Monarez’s ouster was a watershed moment that signaled there are no checks on Kennedy and his agenda, public health advocates say. Leading congressional Democrats such as Senate Minority Leader Chuck Schumer called for Kennedy’s firing. Hundreds of HHS staffers have also implored Congress to intervene, saying Kennedy threatens science and public health. He is slated to testify Sept. 4 before the Senate Finance Committee.

Kennedy said in a message to CDC staff that his focus is on boosting the agency’s reputation and leadership. The Atlanta-based agency was already reeling after the Trump administration pushed out thousands of its staff and a gunman who reportedly believed the covid vaccine had caused him health problems fired hundreds of rounds at its campus last month, killing a police officer.

“The CDC must once again be the world’s leader in communicable disease prevention. Together, we will restore trust,” Kennedy wrote. “Together, we will rebuild this institution into what it was always meant to be: a guardian of America’s health and security.” He said his deputy, Jim O’Neill, would serve as acting CDC director.

Nine former CDC directors or acting directors who served under both Republicans and Democrats criticized Kennedy in the aftermath of the Monarez firing, saying in an op-ed in The New York Times that the impact on public health is “unacceptable, and it should alarm every American, regardless of political leanings.”

HHS spokesperson Hilliard took exception with this point, listing four covid vaccines that continue to get the nod for use.

However, the Food and Drug Administration last week approved updated covid mRNA boosters only for people 65 or older and others at high risk of complications. The CDC has also stopped recommending the shots for healthy children and pregnant women. Previously, the shots had been advised for anyone 6 months or older.

As a result, many people who don’t meet the criteria but want the vaccine will have to get prescriptions or consult with their doctors. Insurance may not always cover the shots, which can run around $200. Major drugstores such as Walgreens and CVS have said the shots may not be available at all pharmacies and may require a prescription.

The American Academy of Pediatrics on Aug. 19 broke with the administration, recommending that all young children get the covid vaccine. Insurance still may not cover the cost in some cases and parents could face obstacles in getting the vaccines without a prescription.

Next Move: The Advisory Committee

Kennedy and his team changed official covid vaccine recommendations even though there have been no new safety issues. A dose of the 2023-24 covid mRNA vaccine prevented significant illness and death across all age groups, according to a study published in August led by a University of Michigan researcher. The virus killed about 1,000 people a week in the U.S. in mid-January, and cases are rising again and expected to accelerate this winter.

Kennedy has handpicked a vaccine advisory committee for the CDC that is reviewing mRNA-based covid vaccines, which he falsely claimed in 2021 were “the deadliest vaccine ever made.” The covid vaccine review is being led by Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology who has said without evidence that the shots cause serious harm, including death. If the committee recommends against them, Kennedy and the FDA could then begin the process of removing them from the market.

Taking mRNA-based covid shots off the market would leave consumers with fewer options for protection. Paxlovid, an antiviral medication that treats the infection in high-risk adults, would be available.

The CDC advisory committee reviewing the covid shots is also probing a long-debunked link between aluminum, used in many childhood immunizations such as those for hepatitis A and pneumonia, and autism or allergies.

The group’s findings are expected to support the erroneous link, some public health officials say. HHS could then require drugmakers to undertake costly reformulations of the shots or stop manufacturing them altogether.

“That would set up the elimination of all childhood vaccines,” Besser said.

The advisory group’s next meeting is set for Sept. 18, although Sen. Bill Cassidy (R-La.) has called for the meeting to be indefinitely delayed. Cassidy, a physician who chairs the Senate Health, Education, Labor and Pensions Committee, voted for Kennedy’s confirmation as HHS secretary after receiving assurances, he said, that the longtime vaccine opponent wouldn’t disrupt the U.S. vaccination system. Kennedy’s promises, Cassidy said, included that he wouldn’t change the CDC’s Advisory Committee on Immunization Practices.

Kennedy removed all of the panel’s members in June and replaced them with his own appointees, including anti-vaccine activists.

Kennedy’s move to put his stamp on the CDC means states that have long relied on the agency’s expertise and help in crises such as disease outbreaks will largely be left to fend for themselves, said Ashish Jha, who served as President Joe Biden’s covid response coordinator from 2022 to 2023.

“States are going to be left on their own,” Jha said. “States will struggle with the CDC incapable and dysfunctional. Our system is not designed for states to go it alone.”

The CDC typically plays a critical role by assisting states with disease surveillance, public health interventions, and outbreak response, especially when a crisis spills across state lines. An outbreak of measles this year led to more than 1,400 cases nationwide, and states including Texas, where the outbreak was identified, struggled to get help from the CDC.

A CDC program that has long tracked pathogens in food has already reduced the number of hazards it looks for from eight to two, which public health leaders say is making it harder to identify outbreaks. Staff overseeing a CDC program that tracks outdoor pollution that can exacerbate asthma also have been cut.

The agency runs a hotline that doctors around the country can call to get treatment and other types of advice. Under Kennedy’s watch, the CDC has had to pare assistance because of staffing reductions, said Wendy Armstrong, vice president at the Infectious Diseases Society of America.

“Lives are 100% at stake, no question about it,” Armstrong said. “That you can no longer trust the recommendations out of the CDC is just devastating. It’s appalling to think we can’t trust that information is science-based anymore.”

Kennedy wants to shake up CDC leadership because he sees the agency as the heart of corruption and resistance within the federal health bureaucracy, according to people familiar with his planning. Kennedy has said the agency suffers from malaise and bias.

Many public health leaders, however, view the CDC as under siege by an administration they say is corrupting science for its own ends. HHS staffers signed onto a letter that now has more than 6,800 signatures, saying Kennedy is “endangering the nation’s health by repeatedly spreading inaccurate health information.”

Kennedy has also been fending off mounting criticism of his response to the shooting at the CDC’s headquarters. He responded to the attack on social media, hours later, after first posting pictures of himself fly-fishing.

Some younger staffers are considering leaving and some workers feel like the shooting accelerated Kennedy’s overhaul of the agency, the CDC employee said.

With the battle for control of the CDC still raging, public health leaders are now looking to Congress to put the brakes on Kennedy. Some Republican lawmakers have called for a review of Kennedy’s actions.

“These high profile departures will require oversight by the HELP Committee,” Cassidy said Aug. 27 on the social platform X. Cassidy had backed Monarez to lead the agency.

Renuka Rayasam, KFF Health News senior correspondent, and Andy Miller contributed to this article.

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The plan involves expanding the types of injuries eligible for compensation, potentially overwhelming the fund with claims that could bankrupt the program. Other elements of the strategy include a potential mandate that vaccine makers stop using a common additive, forcing them to make expensive reformulations or exit the market altogether. 

The Vaccine Injury Compensation Program has paid out more than $5 billion since its inception in 1988 with funds from a small tax on vaccines. The program was established to compensate patients for injuries while preventing lawsuits that could imperil pharmaceutical companies and vaccine supplies. 

Before filing in court, injured individuals must bring their claims to the program’s nonjury vaccine court to determine what, if any, compensation should be provided. 

To expand the list of eligible injuries, Kennedy is looking to link vaccines to allergies or autism even though no scientific data confirms a connection. HHS has already launched a probe into the causes of autism that is expected to implicate vaccines. 

“Given the rate of autism, if a lot of cases are brought, that could bankrupt the program,” said Dorit Reiss, a professor at University of California Law San Francisco.

Kennedy has weighed having a vaccine advisory group examine aluminum, which is used in some vaccines. In July he linked aluminum to allergies, although a recent study in the Annals of Internal Medicine found no connection. 

Some public health leaders derided the strategy as harmful. 

“It’s a radical agenda,” said Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada. “He’s using a bunch of different mechanisms and there really are no guardrails. People are going to catch on but it’s not going to be enough to stop the waves of deaths, and deaths of children.” 

HHS says Kennedy is not against vaccines. 

“Secretary Kennedy is not anti-vaccine – he is pro-safety, pro-transparency, and pro-accountability,” Vianca Rodriguez Feliciano, an HHS spokesperson, said in an email. 

Kennedy has said he wants to alter the vaccine injury fund, writing July 28 on the social platform X that it is “broken, and I intend to fix it.” HHS is working with the Department of Justice to revamp the program.

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