Vought has exerted extraordinary control over government spending this year, usurping congressional decisions on how the nation’s money is used. His push for more layoffs during the government shutdown is only the latest blow, following months of firings, canceled grants, and withheld funds.

By cutting and freezing public health funds, in particular, the Trump administration has already begun to undercut efforts to provide medical care, outbreak response, housing assistance, and research across the U.S., according to health officials, nonprofit directors, and federal agency staffers interviewed by KFF Health News.

Since most federal funds for public health flow to states, Vought is rivaling the Department of Health and Human Services secretary, Robert F. Kennedy Jr., in his ability to upend government-led efforts to keep Americans healthy. In Texas, Centers for Disease Control and Prevention funds to stem a measles outbreak weren’t available until after the crisis had subsided and two children had died. A project to protect Alabamans from raw sewage and hookworm was abandoned. People with HIV have had to delay medical care as clinics scale back hours. Time-dependent surveys on HIV and maternal mortality were halted. Food banks have canceled events. Tobacco prevention programs lapsed. Initiatives to protect older adults at risk of falling have been harried.

No matter what budget Congress ultimately passes for next year, the Trump administration may continue to thwart financial support for such programs in ways that will harm people’s health. “The White House has shown that they are willing to unilaterally exert control over funding,” said Gillian Metzger, a constitutional law professor at Columbia University.

“This is a huge deal,” she added, “because the power of the purse is central to Congress’ ability to shape and direct policy.”

Before he was appointed to lead the White House’s Office of Management and Budget this year, Vought outlined budgetary strategies the executive branch could deploy to wrest power from Congress and federal agencies in Project 2025, the Heritage Foundation’s conservative blueprint.

Vought’s tactics unfolded this year, often below the radar. They include abrupt grant cancellations, extraordinary constraints on how funds can be spent, and excessive layers of review, agency officials say, at every step in the grantmaking process. Getting money out the door has been further complicated by layoffs that have gutted offices overseeing grants on chronic disease prevention, HIV, maternal mortality, and more.

Government employees have described these tactics to members of Congress, said Abigail Tighe, executive director of the National Public Health Coalition, a group that includes current and former staffers at the CDC and HHS. “We want Congress to act, because this is preventing states and communities from doing critical public health work to keep our country safe,” she said. “If they don’t have capacity, we all collectively suffer.”

Democrats on the House and Senate appropriations committees have pushed for transparency, but the extent to which money Congress appropriated for public health in 2024 and 2025 has gone unspent because of the administration’s disruptions is not yet known. “This is a sophisticated strategy to cause money to lapse and then say, ‘If they can’t spend it, they don’t need it,’” said Robert Gordon, a public policy specialist at Georgetown University and a former assistant finance secretary at HHS.

“No one thought this was possible or legal, but that is what’s happening,” he said.

Details on how the administration has subverted health spending have received little attention because many changes have been made quietly — and people who rely on federal funds fear retribution. The Trump administration has defunded and threatened federal offices that hold the government accountable and fired whistleblowers. It has abruptly revoked funds for local governments and organizations.

Vought and spokespeople at the White House and the OMB did not respond to queries from KFF Health News. However, Vought described his intentions in a Sept. 3 speech. He said that federal agencies and Congress had gained more power over spending since the 1970s and that their control became “woke and weaponized” under Presidents Barack Obama and Joe Biden.

“Thankfully, President Trump won,” he said. “And we have now been embarked on deconstructing this administrative state.”

Many Parts, Many Malfunctions

Like a car, the federal budget process has many components that can break down. Through the OMB and its partner, Trump’s Department of Government Efficiency, or DOGE, the administration has intervened at various junctures. “There are so many ways in which money is not operating in the way it is supposed to operate,” said Bobby Kogan, the senior director of federal budget policy at the Center for American Progress, a left-leaning think tank, and a former OMB adviser.

Typically, Congress passes a budget that appropriates money for the next fiscal year to federal agencies. For many public health programs, ranging from housing assistance to cancer screening, agencies then post open calls online for states, local governments, and organizations to apply for funding. Agency experts select winners and send notices of awards — or notices of ongoing funding to groups that previously won multiyear awards.

Next, the OMB, which administers the federal budget, activates money for agencies, like a bank activates a credit card, so that grantees can spend and get reimbursed rapidly. Auditors keep an eye on spending, but the government has in the past limited interruptions so that programs run smoothly.

Early on, the Trump administration canceled billions of dollars in awards granted in 2024 and early 2025 for research and global health. In March, it clawed back $11.4 billion in covid-era funds that Congress had earmarked for health departments that were using the money for disease surveillance, vaccinations, and more.

Although some funds have been restored because of lawsuits, the Supreme Court has allowed other cuts by the administration to stand while the cases move through the courts.

Beyond these “shotgun” cancellations, the administration has taken a quieter, “in-the-weeds, slowing, cutting, conditioning” approach that’s frozen funds for public health, said Matthew Lawrence, a law professor specializing in health policy at Emory University.

By August, the CDC’s center for HIV and tuberculosis prevention had doled out $167 million less than the historical average, according to an analysis by the Center on Budget and Policy Priorities, a think tank focused on reducing inequality. The CDC’s funding for chronic disease prevention lagged by $259 million, the Ryan White HIV/AIDS Program had underspent by $105 million, and funds for mental health at the Substance Abuse and Mental Health Services Administration were more than $860 million behind what was expected.

An unknown amount of Congress’ 2025 funding for research and public health has yet to be awarded and will probably lapse this year, said Joe Carlile, an author of the center’s analysis and an associate OMB director during the Biden administration. The obstructions appear to be concentrated in areas where the White House proposed cutting the federal budget next year. “The administration may be executing their 2026 budget request through administrative controls,” Carlile said.

“This is boring but crazy-high stakes,” he added. “A one-branch veto of spending neuters the power of the purse in the Constitution that Madison said was the fundamental check on the executive branch.”

Incremental Chaos

A key tactic Vought described in Project 2025 occurs when the OMB activates funds for agencies in installments, called apportionments. Vought wrote that “apportioned funding” could “ensure consistency with the President’s agenda.”

Under Vought, the OMB shrank the size of apportionments, HHS and CDC staffers said. It’s illegal for agencies to let grantees withdraw money before the total amount is in the metaphorical bank, so that delayed agencies’ ability to greenlight spending.

The OMB and DOGE also placed conditions on apportionments through memos, footnotes, and spoken directives telling agencies to ensure that spending “aligns with Administration priorities,” according to reports and HHS employees who said that notices of funding opportunities and awards required excessive layers of sign-off. The CDC and other agencies circulated lists of priorities that reflect White House stances, including those targeting diversity, equity, and inclusion efforts; immigration; and transgender rights. Public health efforts have been especially caught up in red tape, since many focus on populations bearing an unequal burden of death, disease, and injury.

Groups that rely on federal funds have largely been unaware of the reasons grants were held up, but they’ve fielded what they viewed as unsettling queries. For example, Kathy Garner, the head of a Mississippi nonprofit, said officials asked her to defend the exclusion of men from a program to shelter women who experienced domestic violence.

Delays were made worse by uncertainty. Grantees said they’ve been unable to reach program officers because tens of thousands of federal workers have been laid off. Agency officials said firings slow funding further.

“Everyone’s inbox is full of letters from grant recipients asking, ‘How do we proceed?’” one high-ranking CDC official told KFF Health News, which granted agency officials anonymity because of their fears of retaliation. “We just say, ‘Please wait.’”

Time was critical as a measles outbreak surged in West Texas early this year. The state asked for federal funding for the response in March, but it didn’t arrive until May, after the outbreak had largely faded in Texas, according to an investigation by KFF Health News. Apportionment control was a key reason, CDC staffers said.

In July, 81 HIV organizations sent a letter to Kennedy. “With every day of delayed FY2025 funding release, the delivery of essential HIV services is compromised,” said the letter, which was reviewed by KFF Health News. Because of delays and uncertainty, it said, HIV clinics had laid off case managers and reduced clinician hours, closed sites, and pared down hotlines that patients call with urgent questions. The funds arrived about a month later, but HIV providers remain shaken.

Lauren Richey, medical director at University Medical Center’s HIV clinic in New Orleans, backed out of hiring a sorely needed dentist she had recruited. “I was afraid to tell someone to move across the country for a job when I wasn’t sure if or when we’d get the funding for their salary,” she said. “The wait is now three to four months for dental services, when it was usually a couple of weeks at most.”

Tamachia Davenport, program director at the St. John AIDS outreach ministry in New Orleans, said that “a lot of us are having to rob Peter to pay Paul.”

When the group didn’t get CDC funds it expected this summer, Davenport had to decide between cutting staff or supplies. Concerned her top employees would take jobs elsewhere, she stopped buying the condoms they distribute throughout the city to prevent the spread of sexually transmitted infections.

Louisiana already has one of the highest rates of HIV, chlamydia, and gonorrhea in the country. Condoms cost far less than treating these diseases. For a person infected by HIV at age 35, such costs exceed $326,000.

Groups focused on cancer, diabetes, and heart disease also report lasting repercussions from delays, as well as ongoing fears that they will happen again. Louisiana State University’s Healthy Aging Research Center canceled some of its workshops to train health workers on caring for people with dementia. “There may be fewer people who have this very specific expertise next year in Louisiana and Mississippi,” said Scott Wilks, the director of the center. “That’s on top of the big shortage we have already.”

Nationwide surveys tallying maternal and infant mortality froze for about five months because of funding delays, causing an irrecoverable gap in data that had been collected continuously since 1987, CDC officials say.

“We are seeing the administration get their way with or without an approved budget,” one said. “It’s such a terrible shame to play with people’s health this way.”

DOGE also inserted itself into grant reimbursements this year, stalling the rapid turnaround that public health groups typically expect to cover salaries, rent, and other monthly costs outlined in budgets that have already been approved. In what’s now labeled Departmental Efficiency Review, itemized expenses must be regularly justified by multiple government officials, according to documents reviewed by KFF Health News.

DOGE posted on its website expense reports covering about a month’s span from April to May. Nearly 230 of the individual expenses filed to federal agencies during that period are for $1 or less. Other entries break down monthly salaries for individual employees and petty costs for postage or monthly subscriptions.

“Public funds deserve scrutiny, but this is different from audit practices I’ve been a part of,” Carlile said.

DOGE also stalled calls for applications for 2025 funding — and some calls never appeared as the fiscal year came to a close on Sept. 30. Among them are programs for groups that provide housing assistance. People will be evicted when these organizations run out of money left over from 2024, said Steve Berg, chief policy officer at the National Alliance to End Homelessness.

Other solicitations came out months behind schedule, leaving groups with a few weeks to put together complicated applications for multimillion-dollar awards, including for Alzheimer’s care, addiction recovery, senior support, and chronic disease management.

“They’ve set projects up to fail,” one HHS official said.

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At the start of this month, people close to the MAHA movement suggested that Kennedy’s upcoming autism announcement would link Tylenol use during pregnancy with the condition. Researchers worried it would veer into vaccines. Both Kennedy and Trump have spread misinformation about an association between vaccines and autism in the past, despite many rigorous studies refuting any link. 

Ann Bauer at the University of Massachusetts-Lowell, an epidemiologist who co-wrote a recent analysis about Tylenol and autism, told me, “I was sick to my stomach,” worrying that Kennedy would distort her team’s conclusions. She also feared scientists would reject her team’s measured concerns about Tylenol in a backlash against politicized or misleading remarks. 

Bauer and her colleagues had reviewed 46 studies on Tylenol, autism, and attention-deficit/hyperactivity disorder. Many found no link, while some suggested Tylenol might occasionally exacerbate other potential causes of autism, such as genetics. 

Since Tylenol is the only safe painkiller for use during pregnancy and fevers during pregnancy can be agonizing as well as dangerous, the team suggested judicious use of the medicine until the science was settled. 

That’s not what Trump advised. “Don’t take Tylenol,” he said. “Don’t give Tylenol to the baby. When the baby’s born, they throw it at you. Here, throw, give him a couple of Tylenol. They give him a shot. They give him a vaccine. And every time they give him a vaccine, they’re throwing Tylenol. And some of these babies, they, you know, they, they’re long born, and all of a sudden, they’re gone.” 

In emailed statements, HHS and White House spokespeople said Trump is using “gold-standard science” to address rising autism rates. 

Helen Tager-Flusberg, director of the Center for Autism Research Excellence at Boston University, called Trump’s comments dangerous. Centers for Disease Control and Prevention scientists told me they were never asked to brief Kennedy or the White House on autism, or to review the recommendations. Had researchers been asked, they would have explained that no single drug, chemical, or other environmental factor is strongly linked to the developmental disorder. 

Quick fixes — the kind promised by Kennedy — won’t make a dent, Tager-Flusberg said. “We know genetics is the most significant risk factor,” she said, “but you can’t blame Big Pharma for genetics, and you can’t build a political movement on genetics research and ride to victory.” 

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In August, Bauer and her colleagues published an analysis of 46 previous studies on Tylenol, autism, and attention-deficit/hyperactivity disorder. Many found no link between the drug and the conditions, while some suggested Tylenol might occasionally exacerbate other potential causes of autism, such as genetics.

Bauer, an epidemiologist at the University of Massachusetts-Lowell, and her team called for more judicious use of the drug until the science is settled.

On Monday, President Donald Trump stood beside Health and Human Services Secretary Robert F. Kennedy Jr. for what he called a “historic” announcement on autism. “If you’re pregnant, don’t take Tylenol, and don’t give it to the baby after the baby is born,” Trump said. “There are certain groups of people that don’t take vaccines and don’t take any pills that have no autism,” he added, without providing evidence. “They pump so much stuff into those beautiful little babies, it’s a disgrace.”

A fact sheet released alongside the White House briefing cited Bauer’s analysis. But she was alarmed by Trump’s comments. If prenatal Tylenol has any association, which it may not, it would help account for only a fraction of cases, she said. Further, research has not deeply examined Tylenol risks in young children, and many rigorous studies refute a link between vaccines and autism.

Bauer worries such statements will cut both ways: People may put themselves at risk to avoid vaccines and Tylenol, the only safe painkiller for use during pregnancy. And she frets that scientists might outright reject her team’s measured concerns about Tylenol in a backlash against misleading remarks from Trump and other members of his “Make America Healthy Again” movement.

“I’m really concerned about how this message is going to play out,” she said. “It’s a sound-bite universe, and everyone wants a simple solution.”

Autism experts at the Centers for Disease Control and Prevention were neither consulted for the White House’s long-awaited autism announcement nor asked to review a draft of the findings and recommendations, CDC scientists told KFF Health News, which agreed not to identify them because they fear retaliation.

“Typically, we’d be asked to provide information and review the report for accuracy, but we’ve had absolutely no contact with anyone,” one CDC researcher said. “It is very unusual.”

Trump and Kennedy promised this year that under their leadership the federal government would swiftly figure out what causes autism. Scientists who work in the field have been skeptical, noting that decades of research has shown that no single drug, chemical, or other environmental factor is strongly linked to the developmental disorder. In addition, both Trump and Kennedy have repeated the scientifically debunked notion that childhood vaccines may cause autism.

Had CDC scientists been allowed to brief Kennedy, they say they would have cautioned that simple fixes won’t make a dent in the number of autism cases in the United States: As many as 1 in 31 8-year-old children had autism spectrum disorder in 2022.

Systemic changes, such as regulations on air pollution, which has been linked to asthma and developmental disabilities including autism, and assistance for parents of disabled children, could improve lives for far more Americans with autism and other conditions than actions taken by the Trump administration on Sept. 22, researchers say.

One federal action is to consider updating the label on Tylenol and to “encourage clinicians to exercise their best judgment in use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest duration.” The American College of Obstetricians and Gynecologists already recommends acetaminophen “as needed, in moderation, and after consultation with a doctor.”

‘Political Crusade’

Despite Kennedy’s many years of speaking about autism, he rarely cites credible autism research or expert recommendations, Tager-Flusberg said. Instead, Kennedy repeats fringe, scientifically debunked theories linking vaccines to autism, despite rigorous studies published in peer-reviewed journals that refute a link.

At the Sept. 22 briefing, Trump said he spoke with Kennedy about autism 20 years ago: “We understood a lot more than a lot of people who studied it,” he said. Ahead of Trump’s first term in 2017, Kennedy said he met with the president to consider a commission on vaccine safety and autism. It didn’t happen then. But soon after Kennedy was confirmed as health secretary, he called autism “preventable,” pointed to “environmental toxins,” and contradicted the results of a CDC study finding that the main driver of rising autism diagnoses was that doctors increasingly recognize the disorder.

At a televised Cabinet meeting in April, Kennedy told Trump, “By September, we will know what has caused the autism epidemic and we’ll be able to eliminate those exposures.”

“You stop taking something, you stop eating something, or maybe it’s a shot,” Trump replied.

“He is on a political crusade,” Tager-Flusberg said of Kennedy, adding that vaccines, Tylenol, aluminum, and food dyes make for simple targets to rally against. “We know genetics is the most significant risk factor,” she said, “but you can’t blame Big Pharma for genetics, and you can’t build a political movement on genetics research and ride to victory.”

“RFK makes our work harder,” said Peter Hotez, a vaccine researcher and the author of a book about his autistic daughter, “Vaccines Did Not Cause Rachel’s Autism.” He said the book stemmed from conversations with Kennedy in 2017, in which Hotez shared studies pinpointing more than a hundred genes linked to autism, and research into the complex interplay between genetics, biological processes, and things that children and fetuses encounter during development.

“I sat down with him and explained what the science says, but he was unwilling or incapable of thinking deeply about it,” Hotez said. “He is extremely careless.”

In addition to its focus on Tylenol, the White House said it would move to update “prescribing information” on leucovorin — a medication related to the B vitamin folate — to reflect its use as an autism treatment. A small clinical trial in 2012-13 suggested the drug may help treat language problems in some children with autism. Tager-Flusberg said the findings warrant further study but clarified these were “old data, not a breakthrough.”

Likewise, studies finding a modest association between autism and prolonged Tylenol use were published years ago. Researchers have suggested the medicine might occasionally exacerbate factors associated with autism, such as genetics and oxidative stress, a biological condition that occurs for a variety of reasons that scientists are still unraveling.

Still, these studies couldn’t rule out the possibility that fevers prompting women to take Tylenol, rather than the medicine itself, might instead be to blame. Fevers and infections — including those prevented by vaccines — have also been linked to autism.

She welcomed the White House’s motion to consider labeling Tylenol to emphasize judicious use of the drug but worries about how the MAHA movement might distort a careful message. On Sept. 2, the right-wing news outlet One America News Network posted an interview with newly appointed CDC vaccine adviser Robert Malone, writing that Malone “speculates RFK Jr. may have an important announcement this month regarding a potential link between Tylenol, multiple vaccinations and autism in children.”

Several medical and scientific associations have called for Kennedy’s removal or resignation. Many scientists are skeptical of what he says because much of it has been misleading or wrong. For example, he’s said HIV isn’t the only cause of AIDS (it is), that antidepressant drugs cause mass shootings (they don’t), that older adults don’t have severe autism (some do), that the measles vaccine causes brain swelling (it doesn’t), that covid vaccines were the deadliest vaccines ever made (they aren’t), that vaccines aren’t safety-tested (they are), and that vaccines contribute to autism (they don’t).

“This is like the boy who cried wolf,” said Brian Lee, an epidemiologist at Drexel University. “One day he might be right about something and Americans who are not prone to conspiracies won’t trust it because it’s coming from RFK’s mouth. And that could be a problem.”

What’s more, the Trump administration is eroding scientists’ ability to probe the safety of pharmaceuticals, said Robert Steinbrook, head of health research at Public Citizen, a nonprofit consumer protection group.

“Public Citizen is very supportive of research on medications that could be linked to diseases,” he said. “But it needs to be through an open process, which looks at scientific evidence, and which doesn’t cherry-pick studies to support a preconceived point of view.”

Steinbrook said the administration has undermined his confidence in the government’s ability to conduct credible work. The Food and Drug Administration has held less than a third the number of advisory committee meetings this year as it did last, meaning fewer opportunities for experts to discuss research on the risks and benefits of drugs. The Trump administration has fired hundreds of career scientists at the CDC and FDA and cut millions of dollars in research funds, including to projects studying autism.

In early September, the CDC issued an unusual contract with the Rensselaer Polytechnic Institute to analyze datasets for signs that vaccinated children were more likely to have autism. Unlike with other research initiatives, the CDC didn’t post an open call for applications in advance. This allows agency experts to review proposals and select studies best designed to answer the question at hand.

CDC researchers told KFF Health News that experts in the agency’s autism and disability group weren’t aware of the contract or asked to review the proposal. That’s important, they said, because researchers digging through data to find clues about autism must show how they’ll rule out biological and environmental exposures that muddy the results, and ensure that children have been accurately diagnosed. One researcher said, “It absolutely looks like Kennedy has subverted the grantmaking process.”

The CDC and HHS did not respond to KFF Health News’ requests for information on the grant, including through a Freedom of Information Act request.

The new vaccine study is separate from Kennedy’s autism data-science initiative, which was posted as an open call at the National Institutes of Health. “The hope is that something good comes of it, and that the government won’t cherry-pick or censor what scientists find out,” Lee said.

Bauer said she didn’t apply to be part of the initiative because of Kennedy’s outsize presence at HHS.

“I would not take his funding because it could take away from the credibility of my study,” she said, “in the same way that taking money from pharmaceutical companies does.”

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En agosto, Bauer y sus colegas publicaron un análisis de 46 estudios previos sobre Tylenol, autismo y trastorno por déficit de atención e hiperactividad (TDAH). Muchos no encontraron ninguna relación entre el medicamento y estas afecciones, mientras que algunos sugirieron que el Tylenol podría ocasionalmente agravar otras posibles causas del autismo, como los factores genéticos.

Bauer, epidemióloga de la Universidad de Massachusetts-Lowell, y su equipo pidieron un uso más cuidadoso del medicamento hasta que la ciencia sea concluyente sobre el tema.

El lunes 22 de septiembre, el presidente Donald Trump se paró junto al secretario de Salud y Servicios Humanos, Robert F. Kennedy Jr., para lo que llamó un anuncio “histórico” sobre el autismo.

“Si estás embarazada, no tomes Tylenol y no se lo des al bebé cuando nazca”, dijo Trump. “Hay ciertos grupos de personas que no se vacunan ni toman medicamentos y no tienen autismo”, agregó, sin ofrecer evidencia. “Les inyectan tantas cosas a esos hermosos bebitos, que es una vergüenza”.

Una hoja informativa publicada junto con la rueda de prensa de la Casa Blanca citaba el análisis de Bauer. Pero a ella le alarmaron los comentarios de Trump.

Si bien el Tylenol durante el embarazo pudiera tener alguna relación —algo que aún no está comprobado—, en todo caso explicaría solo una fracción de los casos, dijo. Además, no se ha estudiado a fondo el riesgo del Tylenol en niños pequeños, y muchos estudios rigurosos han refutado un vínculo entre las vacunas y el autismo.

Bauer teme que este tipo de declaraciones puedan tener un doble efecto: que algunas personas eviten las vacunas o el Tylenol —el único analgésico seguro durante el embarazo— y se expongan a riesgos, y que al mismo tiempo, otros científicos rechacen por completo las advertencias moderadas de su equipo como reacción a comentarios engañosos de Trump y de otros integrantes del movimiento “Make America Healthy Again” (Hagamos a Estados Unidos Saludable de Nuevo).

“Me preocupa mucho cómo va a interpretarse este mensaje”, dijo. “Vivimos en un mundo de frases breves, y todo el mundo quiere una solución simple”.

Expertos en autismo de los Centros para el Control y Prevención de Enfermedades (CDC) no fueron consultados para el esperado anuncio de la Casa Blanca sobre el autismo ni se les pidió revisar un borrador de las conclusiones y recomendaciones, dijeron científicos de los CDC a KFF Health News, que acordó no identificarlos por temor a represalias.

“Normalmente nos pedirían que proporcionáramos información y que revisáramos el informe para verificar su precisión, pero no hemos tenido ningún contacto con nadie”, dijo uno de los investigadores de los CDC. “Es algo muy inusual”.

Trump y Kennedy prometieron este año que bajo su liderazgo, el gobierno federal determinaría rápidamente qué causa el autismo.

Los científicos especializados han sido escépticos, ya que décadas de investigación han demostrado que ningún medicamento, sustancia química ni factor ambiental específico tiene un vínculo sólido con este trastorno del desarrollo. Además, tanto Trump como Kennedy han repetido la afirmación —ya desmentida científicamente— de que las vacunas infantiles podrían causar autismo.

Helen Tager-Flusberg, directora del Centro de Excelencia en Investigación sobre el Autismo de la Universidad de Boston, calificó los comentarios de Trump como peligrosos. La fiebre puede dañar a la madre y al feto en desarrollo, dijo, y agregó que la fiebre tiene una asociación más fuerte con el autismo que el Tylenol.

En una respuesta por correo electrónico, Andrew Nixon, vocero del Departamento de Salud y Servicios Humanos (HHS), dijo: “Estamos utilizando ciencia de máxima calidad para llegar al fondo del aumento sin precedentes del autismo en Estados Unidos”.

Kush Desai, vocero de la Casa Blanca, escribió: “El presidente Trump se comprometió a abordar el creciente número de casos de autismo en Estados Unidos, y lo hará con ciencia de calidad”.

Si los científicos de los CDC hubieran podido informar a Kennedy, habrían advertido que las soluciones simples no reducirían significativamente la cantidad de casos de autismo en el país: en 2022, hasta 1 de cada 31 niños de 8 años tenía un trastorno del espectro autista.

Según investigadores, cambios sistémicos —como nuevas regulaciones sobre la contaminación del aire, que se ha vinculado al asma y a discapacidades del desarrollo, incluido el autismo— y apoyo para padres de niños con discapacidades, tendrían un mayor impacto en mejorar la vida de personas con autismo que las medidas tomadas por la administración Trump el 22 de septiembre.

Una de las acciones federales consiste en considerar la actualización de la etiqueta del Tylenol y “alentar a los médicos a usar su mejor juicio al recetar acetaminofeno para fiebre y dolor durante el embarazo, recetando la dosis más baja posible durante el menor tiempo necesario”. El Colegio Estadounidense de Obstetras y Ginecólogos ya recomienda el uso de acetaminofeno “cuando sea necesario, con moderación y previa consulta médica”.

Una “cruzada política”

A pesar de que Kennedy lleva años hablando del autismo, rara vez cita investigaciones confiables o recomendaciones de expertos, dijo Tager-Flusberg. En su lugar, Kennedy repite teorías marginales ya desmentidas que vinculan las vacunas con el autismo, a pesar de estudios rigurosos revisados por pares que rechazan tal vínculo.

Durante la rueda de prensa del 22 de septiembre, Trump dijo que habló con Kennedy sobre el autismo hace 20 años: “Entendíamos mucho más que mucha gente que lo estudió”, afirmó.

Antes del primer mandato de Trump en 2017, Kennedy dijo que se reunió con el presidente para considerar una comisión sobre la seguridad de las vacunas y el autismo. Eso no ocurrió. Pero poco después de ser confirmado como secretario de Salud, Kennedy declaró que el autismo era “prevenible”, señaló a “toxinas ambientales” y contradijo los resultados de un estudio de los CDC que concluyó que el principal motivo del aumento en los diagnósticos de autismo era que los médicos lo detectaban con mayor frecuencia.

En una reunión televisada del gabinete en abril, Kennedy le dijo a Trump: “Para septiembre sabremos qué causó la epidemia de autismo y podremos eliminar esas exposiciones”.

“Dejas de tomar algo, dejas de comer algo, o tal vez sea una vacuna”, respondió Trump.

“Está en una cruzada política”, dijo Tager-Flusberg sobre Kennedy, y agregó que las vacunas, el Tylenol, el aluminio y los colorantes alimentarios son blancos fáciles para movilizar oposición.

“Sabemos que la genética es el factor de riesgo más importante”, agregó, “pero no se puede culpar a las farmacéuticas por la genética, ni se puede construir un movimiento político basado en investigaciones genéticas y salir victorioso”.

“RFK nos dificulta el trabajo”, dijo Peter Hotez, investigador en vacunas y autor de un libro sobre su hija con autismo, titulado Las vacunas no causaron el autismo de Rachel. Dijo que el libro nació de conversaciones con Kennedy en 2017, en las que Hotez le compartió estudios que identificaban más de 100 genes vinculados al autismo, así como investigaciones sobre la interacción entre genética, procesos biológicos y factores a los que los niños y fetos están expuestos durante su desarrollo.

“Me senté con él y le expliqué lo que dice la ciencia, pero no quiso —o no pudo— pensarlo a fondo”, dijo Hotez. “Es extremadamente irresponsable”.

Además de enfocarse en el Tylenol, la Casa Blanca dijo que actualizaría la “información de prescripción” del leucovorín —un medicamento relacionado con la vitamina B folata— para reflejar su uso como tratamiento del autismo. Un pequeño ensayo clínico de 2012-2013 sugirió que el medicamento podría ayudar a tratar problemas de lenguaje en algunos niños con autismo. Tager-Flusberg dijo que los hallazgos merecen más estudio, pero aclaró que se trata de “datos antiguos, no un descubrimiento revolucionario”.

Del mismo modo, los estudios que hallaron una relación modesta entre el autismo y el uso prolongado de Tylenol fueron publicados hace años. Algunos investigadores han sugerido que el medicamento podría agravar ocasionalmente factores vinculados al autismo, como la genética y el estrés oxidativo, una condición biológica que ocurre por varias razones aún no del todo comprendidas.

Aún así, estos estudios no pudieron descartar la posibilidad de que la fiebre que llevaba a las mujeres a tomar Tylenol, en lugar del medicamento en sí, pudiera ser la culpable. La fiebre y las infecciones, incluidas las que se pueden prevenir con vacunas, también se han vinculado al autismo.

Aún así, Bauer recomienda hacer una pausa antes de tomar acetaminofeno durante el embarazo, un consejo que los médicos dan en general sobre cualquier medicamento durante esa etapa, aunque muchas veces no se sigue. “Trata de aliviar el malestar de otras maneras, como con una compresa fría, hidratación o masajes, antes de tomarlo”, dijo Bauer.

Agradeció la iniciativa de la Casa Blanca de considerar un etiquetado que promueva el uso cuidadoso del Tylenol, pero le preocupa cómo el movimiento MAHA podría distorsionar ese mensaje.

El 2 de septiembre, el medio de derecha One America News Network posteó una entrevista con el recién nombrado asesor en vacunas de los CDC, Robert Malone, en la que se afirmaba que Malone “especula que RFK Jr. podría hacer un anuncio importante este mes sobre un posible vínculo entre el Tylenol, múltiples vacunas y el autismo en niños”.

“Me sentí enferma del estómago”, dijo Bauer, preocupada de que Kennedy vincule su estudio con teorías desacreditadas, y que eso lleve a médicos y científicos a rechazar su trabajo mucho más mesurado.

“El pastor mentiroso”

Varias asociaciones médicas y científicas han pedido la destitución o renuncia de Kennedy. Muchos científicos desconfían de lo que dice porque gran parte ha sido engañoso o incorrecto. Por ejemplo, ha dicho que el VIH no es la única causa del sida (sí lo es), que los antidepresivos causan tiroteos masivos (no es cierto), que los adultos mayores no tienen autismo severo (algunos sí), que la vacuna contra el sarampión causa inflamación cerebral (no lo hace), que las vacunas contra covid fueron las más mortales jamás creadas (no lo son), que las vacunas no se prueban por seguridad (sí se prueban) y que las vacunas contribuyen al autismo (no lo hacen).

“Esto es como el cuento del pastor mentiroso”, dijo Brian Lee, epidemiólogo de la Universidad Drexel. “Un día podría tener razón en algo, y los estadounidenses que no creen en teorías conspirativas no le van a creer porque viene de la boca de RFK. Y eso podría ser un problema”.

Además, la administración Trump está debilitando la capacidad de los científicos de investigar la seguridad de los medicamentos, dijo Robert Steinbrook, director de investigación en salud de Public Citizen, una organización sin fines de lucro de defensa del consumidor.

“En Public Citizen apoyamos plenamente la investigación sobre medicamentos que podrían estar relacionados con enfermedades”, dijo. “Pero debe hacerse a través de un proceso abierto, que examine la evidencia científica y no seleccione estudios para respaldar una idea preconcebida”.

Steinbrook dijo que la administración ha minado su confianza en la capacidad del gobierno para realizar investigaciones creíbles. La Administración de Alimentos y Medicamentos (FDA) ha convocado menos de un tercio de las reuniones de su comité asesor este año en comparación con el anterior, lo que significa menos oportunidades para que expertos debatan los riesgos y beneficios de los medicamentos.

La administración Trump ha despedido a cientos de científicos de carrera en los CDC y la FDA, y recortado millones de dólares en fondos para investigaciones, incluidos proyectos sobre el autismo.

A principios de septiembre, los CDC iniciaron un contrato inusual con el Instituto Politécnico Rensselaer para analizar bases de datos y buscar señales de que los niños vacunados tienen más probabilidad de tener autismo. A diferencia de otras iniciativas, los CDC no publicaron una convocatoria abierta para este contrato. Estas convocatorias permiten que los expertos del organismo revisen las propuestas y seleccionen los estudios mejor diseñados para responder la pregunta en cuestión.

Investigadores de los CDC dijeron a KFF Health News que el grupo especializado en autismo y discapacidades de la agencia no estaba al tanto del contrato ni fue consultado para revisarlo. Eso es clave, señalaron, porque los investigadores que analizan datos en busca de pistas sobre el autismo deben demostrar cómo descartan factores biológicos y ambientales que pueden alterar los resultados, y asegurar que los diagnósticos de los niños sean precisos. Uno de los investigadores dijo: “Todo indica que Kennedy intervino indebidamente en el proceso de asignación de fondos”.

LOs CDC y el HHS no respondieron a las solicitudes de información sobre el contrato, ni siquiera a través de una solicitud bajo la Ley de Libertad de Información.

El nuevo estudio sobre vacunas es distinto de la iniciativa de datos basados en la ciencia sobre el autismo que Kennedy impulsó y que sí fue publicada como convocatoria abierta por los Institutos Nacionales de Salud (NIH). “La esperanza es que salga algo bueno de esto y que el gobierno no manipule ni censure lo que descubran los científicos”, dijo Lee.

Bauer dijo que no se postuló para ser parte de la iniciativa debido al protagonismo de Kennedy dentro del HHS.

“No aceptaría financiamiento de él porque podría restarle credibilidad a mi estudio”, expresó, “de la misma forma que aceptarlo de farmacéuticas también lo haría”.

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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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She recently explored these issues in her article “As Measles Exploded, Officials in Texas Looked to CDC Scientists. Under Trump, No One Answered.”

Click here to watch Maxmen on “CNN News Central”

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The outbreak soon became the worst the United States has endured in over three decades.

In the month after Donald Trump took office, his administration interfered with Centers for Disease Control and Prevention communications, stalled the agency’s reports, censored its data, and abruptly laid off staff. In the chaos, CDC experts felt restrained from talking openly with local public health workers, according to interviews with seven CDC officials with direct knowledge of events, as well as local health department emails obtained by KFF Health News through public records requests.

“CDC hasn’t reached out to us locally,” Katherine Wells, the public health director in Lubbock, Texas, wrote in a Feb. 5 email exchange with a colleague two weeks after children with measles were hospitalized in Lubbock. “My staff feels like we are out here all alone,” she added.

A child would die before CDC scientists contacted Wells.

“All of us at CDC train for this moment, a massive outbreak,” one CDC researcher told KFF Health News, which agreed not to name CDC officials who fear retaliation for speaking with the press. “All this training and then we weren’t allowed to do anything.”

Delays have catastrophic consequences when measles spreads in undervaccinated communities, like many in West Texas. If a person with measles is in the same room with 10 unvaccinated people, nine will be infected, researchers estimate. If those nine go about their lives in public spaces, numbers multiply exponentially.

The outbreak that unfolded in West Texas illustrates the danger the country faces under the Trump administration as vaccination rates drop, misinformation flourishes, public health budgets are cut, and science agencies are subject to political manipulation.

While the Trump administration stifled CDC communications, health secretary Robert F. Kennedy Jr. fueled doubt in vaccines and exaggerated the ability of vitamins to ward off disease. Suffering followed: The Texas outbreak spread to New Mexico, Oklahoma, Kansas, Colorado, and Mexico’s Chihuahua state — at minimum. Together these linked outbreaks have sickened more than 4,500 people, killed at least 16, and levied exorbitant costs on hospitals, health departments, and those paying medical bills.

“This is absolutely outrageous,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “When you’re battling contagious diseases, time is everything.”

‘The CDC Is “Stressed” Currently’

Wells was anxious the moment she learned that two unvaccinated children hospitalized in late January had the measles. Hospitals are legally required to report measles cases to health departments and the CDC, but Wells worried many children weren’t getting tested.

“I think this may be very large,” she wrote in a Feb. 3 email to the Texas Department of State Health Services. Wells relayed in another email what she’d learned from conversations around town: “According to one of the women I spoke with 55 children were absent from one school on 1/24. The women reported that there were sick children with measles symptoms as early as November.”

In that email and others, Wells asked state health officials to put her in touch with CDC experts who could answer complicated questions on testing, how to care for infants exposed to measles, and more. What transpired was a plodding game of telephone.

One email asked whether clinics could decontaminate rooms where people with measles had just been if the clinics were too small to follow the CDC’s recommendation to keep those rooms empty for two hours.

“Would it be possible to arrange a consultation with the CDC?” Wells wrote on Feb. 5.

“It never hurts to ask the CDC,” said Scott Milton, a medical officer at the Texas health department. About 25 minutes later, he told Wells that an information specialist at the CDC had echoed the guidelines advising two hours.

“I asked him to escalate this question to someone more qualified,” Milton wrote. “Of course, we know the CDC is ‘stressed’ currently.”

Local officials resorted to advice from doctors and researchers outside the government, including those at the Immunization Partnership, a Texas nonprofit.

“The CDC had gone dark,” said Terri Burke, executive director of the partnership. “We had anticipated a measles outbreak, but we didn’t expect the federal government to be in collapse when it hit.”

Technically, the Trump administration’s freeze on federal communications had ended Feb. 1. However, CDC scientists told KFF Health News that they could not speak freely for weeks after. 

“There was a lot of confusion and nonanswers over what communications were allowed,” one CDC scientist said.

Georges Benjamin, executive director of the American Public Health Association, said the situation was not unique to measles. “Like most public health organizations, we weren’t able to get ahold of our program people in February,” he said. Information trickled out through the CDC’s communications office, but CDC scientists gave no press briefings and went dark on their closest partners across the country. “The CDC was gagged,” he said.

Through private conversations, Benjamin learned that CDC experts were being diverted to remove information from websites to comply with executive orders. And they were afraid to resume communication without a green light from their directors or the Department of Health and Human Services as they watched the Trump administration lay off CDC staffers in droves.

“It’s not that the CDC was delinquent,” Benjamin said. “It’s that they had their hands tied behind their backs.”

To work on the ground, the CDC needs an invitation from the state. But Anne Schuchat, a former CDC deputy director, said that during her 33 years with the agency, federal health officials didn’t need special permission to talk freely with local health departments during outbreaks. “We would always offer a conversation and ask if there’s anything we could do,” she said.

Lara Anton, a press officer at the Texas health department, said the state never prevented the CDC from calling county officials. To learn more about the state’s correspondences with the CDC, KFF Health News filed a public records request to the Texas health department. The department refused to release the records. Anton called the records “confidential under the Texas Health and Safety Code.”

Anton said the state sent vaccines, testing supplies, and staff to assist West Texas in the early weeks of February. That’s corroborated in emails from the South Plains Public Health District, which oversees Gaines County, the area hit hardest by measles.

“Texas will try to handle what it needs to before it goes to the CDC,” Zach Holbrooks, the health district’s executive director, told KFF Health News.

Responding to an outbreak in an undervaccinated community, however, requires enormous effort. To keep numbers from exploding, public health workers ideally would notify all people exposed to an infected person and ask them to get vaccinated immediately if they weren’t already. If they declined, officials would try to persuade them to avoid public spaces for three weeks so that they wouldn’t spread measles to others.

Holbrooks said this was nearly impossible. Cases were concentrated in close-knit Mennonite communities where people relied on home remedies before seeking medical care. He said many people didn’t want to be tested, didn’t want to name their contacts, and didn’t want to talk with the health department. “It doesn’t matter what resources I have if people won’t avail themselves of it,” Holbrooks said.

Historically, Mennonites faced persecution in other countries, making them leery of interacting with authorities, Holbrooks said. A backlash against covid restrictions deepened that mistrust.

Another reason Mennonites may seek to avoid authorities is that some live in the U.S. illegally, having immigrated to Texas from Canada, Mexico, and Bolivia in waves over the past 50 years. Locals guess the population of Seminole, the main city in Gaines County, is far larger than the U.S. Census count.

“I have no idea how many cases we might have missed, since I don’t know how many people are in the community,” Holbrooks said. “There’s a lot of people in the shadows out here.”

Public health experts say the situation in Gaines sounds tough but familiar. Measles tends to take hold in undervaccinated communities, and therefore public health workers must overcome mistrust, misinformation, language barriers, and more.

About 450 people — including local health officials, CDC scientists, nurses, and volunteers — helped control a measles outbreak sparked in an Eastern European immigrant community in Clark County, Washington, in 2018.

Alan Melnick, Clark County’s public health director, said his team spoke with hundreds of unvaccinated people who were exposed. “We were calling them basically every day to see how they were doing and ask them not to go out in public,” he said.

Melnick spoke with CDC scientists from the start, and the intensity of the response was buoyed by emergency declarations by the county and the state. Within a couple of months, the outbreak was largely contained. No one died, and only two people were hospitalized.

In New York, hundreds of people in the city’s health department responded to a larger measles outbreak in 2018 and 2019 concentrated among Orthodox Jewish communities. The work included meeting with dozens of rabbis and distributing booklets to nearly 30,000 households to combat vaccine misinformation.

The effort cost more than $7 million, but Jane Zucker, New York City’s assistant health commissioner at the time, said it yielded immense savings. The average medical bill for measles hospitalizations is roughly $18,500, according to data from prior outbreaks. Then there’s the cost of diverting hospital resources, of children missing school, of parents staying home from work to care for sick kids, and the lasting toll of some measles infections, including deafness or worse.

“I don’t think there’s a price tag to put on a child’s death that would otherwise be prevented,” Zucker said.

Local health departments in West Texas were understaffed from the start. About 18 people work at the South Plains health department, which oversees four vast rural counties. About 50 staff the department in Lubbock, where patients were hospitalized and health workers struggled to figure out who was exposed. In mid-February, Wells emailed a colleague: “I’m so overwhelmed.”

A Death Ignites a Response

On Feb. 26, Texas announced that a 6-year-old child had died of measles. Wells heard from CDC scientists for the first time the following day. Also that day, the CDC issued a brief notice on the outbreak. The notice recommended vaccines, but it worried public health specialists because it also promoted vitamin A as a treatment under medical supervision.

In emails, Texas health officials privately discussed how the CDC’s notice might exacerbate a problem: Doctors were treating children with measles for toxic levels of vitamin A, suggesting that parents were delaying medical care and administering the supplements at home. A local Lubbock news outlet reported on a large drugstore where vitamin A supplements and cod liver oil, which contains high levels of vitamin A, were “flying off the shelf.”

Too much vitamin A can cause liver damage, blindness, and dire abnormalities during fetal development.

Milton worried that parents were listening to misinformation from anti-vaccine groups — including one founded by Kennedy — that diminished the need for vaccination by inaccurately claiming that vitamin A staved off the disease’s worst outcomes.

“How many people will choose Vitamin A and not a vaccine because it appears to them there are two options?” Milton asked in an email.

Scientists at the CDC privately fretted, too. “HHS pressed us to insert vitamin A into all of our communications with clinicians and health officials,” one CDC scientist told KFF Health News, referring to the agency’s notices and alerts. “If pregnant women took too much vitamin A during the outbreak, their babies could be profoundly disabled. We haven’t seen those babies born yet.”

Another CDC official said they’ve had to “walk a fine line” between protecting the public based on scientific evidence and aligning with HHS.

While CDC scientists held their tongues, Kennedy exaggerated the power of nutrition and vitamin A while furthering mistrust in vaccines. “We’re providing vitamin A,” Kennedy said in an interview on Fox News. “There are many studies, some showing 87% effectiveness,” he claimed, “against serious disease and death.”

The studies Kennedy referenced were conducted in low-income countries where children are malnourished. Evidence suggests that vitamin A supplementation is seldom useful against measles in the United States, because deficiency is exceedingly rare.

Kennedy deflected criticism from those who call him anti-vaccine, saying that any parent in Texas who wants a measles vaccine can get one. He followed this with dangerously inaccurate statements. “There are adverse events from the vaccine. It does cause deaths every year,” he said. “It causes all the illnesses that measles itself causes, encephalitis and blindness, et cetera.” There is no evidence that measles vaccines “cause deaths every year.” Scores of studies show that the vaccine doesn’t cause encephalitis, that most potential side effects resolve quickly on their own, and serious adverse reactions are far rarer than measles complications.

In another interview, Kennedy said, “The MMR vaccine contains a lot of aborted fetus debris.” The measles, mumps, and rubella, or MMR, vaccine does not contain an iota of fetal cells.

HHS spokesperson Andrew Nixon and spokespeople at the CDC did not respond to queries from KFF Health News.

‘Staff Are Exhausted’

Despite national attention after the country’s first measles death in a decade, West Texas was overwhelmed. In late February and March, hospital administrators and health officials exchanged emails about how to lobby for resources.

“Local hospitals are at capacity,” wrote Jeffrey Hill, a senior vice president at the University Medical Center Health System in Lubbock. “The state reports emergency funds that typically cover a response like the measles outbreak are not available from the federal government right now,” he added.

“I am writing to express our urgent need for additional staff and funding,” Ronald Cook, medical director for Lubbock, said in an email, drafted with other Lubbock health authorities, to the deputy city manager. “Our Capacity is Stretched Thin: The health department has been operating seven days a week since February 2nd. Staff are exhausted.”

The city of Lubbock fronted money to help the local health department hire temporary staff. The state did not provide money, but it asked the CDC to send epidemiologists. Some came to Texas in early March. Then Texas requested federal funds.

None arrived, even as the outbreak approached 500 cases. It spread to Mexico when an unvaccinated Mennonite child returned home after visiting family in Seminole. This would fuel the largest outbreak Mexico has seen in decades, with at least 3,700 cases and 13 deaths in the state of Chihuahua.

Then another child in West Texas died of measles.

In a rare moment of openness, CDC scientist David Sugarman mentioned the outbreak at a vaccine advisory meeting in late April. “There are quite a number of resource requests coming in, in particular from Texas,” Sugarman said. “We are scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions.”

Federal funds arrived in Texas on May 21, said Anton, the state health department spokesperson. By then, the crisis was fading. The outbreak seemed to have burned until every unvaccinated person in Seminole was infected, said Richard Eby, a doctor at Permian Regional Medical Center who treated some measles patients. Hundreds, if not thousands, of cases have probably gone undetected, he said. “A lot of people presumed their kids had measles,” he said, “and didn’t see the need to confirm it.”

On Aug. 18, health officials declared the West Texas outbreak over, but the consequences of the catastrophe will be lasting.

The outbreaks it sparked across the U.S. and Mexico are still spreading.

More are inevitable, Nuzzo said. A growing number of parents are deciding not to vaccinate their kids, worried over unfounded rumors about the shots. Misinformation is flourishing, especially after Kennedy fired vaccine experts who advise the CDC and replaced them with doctors and researchers on the fringes of the scientific establishment. For example, one of his recent appointees, Robert Malone, blamed the deaths of children with measles on “medical mismanagement,” without evidence.

At the same time, states are downsizing programs for emergency response, disease surveillance, and immunization after the Trump administration clawed back more than $11 billion in public health funds earlier this year.

Amid Lubbock’s toughest months, Wells sent an email to the department’s exhausted staff. “The future is uncertain, and I know this is an unsettling time for many of us,” she wrote. “Every day we show up and do our jobs is an act of resilience.”

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It had clawed back more than $11 billion in federal public health grants to states and abruptly terminated millions of dollars in funds for HIV work in the United States. Testing and outreach for HIV faltered in the South, a region that accounts for more than half of all HIV diagnoses.

Dangerous changes loomed: To compensate for tax cuts for the wealthy, Trump’s “big, beautiful” bill and budget proposal for fiscal year 2026 threaten to curtail Medicaid, which provides health coverage for people with low incomes and disabilities. About 40% of adults with HIV rely on it for their lifesaving treatments.

Further, the budget proposes to eliminate all HIV prevention programs at the Centers for Disease Control and Prevention. This alone could lead to an additional 14,600 HIV-related deaths within the next five years, according to one analysis.

Trump’s budget proposal also would cancel a major grant that provides housing assistance for people with HIV. And it would end a strategic initiative to expand HIV services in minority communities, and another to support the mental health of people of color with HIV or at risk of infection.

“President Trump is committed to eliminating radical gender and racial ideologies that poison the minds of Americans,” a White House addendum to the budget says. Letters terminating HIV grants used similar language, targeting “diversity,” “equity,” and “gender minorities,” words that focus resources where they are needed most. Black and Latino people account for about 70% of new HIV infections in the U.S.

The cuts affect Sturdevant personally. He is a gay, Black man living with HIV and the co-founder of a grassroots group that combats health disparities in the Mississippi Delta, one of the poorest regions of the country.

That morning at church, a close friend, pastor Jerry Shelton of Anointed Oasis of Love Ministry, asked Sturdevant to help him deliver a sermon about resisting the urge to give up when life is hard. “The storm may come, but I shall not be moved!” Shelton preached, directing the congregation to approach adversity with confidence in themselves and in God. “Walk boldly!” he shouted.

After the service, Sturdevant resolved to bring the same energy to Washington. He’d tell his colleagues that they are survivors, he said. He’d tell them, “Let’s get together and make a plan.”

In the past few months, HIV advocates have begun to organize and strategize ways to limit the damage as federal funds are slashed and inflammatory rhetoric rises.

“It is a very scary time to be Black, queer, and living with HIV,” said Marnina Miller, co-executive director of the Positive Women’s Network, a nationwide group for women living with HIV. “But I am grateful that I am part of a community that will not bow down.”

“People are not giving up,” said June Gipson, the CEO of a health care nonprofit, My Brother’s Keeper, in Mississippi. Then she referenced the 1980s cartoon where heroes combine forces to create a super robot to defend the universe:

“We’ve got to form Voltron.”

The Weight of Stigma

Sturdevant often reminds his colleagues of all the HIV movement has overcome. In the 1980s, the government refused to acknowledge HIV as gay men died young. Once powerful treatments were available in the 1990s and early 2000s, the public health establishment largely neglected Black people with HIV, especially in the South. In that period, the demographics of the epidemic shifted away from white, upper- and middle-class gay populations in liberal states. Half of new diagnoses today are in the South and a third are among people with low incomes.

When Sturdevant first tested positive for HIV in 2005, he didn’t seek treatment. He kept his diagnosis hidden from friends and family because he knew how people talked about HIV. They considered it a death sentence, a punishment for irresponsible behavior, or a disease that could infect them through a touch or a shared toilet seat — which it cannot.

“I thought my family was going to disown me,” he said.

A year later, his weight plummeted because he couldn’t hold down food or water. Gaunt and feverish, he went to the hospital and learned he had AIDS. His mother slept at his hospital bedside for two weeks: “She said, ‘God got you.’”

Once he regained his health, Sturdevant resolved to care for others in his position. Scientists had developed powerful HIV drugs that, if taken daily, transform it from a death sentence into a manageable chronic disease in which a person’s virus levels are so suppressed that they cannot spread HIV to others. And policymakers ensured that almost everyone in the U.S. with HIV could get treated regardless of their ability to pay, largely because of Medicaid and the Ryan White HIV/AIDS Program.

But HIV experts had failed to overcome a key problem: Roughly a third of people living with HIV in the U.S. don’t get treated or don’t take the drugs regularly enough to be virally suppressed. Viral suppression rates are better in many African countries than in America.

To seek treatment and stick with it, Sturdevant understood, people had to have basic needs like food and housing met and, as importantly, a sense of belonging and empowerment. At his first job at an HIV organization in Jackson, Mississippi, Sturdevant regularly checked in with clients who didn’t have family members to support them. He hosted gatherings at his apartment and even offered it up as a place to stay. He has taken on the role of dad or uncle to many. “We called ourselves the family of love,” he said.

He saw how care bolstered lives, but the federal government needed data to drive its approach to HIV.

In 2012, the CDC expanded its in-depth surveys to learn more about the lives of people at risk of HIV and of those with HIV who weren’t virally suppressed. The surveys revealed what Sturdevant knew: A disproportionate number of them grappled with unstable housing, food insecurity, depression, and anxiety. Many participants agreed to prompts like, “Having HIV makes me feel that I’m a bad person,” or “Most people think that a person with HIV is disgusting,” or “Most people with HIV are rejected.”

The data showed policymakers that to curb the epidemic, they needed to address underlying problems that people with HIV faced. Federal funds began to flow to grassroots groups embedded in marginalized communities.

Public health researchers folded Black churches into the effort, recognizing them as hubs of volunteerism and as leaders of social movements. Although churches in the U.S. had historically fueled stigma against sexually transmitted diseases, Amy Nunn, a public health researcher at Brown University, said every pastor she talked with was eager to help. It paid off. In Kansas City, for example, researchers found that congregants who went to Black churches involved in HIV education and outreach were more than twice as likely to be tested.

Community-based interventions worked: New HIV infections dropped by 12% from 2018 to 2022.

Now the grassroots groups that have been so effective are in jeopardy and the in-depth surveys have halted as the Trump administration cuts funds and lays off CDC staff. Some health departments have issued stop-work orders to community-based groups that test people for HIV and connect them to treatment because federal HIV grants are unusually delayed. And as the Department of Health and Human Services continues to cancel HIV grants, the directors of grassroots groups anticipate more cuts.

“A lot of them are new and don’t have the resources to survive a year without funding,” said Masen Davis, executive director of Funders Concerned About AIDS.

One such group is Sturdevant’s.

‘Trust the Process’?

In 2017, Sturdevant returned home to the Mississippi Delta to launch a nonprofit, Community Health PIER, in one of the poorest and most medically underserved parts of the country. The average life expectancy in the Delta is 68, a decade shorter than the national average. The disenfranchisement of its majority-Black population stems from the region’s history, in which policies concentrated wealth and power among the minority-white population during the era of cotton sharecropping, Jim Crow laws and segregation, and, recently, due to gerrymandering.

Sturdevant set up shop in Greenville, near a Black church that served as a headquarters for civil rights activists in the 1960s. In a small office, his team organizes health events, tests people for HIV, and connects those who test positive with treatment and housing assistance, funded through federal programs like Ryan White.

“Whites have been getting Ryan White and other programs for years and living healthy,” said Ashley Richardson, administrative assistant of Sturdevant’s group. “Around here, Black people are just now getting to the point where we know there are resources to help.”

Lately the team fields calls from people with HIV who are terrified they will lose their lifesaving drugs and housing if government programs no longer help with the cost.

Sturdevant worries about keeping his staff employed and his community safe. On the drive home from the April event in Washington, he drearily recounted conversations with Republicans in Congress: “They basically all said trust the process.”

The heads of national HIV organizations have stepped up their advocacy, asking Congress to oppose cuts in President Donald Trump’s budget request, said Gregorio Millett, director of public policy at the Foundation for AIDS Research, a nonprofit known as amfAR.

Emily Hilliard, spokesperson for the Department of Health and Human Services, responded to queries from KFF Health News by writing, “Critical HIV/AIDS programs will continue under the Administration for a Healthy America.” Yet the administration’s proposed budget for HIV prevention represents a 78% reduction compared with fiscal year 2025, according to a KFF analysis.

HHS Secretary Robert F. Kennedy Jr. has fostered skepticism  about scientific facts concerning HIV, without citing evidence. “Any questioning of the orthodoxy that HIV is the sole cause of AIDS remains an unforgivable-even dangerous-heresy among our reigning medical cartel,” he wrote in a 2021 book.

Not Bowing to Barriers

Researchers and HIV advocates are hashing out strategies to fill in the vacuum in HIV care that the government is poised to leave. For decades, it has driven priorities, coordinated a constellation of HIV groups, and tracked the epidemic. Leisha McKinley-Beach, CEO of a training institute, Black Public Health Academy, in Atlanta, said people must remember that wasn’t always the case.

“This massive industry we have today was created by committed individuals at the grassroots level, who were going to help people live with HIV or die with dignity, by any means necessary,” she said.

One idea is to have larger, established HIV organizations partner with nascent groups in underserved regions. The bigger ones stand a better chance of garnering significant private donations. And by taking on the fiscal management of grants, large groups could enable small ones to devote time to service rather than fundraising, McKinley-Beach said.

Another strategy, said Kathy Garner, executive director of Mississippi’s AIDS Services Coalition, is to fill gaps by coordinating with churches and nonprofits dedicated to food assistance, housing, or mental health.

“One of the solutions is going to be civil society stepping up,” Garner said. “That’s an old term for people taking care of each other, outside of the government.”

“We’re going to need to ramp up our services in all kinds of ways, and health and HIV will be a part of that,” said Bishop Ronnie Crudup of New Horizon Church International in Jackson, and a member of Mississippi Faith in Action, a coalition of African American churches involved in HIV.

“I have real concerns with what the Trump administration is doing, and how it will play out for the health of people in a poor state,” he said.

National groups, such as AIDS United, have been speaking with corporate funders and philanthropies about building a pooled fund to help sustain HIV organizations across the U.S.

Philanthropy for HIV has never come close to matching federal dollars, however. Non-governmental funders put $284 million toward HIV in the U.S. in 2023, compared with about $16 billion in annual federal funds for HIV in recent years.

“The truth is there is no way for philanthropy to make up for the cuts from the federal government,” Davis said. “I suspect we will see new infections rise within 18 months, which is heartbreaking.”

Sturdevant focuses on survival, not forecasts. “This isn’t going to be easy,” he said, “but we need to keep fighting for those who don’t have the fight in them.”

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The researchers were laid off in early April, just before they put the finishing touches on in-depth, national surveys about HIV. Health officials across the country had interviewed tens of thousands of people at risk of acquiring HIV, or who are living with the virus, and compiled information from mountains of medical records.

States and cities were prepared to submit the information they collected to the CDC in April so the agency’s statisticians could prepare the volumes of data for analysis.

Health officials and policymakers use the data to design HIV programs that more efficiently curb the spread of infections and save lives. For example, a 2023 survey revealed that about half of adults under age 30 who were living with HIV weren’t on treatment steadily enough to keep them healthy and prevent them from spreading the virus to others. Treatment rates were far higher for those over 50. As a result, health officials doubled down on outreach to younger generations.

However, in April, state and local health officials found themselves cut off from their CDC counterparts after the layoffs. Emails from the Department of Health and Human Services told staff their roles were “either unnecessary or virtually identical to duties being performed elsewhere in the agency.”

Marti Merritt, a project coordinator at the Illinois state health department, was flabbergasted that she and other state employees had invested more than a year into the surveys only to have them go dark in the final phase. “It’s like the data has gone into a black hole,” she said. “How do you set priorities if you don’t have data?”

Merritt worries that if the surveys don’t resume, limited budgets will be misspent — and that cases will rise. Data allows health departments to tailor their efforts to the populations at greatest risk of infection or disease progression.

Evidence shows that preventing HIV is far cheaper than treating people once they’re infected. Preventing one HIV infection results in $466,000 in lifetime savings. Merritt was also dismayed to have wasted the time of thousands of people who opened up about intimate details of their lives in hopes of fighting the HIV epidemic.

A doctor and HIV expert reinstated at the CDC this week said the late termination of the surveys would waste millions of taxpayer dollars that have already been spent on data collection. Two large, long-standing efforts, the Medical Monitoring Project and the National HIV Behavioral Surveillance system, cost around $72 million, he said.

“Two years’ worth of data from 30,000 participants will be unusable, and therefore wasted,” if the projects can’t be finished, he said.

To resume the surveys, he and other CDC researchers would need a green light from higher up because the grants covering these surveys ended while they were on administrative leave in May.

State health officials said they haven’t received the CDC notices that typically renew the surveys every June. Merritt has conducted interviews for the Medical Monitoring Project for about 20 years, she said, but the Illinois health department has now assigned her to other tasks. Other health departments have laid off or reassigned employees dedicated to HIV surveillance, too.

If HHS allows the reinstated researchers to resume the projects, they could try to account for the 10-week gap in their analysis. But it would take time, further delaying the next round of surveys — if those begin at all.

“These surveys aren’t lights that you turn on and off,” said John Brooks, a researcher who retired from the CDC’s Division of HIV Prevention last year. If the surveys resume, he said, “we can get some value out of all of the money spent.”

However, the surveys would be further impaired by actions related to Trump’s executive orders targeting words such as “gender” that researchers use to learn who has HIV, who is at risk, and why.

Experts at the CDC said they’ve already had to revise earlier surveys and recalculate results to not reference gender. This has meant altering data on two populations disproportionately affected by HIV: transgender people and men who have sex with men.

“To erase people from our data harms them,” said the researcher and doctor now reinstated at the CDC. “I care about the transgender patients I see, and it’s so hurtful to see them treated this way by the government.”

The doctor said he has treated HIV patients since the beginning of the epidemic in the 1980s, and the sting he feels now is worse than under President Ronald Reagan, who never publicly mentioned HIV in his first term.

“There was a lack of funding,” he said, “but they didn’t censor science or try to control science like they’re doing now.”

Many HIV researchers have taken jobs outside the government or moved since the April layoffs. Some researchers returning to the agency called the reinstatements perplexing because the notices don’t say what they’ll be doing when they return and for how long.

A terse email to CDC employees from Tom Nagy, chief human capital officer at the Department of Health and Human Services, reviewed by KFF Health News, simply refers to the notice regarding the reduction in force and says, “That notice is hereby revoked.”

In an email response to queries, Andrew Nixon, HHS director of communications, wrote, “HHS is streamlining operations without compromising mission-critical work. Enhancing the health and well-being of all Americans remains our top priority.”

“We’ve been getting paid this whole time even though we’ve not been allowed to work, and that doesn’t feel good when you’re a dedicated civil servant,” said one reinstated employee.

We’d like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what’s happening within the federal health bureaucracy. Please message KFF Health News on Signal at (415) 519-8778 or get in touch here.

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Sin embargo, el daño a sus proyectos podría ser permanente, y las restricciones continuas a sus investigaciones perjudicarán vidas, dijeron científicos de los CDC que trabajan en el área de VIH a KFF Health News. Lo hicieron de manera anónima por temor a represalias.

Estos investigadores fueron despedidos a principios de abril, justo antes de finalizar las encuestas nacionales exhaustivas sobre el VIH. Oficiales de salud de todo el país entrevistaron a decenas de miles de personas en riesgo de contraer el VIH o que viven con el virus, y recopilaron información de montañas de historiales médicos.

Los estados y ciudades estaban preparados para enviar la información recopilada a los CDC en abril para que los expertos en estadísticas de la agencia pudieran preparar la enorma cantidad de datos para su análisis.

Oficiales de salud y legisladores utilizan estos datos para diseñar programas contra el VIH que frenen la propagación de infecciones y salven vidas de manera más eficiente.

Por ejemplo, una encuesta de 2023 reveló que aproximadamente la mitad de los adultos menores de 30 años que vivían con VIH no recibían tratamiento de forma regular para poder mantenerse sanos y evitar transmitir el virus a otras personas. Las tasas de tratamiento eran mucho más altas para los mayores de 50 años. Como resultado, las autoridades sanitarias redoblaron sus esfuerzos para llegar a las generaciones más jóvenes.

Sin embargo, en abril, luego de los despidos, se cortaron los vínculos entre las autoridades sanitarias estatales y locales y sus homólogos de los CDC. Correos electrónicos del Departamento de Salud y Servicios Humanos (HHS) indicaron al personal que sus funciones eran “innecesarias o prácticamente idénticas a las que se desempeñaban en otras partes de la agencia”.

Marti Merritt, coordinadora de proyectos del Departamento de Salud de Illinois, se quedó atónita al ver que ella y otros empleados estatales habían invertido más de un año en las encuestas, solo para que estas se esfumaran en la fase final. “Es como si los datos se hubieran ido a un agujero negro”, dijo. “¿Cómo se establecen prioridades si no se tienen datos?”.

A Merritt le preocupa que, si no se reanudan las encuestas, se malgasten los presupuestos limitados y aumenten los casos. Los datos permiten a los departamentos de salud adaptar sus esfuerzos a las poblaciones con mayor riesgo de infección o progresión de la enfermedad.

La evidencia demuestra que prevenir el VIH es mucho más económico que tratar a las personas una vez infectadas.

Prevenir una sola infección por VIH supone un ahorro de $466.000 a lo largo de una vida. Merritt también se mostró consternado por haber desperdiciado el tiempo de miles de personas que se sinceraron sobre detalles íntimos de sus vidas con la esperanza de luchar contra la epidemia de VIH.

Un médico y experto en VIH reincorporado a los CDC la semana del 9 de junio afirmó que finalizar las encuestas más tarde supondría un desperdicio de millones de dólares de los contribuyentes que ya se han gastado en la recopilación de datos. Dos grandes iniciativas de larga data, el Medical Monitoring Project, y el National HIV Behavioral Surveillance System, costaron alrededor de $72 millones, afirmó.

“Dos años de datos de 30.000 participantes serán inutilizables y, por lo tanto, se desperdiciarán” si los proyectos no se pueden finalizar, agregó.

Para reanudar las encuestas, él y otros investigadores de los CDC necesitarían luz verde de las máximas autoridades, ya que las subvenciones que cubrían estas encuestas finalizaron mientras estaban de baja administrativa en mayo.

Las autoridades sanitarias estatales afirmaron no haber recibido las notificaciones de los CDC que suelen renovar las encuestas cada junio. Merritt dijo que ha realizado entrevistas para el Medical Monitoring Project por unos 20 años, pero el Departamento de Salud de Illinois lo ha asignado a otras tareas. Otros departamentos de salud también han despedido o reasignado a empleados dedicados a la vigilancia del VIH.

Si el HHS permite que los investigadores reincorporados reanuden los proyectos, podrían intentar compensar el lapso de diez semanas en sus análisis. Sin embargo, esto llevaría tiempo, lo que retrasaría aún más la siguiente ronda de encuestas, si es que llegan a comenzar.

“Estas encuestas no son luces que se encienden y se apagan”, dijo John Brooks, investigador que se jubiló de la División de Prevención del VIH de los CDC el año pasado. Si las encuestas se reanudan, “podemos obtener algún valor de todo el dinero gastado”, expresó.

Sin embargo, las encuestas se verían aún más perjudicadas por las acciones relacionadas con las órdenes ejecutivas de Trump que se centran en palabras como “género”, que los investigadores utilizan para saber quién tiene VIH, quién está en riesgo y por qué.

Expertos de los CDC afirmaron que ya han tenido que revisar encuestas anteriores y recalcular los resultados para que no hagan referencia al género. Esto ha implicado alterar datos de dos poblaciones desproporcionadamente afectadas por el VIH: las personas transgénero y los hombres que tienen sexo con hombres.

“Borrar personas de nuestros datos les perjudica”, declaró el investigador y médico, ahora reincorporado a los CDC. “Me preocupan los pacientes transgénero que atiendo, y es muy doloroso ver que el gobierno los trate así”.

El médico afirmó que ha tratado a pacientes con VIH desde el comienzo de la epidemia en la década de 1980, y el dolor que siente ahora es peor que durante la presidencia de Ronald Reagan, quien nunca mencionó públicamente el VIH durante su primer mandato.

“Había falta de financiación, pero no censuraron la ciencia ni intentaron controlarla como lo hacen ahora”, dijo.

Desde los despidos de abril, muchos investigadores del VIH han aceptado trabajos fuera del gobierno o se han mudado. Algunos que volverán a la agencia definieron a las reincorporaciones como desconcertantes, ya que los avisos no especifican qué harán a su regreso ni por cuánto tiempo.

Un breve correo electrónico dirigido a los empleados de los CDC de Tom Nagy, director de capital humano del HHS, que KFF Health News revisó, simplemente se refiere al anuncio sobre la reducción de personal y dice: “Por la presente, se revoca dicho aviso”.

En respuesta a consultas por correo electrónico, Andrew Nixon, director de comunicaciones del HHS, escribió: “El HHS está optimizando sus operaciones sin comprometer su labor esencial. Mejorar la salud y el bienestar de todos los estadounidenses sigue siendo nuestra principal prioridad”.

“Hemos estado cobrando todo este tiempo a pesar de no tener permiso para trabajar, y eso no es agradable para un funcionario dedicado”, dijo un empleado reincorporado.

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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