Kennedy’s actions at HHS cause upheaval in nation’s health direction
The HHS head is facing blistering criticism for CDC firings and resignations, as well as vaccine decisions that aren’t based on science.
Upheaval, turnover and uncertainty now surround federal health policymaking, and the path ahead looks unclear, uneven and potentially dangerous.
High-profile firings and resignations from the Centers for Disease Control and Prevention, and other funding and staffing decisions from Health and Human Services Secretary Robert F. Kennedy Jr. are prompting calls for his resignation or, at the minimum, reversals of the agency’s direction. In his role, Kennedy oversees HHS, the CDC, the National Institutes of Health and other federal health/safety initiatives.
Kennedy faced blistering questioning Thursday before the Senate Finance Committee, responding at times with his own rancor toward Senate members when he was asked about his past statements about vaccines and current health policy decisions. Committee members also questioned Kennedy about his decision to fire recently appointed CDC Director Susan Monarez and the resulting resignation of senior CDC officials, leaving the agency short on critical experience.
Vaccine policies in disarray
Kennedy also has fired 17 members of the CDC’s influential vaccine advisory committee, replacing them with members who have repeatedly expressed skepticism about vaccines. Kennedy has long argued against the use mRNA-based vaccines (a form of which enabled quick formulation of the vaccine used to protect recipients against serious consequences of the COVID-19 virus), and he recently canceled nearly $500 million in federal funding for their development.
Anti-vaccine extremism is certainly on the rise. For example, this week, Florida officials announced plans to eliminate vaccine mandates for children, making it the first state to do away with a longtime key component of public health policy for protecting schoolchildren from infectious diseases.
Nationally, federal approval of the fall vaccine for current variants of the COVID-19 virus has been restricted to those older than age 65 or with high-risk health conditions. That delay is expected to impact availability of the COVID vaccine – two large pharmacy chains (CVS and Walgreens) have indicated they would not offer COVID-19 vaccines without a prescription in more than a dozen states this fall.
Meanwhile, officials in other largely Democratic-led states are taking steps to ensure wide availability to the COVID vaccine. Massachusetts and other states are attempting to organize their own vaccine policy coalitions.
Specifically, the Democratic governors of Washington, Oregon and California announced Wednesday that they created an alliance to safeguard the public through science-based health policies. "The CDC has become a political tool that increasingly peddles ideology instead of science, ideology that will lead to severe health consequences," the governors said in a joint statement. The Washington, Oregon and California partnership is hoping to coordinate health guidelines by aligning immunization plans based on recommendations from respected national medical organizations.
Over time, the various politicized health policies are likely to create a patchwork of rules and vaccination rates. The lack of vaccinations among some large segments will increase the likelihood of outbreaks, which could expand even into areas where residents are widely vaccinated.
The path forward
There’s no simple solution here, admits Devin Jopp, CEO at the Association for Professionals in Infection Control (APIC). His organization has joined about 20 other professional organizations calling for the resignation of Kennedy as HHS Secretary.
“Forcing high-level CDC expert leaders to turn their back on decades of sound science to meet Kennedy’s agenda puts us all at risk,” the organizations’ statement contends. “This final exclamation point on a term defined by repeated efforts to undermine science and public health definitively leaves Americans less safe in a multitude of ways.”
The professional groups are not alone in this. Democratic senators also at the hearing also called for Kennedy to resign – Sens. Ron Wyden (D-Ore.) and Angela Alsobrooks (D-Md.) detailed “higher costs, more chaos and boundless corruption” in a report they say tallies Kennedy’s actions “to undermine Americans’ health and safety.” The report can be found here.
Unsurprisingly, Kennedy indicated no intention of resigning, and he was feisty in responding to questions from senators. Jopp says he expects to uncertainty and challenges for the nation’s healthcare system under the current administration.
“This is causing a ripple effect, where we’re seeing agencies that we’ve relied on for guidance becoming politicized,” he says. “If we start pulling back from the science of vaccines, it weakens our collective ability to respond. We’ve seen this misinformation train coming for a while, but now, misinformation has found a political home. Before now, these things were on the fringe – now it’s getting into policy, which is certainly scary. It will lead to bad outcomes for our country.”
Jopp also says the Trump administration’s decision to terminate the Healthcare Infection Control Practices Advisory Committee (HICPAC) was dangerous because it limited the nation’s ability to have a coordinated response to prevent and control healthcare-associated infections and the spread of antimicrobial resistance. A statement from an HHS official in May said HICPAC was shuttered because it was “unnecessary.”
Countervailing efforts by states or regions may provide some relief in some instances for their residents, but a unified national response to epidemics or other health issues will be difficult to achieve, Jopp contends.
“How good can a public health response system be when it’s typically been built on goodwill? How quickly can you establish an emergency response framework when it’s bearing down on you?”
The real payoff for federal leadership and coordination has been the “ability to scale (response) and do the right thing at the right time.”
There’s not much of a silver lining to the current situation, although he believes professional healthcare organizations such as APIC can step into the breach to provide some guidance and leadership. However, it will be impossible to fill the void left by the absence of credible federal health direction, he adds.
“The reality is that the amount of evidence gathering that goes on (with federal agencies) is significant,” he says. “It’s hard for the private sector to assume this role.”
Fred Bazzoli is the Editor in Chief at Health Data Management