Welcome to Public Health Watch, a weekly roundup from Protect Our Care tracking catastrophic activity as part of Donald Trump’s sweeping war on health care. From installing anti-vaccine zealot RFK Jr. as Secretary of HHS to empowering Elon Musk to make indiscriminate cuts to our public health infrastructure, including the National Institutes of Health and the Centers for Disease Control, Donald Trump is endangering the lives of millions of Americans. Protect Our Care’s Public Health Watch will shine a spotlight on the worst of the Trump/RFK war on vaccines, science and public health and serve as a resource for the press, public and advocacy groups to hold them accountable.
What’s Happening In Public Health?
Dangerous Chaos At The HHS and the CDC
Stat: HHS employees to be fired as White House enacts mass terminations it blames on shutdown Federal health employees on Friday were being fired as the White House followed through on its threat to terminate federal employees en masse as the second week of the government shutdown drags to a close. Between 1,100 and 1,200 employees at the Department of Health and Human Services were to be let go as part of the “reductions in force,” according to a legal filing by the administration, more than at any other department other than the Treasury. An HHS spokesperson confirmed the firings had hit the department, but did not specify which agencies were affected. During a Thursday Cabinet meeting, President Trump said the firings would impact “Democrat” programs, as Republicans put the blame for the shutdown on their Democratic colleagues.
- Washington Post: Hundreds of CDC layoffs reversed, but biodefense preparedness staff hit Officials have reversed more than half of the about 1,300 layoff notices sent to staff members at the Centers for Disease Control and Prevention, sparing personnel who were leading the response to measles outbreaks in the United States and an Ebola outbreak abroad. But details emerged about the other health officials who lost their jobs, including analysts responsible for monitoring and protecting the United States from biological, chemical and nuclear threats, according to current and former officials. Dozens of fired staff members at the Administration for Strategic Preparedness and Response, a federal health agency, included individuals with top-secret clearance who work with intelligence agencies on biodefense issues such as pandemics and weaponized pathogens, said a former Department of Health and Human Services official who has been in contact with those dismissed.
- Associated Press: Federal employees in mental health and disease control were among targets in weekend firings Hundreds of federal employees working on mental health services, disease outbreaks and disaster preparedness were among those hit by the Trump administration’s mass firings over the weekend, current and laid-off workers said Monday, as the administration aimed to pressure Democratic lawmakers to give in and end the nearly two-week-long government shutdown. The government-wide reduction-in-force initiative that began Friday roiled the massive U.S. Department of Health and Human Services just six months after it went through an earlier round of cuts and as many staffers already were disconnected from work because of the shutdown. The situation turned even more chaotic over the weekend, when more than half of the U.S. Centers for Disease Control and Prevention employees who’d gotten layoff notices learned they received them in error and were still employed with the agency.
Stat: Inside FDA, career staffers describe how political pressure is influencing their work The inquiry came in August, and struck scientists at the Food and Drug Administration as highly unusual. The leader of the center that regulates prescription medicines wanted to know what they thought about leucovorin, a generic drug that’s mainly used to alleviate side effects of cancer therapies. He’d seen some promising studies and thought the agency could find a way to approve it as an autism treatment. Autism, with its broad spectrum of symptoms, is one of the most challenging conditions to treat with medication. For the FDA itself to push for such a significant change to a drug’s label, and based on a handful of small studies — it would be unheard of, officials told STAT. The request would have seemed completely random if not for health secretary Robert F. Kennedy Jr.’s longstanding interest in autism. In April, Kennedy announced his intention to identify autism’s root cause by September. President Trump zeroed in on the condition, too, and the political pressure to announce something big and splashy was ramping up. Even given the president’s interest in the subject, the request was so extraordinary that FDA staff pushed back, STAT has learned. The drug center director who made the request, George Tidmarsh, eventually came to a compromise with his staff: He agreed to ask GSK, the original manufacturer of the drug, to instead submit an application for cerebral folate deficiency, a rare neurological disorder that can have overlapping symptoms with autism. This episode was described by two people familiar with the situation. But at the Trump administration’s press conference on autism in September, the career staff’s efforts to ground the move in science didn’t seem to matter. When FDA Commissioner Marty Makary reintroduced the public to leucovorin, he touted the drug as an autism treatment. “Today, the FDA is filing a federal register notice to change the label on an exciting treatment called prescription leucovorin so that it can be available to children with autism,” he said. “Leucovorin holds promise for hundreds of thousands of kids with autism,” he later tweeted. Reshma Ramachandran, a health services researcher and clinician at Yale School of Medicine, said the sequence of events is the antithesis of how the FDA is supposed to function. “What we’re seeing here is, ‘We believe this and we’re going to find the evidence to support that’,” Ramachandran said. “That’s just inherently wrong in terms of how a scientific agency like the FDA operates.”
Politico: Health agencies lose ‘the backbone folks who can keep things running’ to Indian Health deployments Health Secretary Robert F. Kennedy Jr. is transferring dozens of public health corps officers from their posts around the country to work multi-month stints at Indian Health Service centers with severe staffing shortages. The perennially under-resourced clinics for Native Americans are welcoming the help. But current and former officials warn the 120-day details for about 70 officers will strain the health agencies they are leaving behind while failing to solve the clinics’ staffing woes in the long term.
Washington Post (Opinion): Six surgeons general: It’s our duty to warn the nation about RFK Jr. As former U.S. surgeons general appointed by every Republican and Democratic president since George H.W. Bush, we have collectively spent decades in service as the Nation’s Doctor. We took two sacred oaths in our lifetimes: first, as physicians who swore to care for our patients and, second, as public servants who committed to protecting the health of all Americans. Today, in keeping with those oaths, we are compelled to speak with one voice to say that the actions of Health and Human Services Secretary Robert F. Kennedy Jr. are endangering the health of the nation. Never before have we issued a joint public warning like this. But the profound, immediate and unprecedented threat that Kennedy’s policies and positions pose to the nation’s health cannot be ignored.
RFK Jr.’s War on Vaccines Will Have Deadly Consequences
CNN: Fact check: Trump makes numerous false claims at Cabinet meeting, many about vaccines President Donald Trump made numerous false claims during a Cabinet meeting Thursday at the White House – many of them about vaccines. He wrongly asserted that babies are given 82 vaccines in a single shot (not even close to true). He wrongly asserted that babies are given vaccine doses the size of two glasses of water (a standard dose is a small fraction of a teaspoon). He wrongly asserted that Amish people don’t take vaccines or pills (many do) and don’t have any autism (they do). And he wrongly asserted that the measles vaccine is already given separately from other vaccines (no separate measles shot is available in the US).
MedPage Today: RFK Jr. Links Circumcision to Autism via Supposed Tylenol Use HHS Secretary Robert F. Kennedy Jr. has made yet another bold claim about acetaminophen (Tylenol), this time charging that circumcised boys were twice as likely to develop autism as those not circumcised, because they were given the painkiller. Kennedy’s remarks came during a Cabinet meeting Thursday, weeks after he and President Donald Trump warned pregnant women not to take acetaminophen over an unproven link to autism. While Kennedy did not cite specific research, he appeared to be referencing two older studies. One was a 2015 Danish national cohort study published in the Journal of the Royal Society of Medicine. Among boys born between 1994 and 2003, those who were circumcised were 46% more likely to develop autism spectrum disorder (ASD) before age 10, and the risk was particularly elevated for infantile autism diagnosed before age 5, where a twofold risk was observed. But the study authors acknowledged numerous weaknesses, most notably that it had no data on whether acetaminophen was actually administered during circumcisions. The investigators acknowledged that while their evidence was “compatible with a possible causal role of circumcision trauma in some cases of ASD,” they cautioned that “no firm conclusions should be drawn at this point” and called for confirmatory studies.
Axios: RFK Jr.’s next vaccine target The CDC’s vaccine advisory committee this week announced the creation of a working group to review the childhood vaccination schedule, including the timing and order of different vaccines and the safety of certain ingredients. An example topic for discussion, per the document, would be whether “either of the two different aluminum adjuvants increase the risk of asthma? The big picture: Vaccine skeptics, including Health Secretary Robert F. Kennedy Jr., have long questioned the scientific consensus that the small amount of aluminum used in vaccines is safe. Now, the federal government is poised to reopen the safety debate and potentially add guardrails. This could affect DTaP, hepatitis A and B, HPV, pneumococcal and meningococcal vaccines. “Previous scientific research has shown the amount of aluminum exposure in people who follow the recommended vaccine schedule is low and is not readily absorbed by the body,” the CDC website states.
NBC: Acting CDC director calls to ‘break up’ the measles, mumps and rubella vaccine into three shots Acting CDC Director Jim O’Neill on Monday called on vaccine manufacturers to develop separate shots for measles, mumps and rubella instead of the current vaccine, which combines the three. O’Neill wrote in a post on X that manufacturers should replace the MMR vaccine with “safe monovalent vaccines,” which only target one virus. His statement referenced a recent comment from President Donald Trump, who advised people last month on Truth Social to “break up the MMR shot into three totally separate shots.” However, no monovalent vaccines for measles, mumps or rubella are approved in the U.S., and the Centers for Disease Control and Prevention says there is no published scientific evidence that shows a benefit to separating the combined vaccine. It is not clear whether the change O’Neill is calling for is possible or likely to come about.
Politico: CDC, its advisers quietly expand access to Covid-19 shot for pregnant women The CDC and its independent panel of vaccine advisers have quietly opened the door to wider access to Covid-19 vaccination during pregnancy, softening an earlier decision by Health Secretary Robert F. Kennedy Jr. to stop recommending that pregnant women get the shots. The CDC’s Advisory Committee on Immunization Practices voted in September to advise that adults get the Covid-19 shot through shared clinical decisionmaking between patients and providers. It did not specifically vote on whether the shot should be administered during pregnancy, yet the vote appears to encompass pregnant women, according to an update this month on the CDC website that reflects the new guidance.
Politico: RFK Jr.’s got advice for pregnant women. There’s limited data to support it. The uproar over the Trump administration’s efforts to discourage pregnant women from taking Tylenol is highlighting a bigger problem: There has never been adequate data on the safety and effectiveness of many drugs during pregnancy, and that data became even harder to gather after the fall of Roe v. Wade. Medical experts and women’s health advocates warn that state abortion bans are exacerbating longstanding barriers to including women of reproductive age in drug trials and other health studies, as both scientists and participating women could face new legal consequences if a drug harms a fetus. And without good information about how drugs affect pregnant women, it’s harder to navigate a morass of conflicting messages from the government and medical groups on the safety of everything from painkillers to antidepressants to vaccines.
RFK Jr. Is A Political Liability For Trump And Republicans
NBC: Trump gets Covid vaccine and flu shot during second checkup of the year The White House on Friday released a memo from President Donald Trump’s physician summarizing his visit to Walter Reed Army Medical Center earlier in the day, which included a Covid vaccine booster and a flu shot. […] Barbabella said Trump, 79, received the flu shot and a Covid vaccine booster “in preparation for upcoming international travel.” Trump is scheduled to leave for the Middle East on Sunday after helping secure a ceasefire deal between Israel and Hamas this week. Covid shots have become harder to get under the Trump administration. The Centers for Disease Control and Prevention updated its Covid vaccine guidance on Monday, limiting its recommendation for the shots only to people 65 or older or those with an underlying health condition — and only after they consult doctors, nurses or pharmacists. That change comes after many states had set their own guidance on vaccines, resulting in a complex landscape with a patchwork of different vaccine policies, making it harder to find the shot depending on where a person lives.
Axios: Most Americans unsure about Trump Tylenol warning Most Americans aren’t sure what to make of President Trump’s claim that taking Tylenol during pregnancy can increase the risk of autism in children, but few are accepting it as fact, a new KFF poll finds. Why it matters: There are deep partisan divisions on the question, just as there are on vaccines, the pandemic response and other health issues. What they found: Three-quarters of the public (77%) said they had heard the claim, which was aired during a Sept. 22 news conference despite no new evidence of a causal relationship. Only 4% of the 1,334 adults polled said it was “definitely true” while a much larger share (35%) said the claim is “definitely false. 60% were unsure, divided roughly evenly between those who said it was “probably true” and others who believe it was “probably false. The partisan splits were significant, with 59% of Democrats saying the claim was “definitely false” compared with 12% of Republicans. Only 2% of Democrats and 3% of independents said the claim was “definitely true.” Half of the Republican respondents said the claim was “probably true” while 30% thought it was “probably false.”
Other Dangerous MAHA Initiatives
New York Times: The E.P.A. Followed Up on an Unusual Request About Abortion Pills Senior officials at the Environmental Protection Agency directed scientists over the summer to assess whether the government could develop methods for detecting traces of abortion pills in wastewater — a practice sought by anti-abortion activists seeking to restrict the medication. The highly unusual request appears to have originated from a letter sent from 25 Republican members of Congress to Lee Zeldin, the E.P.A. administrator, asking the agency to investigate how the abortion drug mifepristone might be contaminating the water supply. “Are there existing E.P.A.-approved methods for detecting mifepristone and its active metabolites in water supplies?” the lawmakers asked at the end of the public letter, sent on June 18, an effort led by Senator James Lankford and Representative Josh Brecheen, both of Oklahoma. “If not, what resources are needed to develop these testing methods?” Scientists who specialize in chemical detection told the senior officials that there are currently no E.P.A.-approved methods for identifying mifepristone in wastewater — but that new methods could be developed, according to two people familiar with the events, who spoke on the condition of anonymity to discuss sensitive information. Abortion pills have emerged as a major focus for the anti-abortion movement since the fall of Roe v. Wade, as growing numbers of women in states with abortion bans have turned to websites and underground networks that send the pills through the mail, allowing them to circumvent the laws. The widespread availability of abortion pills — which women usually take at home in the first 10 weeks of pregnancy — has inspired many anti-abortion activists to push for new approaches to curtail their use. That has included a campaign by one prominent group to raise awareness about environmental harms they say are caused when the medication and fetal remains enter the sewage system.
- NOTUS: Nearly All GOP Senators Urge the FDA to Restrict Abortion Pills Most Republican senators on Thursday sent a letter to the Food and Drug Administration calling for restrictions on abortion pills, in response to the agency’s approval of a new generic version of mifepristone. “We urge you to take decisive action to reevaluate whether this generic version ofmifepristone is suitable to enter the market,” 51 senators — led by Sen. Lindsey Graham — wrote in the letter. (Sens. Susan Collins and Lisa Murkowski, who support abortion access, were the only Republicans to not join in the effort.)
Washington Post: She left the medical mainstream and rose to be RFK Jr.’s surgeon general pick Seven years ago, Casey Means was on a path to finishing up a highly competitive residency and becoming a well-paid surgeon. But she resigned, becoming a health products entrepreneur and popular online personality who has frequently suggested that Americans should question the advice they get from medical authorities. “We are told to ‘trust the science,’” she wrote in her 2024 book, “Good Energy: The Surprising Connection Between Metabolism and Limitless Health.” “This obviously doesn’t make sense. We have been gaslighted to not ask questions over the past fifty years at the exact time chronic disease rates have exploded.” As a best-selling author with more than 850,000 followers on her Instagram account, @drcaseyskitchen, she centers her message around the concept of “good energy,” which she defines as optimizing metabolic health. This idea suggests that maintaining a healthy lifestyle will ward off — and potentially treat — diseases. Now Means, 38, is poised to become the next surgeon general of the United States, one of the nation’s most recognizable and trusted medical posts. There, her backers and critics believe, she will advance Health and Human Services Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” movement aimed at addressing childhood illness and chronic disease. Several medical and scientific experts say she has portrayed healthy eating, an active lifestyle and using health-tracking devices as more powerful in reversing disease than scientific research has established. They are concerned she may use the surgeon general’s bully pulpit to amplify policy recommendations that are not grounded in evidence.
Public Health Threats
NBC: Hundreds of U.S. students quarantined amid measles outbreaks A bubbling measles outbreak in the upstate of South Carolina has forced 153 unvaccinated children out of the classroom and into quarantine for a minimum of 21 days. In Minnesota, where a small outbreak has been growing for the last month, 118 students are also under quarantine in the Minneapolis-St. Paul area after being exposed to the highly contagious virus, health officials said Friday. The restrictions mean three weeks of remote learning as parents monitor for fever, rash and other symptoms. “Communities are having to bear the price of quarantining so many children,” said Michael Osterholm, an infectious disease expert and the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Expect more of the same. This is going to happen more and more frequently.”
Chicago Sun Times: 8-year-old boy’s death from rare infectious disease shows importance of vaccines, mom says Eight-year-old Liam Dahlberg stepped off the school bus with a headache one Thursday afternoon last spring. The following Saturday morning, he was in a coma with no brain activity. He was dead by Monday. His doctors said the northwest Indiana boy contracted an aggressive form of H flu, a rare bacterial infection. He died in a Chicago hospital despite being a healthy kid and vaccinated against the disease, his mom, Ashlee Dahlberg, told the Sun-Times. While doctors can’t say for sure how he got sick, one way that the disease can spread is through the unvaccinated, who are more likely to be infected and spread the disease. Unlike Illinois, Indiana does not require the vaccine as a part of a student’s immunizations. The boy’s mom worries her son’s tragic case could become more common as vaccine skepticism rises and vaccination rates fall.