HHS visibility ≠ transparency. The legal processes for national vaccine policy have been usurped. This week in public hell—um, health. May 30, 2025.
Wow, HHS had a weird one.
One main policy position on vaccines, followed by two related stories to round out the week. Let’s dive in…
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Let me state this clearly. Under Secretary Robert F. Kennedy Jr., HHS officials are confusing visibility and transparency.
Visibility is getting on camera, a podcast, or social media, and saying stuff. Transparency is an open process wherein the public has access to the data and the expert deliberations that determine national policy.
HHS officials in the Trump administration seem to love posting videos of themselves and even publishing insular policy statements in The New England Journal of Medicine (despite the fact that Secretary Kennedy this week threatened to ban government scientists from publishing work there).
Do not be confused. These are PR tactics, and they are not the same thing as transparency. Transparency has now been replaced by publicity stunts and inappropriate use of power at HHS. This matters because access to vaccines are in question because of it.
Vaccine policy by fiat.
Earlier this week, Secretary Kennedy announced there would be changes to the US government’s recommendations on Covid-19 vaccines, including a plan to remove the CDC’s recommendation that children and pregnant women be vaccinated. On Friday, in a surprise, the CDC released a revised vaccination schedule that kinda threads a needle between removing and maintaining the prior recommendations. According to the CDC, Covid-19 vaccination can now be given to children based on “shared clinical decision-making” between doctors and parents. This replaces the agency’s previous recommendation in favor of pediatric Covid-19 vaccinations. Meanwhile, the CDC’s recommendations for pregnancy are not clear, but the prior ones have been removed, at a minimum.
The New York Times described the CDC’s actions as contradicting Secretary Kennedy’s earlier announcement, and to some extent that’s true.
But that is not the larger point.
Leaving semantics and specific recommendations aside, this current process—the implementation of national vaccine policy by fiat and instead of the usual public processes—is entirely inappropriate and likely not legal.
Be clear on what occurred this week: The viewpoints of an arrogant few who find themselves in power at HHS supplanted the expertise and established legal processes required of the actual experts statutorily tasked with making important decisions by voting in public hearings—votes which determine national vaccine policy, and therefore access to them.
How it’s supposed to work…
Normally, when the CDC’s Advisory Committee on Immunization Practices (ACIP) makes a recommendation, it does so after many steps. First, working groups are assembled. While a working group’s fact-finding and initial deliberations may not be public, its existence is announced in advance so that stakeholders can prepare to participate later in the process. Next, ACIP meetings are announced in the Federal Register and, prior to those meetings, the agendas and even the slides with detailed safety and efficacy data are made public. Then, ACIP meets to discuss the data, often including presentations from multiple parties. These meetings are open to the public and include the opportunity for stakeholders (or anyone) to make comments or ask questions that can influence the outcome of these votes. Then, based on published standards and frameworks that ensure that the data presented are of adequate quality and certainty, votes are cast by official voting members of ACIP, a body comprised of highly-regarded experts. Again, all of this is public. If a vote passes, the CDC Director (or Acting Director) can choose to adopt the recommendation or not. The CDC Director usually adopts the recommendations, but not always. Also, in the absence of a permanent or acting CDC Director, the HHS Secretary can make these decisions, but nobody else may, by law. (Aside: there is a slightly different process for pediatric vaccines, which actually means that ACIP votes are binding without further sign-off.) Finally, when the recommendations from those votes are published in the CDC’s Morbidity and Mortality Weekly Report, those decisions become official US government policy. That means that private insurers, by law, must cover the cost of the vaccines for the specific populations covered by the votes. Them’s the stakes.
Long story short, when ACIP makes even the smallest change to vaccine policy, a careful, open, and public process occurs.
All of that got flushed down the toilet when HHS Secretary Kennedy just went ahead and announced plans for new CDC vaccine recommendations this week, which was then followed up by reports today that the CDC was summarily adopting something like what Kennedy said (but not actually what he said). The fact that Kennedy made a video about this earlier in the week made the changes highly visible, but not at all transparent. Don’t lose sight of that.
By what means did the Secretary determine his statement earlier in the week, and by what means did the CDC decide what precise changes to make? Suddenly, everything has become opaque. YouTube videos and social media announcements do not count as public deliberation.
That is intolerable. Even if the officials making these decisions were correct on the merits—and I question that—the process by which this occurred is highly problematic and almost certainly illegal, according to UC San Francisco law professor Dorit Reiss—not to mention arrogant and dismissive of the rights of the American people. We deserve and are entitled to an open process so that we can understand our government’s vaccine policies.
Indeed, there’s established law around this. “ACIP is codified in statute and Affordable Care Act regulations, and they have the authority to recommend,” Professor Reiss told me. That means that previously adopted ACIP recommendations cannot be changed by anyone, including the HHS Secretary, Reiss added. Will someone sue over this? Probably. The question is who has standing and when that will occur.
Bottom line: Trump administration HHS officials promised transparency. Instead, they are confusing the visibility of talking at the American people on video with well-established protocols that have long ensured that the public has genuinely transparent and reliable access to the information we need to understand national policy, and the opportunity to influence it. Fiats from on high are not how this is supposed to be done.
Resources:
CDC’s Adult Immunization Schedule by Medical Condition and Other Indication (revised May 29, 2025).
CDC’s Child and Adolescent Immunization Schedule by Age (revised May 29, 2025).
Other stories…
Meanwhile, vaccines and public health were under sustained attack this week by Secretary Kennedy’s increasingly dystopian HHS…
RFK Jr.’s HHS cancels H5N1 vaccine contract with Moderna. The consequences could be astounding.
HHS canceled a contract with Moderna that supported the development of an mRNA vaccine against H5N1 avian influenza this week. The decision is clearly based on RFK Jr.’s distrust of vaccines, rather than any scientific update or research news. It was another sign that Senator Bill Cassidy was misled (bamboozled, I’d say) by assurances Secretary Kennedy made to him during the confirmation process.
Look, there are many ways that our response to Covid-19 was not optimal, and I spend a lot of time thinking about what the best-case scenario could have been. There’s lots we can do to prepare for next time. But having a head start on a vaccine is probably the single best investment we could ever make. If Moderna is unable to continue the development of the vaccine now, it could mean that the emergency phase of the next pandemic lasts many months longer than it needs to, and that vaccines are more expensive to Americans when they do come. This decision, to cancel a $600 million contract, will likely someday cost hundreds of thousands of lives, and trillions of dollars to our economy. It’s among the worst decisions imaginable.
The rationale? Secretary Kennedy mistakenly believes that mRNA vaccines are dangerous. Interestingly, his boss, President Trump, deserves some credit for helping those vaccines save millions of lives via Operation Warp Speed. So, let’s not forget that RFK Jr. is undermining one of President Trump’s main laudable achievements during the Covid-19 pandemic.
Make American Healthy Again. You literally CAN make this stuff up…and someone, or something, did.
Earlier this month, the White House published its Make American Healthy Again report. Many scientists called bullshit on its content, created by a committee chaired by Secretary Kennedy. Today, we learned that the document included references to research that simply does not exist, raising the possibility that AI was used to create it—and not even a very good AI product, I might add. (I’ve found that ChatGPT 4o no longer routinely “hallucinates” the existence of research papers, as earlier versions did.) The administration acknowledged some “formatting errors.” Cool, cool.
The Make American Health Again report is meant to provide the rationale for the proposed $500 million in taxpayer spending that would fund the initiatives. You’d think they’d put a little more effort into it…
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“It makes me concerned about the rigor of the report, if these really basic citation practices aren’t being followed,” said Katherine Keyes, a professor of epidemiology at Columbia University.
Emily Hilliard, a spokeswoman for the department (HHS), did not answer a question about the source of the fabricated references and downplayed them as “minor citation and formatting errors.” She said that “the substance of the MAHA report remains the same —🤔
References cited were fabricated, my conclusion the entire report is therefore suspect & a complete waste of tax payers resources and funds.
If any student submitted an assignment or "research paper" with such fabrication would receive a failing grade & most likely be disciplined for the seriousness of such misrepresentations.
Cassidy suffers from an Ivory Tower Ego like so many. Kennedy is just a whack job. Both come with no moral compass. The transparency vs. marketing is a hallmark of Trump/MAGA/Musk. Even as chair of my small city’s Commission on Disability we are required to adhere to strict public meeting law which means we are not allowed to discuss any issue with four or more people without the public witnessing. We also must abide strictly by conflict of interest laws. Years ago, when an immune suppressant drug was finally developed to help progressive MS., it was reassuring to me to participate and hear publicly FDA’s process. And the counseling of the contract with Moderna for Covid VAX is petrifying to me. And I am deeply worried about the quality and safety of already manufactured drugs. We need to stay alive and functioning, considering the removal of oversight and manufacturing and listing of labor because of tariff costs.