RFK Jr. quietly signed off on some narrow CDC vaccine recommendations, but left RSV and new meningitis shots in limbo.
Also: The HHS Secretary told the Senate that a Trump-appointed lawyer is running the CDC, one day after the CDC itself stated it has no Director. His statement seems to have been false.
One major story, one shorter (but important) one, followed by four open tabs and some Inside Medicine media moments. Let’s get you caught up!
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RFK signed off on a narrow CDC vaccine recommendation, but not a major one. Oh, and did he mislead the Senate on who is running the CDC?
For starters, remember that only the permanent or acting CDC Director can adopt the recommendations of the CDC’s Advisory Committee on Immunization Practices. There is one, and only one, exception permitted by law. ACIP recommendations can be adopted by the Secretary of the Department of Health and Human Services, a position currently held by Robert F. Kennedy Jr.
This is uniquely problematic, given RFK Jr.’s long history of undermining vaccines and spreading falsehoods about them, including while in his current job.
Now, back in April, Inside Medicine broke the story that the CDC does not have an acting Director. So, I’d been wondering whether RFK Jr. would or would not sign off on the CDC Advisory Committee on Immunization Practices votes from its April meeting.
Things got interesting on May 14. Secretary Kennedy told the Senate Committee on Health, Education, Labor, and Pensions (HELP) that the Acting CDC Director is Matthew Buzzelli. That was breaking news to me, and anyone else paying attention.
It also seemed to be false.
Buzzelli had not been the Acting CDC Director the day before RFK Jr. testified before the Senate HELP committee. And it turns out that on May 13, Secretary Kennedy himself signed off on three ACIP vaccine recommendations regarding Chikungunya virus vaccines (but not on votes regarding two other diseases, RSV and meningitis) from its April 15-16 meeting, explicitly because there was no director to fulfill that duty.
On its website, the CDC said all of this, if you clicked the right dropdown menu. “With pending confirmation of a new CDC Director, [the Chikungunya] recommendations were adopted by the HHS Secretary on May 13, 2025 and are now official recommendations of the CDC.”
There are two possibilities here. The first is that Mr. Buzzelli was named Acting CDC Director on May 14, but nobody was told this. If that is so—and it isn’t, apparently—the CDC still has not acknowledged it. Buzzelli is not listed as the Acting Director of the CDC as of May 26th (the CDC’s leadership website has been updated when changes have occurred, and it was last updated on May 4, when it stopped listing the previous Acting Director Dr. Susan Monarez. That’s because, as Secretary Kennedy correctly stated to the Senate, Monarez could no longer serve in that position after she had been nominated for the permanent position.) Meanwhile, according to multiple Inside Medicine sources, Buzzelli does not present himself as the Acting Director, nor even as any kind of expert on CDC content. (Kennedy said he is an expert in his testimony to the Senate. That’s simply inaccurate, by all accounts.) Buzzelli apparently does not perform the key duties of an Acting CDC Director. Buzzelli is a lawyer with no public health or medical background. Of course that doesn’t mean he couldn’t be the Acting CDC Director. As far as I know, anyone with a pulse can serve in the position. It just seems clear that Mr. Buzzelli isn’t the Acting CDC Director. The status quo was confirmed to me last night by a CDC employee with adequate knowledge to provide a reliable update.
Does anyone mind that Secretary Kennedy told the Senate HELP committee that Matthew Buzzelli is the Acting Director of the CDC, despite the fact that he apparently is not?
What is true is that Mr. Buzzelli has been at the CDC as the Chief of Staff since February. He was installed because he’s a Trump loyalist. His main task? Babysitting the non-partisan dedicated career CDC professionals who are trying to keep the place as functional as possible.
About those vaccine recommendations…
The fact that one set of narrow recommendations on Chikungunya virus vaccines was stamped by Secretary Kennedy, but not votes on two other far more important vaccines that affect far more people, should have been headline news. It’s especially problematic given Kennedy’s assurances to Senator Bill Cassidy that he wouldn’t mess with vaccines. (Recall that Cassidy’s vote to confirm Secretary Kennedy was essential. Without it, other Republicans likely would have also broken ranks and voted against the nomination. Cassidy’s vote hinged on Kennedy’s assurances that he’d leave vaccines alone. Oof.)
It’s all working out quite nicely for Secretary Kennedy. The news that he signed off on the Chikungunya vaccine CDC ACIP votes, but has not done so for the RSV and meningitis votes flew by with virtually no comment from the American Academy of Pediatrics, let alone other outlets.
So what are the statuses of the CDC’s ACIP votes on three pathogens from its April meeting?
Votes on meningitis vaccines: The committee voted to recommend a recently FDA-approved vaccine that protects against meningitis for healthy individuals ages 16-23 and for children at high risk starting at age ten.
Status: No action taken. There is no CDC Director to sign off and Secretary Kennedy has not adopted the recommendation.
Votes on RSV vaccines: The committee voted to recommend one dose of an RSV vaccine for adults ages 50-59 with elevated risk of severe disease. Until that vote, ACIP had recommended the vaccine for all people ages 75 and up, plus those ages 60-74 at risk of severe disease. (Note these are one-time doses, for now, as opposed to annual vaccinations. We’ll see how often these vaccines may be needed, but we do not yet know.)
Status: No action taken. There is no CDC Director to sign off and Secretary Kennedy has not adopted the recommendation.
Votes on Chikungunya vaccines: The committee voted to recommend vaccination against Chikungunya virus for some travelers to regions with outbreaks (or laboratory workers who might have exposure to the virus). Currently, the regions with outbreaks are Mauritius, Mayotte, Réunion, Somalia, and Sri Lanka. So this is a pretty narrow one.
Status: Adopted by Secretary Kennedy, on May 13, the day before he testified to the Senate Committee.
This is not random. Reuters reported earlier in May that a new HHS appointee has questioned the RSV and meningitis vaccines.
The fact that Secretary Kennedy feels he knows enough to sign off on the Chikungunya vaccine votes but not the RSV and meningitis vaccine votes is alarming—not for the vaccines, but for the American people who would benefit from the now held-up vaccines. On what basis is Kennedy able to adjudicate the difference? If the answer is that he is acting on the input of a close advisor, then I ask a simple question: why is that person not the Acting Director of the CDC?
Some receipts:
The CDC’s website announcement on Chikungunya vaccines (and the lack of a CDC Director as of May 13):
The CDC’s website’s summary of votes for the April 15-16 ACIP meeting. With some slight wording changes, all of these votes passed:
Researchers given painful “choice” by Trump administration. Cut stuff we don’t like, or lose the whole thing.
The Chronicle of Higher Education’s Stephanie Lee published a story this week that is both encouraging and alarming.
The good news: Some NIH funding for HIV research has been restored.
The bad news: For that to happen, researchers had to choose between bending to the Trump administration thought policing or losing all funding permanently.
While restored funding is better than the alternative, what is happening now is a development in how the administration is attempting to weaponize censorship.
Think back to March. When the Trump administration began axing research grants, some of the wording in the notices caught my eye. The documents (clearly authored by DOGE operatives but signed by NIH officials taking orders from their new masters), stated that the funding decisions were final terminations, rather than suspensions which could be appealed and adjudicated. The reason given was (italics added) that grants were “incompatible with agency priorities, and no modification of the project could align them with agency priorities.”
This was not only offensive but patently incorrect. Many of the targeted projects involved research that included or focused on LGBTQ+ populations, and had aims that even the oddly snowflake Trump administration thought police (why are they so afraid of diversity in all of its manifestations?) would have to acknowledge as important for all Americans—that is, if DOGE was really being careful. Rather, the approach was to use a chainsaw to make $2.5 billion worth of grant cuts based on keyword searches.
If DOGE had been doing things carefully, things would have played out very differently. We might not have liked it, but DOGE could at least have had researchers complete the work that was underway (i.e., get the return on the investment) and make it clear that any future proposals were only likely to succeed if they addressed the administration's newly stated priorities. Cutting off funding in the middle of large studies ruined science and threw livelihoods into disarray. DOGE methods made it pretty obvious what they are really after. Reforms can be implemented without destruction. So when the wrecking ball shows up, it’s not hard to know why.
In the end, we’d rather see research funding restored. So, the news above is better than nothing. But we should reject the notion of censorship-based approaches becoming a new normal, legal issues aside. Unfortunately, we’ve got a long battle ahead. Last week, it was reported that the Trump administration explicitly wants research decisions to be made by political appointees.
Open tabs…
The White House issued an Executive Order entitled “Restoring Gold Standard Science” on Friday. Some actual scientists responded, including the ever-acerbic Dr. Carl Bergstrom, known to many as a leading expert on bullshit.
The FDA selected newer strains for an updated Covid-19 fall booster last week. We don’t yet know who the CDC will recommend should receive it. That’s coming.
An excellent article in JAMA Health Forum by my Brigham and Women's Hospital colleague Dr. Benjamin Sommers: “The Public Health Damage—and Personal Toll—of Federal Worker Layoffs.”
Someone sent me what seems to be a fascinating lecture on autism epidemiology from an actual expert on the topic. I watched some, and it seems really interesting.
Inside Medicine in the media…
The Washington Post’s Stephanie Armour reported that “E. coli outbreak sickened more than 80 people, but details didn’t surface.” The story quoted Inside Medicine’s exclusive interview with FDA Commissioner Marty Makary.
The Huffington Post took interest in my MSNBC segment last week in which I said that, yeah, maybe emerging scientists should think about studying places other than the United States, if things stay on their current trajectory.
I’ll likely be on CNN this morning at 9:05am ET (These types of things are always touch-and-go, but that’s the current plan).
If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.
Thanks for reading, sharing, speaking out, and supporting Inside Medicine. Please ask your questions in the comments.
"Making it up as you go" is not the hallmark of professional behavior in any sector, and this ongoing story is dangerous. The medical profession requires public servants who are honest and trustworthy.
Sorry to say the HHS Secretary has failed in meeting both criteria
I was watching your CNN interview about the latest Harvard attacks just now and it was suddenly interrupted. I don't want to think that this could be censorship.....