Senate grills RFK Jr. after firing of CDC director

Following the ousting of CDC director Susan Monarez just weeks into her tenure, HHS Secretary Robert F. Kennedy Jr. underwent questioning from the Senate Finance Committee about recent turmoil at CDC and other policy changes.

In his opening statement before the committee, Kennedy defended his decisions surrounding recent upheaval at CDC, saying that "[t]hese changes were absolutely necessary adjustments to restore the agency to its role as the world's gold standard public health agency."

"We are the sickest country in the world. That's why we have to fire people at the CDC. They did not do their job," Kennedy said. "I need to fire some of those people to make sure this doesn't happen again."

During the hearing, both Democratic and Republican senators questioned Kennedy about his recent changes to CDC leadership and COVID-19 vaccine policy.

In an op-ed published in the Wall Street Journal, Monarez said she was pressured to fire senior CDC staff and "preapprove the recommendations of a vaccine advisory panel newly filled with people who have publicly expressed antivaccine rhetoric." When she refused, Monarez said Kennedy asked her to resign or be terminated.

Kennedy disputed Monarez's account, saying that he asked her to resign because she admitted to not being "trustworthy." Later, he acknowledged that he had asked Monarez to fire some CDC staff members.

Senators also pushed Kennedy about access to COVID-19 vaccines. In late August, FDA limited the approval of new COVID-19 vaccines to certain high-risk groups, making it unclear who would be eligible to receive the shots.

"I would say, effectively, we're denying people vaccines," said Sen. Bill Cassidy (R-La.), who cited several examples of confusion among patients and doctors about who can get vaccinated.

Sen. Elizabeth Warren (D-Mass.) also accused Kennedy of breaking a promise he made not to reduce vaccine availability.

"I'm not taking them away. Anybody can get access to them," Kennedy said, though he later conceded that "it depends on the state."

"I'm a doctor. Vaccines work. Secretary Kennedy, in your confirmation hearings, you promised to uphold the highest standards for vaccines. Since then, I've grown deeply concerned," said Sen. John Barrasso (R-Wyo.).

"If we're going to make America healthy again, we can't allow public health to be undermined," Barrasso added.

Despite recent pushback from both Democrats and Republicans, the White House has continued to stand by Kennedy's actions. According to White House press secretary Karoline Leavitt, the administration is "addressing root causes of chronic disease, embracing transparency in government, and championing gold-standard science. Only the Democrats could attack that commonsense effort."

(Levien, Politico, 9/4; Hellmann/Cohen, Roll Call, 9/4; Ovalle, et al., Washington Post, 9/4; Goldman/Lotz, Axios, 9/3)

RFK Jr. to select 7 new members of ACIP

In June, HHS Secretary Robert F. Kennedy Jr. fired all 17 members of CDC's Advisory Committee on Immunization Practices (ACIP). In an op-ed published in the Wall Street Journal, Kennedy argued that ACIP had been "plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine" and that the committee had "never recommended against a vaccine — even those later withdrawn for safety reasons."

Kennedy then appointed eight new ACIP members, though one has since left the committee. Several of the newly appointed members had previously expressed skepticism about vaccines and their safety, leading to concerns from health experts.

According to information from an internal CDC document, Kennedy is expected to name seven additional members to the committee. The seven new prospective members include:

• Joseph Fraiman, an emergency medicine physician who has previously questioned the safety of COVID-19 vaccines. He was also part of a public health integrity committee that investigated COVID-19 vaccines.
• Catherine Stein, a professor at Case Western Reserve University who focuses on infectious disease epidemiology and population health. During the COVID-19 pandemic, Stein testified in support of bills that would allow Ohio lawmakers to vote against public health orders, as well as a "Truth in COVID Statistics" bill.
• John Gaitanis, a pediatric neurologist at Brown University Health's Hasbro Children's and a leader of biomedical research at the Autism Discovery Coalition. According to court records, Gaitanis has been involved as an expert in a vaccine injury lawsuit involving parents who alleged that pediatric vaccines cause their son's encephalopathy or febrile infection-related epilepsy syndrome.
• Evelyn Griffin, an ob/gyn at Baton Rouge General Medical Center. Griffin has expressed vaccine skepticism and in 2023 testified against Louisiana's decision to add COVID-19 to the school immunization schedule.
• Kirk Milhoan, a pediatric cardiologist who reportedly has ties to Children's Health Defense, an anti-vaccine group founded by Kennedy. Milhoan has advocated against COVID-19 vaccines for children and supported failed COVID-19 treatments like ivermectin and hydroxychloroquine.
• Raymond Pollak, a semi-retired transplant surgeon with a background in immunology. Pollak has confirmed he is "being considered pending the vetting process" and would think carefully about his decision if offered the position.
• Hillary Blackburn, a pharmacist who currently serves as director of pharmaceutical services at a national nonprofit medication distributor hosted by Ascension.

Currently, ACIP is scheduled to meet Sept. 18 and 19, with a posted agenda saying that "recommendation votes may be scheduled" for vaccines against hepatitis B, COVID-19, respiratory virus, and measles, mumps, and rubella. It is not clear whether the seven new members will be officially announced before the meeting or included in the discussions.

(MedPage Today, 9/4; Steenhuysen/Aboulenein, Reuters, 9/4)

California received a similar warning and $12 million in grants for its pregnancy and sexually transmitted infections prevention program was rescinded in August after the state refused to change the lessons in the program.

According to Connecticut attorney general William Tong, states could potentially take legal action to challenge the administration's efforts. "Threatening to defund our schools over this is completely unhinged and we're not going to let Trump steal money from our kids," Tong said.

Separately, Alison Macklin, spokesperson for SIECUS: Sex Ed for Social Change, said the grant money is "essential to states and territories to support sex education" and helps "build critical life skills for young people."

(Mulvihill, Associated Press, 8/29)

HHS officially releases new MAHA report

In May, HHS Secretary Robert F. Kennedy Jr.'s Make America Healthy Again (MAHA) Commission released its first report outlining what it believed to be drivers of chronic disease in America, especially among children. Some areas targeted in this report were technology and social media, ultra-processed foods, and vaccines. Then, last month, a new report from the MAHA Commission was leaked. The leaked report provided recommendations for the challenges presented in the first report.

On Tuesday, the second MAHA report was officially released. According to STAT, the final version of the report is largely similar to the draft but includes more details in certain areas.

"Together, this strategy will translate the work of the Make America Healthy Again movement to policies that make a transformative and lasting impact for Americans and end the childhood chronic disease crisis," the report said.

Some recommendations in the report include making changes to school diets, investigating vaccine and prescription drug safety, and increasing federal oversight and enforcement of direct-to-consumer advertising for prescription drugs and unhealthy foods to children. The report also suggests collaboration with food and agriculture industries instead of calling for any restrictions on pesticides or processed foods.

So far, responses to the report have been critical, including among MAHA advocates who feel like the report does not go far enough in certain areas, particularly pesticides.

"The pesticide section of the report, which directs EPA to partner with industry on PR campaigns to convince Americans the system is 'robust,' reads like it was written by Bayer and Monsanto," said Elizabeth Kucinich, an organic food advocate who is married to former Kennedy campaign manager and congressman Dennis Kucinich.

"The topics on which (Kennedy) wishes to work are not the major causes of chronic disease and many of those are essentially missing from the report (tobacco, alcohol, sodium, added sugars reduction)," said Peter Lurie, president of the Center for Science in the Public Interest.

(Cueto/Todd, STAT, 9/9; Aboulenein, et al., Reuters, 9/9; Blum, et al., New York Times, 9/9)