It's no secret that HHS Secretary RFK Jr. has strong opinions about vaccines and a history of spreading misinformation about science and medicine. Over the last few months, we've seen that rhetoric turn into a series of actions that fundamentally change the way agencies like CDC and FDA operate — shifting recommendations for the public and introducing confusion for consumers and clinicians.

Contention over vaccine policy appeared to hit a peak in September, with all eyes on how the Advisory Committee on Immunization Practices (ACIP) would or would not change vaccine recommendations. But in some ways, it didn't matter what the committee decided. While the ACIP did make changes (more on that below), other powerful actors stepped in, bypassing the committee to issue their own recommendations and make decisions on coverage and accessibility. Those efforts were largely focused on preserving existing vaccine policies, but it's unclear how much that work preserve vaccine access.

Confusion and misinformation coming from the agencies coupled with existing (and growing) distrust will dampen vaccine uptake, which in turn will have very real consequences for patients, members, and healthcare business. Here's a reminder of some of the key milestones that have happened so far — and some guidance on what you can do as we enter respiratory virus season.

What's been happening with vaccines?

The new reality: A patchwork of vaccine guidance, coverage, and access

These new changes, as well as the rapid-fire pace at which they have been implemented, have created a patchwork system of vaccine access, coverage, and information, furthering adding to confusion and uncertainty for patients and providers.

While some of the dust has settled, many questions remain. How do healthcare organizations combat misinformation and manage genuine concern and questions over medical advice? How long will commercial insurers be able use past guidance to inform future coverage decisions? What does coverage look like for government payers? How will cancelled research contracts impact future vaccine development and disease readiness? Can we trust CDC — even though the agency and its advisory committee have been overhauled in recent months? Who do we trust? And how do we align all the differing recommendations and advice?

Even with near-term coverage decisions largely in place, consumers still need a clinician to offer them vaccinations. Although some medical organizations and states have tried to issue their own recommendations to counteract recent federal changes, they won't be able to completely cover all patients or situations. The reactionary measures will not successfully plug the hole that misinformation and evolving recommendations have created.

This chaotic environment will negatively impact vaccination rates. As fewer people get vaccinated against COVID-19, the flu, and other infectious diseases, the burden of these diseases will only become greater, leading to a higher number of and more severe cases. Hospitals, already battered by financial and workforce challenges, will be pushed even further to the brink if cases of respiratory illness surge during the fall and winter.

What matters now is that healthcare leaders find ways to quickly and effectively adapt to this new reality to ensure that they're able to meet the needs of their organizations, staff, patients, and the public. 

3 things health leaders must prioritize

Amid these ongoing changes and challenges surrounding vaccines, here are three things you can expect in the near term — and what you can do to address them.

1. Expect more questions and be prepared to answer them

Because recommendations have and will continue to change, confusion will grow for both providers and patients. To help your staff effectively address questions that patients or members may have, compile a single source of truth. Provide resources and talking points to help staff members hold complex conversations and lead with evidence while also holding space for genuine concern and curiosity. Make sure that you're accounting for the additional time and resources needed for these conversations in your workflows, rather than asking an already burned-out workforce to spend more time and energy managing difficult conversations.

2. Increase your capacity ahead of a more severe respiratory season

There's a good chance that the upcoming respiratory season will be more severe than before, especially if vaccination rates dip due to changing recommendations, access challenges, and more.

To manage extreme seasonality, hospitals and health systems should shore up their capacity now and ensure they have the right staff — both people and expertise — in place to handle higher acuity patients. Be sure that your throughput and length of stay (LOS) are efficient as possible.

For leaders looking for strategies to hone their acute care operating models, I highly recommend checking out Advisory Board's resources on operational efficiency:

• Provider operations topic
• 3 key insights from our health system margin performance benchmarks
• 3 strategies to optimize your patient flow
• Identify your biggest opportunities for care variation reduction

3. Track and analyze data to measure the impact of these changes

As trust in public health erodes, I want to come back to a word of caution I've given before: Don't fall into the trap of merely raising the alarm.

Health leaders have the power — and the responsibility — to systematically track the effects of policy changes, starting now. Track things clinical impacts like vaccination rates, ED volumes, and patient acuity along with operational changes like length of stay, staff turnover, and rates of workplace violence. The healthcare industry will need a more complete picture of how vaccine policies and mistrust are affecting the cost and quality of care. We must work together to build a compelling, data-driven case that resonates with business leaders, the public, and with policy makers who will continue to make decisions around vaccine policy and public health.

The policy environment is changing rapidly. To help keep health leaders informed and focused on their next best action, Radio Advisory has been adding bite sized policy breakdowns to the end of episodes and releasing special mini episodes on things like the passage of the One Big Beautiful Bill Act, the government shutdown, and vaccine policy. 

Subscribe to Radio Advisory and visit our policy updates timeline to keep track of all the big policy changes.