Stop Coming For My Girl (Public Health)

I’ve Criticized Public Health Communication. But I’m Done Watching It Become the Scapegoat.

If you’ve followed my work, you know I haven’t been shy about critiquing traditional public health communication. The paternalism. The academic jargon that talks past people instead of to them. The instinct to lecture rather than listen. I’ve built my career on doing it differently—meeting people where they are, leading with empathy, and translating complex science without dumbing it down or talking down.

So when I say I’m fed up with public health being the scapegoat for our current moment, it’s not because I think the field is above criticism. It’s because I’m watching something far more insidious happen: the deliberate dismantling of population health protections, repackaged as a reasonable response to public distrust. Let’s discuss…

The Incomplete Narrative

There’s a story gaining traction: if only public health had communicated better, if only scientists had been more humble, we wouldn’t be here. And there’s some truth to that. I’ve made similar arguments myself. Humility matters. Listening matters. Meeting people where they are matters.

But that narrative is dangerously incomplete.

The people losing trust in vaccines aren’t just confused citizens who got spooked by confusing CDC messaging during the pandemic. Many are targets of organized, well-funded disinformation campaigns run by profiteering conspiracy theorists. They are victims of both—imperfect public health communication at times AND deliberate, sustained manipulation by people who profit from their fear.

I still believe in bridge-building, it’s my whole MO. And I’ll be the first to say that many people drawn to MAHA have genuinely good intentions. They’re worried about their kids, frustrated with a healthcare system that’s failed them, looking for answers. I get it. But there are puppetmasters pulling strings and pouring gasoline on every fire that might otherwise burn out—not because they want answers, but because the chaos is the point. Bridges can’t be built when someone’s paying to keep them burning.

We’re not talking about grassroots skepticism that bubbled up organically. We’re talking about an industry. According to Politico, Children’s Health Defense—the organization RFK Jr. chaired for nearly a decade—saw its revenue explode from around $1 million in 2018 to over $15 million by 2021. The Informed Consent Action Network went from $1.4 million to $13.3 million in the same period. These organizations have expanded internationally, hired lawyers and scientists, and filed lawsuits rolling back vaccine requirements across the country. And the same people pushing distrust are selling the alternatives—supplements, “detoxes,” consultations, subscriptions. The financial incentives are tied directly to vaccine fear.

Meanwhile, public health workers—many of whom haven’t stopped running since 2020—are fighting this with shrinking budgets, bureaucratic constraints, and death threats. The disinfo machine is nimble, flush with cash, and algorithmically amplified. And somehow, public health is the one being told it needs to try harder. For real?

When we only acknowledge the first half of that equation, we let the manipulators off the hook. And worse, we abandon the people who are going to pay the price for policies shaped by manufactured outrage rather than evidence.

The Privilege of Individual Choice

In a recent ACIP commentary, a physician-scientist described how he and his wife chose to delay their baby’s Hepatitis B vaccine by about a month. It was, he explains, “very deliberate, very safe, and very data driven.”

Good for him. Sincerely. (And by the way, I admire this person very much—this is not a personal attack.)

But that framing misses the fact that he does not represent everyone in the population. That’s the whole point of population health—a concept that everyone nods along to until it actually requires thinking beyond individual circumstances.

Some reports indicate that one in four mothers in the United States has to return to work within two weeks of giving birth. (Tell me again how we’re like Denmark?) Those babies will be in someone else’s care—family members, daycares, informal arrangements—before they’re a month old. And nearly 57% of new mothers are already missing critical postpartum follow-up visits entirely, with rates even higher among younger moms. The assumption that families will just “come back later” ignores a healthcare system that’s already losing more than half of them.

The calculus for those families isn’t the same as for a couple with the knowledge, resources, and flexibility to make an informed decision about delaying.

When you go into public health, you learn something that sounds obvious but apparently isn’t: collective health means making recommendations that protect whole populations, including the people with the least flexibility and fewest resources. Individual choice is a privilege not everyone can afford. Policy has to account for that.

When we shift from protecting the vulnerable to a framework where everyone fends for themselves, we’re not offering freedom. We’re offering abandonment dressed up as autonomy.

In Bad Faith

The Hepatitis B birth dose debate is a symptom of a much larger assault on public health—and a distraction from the rest of it. Medicaid cuts. SNAP cuts. Letting children go hungry. They’re about the fact that nearly 57% of new mothers miss critical postpartum follow-up care that screens for postpartum depression, preeclampsia, and complications that can kill them, with rates even worse among younger mothers. They’re about maternal mortality rates that remain an international embarrassment. The return of vaccine-preventable illness. The systematic dismantling of the infrastructure that catches people before they fall.

The Hepatitis B birth dose decision wasn’t a good-faith effort to rebuild vaccine confidence by offering more flexibility. Multiple observers at that ACIP meeting described it as predetermined, ideological, and political. Malone tweeted a response to President Trump saying, “Mission Accomplished.” Which mission was that? Members didn’t even understand what they were voting on. No new safety data was presented—just the assertion that absence of a specific type of evidence equals evidence of absence.

Pretending otherwise isn’t nuance. It’s naivety at best. (Complicity at worst.)

Public Health Has Fought HARD.

Despite everything—despite the bloodbath budget cuts, workforce reductions, political targeting, and endless bad-faith criticism—I have been genuinely blown away by how hard the public health community has fought to defend population health.

These are people who went into a field because they care about collective well-being. They’re watching the infrastructure they’ve spent careers building get dismantled. And they’re still showing up.

Yes, public health communication has room for improvement. Yes, the field can be insular and academic and sometimes tone-deaf. I’ve said all of that before, and I’ll say it again.

But I refuse to keep hearing that public health brought this on itself while watching a political movement systematically dismantle everything from mRNA vaccine contracts to global health commitments to the basic social safety net.

We’re Missing The Point

We’re so busy debating whether public health should have been more humble about COVID vaccines that we’re not asking the harder question: What does it mean that we’re now making vaccine policy by capitulating to the loudest, most organized voices (who, as a reminder, represent a minority of the population) while ignoring the structural forces that manufactured their distrust in the first place?

Has anyone pushing the “public health needs to listen more” narrative ever done a deep dive into the political and moneyed forces actively degrading public health? Into the deliberate, well-funded campaigns to undermine vaccination? Into who profits from this distrust?

I haven’t seen it. And until the conversation includes both sides of the equation—the ways public health can improve AND the forces actively working to tear it down—we’re not having an honest debate. We’re just finding a convenient scapegoat while the real threats to American health go unexamined.

Stay Curious,

Unbiased Science