We Took Another Look at Vaccine Access Risks—And It’s Not Great

New Expert Insights, State-Level Restrictions, and Why the Alarm Bells Are Getting Louder

Our analysis last week about vaccine availability under RFK Jr.'s HHS leadership really struck a nerve. Your responses flooded our inbox: many of you shared deep concerns about vaccine access, while others accused me of fearmongering. Some questioned why we should worry at all, suggesting this might be an opportunity to "expose corruption" in healthcare. (I actually wrote about these diverging perspectives in a follow-up piece about evidence and trust in science.)

But today, we’re sharing some important new information and perspectives that suggest those of us worried about vaccine access might have good reason. I recently corresponded with Dorit Reiss, a leading expert in vaccine law and policy, whose feedback highlighted several areas where the risks may be more immediate and significant than I initially suggested. Plus, we're already seeing troubling developments across multiple states that paint a concerning picture of where things might be headed. Let’s discuss.

Key Developments Warrant Attention

1. Public Support for Vaccines Remains Strong: Recent polling by the Partnership to Fight Infectious Disease shows 74% of U.S. voters want FDA-approved vaccines to be widely available. Over 70% of respondents expressed favorable views toward vaccines, with even higher support for childhood vaccines.

2. Complex Political Landscape: The situation in Congress highlights the competing pressures at play. Senator Bill Cassidy, a physician and chair of the Senate Health Committee, voted to confirm Kennedy despite his own pro-vaccine stance. While he secured promises of a "closely collaborative working relationship" and oversight provisions, including 30-day notice of any changes to vaccine safety programs, recent events in his home state of Louisiana illustrate the challenges ahead. Just days after Kennedy's confirmation, Louisiana's health department announced it would "no longer promote mass vaccination" - a move Cassidy publicly criticized as preventing "making health care more convenient and available for people who are very busy."

3. Expert Concerns Persist: Dr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia, has expressed serious concerns about Kennedy's appointment, stating in a recent PBS interview that Kennedy "will do everything he can to make vaccines less affordable and less available."

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Critical Updates from Prof. Reiss

Professor Reiss highlighted several areas where the risks may be more significant than I initially suggested:

1. ACIP Control: It seems that I previously understated the Secretary's power over the Advisory Committee on Immunization Practices (ACIP). Rather than mere "influence," the Secretary has direct control over committee appointments and can remove members and appoint new ones at will.

2. COVID-19 Vaccine Vulnerability: The situation for COVID-19 vaccines is more precarious than I indicated. While adult mRNA vaccines have full approval, children's vaccines remain under Emergency Use Authorization (EUA). RFK Jr. could revoke these EUAs "with a stroke of a pen," as Prof. Reiss notes (yikes). Given his history of legal action against COVID-19 vaccines for children, this is a real concern. Reminder: RFK Jr. filed a petition with the FDA in May 2021 demanding that officials rescind authorization for COVID-19 vaccines and refrain from approving any future COVID-19 vaccines.

3. FDA Review Process: The vulnerability extends beyond advisory committees. Prof. Reiss points out that career FDA staff conducting independent reviews could face pressure to set extremely high demands for clinical trials, effectively slowing or halting new approvals.

Early Warning Signs

The combination of Prof. Reiss's legal analysis and recent developments paints a concerning picture. While institutional safeguards exist and polling shows strong public support for vaccines, we're already seeing troubling changes at the state and local levels:

• Louisiana's health department announced it would "no longer promote mass vaccination" on the same day as Kennedy's confirmation

• Texas is currently experiencing its worst measles outbreak in three decades in counties with high rates of vaccine exemptions

• A health district in Idaho became the first in the nation to ban public clinics from distributing COVID-19 vaccines, despite federal safety assurances

• According to the Washington Post, the doctors who advocated for Idaho's ban claim that six other counties or health districts have contacted them about implementing similar restrictions

These developments suggest that even before any federal policy changes, state and local impacts are already materializing. Particularly concerning is how these changes often disproportionately affect vulnerable populations - for instance, the Idaho ban means residents of long-term care facilities no longer have easy access to COVID-19 vaccines through public health clinics.

Looking Forward

I'll be honest - after diving deeper into these developments and speaking with experts like Prof. Reiss, I'm more concerned than I was when I wrote my initial analysis. While we have institutional safeguards and strong public support for vaccines, the speed and scope of changes at the state and local level are sobering. We're not just theorizing about potential future impacts anymore - we're watching real restrictions unfold in real communities.

For those of you who share these concerns, here are some practical steps you might consider:

• Ensure your family is up to date on recommended vaccines

• Stay informed about any changes to vaccine policies in your state or local health district

• Maintain connections with healthcare providers who can help navigate changing access to vaccines

• Consider advocating for continued vaccine access through your local health boards and state representatives

We'll keep monitoring these developments and updating you as the situation evolves. As always, I appreciate your engagement with these critical public health issues - even (maybe especially) when we don't all see eye to eye. Your questions and perspectives help ensure we're having the important conversations we need to have right now.

Stay curious,

Unbiased Science

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