Watching America’s most reputable public health organization become the target of lawsuits brought by the very physicians and states it is meant to assist is almost disorienting. The fact that the American Academy of Pediatrics, the American College of Physicians, and fifteen state governments are suing the CDC rather than fringe organizations or political outliers illustrates how drastically things have changed in a short period of time.
The legal dispute began in January when the CDC discreetly declared that it would no longer recommend seven childhood vaccines. Flu, hepatitis A, hepatitis B, rotavirus, some meningitis protections, and RSV have been removed from the general schedule. These weren’t suggestions from the fringe. For years, pediatricians had been regularly recommending these vaccines to families, supported by decades of research. Jim O’Neill, the acting director of the agency, described the shift as a step toward “clarity” and “public confidence.” Medical organizations referred to it as dangerous and illegal.
The fact that the modification occurred only a few months after Robert F. Kennedy Jr. disbanded the CDC’s Advisory Committee on Immunization Practices is difficult to overlook. Last summer, all 17 voting members were eliminated. Kennedy had promised not to do precisely that during his Senate confirmation hearing. Nevertheless, he did it. The ongoing legal complaint centers on the fact that some of the replacements had documented skepticism about mainstream vaccine research. The plaintiffs contend that ACIP must be fairly balanced and rely on independent, multidisciplinary expertise in accordance with federal law. They claim that what took its place does not live up to that standard.
California took swift action. The state will co-lead a multi-state lawsuit against Kennedy, HHS, and the CDC itself, according to Governor Gavin Newsom. In what he claimed was his 59th lawsuit against the Trump administration, Attorney General Rob Bonta claimed that the changes would put children in danger, increase state Medicaid costs, and require public health organizations to spend money combating false information. Beyond the legal argument, there is a practical aspect to this. Much of what is shaped by federal guidance is funded by the states. There are actual downstream costs when that guidance changes suddenly.
It is challenging to distinguish the timing from the context. The number of measles cases, outbreaks, hospital admissions, and fatalities in the US is at its highest point in over thirty years. The number of whooping cough cases is also rising. These are diseases that the nation had largely eradicated but are now resurfacing in areas with lower vaccination rates; they are not abstract statistics. It’s still unclear if the CDC’s schedule modifications were a direct cause or if they just happened at a particularly vulnerable time. However, it’s challenging to look at the numbers and be comforted by the trend.
Kennedy has insisted that he is not against vaccinations. “What I’m gonna do is make sure that we have good science so that people can make an informed choice,” he said to CBS News. He might actually think that. However, the organized, legally aggressive response from the medical establishment, which spans specialties from public health to pediatrics, suggests that the scientific community views the situation differently. According to the legal complaint, the CDC’s recent actions have created “a moving target,” with changes occurring more quickly than courts can assess them.
The scope of the opposition is what distinguishes this moment from regular policy disputes. This is not just one advocacy group bringing a symbolic lawsuit. The organizations that manage clinics, educate physicians, and care for children are states, hospitals, and professional medical associations. They are all looking at the same schedule modification and coming to the same conclusion. Whether the procedure was legal will ultimately be determined by the courts. However, there has evidently been a breakdown between the federal health leadership and the system it is meant to oversee in the interim.
