New ACIP members, LGBTQ+ suicide prevention, and a huge legal victory restoring NIH grant funding.
What in the Health?! June 22, 2025
It’s been a busy news weekend, with things that have nothing to do with public health. (Well, except that war is a profound public health issue.) I don’t have expertise to comment on political issues not directly about public health programs or infrastructure, so instead of talking about that I’ll tackle three major items since my last update:
1. RFK Jr’s overhaul of the Advisory Committee for Immunization Practices (ACIP) is likely to endanger the American public’s access to vaccines.
The last time I posted was the day RFK Jr. summarily dismissed all 17 members of ACIP. Two days later, he announced the names of 8 people who will replace them, and meet this coming week during the scheduled ACIP meeting time. Wow, how efficient! Good to know he’s not going to prevent ACIP from meeting, after all. Except…there are a few major problems here.
The people he picked include a couple qualified people, a few who are not particularly qualified but not explicitly anti-vax, and a couple who are infamous anti-vaxers. Lest you think I’m being unfair or inflammatory in my characterization, one of them—Dr. Robert Malone—actually posted this on X two days before his appointment was announced:
It’s not just about vaccine mandates. Dr. Malone is well known for his podcast appearances in which he questions COVID-19 vaccine safety, including a 2021 appearance on Joe Rogan's podcast in which he spread misinformation on vaccines. Big red flags here.
Then we have Vicky Pebsworth, a nurse and public health researcher. She’s a board member of the National Vaccine Information Center (NVIC), which is a leading anti-vaccine organization widely recognized for promoting vaccine misinformation.
Retsef Levi is a professor at MIT who has said himself he has little vaccine expertise. He studies healthcare management and supply chain logistics, but has also gone on record saying he thinks mRNA vaccines have caused the deaths of young people and children and that "mRNA vaccines should not be given to anybody young or healthy. It is also not at all clear to me that they should be given to anybody, based on the evidence."
Who else is on the list? Dr. James Pagano is an emergency medicine physician with no apparent expertise in vaccinology or immunology. Dr. Joseph Hibbeln is a psychiatrist focused on nutrition and mental health, and also has no direct experience or expertise in vaccinology or immunology. Dr. Michael Ross is a biotech startup exec and an OB/GYN without vaccine-specific experience of any kind. Other than the way these picks betray how few actually qualified experts would be willing to serve on this new ACIP under RFK Jr’s rule, they’re not necessarily harmful...but we should all be concerned that these are the people who are tasked with evaluating complex vaccine safety and effectiveness data and making recommendations that affect our access to them in the United States.
Dr. Martin Kulldorff is at least a biostatistician who focuses on infectious disease epidemiology. But he’s also a co-author of the infamous Great Barrington Declaration, which I wrote about last time. He is also a leader at the Brownstone Institute, which opposed COVID-19 restrictions and regularly publishes literature on the dangers of COVID-19 vaccines (and others).
One is a decent pick: Dr. Cody Meissner is a pediatric infectious disease specialist and served on ACIP from 2008-2012. He’s outwardly skeptical about COVID-19 vaccines for children, which is probably why he made RFK’s short list in the first place, but skepticism shouldn’t disqualify someone from this role. Regardless, he’s only one vote.
One of the main reasons RFK Jr. said he had for removing all prior members of ACIP was concerns about conflict of interest. But the vetting process for ACIP members often takes years to try to prevent bias and conflicts of interest, and he appointed these folks in 2 days. Even if he’s been plotting this since the day Trump was elected, it’s still only been a few months, with no systematic vetting. Both Malone and Kulldorff have recently been paid as expert witnesses in legal cases against Merck, the former in a case about their mumps vaccine and the latter in a case about the HPV vaccine. According to CDC’s guidelines, both of them will have to recuse themselves from discussions or votes on vaccines that have anything to do with Merck, or from companies with products in direct competition with Merck’s products. So much for removing conflict of interest from ACIP.
Underscoring the above point, RFK Jr. doesn’t even seem to know the credentials of the people he picked. In his announcement on X, he said that Dr. Ross “is a Clinical Professor of Obstetrics and Gynecology at George Washington University and Virginia Commonwealth University.” But when the Washington Post contacted those universities, they found Ross has not held faculty positions at George Washington since 2017 and VCU since 2021. They called Ross to ask him about this, and he hung up on them.
With no CDC Director, RFK can basically do whatever he wants. This does not appear to be an accident. If you haven’t been following this, when Dr. David Wheldon’s nomination was withdrawn in March, Dr. Susan Monarez was named as the replacement nomination. This happened March 24. The thing is, she was already the acting CDC Director. And under federal law, someone nominated for the CDC Director position cannot simultaneously function as the Acting Director. Dr. Jeremy Faust, who has written about this extensively on his Substack Inside Medicine, reports that immediately after her nomination Dr. Monarez stopped showing up to CDC leadership meetings. (Since she can no longer be the acting director, this makes sense.) But no one is rushing to try to confirm Monarez in this appointment. In fact, as of June 5 her paperwork hadn’t even been completely filed. On May 14, in a Senate HELP Committee meeting, RFK Jr. was asked who the Acting Director of CDC was, and he replied it was Matt Buzzelli, since Monarez could not serve in the role. This is, by all accounts, simply untrue. He’s the Chief of Staff of CDC, and not functioning as a Director in any way. And why are they slow-walking this? Because if there’s no CDC Director, then by law vaccine policy is left entirely to the HHS Secretary. A man who founded a non-profit known for anti-vaccine advocacy and spreading vaccine misinformation, with a long record of promoting anti-vaccine views. He wants total control to reshape our access to vaccines—and he has it.
The 17 former members of ACIP who were dismissed last month co-wrote a viewpoint piece published in the Journal of the American Medical Association (JAMA) on June 16. It’s open-access, brief, and worth the read. But just in case you don’t click the link, here are two highlights:
The abrupt dismissal of the entire membership of the ACIP, along with its executive secretary, on June 9, 2025, the appointment of 8 new ACIP members just 2 days later, and the recent reduction of CDC staff dedicated to immunizations have left the US vaccine program critically weakened. These actions have stripped the program of the institutional knowledge and continuity that have been essential to its success over decades. Notably, the ACIP charter specifies that committee members serve overlapping terms to ensure continuity and avoid precisely the disruption that will now ensue.
In this age of government efficiency, the US public needs to know that the routine vaccination of approximately 117 million children from 1994-2023 likely prevented around 508 million lifetime cases of illness, 32 million hospitalizations, and 1 129 000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs.
2. The Trump Administration went on record saying that LGBTQ people don’t need specialized support to prevent suicide, and they’re taking this support away.
Here are some distressing facts about suicide among LGBTQ+ people in the United States, taken directly from the website of The Trevor Project:
LGBTQ+ youth are more than four times as likely to attempt suicide than their peers.
More than 1.8 million LGBTQ+ young people (ages 13-24) seriously consider suicide each year in the U.S. — and at least one attempts suicide every 45 seconds.
A major survey in 2023 found that 41% of LGBTQ+ young people seriously considered attempting suicide in the past year, including roughly half of transgender and nonbinary youth.
Plus, a 2023 study from the Williams Institute at UCLA found that 81% of transgender adults in the U.S. have thought about suicide, and 42% have attempted it.
These statistics should horrify you. We should be working to turn these figures around, and quickly. And there was progress being made: in September 2022, The Trevor Project began providing LGBTQ-specialized suicide prevention services through 988, with a $33 million grant by the federal government. 988 is a suicide prevention lifeline run by SAMHSA, within HHS. Since 2022, when people dial 9-8-8 on their phone they can connect with trained counselors to receive free, confidential support 24 hours a day, 7 days a week. The initial forecast was that The Trevor Project would receive 10,000 calls, texts, or chats per month through 988. But during the pilot period they received closer to 23,000 per month, and three years in they receive 50,000 contacts per month. That is huge volume, and a sign of how serious this issue is—especially at a time when the federal government is going out of its way to make life harder for trans and queer youth. In fact, the need was so great that this specialized support grew beyond just The Trevor Project, and more recently there have been seven centers making up what’s known as the “LGBTQ+ Youth Subnetwork.” In 2024, the Trevor Project had more than 231,000 crisis contacts with LGBTQ+ youth contemplating suicide, which was less than half of the total volume served by the LGBTQ+ Youth Subnetwork. So naturally, last week the Trump Administration announced they were ending this specialized support service. As of July 17, when LGBTQ+ youth call 988, they can still reach a crisis counselor for free just like anyone else, but that person may not be trained to help them, nor sensitive to their needs as a queer or trans young person. Make no mistake, more young people will die as a result of this decision. It’s hard to draw any conclusion other than this: since they’ll be queer, trans, or non-binary, that’s the plan.
3. A federal judge—appointed to the bench by Reagan, no less—ruled hundreds of NIH grant terminations void and illegal, and explicitly called out the current government’s actions as “unlawful racial discrimination.”
Let’s end on an up note. In response to two lawsuits about NIH terminations—one brought by the American Public Health Association and another filed by a group of 16 states—alleging the abrupt terminations of NIH grants as part of an “ongoing ideological purge” of scientific research, federal judge William Young ordered that funding for hundreds of these grants must be restored, promptly. According to an analysis by the Association of American Medical Colleges, since February the NIH has revoked a total of 2,282 grants that add up to almost $3.8 billion of terminated funding. (I’ve already written a lot about how and why this is dangerous and wasteful.) This won’t restore all of them, but it’s a start, and sets a precedent.
There are a few things about this ruling that are remarkable:
Even though the plaintiffs in these lawsuits didn’t specifically accuse the government of racial discrimination, Judge Young raised the issue on his own, saying, “I‘ve sat on this bench now for 40 years. I’ve never seen government racial discrimination like this…Is it true of our society as a whole? Have we fallen so low? Have we no shame?”
When a lawyer for the Trump Administration asserted that funding DEI-related research projects supports “unlawful discrimination,” the judge replied, “Where’s the support for that? Any support? Any rational explanation? I see no evidence of that. Point me to...any particular grant or group of grants being used to support unlawful discrimination on the basis of race. From what I can see, it’s the reverse.”
Judge Young asked another lawyer from the Justice Department how the Trump Administration could justify withdrawing funds that Congress had already appropriated to the NIH for the purpose of its mission to “improve health, revolutionize science, and serve society.” The lawyer replied that it was up to the NIH Director to decide what research is worth pursuing and that Director Jay Bhattacharya had decided that research about topics like gender identity was “not scientifically valuable.” This is noteworthy not just because it is awful to say and of course that research has scientific value (just see the statistics in #2 above!), but also because it flies in the face of the way NIH has always worked: it uses a comprehensive peer review process that is science-backed, and mandated by law, to determine what grants are scientifically worthy of funding. In fact, the APHA’s lawsuit alleged that it is precisely the departure from this process that makes this “reckless and illegal purge” illegal.
Ultimately, Young ruled the grant terminations must be voided because they are “arbitrary and capricious,” which is a legal term that means a decision was made without a rational basis. “This court finds and rules that the explanations [from the Trump administration for the grant terminations] are bereft of reasoning virtually in their entirety,” Young said. Will this decision be appealed? I have no doubt. Could it be overturned? Yes. But for now, let’s celebrate it as a huge win.