We open this Sunday morning’s commentary with this recent headline:
“Third infant in Kentucky dies of whooping cough as national cases stay high for second year in a row” | CIDRAP, https://www.cidrap.umn.edu/pertussis/third-infant-kentucky-dies-whooping-cough-national-cases-stay-high-second-year-row.
Dear readers, there are three points we want to make in today’s commentary.
First, in economic terms, when a policy raises mortality in younger people, the entire national economy suffers for generations. Any demographer will substantiate that for you. In America today we have an outright attack on the nation’s public health coming from Washington and led by a cabal of RFK Jr. acolytes. The Republican Senator who chairs the Health Committee, Bill Cassidy (R–LA), himself a physician, knows the facts; and he knows that RFK Jr. lied to him during confirmation hearings. What is the Senator doing about it besides talking and talking?
Second, there is no reason for an infant to die in the United States from a disease that is fully preventable, given a long-established, safe, and proven vaccine. No reason! None, nada, zip! No reason other than the RFK Jr. falsehood dispensary at work and the resultant policy ignorance —or is it intentional malevolence? Readers may decide for themselves. But please remember that when an infant dies, as has occurred in Kentucky, the entire family, neighborhood, and community suffer this unnecessary loss, and the penalty is an irreplaceable life expectancy reduction for the entire United States.
We are now seeing deaths from preventable disease.
Third, alongside the life-changing tragic losses and accompanying economic costs of preventable childhood deaths, for the many children who fall ill and survive vaccine-preventable illnesses, we can add the burdens and costs of illness, work and school absences, health care, and caregiving. A sick child is not at school. Visits to the doctor and medications and absences from work for caregiving add up. Stresses wear on families. The result, in economic terms, is that preventable childhood illnesses, some of them chronic health problems caused by preventable infections, pose a drag on economic productivity while increasing costs.
Public Health and Economic Benefits of Childhood Vaccinations
A CDC report last year estimated the economic impacts of childhood vaccinations over almost 30 years as follows:
Among approximately 117 million children born during 1994–2023, routine childhood vaccinations will have prevented approximately 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. From both payer and societal perspectives, routine childhood vaccinations among children born during 1994–2023 resulted in substantial cost savings.
(“Health and Economic Benefits of Routine Childhood Immunizations in the Era of the Vaccines for Children Program — United States, 1994–2023” | CDC [August 2024], https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a2.htm)
See also
“Reversing the Decline in Routine Childhood Immunization Rates Is Good Health, Equity, and Economic Policy (2023)” | Center for American Progress, https://www.americanprogress.org/article/reversing-the-decline-in-routine-childhood-immunization-rates-is-good-health-equity-and-economic-policy/
Compromising the scientific integrity of federal public health guidance, promulgating falsehoods continually debunked by the medical community and thereby reducing childhood vaccination rates reverses these health benefits and savings, burdening families, the healthcare system, and the national economy. The numbers above suggest the scope of the potential damage to both human health and the overall US economy.
Most importantly, when we know full well how to better their odds, our kids and grandkids deserve not to have to face the infectious disease roulette that our ancestors did. The chart below documents the march of progress that helped to cut the odds of a child’s dying before reaching adulthood from more than one chance in three in 1880 to less than one in a hundred by 2020.
Hepatitis B
Only one out of ten infants infected with hepatitis B manages to escape a sentence of chronic liver disease. Delaying vaccination for a couple of months in infancy except when the mother is infected, as RFK Jr’s reconstituted ACIP Committee decided on Friday to do, risks opportunities for exposure to this highly contagious virus, which infected 16,000 children in 1991, before vaccination at birth for hepatitis B was begun.
Epidemiologist Katelyn Jetelina reported on the decision, which was not science-based:
In the end, the committee voted to move America back to pre-1991 by removing the universal vaccination recommendation for the Hepatitis B infant dose despite no new evidence of harm and ignoring clear benefits. They also recommended that parents ask clinicians for an antibody blood test to determine the need for subsequent doses, even though there’s no evidence that this works. This ultimately shifts the burden to clinicians and parents and abdicates the responsibility of the recommending body.
(“ACIP key takeaways: What really happened and what it means for you” | Your Local Epidemiologist, https://open.substack.com/pub/yourlocalepidemiologist/p/acip-key-takeaways-what-really-happened?utm_campaign=post&utm_medium=email)
We encourage readers to read her whole letter, which encompasses the specifics of the new recommended federal guidance from RFK Jr’s personally appointed ACIP Committee and the efforts by the medical community to ensure that the public receives scientifically sound guidance instead.
Let’s look at some other crucial facts from a December 2 report from CIDRAP (emphasis is ours):
Without prophylaxis at birth, approximately 90% of newborns infected perinatally will develop chronic hepatitis B infection, and 25% of those with chronic infection will die prematurely from chronic liver disease, including cirrhosis and hepatocellular carcinoma (Schillie 2015, Beasley 1983, Nelson 2014, Margolis 1995, Kimberlin 2021). In comparison, approximately 5% of persons infected with HBV as adults develop chronic hepatitis (Haber 2024). Although beyond the scope of this review, antivirals may be used in the management of hepatitis B disease, though not curative and generally require lifelong use once initiated, underscoring the importance of primary prevention.
(“Universal Hepatitis B Vaccination at Birth – Safety, Effectiveness, and Public Health Impact” | CIDRAP (Dec 2025), https://www.cidrap.umn.edu/sites/default/files/searchable-download/Universal%20Hepatitis%20B%20Vaccination%20at%20hBirth%202Dec2025.pdf)
See also
“Universal Hepatitis B Vaccination at Birth—Risks of Revising the Recommendation” | JAMA, https://jamanetwork.com/journals/jama/fullarticle/2842435#google_vignette
“Debunk Briefing: December Meeting of the Advisory Committee on Immunization Practices (ACIP) | The Evidence Collective, https://static1.squarespace.com/static/68435457c33bc03421c23ff7/t/693347ab2b70aa78cc908df3/1764968363179/Dec+ACIP_TEC+Brief.pdf
Before the new ACIP guidance becomes official, of course, Acting CDC Director Jim O’Neill must approve it. Among those urging him not to do this is Senator Bill Cassidy (R-La). Cassidy makes his case as “a liver doctor who has treated patients with hepatitis B for decades.” Senator Cassidy points out that we were able to reduce hepatitis B cases in newborns from 20,000 to 20. Why would any sane person want to reverse that public health success?
To prevent infection with this highly contagious illness we would not only have to ensure that the mother is negative for hepatitis B, but also that everyone who handles a baby’s things and cares for the baby is, too. Are we also testing Dad, Grandma, other caregivers at daycare or the nursery at church, and incidental contacts?
It is clear that parents who care about the facts will have to look to sources other than the CDC to make decisions about their children’s vaccinations and their timing.
Measles
As of December 2, 2025, the CDC reports, the US has seen 1825 confirmed measles cases and 46 outbreaks reported in 43 jurisdictions thus far this year. This figure does not include probable cases. Twelve percent of cases have required hospitalization. The age distribution among cases reflects declining vaccination rates among children.
Three people have died of measles and measles-related conditions this year, including two young children. These deaths, like whooping cough deaths in Kentucky, were 100% preventable. Worldwide, the WHO reports, measles cases are surging. In the US, the Columbia, SC, area is currently a hotspot. Canada, our neighbor to the north, lost its measles elimination status in 2025, and the US is on track to do so as well should outbreaks continue into late January, which would mark a year of continuous circulation of the virus.
The RFK Jr.-appointed ACIP Committee in September recommended that MMR shot be reconstituted as three separate shots for measles, mumps, and rubella, but this recommendation is currently irrelevant since the vaccines do not exist in this form. The CDC still recommends two doses of the MMR vaccine, the first at 12–15 months and the second before children reach school age.
Childhood vaccination recommendations and policy are in flux and under a siege driven by disinformation. The disinformation surrounding vaccines and their safety parroted by Trump administration appointees continues to drive damage independently of official guidance that is finally approved by the acting CDC director. Parents buy into the narrative and fear vaccines more than they do infections. They fall prey to the “immunity through infection is best” delusion when infections without the protection vaccines provide unnecessarily risk children’s lives and long-term health. Parents opt out, to the peril of their children. They repeat misinformation online. Ironically, in the case of measles (as with COVID), infection can damage the immune system for a time such that children are more vulnerable to various other infections, not less.
A New, Protracted Vaccine Approval Process
Even as long-established guidelines are brought into question, the vaccine approval process for all ages is being made more difficult. Vinay Prasad, MD, the FDA’s chief medical and scientific officer announced these changes in a recent, widely criticized memo. Becker’s Hospital Review reports:
In the memo, Dr. Prasad outlined a range of changes to the agency’s approval process for vaccines that would require vaccine manufacturers to conduct larger studies that take longer to complete. Among the changes listed include more stringent requirements and evidence of safety and efficacy before approval. For example, studies comparing individuals in a vaccine or placebo group must include all subgroups, including pregnant women.
Dr. Prasad also said makers of pneumonia vaccines would need to conduct randomized trials to show they reduce disease incidence rather than producing antibodies to fight off the illness. Additionally, he said the agency will “revise the annual flu vaccine framework,” describing the current process of updating annual flu shots to match circulating strains as a “catastrophe of low-quality evidence.”
Readers, given these changes, how long do you think it will take for a vaccine maker to win approval for a new vaccine or an updated one?
More Trouble to Come
Hours after the ACIP decision on the hepatitis B vaccine, Trump chimed in with orders to review the childhood immunization schedule, calling for fewer shots in a Truth Social post and pointing to the examples of other countries in his memorandum. Clearly, the ACIP Committee’s recommendations regarding the MMR vaccine and the hepatitis B vaccine are the opening forays in a long battle ahead with regard to vaccines, with enormous implications for public health and sizable economic implications, from driving new costs to whittling productivity. Lower vaccination rates, resulting rises in preventable illnesses, increased deaths are the combined characterizations of an RFK Jr healthcare recession looming ahead. Today’s commentary is Part 1 of a series. Stay tuned.
Pushback
We close with three statements from consummate medical professionals, in response to the ACIP Committee’s proposed changes in guidance for the hepatitis B vaccine. The first is from Susan J. Kressly, MD, FAAP, president of the American Academy of Pediatrics:
I want to reassure parents and clinicians that there is no new or concerning information about the hepatitis B vaccine that is prompting this change, nor has children’s risk of contracting hepatitis B changed. Instead, this is the result of a deliberate strategy to sow fear and distrust among families.
The second is from Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota:
Today is a defining moment for our country. We can no longer trust federal health authorities when it comes to vaccines.
Epidemiologist Katelyn Jetelina did not hold back, characterizing last week’s ACIP meeting as “Disgraceful. Unprepared. Dysfunctional. Incompetent. Terrifying. Embarrassing. Opaque” and concluding, “Our children deserve better. Period.”
For other expert takes regarding Friday’s ACIP decision, see
“AAP: Changes to hepatitis B recommendations ‘irresponsible and purposely misleading’” | AAP News, https://publications.aap.org/aapnews/news/33915/AAP-Changes-to-hepatitis-B-recommendations
“CDC advisers drop decades-old universal hepatitis B birth dose recommendation, suggest blood testing after 1 dose” | CIDRAP, https://www.cidrap.umn.edu/anti-science/cdc-advisers-drop-decades-old-universal-hepatitis-b-birth-dose-recommendation-suggest
Below is a list of sources where readers may find information, curated by medical experts, that may not be posted anymore on certain federal or state public health-oriented websites.
List of Medical Sources We Deem Worthy of Trust
(Some people disagree and use social media to attack sources like those we have listed.)
Force of Infection (Caitlyn Rivers), https://caitlinrivers.substack.com. “Weekly updates on what’s going around. Tracking COVID-19, influenza, RSV, food recalls, and more. Helpful for anyone looking to stay well.”
Ground Truths (Eric Topol), https://erictopol.substack.com, “Facts, data and analytics about biomedical matters.”
Your Local Epidemiologist (Katelyn Jetelina and team), https://yourlocalepidemiologist.substack.com. “YLE brings public health science directly to your inbox two times a week, making it understandable, relevant, and useful.”
Center for Infectious Disease Research and Policy (CIDRAP), https://www.cidrap.umn.edu. “The Center for Infectious Disease Research and Policy (CIDRAP; “SID-wrap”) is a global leader in addressing public health preparedness and emerging infectious disease response…. CIDRAP works to prevent illness and death from targeted infectious disease threats through research and the translation of scientific information into real-world, practical applications, policies, and solutions.”
American Association of Pediatrics (AAP), https://www.aap.org/. “The mission of the American Academy of Pediatrics is to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults.”
American Medical Association (AMA), https://www.ama-assn.org/. (A membership organization, the AMA serves physicians who serve their patients. It is not a consumer-facing organization but does provide educational materials for patients to its members.)
