1. LIE: “I’m not anti-vax, I’m pro-science” (April 17, before the House Education and Workforce Committee)

TRUTH: For years, RFK Jr. has spread anti-vaccine messaging. In 2023 on the Lex Friedman podcast, he said “there is no vaccine that is safe and effective.” When questioned about polio, he said he couldn’t answer if the vaccine caused more deaths than it averted. But the polio vaccine is highly effective and safe. It has been eliminated in the US, and the vaccine has prevented an estimated 20 million cases of paralysis in children since 1988.

A 2019 study found that the majority of the Facebook ads spreading vaccine misinformation were coming from just two anti-vaccine groups. One of them was Children’s Health Defense, which at the time was founded and led by RFK Jr.

And in just the past year, as HHS secretary, RFK Jr. has made many anti-vax, anti-science moves, including:

1. Ended $500 million for mRNA vaccines

2. Removed 8,000+ public-facing federal health and science webpages, including datasets on youth risk behavior, reproductive health, and environmental hazards

3. Changed the pediatric vaccine schedule

4. Fired all ACIP members and replaced them with anti-vaxxers

5. Cut HIV vaccine research

6. Canceled a contract with Moderna to study bird flu vaccine

Saying “I’m not anti-vax, I’m pro-science” is a well-documented rhetorical strategy that’s been used in anti-vaccine movements for years to broaden appeal and avoid immediate dismissal. It’s used to make anti-vaccine positions sound credible and aligned with scientific values, while continuing to erode trust in the actual scientific consensus. And it provides cover. When called out, they can default to “I’m just asking questions” or “I never said don’t vaccinate,” despite a clear pattern of messaging that does exactly that.

2. LIE: “COVID is gone” (April 22, before the HELP Committee)

TRUTH: COVID is not gone. The pandemic is over, but SARS-CoV-2, the virus that causes COVID, is here to stay. It is now an endemic virus, which means it will continue to circulate in our population, at times seasonally, but there’s no chance of eradication. Not only is the claim false, it’s also cruel, especially when you look at the data. COVID continues to sicken, disable, and kill people all over the world. In 2025, COVID resulted in 450,000 hospitalizations and up to 53,000 deaths in the US alone.

3. LIE: “The hepatitis B vaccine was tested for 4 days…there was no placebo in that, so we don’t know the risk factor of that” (April 21, before the Senate Committee on Appropriations)

TRUTH: This is a common anti-vaccine claim based on the misinterpretation of the vaccine insert information. Both Engerix-B and Recombivax HB were studied as 3-dose vaccines given over a 6-month period, with participants followed for 9–18 months. The 4–5 day window referenced in inserts is specifically for tracking acute adverse events, not the full duration of safety monitoring.

We also have decades of research showing the hepatitis B vaccine is safe and effective, including studies with placebo groups.

And we know the impacts of the hepatitis vaccine:

1. A dramatic reduction in infant hepatitis B following the universal birth dose, one of public health’s major successes

2. Prevention of serious illness and childhood deaths

4. LIE: “It [measles outbreak] has nothing to do with me” (April 22, before the Finance Committee)

TRUTH: As much as RFK Jr. wants to claim this outbreak began before his tenure as HHS Secretary, that ignores a much bigger reality. He has spent nearly two decades as one of the most visible figures in the anti-vaccine movement, repeatedly spreading misinformation about the Measles, Mumps, and Rubella (MMR) vaccine.

The data show that over 4,000 measles cases have been confirmed since his confirmation. Most of those cases are unvaccinated individuals who believed his many lies about the MMR vaccine, such as:

1. The MMR vaccine leads to deaths every year–it doesn’t

2. The MMR vaccine causes “all the illnesses” of the disease–it doesn’t

3. The MMR vaccine “wanes about 4.5%” per year–it doesn’t

4. The MMR vaccine “does not appear to provide maternal immunity”-- if given before pregnancy–it does

5. LIE: “mRNA vaccines have limited efficacy against respiratory viruses” “I terminated the COVID vaccine because it didn’t make any sense” (April 22, before the HELP and Finance Committees)

TRUTH: Kennedy has repeatedly made the false claim that mRNA vaccines are not effective against respiratory viruses, but 6 years of vaccine effectiveness data prove him wrong. The mRNA COVID-19 vaccines prevented millions of deaths.

In general, vaccines are designed to prevent severe illness, hospitalization, and death–the mRNA vaccines for COVID-19 continue to do this very well. Vaccines that do not completely prevent infection are not “ineffective”--it’s important to remember we have these tools for harm reduction, not harm elimination. When we have high enough vaccination rates in populations, we can also see a reduction in infections and transmission.

Cutting funding for mRNA vaccines for respiratory viruses will set the US back, especially when it comes to the seasonal burden of viruses like flu and COVID-19 that mutate rapidly.

6. LIE: “Russ Vought doesn’t want to cut NIH programs” (April 21, before the House Energy & Commerce Health Subcommittee)

TRUTH: Russel Vought was one of the key authors of Project 2025 where he created a blueprint to cut government programs and consolidate control under the President. He is an outspoken proponent of massive firings of career civil servants. At a conservative event talking about our federal employees, he said “We want the bureaucrats to be traumatically affected. When they wake up in the morning, we want them to not want to go to work, because they are increasingly viewed as the villains. We want their funding to be shut down … We want to put them in trauma.”

Now he is in charge of the federal budget and between Vought and DOGE, the Trump administration has cut billions of dollars in NIH funding. Vought also withheld NIH spending for months into the fiscal year, leading to significantly less grants awarded this year at this point compared to previous years.

7. LIE: “We have done more for maternal health than any administration in our history” (April 17, before the House Committee on Education & Workforce)

TRUTH: The FY 2027 proposed budget does the opposite. It eliminates programs like Healthy Start and cuts the CDC’s safe motherhood and infant health portfolio, which supports Maternal Mortality Review Committees, Perinatal Quality Collaboratives, and the Pregnancy Risk Assessment Monitoring System. It also eliminates the Infant and Early Childhood Mental Health program at Substance Abuse and Mental Health Services Administration.

At the same time, NIH grants focused on maternal health are being canceled, including research specifically on Black maternal health, despite the fact that Black women are three times more likely to die from pregnancy-related causes than white or Hispanic women, according to the CDC.

You cannot claim to prioritize maternal health while dismantling the very programs and research infrastructure designed to improve it.

8. LIE: “I never said that”…“I have no memory of saying anything like that” [on his comments about Re-parenting Black children] (April 16, before the Ways and Means Committee, and April 22, before the HELP committee)

TRUTH: In 2024, RFK Jr. appeared on the High Level Conversations podcast and said: “Psychiatric drugs, which every Black kid is now just standard put on—Adderall, SSRIs, benzos—which are known to induce violence… those kids are going to have a chance to go somewhere and get re-parented; to live in a community where there’ll be no cell phones, no screens, you’ll actually have to talk to people.”

And this is part of a pattern with this man. RFK Jr. has a documented history of making race-based claims about health. During the COVID-19 pandemic, he repeatedly promoted the false idea that the virus was “ethnically targeted” to spare Ashkenazi Jewish and Chinese populations while specifically targeting Black and white individuals. He has also claimed that Black people have “better” immune systems than white people and, for that reason, should follow different vaccine schedules, along with other race-based pseudoscientific claims.

9. LIE: The rate of autism is increasing “Autism rates have gone from 1 in 10,000 in 1970 to 1 in every 31 today” (April 22, before the HELP Committee)

TRUTH: The rate of autism is not increasing, the diagnoses are–and that’s because we now have better tools and diagnostics to identify cases that went undetected for years, sometimes decades. RFK Jr. has repeatedly claimed that autism rates are increasing, and mischaracterized the prevalence as an “epidemic.” First, autism is not a disease, therefore it cannot be an epidemic. Second, we are better at identifying autism spectrum disorder. Many people who would today be diagnosed as autistic would have probably received insufficient and incorrect diagnoses such as “intellectual disability.” In fact, a correlated decline in diagnoses of “intellectual disability” or “learning disability” suggests that there is a bit of accurate substitution happening, rather than a true increase.

10. LIE: “The US had the highest death of any country on earth” (April 22, before the HELP Committee)

TRUTH: This lie is especially telling. In September 2025, during another congressional hearing, RFK Jr. claimed that no one actually knows how many Americans died from COVID-19 because of “data chaos” and “perverse incentives.”

So which is it? Do we have the highest death toll, or do we not know the number at all?

We know that at least 1.2 million people in the US died from COVID-19, and even that is considered a significant undercount.

We also know the US did not have the highest mortality rate in the world, despite him repeating that claim all week. When you look at deaths per million, multiple countries had higher rates, including Peru, Bulgaria, Croatia, and Hungary.

11. LIE: “There are no cuts to Medicaid” (April 22, before the Finance Committee)

TRUTH: Just like defending the idea that President Trump can invent his own way to calculate percentages, this claim only works if you ignore how basic math and budgeting actually function.

The Big Beautiful Bill cut nearly $1 trillion from Medicaid over the next decade compared to what the program would have received under current law, according to the Congressional Budget Office. That is, by definition, a cut.

Saying “there are no cuts” relies on pointing to the fact that total spending may still increase over time. But health policy experts say that the increase is driven by inflation, rising healthcare costs, and population changes, not expanded coverage or benefits.

In reality, spending will be reduced by close to $1 trillion over the next decade because of the cut compared with prior projections, even as absolute spending continues to rise. And as a result, nearly 7 to 8 million people are projected to lose Medicaid coverage, largely due to work requirements and new administrative barriers, not because of immigration status.

12. LIE: “The flu shot is an intervention that is often ineffective. It has a 20% efficacy rate. There are studies that show that getting a flu shot actually increases the chance of a non-flu infection” (aka non-specific effects) (April 22, before the HELP Committee)

TRUTH: RFK Jr. loves this made-up statistic. The problem is he’s turned his skepticism into policy, with the removal of CDC flu vaccine campaigns and the most recent move to no longer mandate it for US military personnel. Flu vaccines are designed to do two main things: reduce severe infections requiring hospitalization and deaths. Flu vaccines do not increase your chance of non-flu infections. RFK Jr’s claim is based on a pre-print study (not peer-reviewed) with significant limitations, including selection bias. The study did not show a causal link between vaccination and non-flu illnesses nor did it measure the risk of serious illness or new infections.

13. LIE: “[The study says] 80% in mortalities from chronic disease that took place in the 20th century – almost none of it was attributable to vaccines. (April 22, before the HELP Committee)

TRUTH: RFK Jr. referred to a “Johns Hopkins study” which he has referred to before to incorrectly claim that vaccines do not account for “impressive declines in mortality” in the first half of the century. Senator Cassidy, a board-certified physician, fact-checked him on the conveniently missing context from said study, which concludes the exact opposite. The paper notes “the reductions in vaccine-preventable diseases, however, are impressive.”

In the mid 1900s, vaccines, particularly for measles and diphtheria, were instrumental in reducing overall mortality in the US. Over a century of data has shown that the two largest contributing factors to our increased life expectancy (and reduced mortality) are vaccines and clean water. A landmark study led by the WHO shows that global immunization efforts have saved at least 154 million lives over the past 50 years.

RFK Jr., who for years has denied germ theory, continues to promote that deeply problematic and eugenic principles of terrain theory.

14. LIE: The Trump administration is delivering the “largest investment in rural health in our nation’s history” (April 16, before the Ways and Means committee)

TRUTH: This is the same logic as calling a cut an increase. You take something away, give a small portion back, and present it as a historic investment.

The Big Beautiful Bill cut more than $900 billion from Medicaid, a program that rural hospitals, clinics, and nursing homes rely on to stay open. As a result, nearly 880 hospitals, clinics, and nursing homes are at risk of closure or have already cut essential services.

Because of this, the bill also included roughly $50 billion in funding for rural healthcare to help offset some of the damage those Medicaid cuts are expected to cause. So, importantly, that funding is not a new investment on its own. It is there to respond to the consequences of the cuts themselves.

Framing that as a historic investment is highly misleading. You do not get to slash the foundation rural healthcare depends on and then call partial stabilization funding a major health victory.

15. LIE: TrumpRx is making a difference “Americans no longer pay more than people in other wealthy countries for the exact same medications” (April 22, before the Finance Committee)

TRUTH: Last month, the New York Times reported that Americans could pay nearly twice as much for prescription drugs through TrumpRx compared to other countries, including GLP-1s.

TrumpRx is essentially a discount card, similar to GoodRx. It doesn’t actually solve the problem of pricing since most insured individuals already get negotiated rates on drugs. For the uninsured, a discount card to pay out-of-pocket has not proven to be cheaper than the discount programs already available in the US.

And in some cases, it’s not even cheaper. During the hearing, Senator Elizabeth Warren pointed out that a 30-day supply of Protonix costs about $200 on TrumpRx, while the exact same medication in generic form costs about $16 at Costco. That means patients using TrumpRx could end up paying significantly more for the same drug.

In fact, analysis presented in the hearing found people have more than a one-in-four chance of paying more through TrumpRx than they would through existing options. So no, Americans are not suddenly paying less than people in other countries. In some cases, they’re paying more than they need to.

16. LIE: “For the first time they [Dietary Guidelines] are not dogma-based guidelines, but science-based guidelines” (April 16, before the Ways and Means Committee)

TRUTH: The Dietary Guidelines have always been grounded in science and informed by an independent advisory committee that reviews the totality of nutrition evidence.

This past year, RFK Jr. rejected that committee’s evidence-based recommendations and instead relied on a newly selected group with ties to the meat and dairy industry, overriding the established scientific review process.

The resulting guidelines diverge from global nutrition consensus and contain inconsistencies and factual errors, including contradictions between the written recommendations and the consumer-facing visual guidance.

17. LIE: “All decisions that have been made at that agency [FDA] are made with the approvals of panels of career scientists” (April 21, before the House Energy & Commerce Health Subcommittee)

TRUTH: Career scientists have faced layoffs and pressure under the Trump administration, leading to a wave of resignations across federal health agencies. At the same time, key decisions, like changes in drug approvals, have increasingly bypassed or overridden standard scientific review processes, with political appointees stepping in where career experts traditionally lead. This has included instances where career scientists’ recommendations on COVID-19 vaccines were overruled.

And former CDC Director Susan Monarez, who RFK Jr. fired, testified before Congress that she was instructed to not speak to or work with any career scientists at CDC, directly contradicting the claim that these decisions are driven by independent scientific panels.

18. LIE: “The food pyramid was written by food industry lobbyists for 50 years. And it reflected the mercantile impulses of those companies that put Fruit Loops at the top of the food pyramid” (April 22, before the HELP committee)

TRUTH: Fruit Loops have never been on the food pyramid. Federal ethics rules prohibit USDA officials from endorsing private brands in official guidance.

The 1992 Food Guide Pyramid, which was discontinued and replaced in 2005, recommended grains, fruits, vegetables, dairy, and a mix of plant and animal proteins, while emphasizing variety and moderation. It explicitly placed fats and added sugars at the top with a clear “use sparingly” label.

There is no evidence that the pyramid promoted or instructed people to eat products like sugary cereals. Quite the opposite.

19. LIE: “I authorized $500 million for cancer vaccines” (April 17, before the House Committee on Education & Workforce)

TRUTH: There is no evidence of a $500 million investment in cancer vaccines. If anything, this appears to be a reversal of what actually happened.

Last year, RFK Jr. canceled $500 million in mRNA vaccine research, a platform also being studied for cancer treatments like personalized cancer vaccines.

Cutting funding to this technology not only slows progress in areas like cancer, but also puts the US at a disadvantage as other countries continue investing in it.

20. LIE: “The Mennonites have not vaccinated since 1796” [while blaming the current measles outbreaks on Mennonites, Canadians, and Mexicans] (April 21, before the House Energy & Commerce Health Subcommittee)

TRUTH: This is historically and factually incorrect. There is no evidence that Mennonites have universally avoided vaccination for centuries. While some Mennonite and Amish communities have lower vaccination rates, this is not uniform and is largely a more recent trend, not something that dates back to the origins of vaccination. Framing an entire religious group this way is both inaccurate and misleading.

21. LIE “This [COVID] was not a disease that was killing healthy people. It was killing sick people” (April 22, before the HELP Committee)

TRUTH: COVID killed the young, the old, the healthy, and the sick. This has been documented for years. What RFK Jr. wants you to believe is the lie that comorbidities from chronic illnesses were WHY people died–this is based on a 6-year-old misinterpretation of a CDC death certificate chart data.

Many people, including children, without comorbidities have died from COVID-19. By far, the biggest risk factor for COVID mortality was age, and no chronic diseases came close to age as far as impact on COVID mortality outcomes go. RFK Jr. cannot accept the fact that at least 200,000 Americans needlessly died because they refused the life-saving COVID-19 vaccines.

Final Thoughts

RFK Jr. asked for “one piece of misinformation” he’s ever said. These are 21 examples from just the last week of hearings. At this point, the volume and consistency of these claims make it difficult to believe this is about confusion or misunderstanding. The line between fact and fiction in his messaging has become so blurred that it’s effectively meaningless.

And that would be concerning on its own, but it is especially dangerous given that he is leading HHS, where these views can directly shape policy, influence public behavior, and impact health outcomes.

December 26, 2019. We were enjoying the holidays with my family when my son, Laith, came down with respiratory syncytial virus (RSV). What started as cold-like symptoms quickly escalated into a five-day hospital stay. I’ll share my testimonial as it was written for VYF.

How would you describe Laith? What was he like as a baby?

Laith is my second-born, and he’s my only son. From the moment he was born, he was the most affectionate, tender, sweet, and cuddly boy. He was huge—he was my biggest baby at over 9 pounds—but the post-partum season with him was heaven because he was so lovely to hold and breastfeed.

He’s now a very energetic, athletic, sports-obsessed boy who’s really good at reading and math.

When did Laith get sick with RSV? How did you know he wasn’t feeling well?

I remember it quite vividly. It was Christmas time in 2019, and my parents were in town. My son had symptoms that I thought were just a cold. He had been down for a nap and was just waking up, so his door was open. My oldest child is about 2 years older than him, and she went into his room and said, “Mama, Laith is in trouble.”

My daughter wasn’t even four years old at the time; I don’t even know how she had the discernment or ability to tell that her brother was in distress. But every hair on my body stood up, every maternal instinct I had was activated, and I ran into his room.

I picked him up, and I could tell that he was working too hard to breathe. My daughter had needed a couple of breathing treatments before, so I was familiar with the signs and could recognize when a kid might need a nebulizer. So, in my mind, I thought Laith probably needs to go to the pediatrician, and they can do a breathing treatment. I called the after-hours nurse, and she recommended that we come in. I walked into their office thinking, we’ll be back home in a few hours, he’ll have a nebulizer, and he’ll be okay.

While we were in the doctor’s office getting the treatment, our pediatrician very calmly put her hand on my knee and said, “I don’t want to scare you, but we are going to call an ambulance.” In that moment, all the blood rushed out of my head, and I felt like I was going to faint. I responded, “What do you mean? I thought we were doing the breathing treatment, and it looked like it was working.” But his oxygen saturation level was low, and he was still working too hard to breathe.

Our pediatrician explained to me what would happen next, saying that the paramedics would come, put me on the gurney, then put Laith on top of me on the gurney, and I would ride with him to the children’s hospital. Everything after that felt like it was moving in slow motion. The paramedics came, did what our pediatrician said they would do, and we had a very uneventful ride to the hospital. I was sobbing the whole time.

As they pulled us out into the waiting room, there was a mom who looked at me and said, “We’ve been there. You’ll be fine.” It was a really sweet, human moment, where this woman looked at me and Laith and basically said: this sucks, but he’s going to be okay.

In the emergency room (ER), my husband and I thought my son might just need another treatment and then be sent home, but they told us he needed to be admitted. Our family had never experienced a hospital admission, so I remember thinking, what does this mean? The doctor there said he would need to be monitored on supportive oxygen until his oxygen saturation level improved.

During all this, Laith still seemed like my son, but he looked uncomfortable and sad. Even though everything escalated so quickly, there was never a moment when I thought he was dying—at least I didn’t let my mind go there. I knew he needed more care, but I kept feeling shocked by how the situation unfolded.

I am an infectious disease epidemiologist, so I feel like I’m a medically literate person. I understand a lot of information adjacent to what my son was experiencing, but I still felt powerless. Even if in my head I knew the progression of how a virus would work in a body, I felt completely helpless. My son's hospitalization humbled me to the max.

How did his illness progress?

Laith ended up spending five days and four nights in the hospital, which is a pretty long stay. He got better each day, but those first few days his oxygen saturation was not at a level where they felt comfortable discharging him. They were worried about him regressing at home and then having to come back.

The care team told us that we weren’t alone—there were so many children in the hospital and intensive care unit (ICU) because of respiratory viruses. They connected us with the pulmonologist, and the respiratory therapy team came in and explained what the treatment device was going to be like. They put Laith in a special crib that had every tube you can imagine. He was on oxygen through his nose, and they placed an IV as back up if he needed it. We had to treat his room as a quarantine, so we were all in masks, gloves, and gowns. It wasn’t until the third day that they allowed us to drop those precautions.

Laith did alright, but I don’t think I slept a minute any of those nights. My husband and I took turns for the overnights, but I typically just watched him as he slept all night. I kept waiting for inconsistencies in the beeping from his monitors, waiting for a moment when a signal went off. The care team was coming in every few hours to check on him and take vitals. I always asked them if he was okay.

There is nearly a 100% chance that your kid is going to get RSV, and you just don’t know if they’re going to get it severely or not.

How was Laith’s recovery?

Eventually, Laith tested positive for RSV, but the doctor said the diagnosis didn’t change the treatment. We were thankful that Laith never developed pneumonia or had any acute complications. When he was strong enough to sit up, I remember watching him chomp on crackers and thinking, oh, he’s coming back to us.

Around the fourth day, the care team allowed my parents to visit. The team was starting to talk about discharging Laith, as long as he did well overnight and was consistently well in the morning. We ended up being discharged the next day, which was New Year’s Eve, and all I wanted to do was be home with my healthy babies and end 2019.

I never could have expected what would happen in 2020. Laith’s hospitalization occurred three months before the COVID-19 pandemic, so when COVID-19 emerged, I had such a deep trauma response to it. I remember thinking, “I just saw my son on supportive oxygen—I am not going to do that again.” Because of our experience with RSV, I had an extremely low risk tolerance for COVID-19. We still play it fairly safe with COVID-19, because once you experience your kid needing oxygen, you don’t ever want to go through that again.

When we went back to the pediatrician about a week later for a check-up, Laith was totally fine; he fully recovered and didn’t have any damage or impairments. We were really, really lucky. I think his age helped, because at that point my son was 19 months old. Usually, it’s children who are one year old or younger who are most at risk for an RSV hospitalization.

How did Laith’s illness impact your family?

Laith’s hospitalization was really hard on my parents. They were completely sick to see him so unwell. When they visited him in the hospital, I asked them not to show how visibly distraught they were because Laith was getting stronger and recovering. I have really sweet memories of them holding his hand and smiling and laughing with him.

I am the emotional one in my marriage, so I was usually the one with the wet face. But my husband was also very scared because we’d never experienced anything like that. We’d only been parents for a few years. Now that I have three kids, things are not as scary, but your first hospitalization is a really intense core memory. It trauma-bonded me and my husband.

I’ve heard parents talk about having to carry two worlds when you’re dealing with a traumatic event like a hospitalization. It was so important for us to try and keep things as normal as possible for our oldest child, who was still a toddler. She didn’t understand why her brother wasn’t coming home to sleep in his bed. My husband and I would spend time with her in shifts, and he suggested I take her ice skating. I remember thinking, how can I go ice skating when my son is in the hospital? But we also had a daughter to take care of, and she wanted to go.

How did your experience with Laith’s hospitalization impact you moving forward?

Laith’s experience with RSV impacted my parenting. I always tried to be risk-averse, and we were very cautious during the COVID-19 pandemic. Laith’s illness had a lingering, residual impact on the decisions we made for our family.

When I was pregnant with my third child, the maternal RSV vaccine wasn’t available yet, nor were the monoclonal antibodies when she was born. Both prevention options were approved a year later. At that point, she was no longer eligible.

She got sick during her first winter, and she came back positive for RSV. Getting a positive RSV test on my third kid was a bit triggering, even though she was doing okay. I remember thinking, I can’t do this again.

Thankfully, she fared much better, but that’s how prolific RSV is. Almost every kid gets it by the time they turn 2. It wasn’t shocking that she got it; it was more of a welcome relief that she didn’t get it so severely

What would you tell new moms who are considering RSV prevention options for their baby?

Every day, I wish I could go back in time with the RSV protection tools that are now available. All of my family’s heartache, pain, and suffering could have been prevented. I’ve had many friends who have had babies within the last couple of years, and it is, without a doubt, one of the first things I say: if you’re going to give birth around respiratory virus season, please don’t skip this one. There is nearly a 100% chance that your kid is going to get RSV, and you just don’t know if they’re going to get it severely or not. It’s not worth the risk.

The statistics are shocking—most hospitalizations for children under 5 are from RSV, most children will get the virus, and these RSV prevention options are so effective that they essentially take away the risk. I have a friend who is a pediatric critical care doctor in Washington, D.C., and she told me that they barely saw RSV last season. The virus used to overwhelm their emergency room. RSV prevention options are nothing short of a miracle.

If there are parents who are on the fence, I want to clarify that RSV monoclonal antibodies are not a vaccine for babies. The antibodies are created from people who have recovered from RSV, and it’s a dose of protection given directly to the body. You don’t even have to wait two weeks for your baby’s body to build protective antibodies on their own. Your baby essentially receives a ready-made protective shield against a really nasty disease.

RSV doesn’t discriminate. I am a healthy person with healthy kids. My son didn’t have any preexisting health conditions, and he wasn’t immunocompromised. I never could have known he would need to be hospitalized with RSV, nor could any of his doctors.

When we were in the hospital, I remember thinking, when are they going to get a vaccine for this? RSV isn’t flu, it isn’t a regular cold—surely we could do something to protect children from this virus. And now, we can.

I have the great honor of serving as a Board Member and the Chair of the Medical and Scientific Advisors at VYF. You can learn more about RSV prevention through VYF resources here and ways to become a vaccine advocate here.

I’m married to a lawyer, and I have to say, this was one of the most poetic pieces of legal writing I’ve ever seen. Judge Brian Murphy started his historic ruling with a Carl Sagan quote: “Science, like law, is far from a perfect instrument of knowledge,” but it’s still, “the best we have.”

My colleagues and I at Defend Public Health had the great honor of supporting this lawsuit by submitting two Amicus Briefs to the court, in support of the lawsuit filed against RFK Jr. by the American Academy of Pediatrics, and three other health organizations. You can read them here and here. It is incredibly humbling to witness a judge completely get it. His ruling demands a return to scientific standards for the proper review of data (like the evidence to recommendation (EtR) framework) since the Advisory Committee on Immunization Practices (ACIP) made arbitrary and capricious decisions, ignoring long-used, and well-regarded scientific processes for developing vaccine policies. He argued that the “government has disregarded those methods and thereby undermined the integrity of its actions.”

Truly poetic, and powerful.

Here’s What Today’s Ruling Means in 2 Parts

Part 1

1. The firing of the 17 ACIP members and the appointment of the 13 current members by RFK Jr. violates federal law, specifically the Federal Advisory Committee Act (FACA), thereby making their appointment invalid.

   1. Effectively, that means without a valid committee, ACIP cannot meet this week or for the foreseeable future.

   2. It also means that since their appointments are invalid, all of their previous votes as ACIP members are thereby invalid.

Part 2

2. The decision in January to reduce the pediatric vaccine schedule from 17 to 11 was done outside of scientific standards and thereby invalid.

   1. Effectively, that means that the previous pre-RFK Jr. vaccine schedule is upheld, and any decisions or votes to deschedule vaccines to shared clinical decision making (SCDM) are cancelled.

   2. Specifically, this restores the Hepatitis B birth dose recommendation. This is significant since we’ve already seen a drop in uptake since January.

   3. This restores MMRV (measles, mumps, rubella, and varicella) vaccines and thimerosal in vaccines (which were only used in multi-dose flu vaccines).

OK, so What is MAHA/ACIP Going to Do in Response?

We know they are quite mad already. A spokesperson for the Department of Health and Human Services (HHS) confirmed that they plan to appeal the ruling with the hope of overturning the judge’s decision.

Here are a few scenarios that could play out:

1. They could replace the 13 ACIP members with new members. But it would likely have to be in accordance with FACA rules, given the judge’s ruling. This seems unlikely.

2. They could reinstate some of the previous ACIP members for the purpose of satisfying some of the FACA rules and meeting quorum. This seems extremely unlikely.

3. They could meet in an unofficial convening, outside of the banner of ACIP and CDC, perhaps to grumble about medical tranny, and continue to spread vaccine propaganda. This seems likely and immature.

4. They could completely defy the order and proceed as if nothing had happened today. This would be a terrible precedent for the rule of law. We’ve seen them defy orders in the past, so this seems possible.

Some important considerations:

While insurance companies have committed to paying for vaccines through 2026, the uncertainty of ACIP highlights the uncertainty of vaccine access and coverage in 2027 and beyond. It is also unclear how this will impact the availability of flu and COVID-19 vaccines for the upcoming respiratory virus season. Given the volatility of this situation, we expect the next few days and weeks to be eventful—with many updates to come.

I invite you to share this post and follow along for more news as it comes. As always, my job here is to make science and public health make sense.

JMR

Image credit: iStock.com/Fatcamera

I’ve asked a number of my colleagues if they could define “shared clinical decision-making,” and I couldn’t get two exact answers. Instead, I got responses like: Isn’t that what’s already happening with providers and patients? and You mean informed consent?

In January of 2026, the Centers for Disease Control and Prevention (CDC) slashed the number of recommended vaccines in the pediatric schedule from 17 to 11. It’s not lost on me that exactly one year earlier, in January of 2025, RFK Kr. said in his confirmation hearing, “I support the childhood schedule.” In that year, the science didn’t change—only the politics.

The decision to modify the schedule affected influenza, COVID-19, and RSV recommendations in the middle of respiratory virus season under the false narrative that we would be “aligning the U.S. childhood vaccine schedule with the international consensus while strengthening transparency and informed consent.”

Let’s be very clear: there is not a singular international vaccine schedule because every country tailors its vaccine schedule to the population’s health needs. On average, most countries vaccinate against 13 to 16 diseases. The smallest schedule we compared ours to was Denmark’s, where they vaccinate against 10 diseases. After being right in the middle of consensus, our pediatric vaccine schedule is now the outlier.

Image credit: STAT News

The decision also included a nod to a common trope in the anti-vaccine movement: that vaccines are given without proper informed consent.

Let’s be very clear again: Providers are required by federal law — under the National Childhood Vaccine Injury Act, NCIVA — to share Vaccine Information Statements (VIS) at every vaccination appointment. They can be shared in paper or digital format. VISs are information sheets produced by the CDC that explain, in detail, the risks and benefits of vaccines. If the person being vaccinated is under the age of 18, the VIS is given to the parent or caregiver.

So what about shared clinical decision-making?

In addition to massively reducing the vaccine schedule, the CDC said that parents should choose whether or not they want some of the previously recommended vaccines (like rotavirus, hepatitis A, hepatitis B, etc.) based on “shared clinical decision-making.” According to the CDC’s new webpage on this topic:

"Unlike route, catch-up, and risk-based recommendations, shared clinical decision making vaccinations are individually based and informed by a decision process between the health care provider and the patient or parent/guardian.” The webpage goes on to say that “ACIP makes shared clinical decision-making recommendations when individuals may benefit from vaccination, but broader vaccination of people in that group is unlikely to have population-level impacts.”

I must admit, my jaw nearly hit the floor when I read that. Especially, as it relates to the Hepatitis B vaccine, where we have years of data to show that early vaccination reduces the risk of chronic hepatitis B vaccine—at a population level—by 90%.

You might have read that and been confused. And to be honest, you wouldn’t be alone. Most patients/parents do not know what shared clinical decision-making really means. Instead of empowering them in their decision-making, it's actually causing more confusion. And we have some data on this.

In August and December of 2025, the Anneberg Public Policy Center (APPC) surveyed nearly 2,000 adults about their understanding of this new framing. The surveys showed significant gaps in understanding the specific context of whether to get a vaccine or not. Here are some of the findings:

• 1 in 5 people think shared clinical decision-making means that “taking the vaccine may not be a good idea for everyone, but would benefit some.”

• More than 2 in 5 people think that shared clinical decision-making is “up to an individual whether to consult with their health care provider before taking a vaccine, about whether it would be a good idea.”

• 1 in 4 people think shared clinical decision making means they should discuss vaccination decisions with family members

• 1 in 10 people are unsure what shared clinical decision-making means for new vaccines

It’s exactly what we feared: it’s presenting the vaccine schedule as an à la carte menu.

When participants were asked about who should be a part of shared clinical decision-making, many were unsure. Most chose physicians, but only half included nurses, and only a third included pharmacists.

The introduction of shared clinical decision-making presents a false reality that there is no discussion happening between providers and patients. I can absolutely empathize with patients not feeling like they have enough time with their providers, but to claim that vaccinations are happening without informed consent and that this new framing will increase transparency and trust is both untrue and incredibly harmful.

“Hi, Due to a controlling & abusive marriage, my 13-year-old has never had a vaccine. Now that I am away from that marriage, and can make these decisions, can you please tell me how to catch her up with her vaccines? I’ve looked online and see different catch-up schedules. It’s very confusing. And also the best place to go for no shame? Thank you so much for everything you do!! Have a wonderful holiday season!”

I asked this person for permission to share their DM anonymously and to turn it into a longer form post to share here, on Substack. They graciously agreed.

My first response to this incredibly brave parent is: I am so proud of you. I’m proud of you for stepping away from harm, protecting yourself, your child, and both of your futures. My next response is: you’ll never feel shame here. My work is to make it all make sense, so that folks like you feel equipped, empowered, and confident to make informed and evidence-based health decisions. My goal isn’t to dumb things down either—I’m here to lift you up, to increase your science literacy, and give you some navigational tools to journey through the wild information ecosystems online.

As for catching up on missed vaccine appointments. Last week, we shared the “pre-RFK Jr” version of the recommended pediatric vaccine schedule from the American Academy of Pediatrics (AAP). Table 2 provides the recommended “catch-up” schedule for children and adolescents who either start late or who are more than one month behind schedule. This is an invaluable resource for folks looking to get their kids back on schedule.

The recommendations are split into two age groups: children between the ages of 4 months to 6 years old, and children from ages 7 to 18. You can see the full schedule below.

I spoke with one of my most trusted pediatrician friends, Dr. Krupa Playforth (@thepediatricianmom), about how she would manage a case like this. Here’s what she said:

“First, I want to say how proud I am of you for taking this step for your child. You’ve been through a lot, and choosing to protect her health now is a really big deal. There is no shame here at all. Pediatricians see this more often than you might think, and our job is to help, not judge.

The good news is that a 13-year-old can absolutely be safely and effectively caught up on vaccines. The reason you’re seeing different schedules online is because catch-up schedules depend on age and what (if anything) has been given before. A pediatrician can create a personalized plan so she doesn’t get anything unnecessary and the spacing is done correctly.

In general, catch-up usually happens over several visits spread out over months, not all at once. We prioritize the most important protections first and build from there, and in my practice I would usually work on trying to balance shot frequency / any anxieties a child may have with trying to optimize protection in the most high-yield way possible, using the AAP schedule (see above). Finding a local pediatrician who you trust is going to be important here. They can help figure out what works best for your child (based on where you are located and any plans you may have, eg for travel).  

For no-shame care, I recommend:

• A pediatrician’s office you trust (you can even say up front: “We’re starting vaccines now and want supportive care.”)

• Local health departments

• Children’s hospitals or academic pediatric clinics

• Some community health centers and Planned Parenthood locations (they are very used to catch-up care)

You can also bring this exact message to the visit. You don’t owe anyone explanations beyond what you’re comfortable sharing. You’re doing the right thing. It is not too late. And your child is lucky to have you advocating for her now.”

—Dr. Krupa Playforth

I know the holidays can be a complicated time for many of you—especially if topics like vaccines have caused division among families and loved ones. As you gather, I wanted to point you to another piece that I created with fellow science communicators, with tips on how to have those hard conversations.

It’s the honor of my life to be trusted by you, and I’m so grateful you’re here. If this post was helpful to you—I’d appreciate it if you shared it with your circles. As always, my content is free and never pay-walled.

Wishing you a happy and healthy holiday season,

Jessica Malaty Rivera, MS

In the meantime, we’ll be here to answer any of your questions.

To protect her privacy, I’ll refer to the author of this story as M. I am sharing her story below with an invitation to submit questions in the comments—they can be questions about M’s story, questions you’re struggling to answer, or questions about anything related to the topics below.

Wishing you all a happy, healthy, and peaceful holiday.

JMR

I stood before my middle school classmates and explained the supposed harms of vaccines because I loved my mom and wanted to make her proud. All my life, my mother had been devoted to exposing what she believed was a vast conspiracy to obscure the dangers of vaccines, and I spent my childhood immersed in her world of paranoia. By high school I was skeptical of sunscreen and Wi-Fi, and I warned friends that the HPV vaccine causes cancer. My mom was thrilled I was following in her footsteps and sang my praises to all her closest friends. When I was a teenager, she was appointed to the board of a prominent anti-vaccine organization. Over the years, I accompanied my mom to events where, among other noteworthy anti-vaccine-activists, I met RFK Jr., whom everyone called “Bobby.” One summer we visited the Kennedy compound in Massachusetts, where Bobby took us sailing. My mom must be knowledgeable and well-informed to have gotten these opportunities, right?

The first major challenge to my worldview came in the summer of 2020, as I prepared to move across the country to start college in the midst of the COVID-19 pandemic. Unlike so many students around the country, I was given the opportunity to attend in-person, but only if I received the MMR and Tdap vaccines. I had to choose between my relationship with my mom and education. I chose my future, receiving two vaccines that summer, my first in over sixteen years.

That decision marked the erosion of my once-close relationship with my mother. When I refused her offer of what was likely a forged medical exemption, she knew what I had done. To her, it was the ultimate betrayal. I started college with plans to pursue a career in medicine. As I learned the basics of biology and chemistry, I hoped we could connect over our shared passion for science and begin to repair our relationship. I was eager to discuss my coursework with my mother, who often boasted about the extensive research she had done to come to her conclusions.

As mRNA vaccines for COVID-19 were being developed, I learned about messenger RNA in introductory biology. When I spoke to my mom about mRNA, she couldn’t explain its function. Yet she was preaching to thousands about the supposed harms of mRNA vaccines. I wondered how she could make such claims without even a basic scientific foundation. As I learned more, I started seeing that she and her fellow advocates were not nearly as knowledgeable as I’d thought.

At the end of my freshman year I had the opportunity to get the COVID-19 vaccine. This was one of the most difficult times of my life. I would not have made the appointment without my boyfriend sitting beside me, physically helping me click the button to sign up. I was simultaneously terrified of being injured by the vaccine and of further shattering my relationship with my mom. I tried not to tell her, but it’s hard to keep secrets from your mom as honesty was one of the core values my parents emphasized growing up. Four years later, I still find it incredibly challenging to get vaccinated. Years of anti-vaccine rhetoric left me with a deep phobia; I often break down after a vaccination. This has improved as I’ve slowly begun to catch up on my shots, but I still struggle.

After receiving my bachelor’s degree in neuroscience, I began my career studying how viruses contribute to autoimmune disease. I met the scientists my mom and her friends had lambasted as “evil” and “bought off by Big pHARMa.” It was humbling and disorienting to find that the researchers I now respect had been the target of my childhood scorn.

I thought I was free from my mom’s anti-vaccine world until November of 2024, when Robert F. Kennedy Jr. was nominated to be Secretary of Health and Human Services. The people I had tried so hard to escape for the last four years were now poised to take over our nation’s healthcare. My heart broke because I am deeply familiar with the anti-vaccine community and their agenda. More familiar names kept being hired for senior positions within HHS. Each announcement felt like a blow. Then Secretary Kennedy began to act. He dismissed every member of the CDC’s vaccine advisory committee, fired the top scientists at CDC, rolled back COVID-19 vaccine recommendations, slashed funding from mRNA vaccine research, and purged thousands of people from federal health agencies. All of this was eerily familiar to the plans that I had been exposed to through my mother’s work.

I know what it is like to live in Robert F. Kennedy Jr.’s America. I grew up “drinking the raw milk.” I was lucky to only be damaged psychologically. I have truly seen both sides of this issue. I understand that both sides believe they are saving children’s lives, as my mom believed she was saving mine. My community protected me from the diseases I wasn’t vaccinated against through herd immunity and each parent’s decision to vaccinate their children. If Robert F. Kennedy Jr. is allowed to continue his agenda, more children will grow up like I did, but without this protection.

I can no longer stand by and watch as more people fall victim to the health misinformation that plagued my childhood. In a way, I am still following in my mother’s footsteps—speaking out for injustice I see in the medical system—but now I speak to protect public health and to prevent other children from living in the conspiratorial world of my childhood.

—M

At best these people are unqualified for the job. At worst, they will sabotage the June ACIP meeting and make the future of vaccine access and availability in the United States even more uncertain. Dr. Lauren Hughes, and Dr. Anita Patel and I decided to download and publish the 2024 CDC Pediatric Vaccine Schedules on Instagram. These are approved and recommended by the American Academy of Pediatrics. Unfortunately, the 2025 Schedules have already been revised to reflect the not-evidence-based wishes of RFK Jr. and Dr. Marty Makary.

The most notable differences are the changes to guidance on COVID-19 and HPV vaccinations for children.

Please bookmark, screenshot, download, and save the resources below. You can also download them directly and purchased physical laminated copies from Immunize.org —I’ve got copies on desk right now.

Make sure you and your children are up-to-date on your vaccines—I’ll provide updates as they become available.

Yours,
JMR

As we write this, we’re both drinking coffee, in the late afternoon. Both of us can do that without being jittery or up all night because of an enzyme called cytochrome P450 (CYP450) which is responsible for metabolizing about 80% of drugs–including things like alcohol, caffeine, and you guessed it: vaccines.

Here’s a familiar example to explain the function of these enzymes:

You know how you get warnings about not drinking grapefruit juice while taking some medications? That’s because it can inhibit CYP450, specifically CYP3A4, and cause too much drug to be in the body.

Image credit: https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix

If the enzyme is blocked, then it can do the opposite, and cause too little of the drug in the body.

Image credit: https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix

Before we jump into the mess of this blog post, we want to give you a tool for your toolkit to help you navigate the current information ecosystem.

The tool is an easy to remember acronym: SIFT.

• (S)TOP

• (I)nvestigate the Source

• (F)ind better coverage

• (T)race claims, quotes, and media back to the original context

The claim: A “jaw-dropping study” suggests vaccines cause SIDS via brainstem failure.

First, let’s STOP. Take a beat. Pause before sharing and ask yourself: does this content or its claims and conclusions make feel reactive? It’s about SIDS, so of course it’s going to elicit strong feelings. That’s a first sign to slow down before you go deeper in the doomscroll.

Second, let’s Investigate the Source. Ask yourself what is this paper/article/video saying, and what is it not saying?

Here are 3 things the paper IS saying:

1. Let’s start with the first line: “Vaccines are a cornerstone of modern medicine, significantly reducing morbidity and mortality worldwide.”

2. Like we mentioned, this paper looks at CYP450–a truly fascinating topic and one that should be researched. It asks the question of how the genetic variability and the immaturity of CYP450 enzymes may influence vaccine-related outcomes in vulnerable populations.

3. The paper notes that CYP450 does not metabolize most of the adjuvants/stabilizers they mentioned, but their question is for cumulative dose. Aluminum? Cleared by the kidneys.

   Formaldehyde? Does not accumulate in tissue.

   Polysorbate 80? Does not accumulate in tissue.

Here are 3 Thing the Paper is NOT saying:

1. Let’s be very clear here: SIDS is often due to an abnormality of serotonin, impairing an infant's arousal response, raising carbon dioxide (CO2), and increasing the risk of apnea events and death. The paper is not saying vaccines cause SIDS. Full stop.

2. Data in VAERS does not imply that SIDS occurs “within 3 to 7 days after vaccination appointments”--VAERS is a reporting database, not a proof of association. Anyone can report anything at any time on VAERS. While we don’t discount these children died, we do have to realize that infants sometimes do die and infants also get vaccines. Two things can be true without one causing the other.

3. The paper also does not suggest that vaccine ingredients are a) toxic or b) overwhelm immature infant livers and cause inflammation or dysfunction in the brainstem’s cardiorespiratory centers.

Ok step three–let’s Find Better Coverage. Ask yourself who wrote this, who they are, and why they might have written it. Look for trustworthy sources (like this Substack and our Instagram accounts) who base their conclusions on evidence-based research.

One thing to consider is WHO wrote this. The name should be pretty familiar, as he was an infamous serial misinformer during the COVID-19 pandemic: Peter McCullough. Earlier this year, the American Board of Internal Medicine (ABIM) revoked McCullough’s board certification. Why? For repeatedly promoting discredited treatments like hydroxychloroquine and ivermectin and spreading lies about vaccines and mRNA technology. He is not a reliable source for public health information. Additionally, a source mentioned this hot take is another red flag—the Mawson study–Dr. Hughes did a thorough debunk last year.

Fourth, let’s Trace the Claims, Quotes, and Media back to the original context. Look for buzz words and see if the claims are even stated in the original source itself. In this case, the paper said quite the opposite of the bad takes circulating online.

Whenever you see buzz words like “toxic”--remember these words first: the dose makes the poison.

What does that mean? Everything can be toxic, at a toxic dose. Even water.

No ingredients, including adjuvants, are at a toxic dose (a level determined by the EPA for every chemical we are exposed to). No vaccine ingredients accumulate in the body to develop toxicity either.

The vaccine schedule is safer, less taxing on developing immune systems, and more effective than it was 40 years ago. In fact, the number of antigens–what triggers the immune response–decreased by 90%, from 20,000 to about 200. Jessica did an debunk of the vaccine schedule misinformation here.

This is a textbook example of misusing VAERS data to prey on the vulnerability of parents–especially new parents–who are trying to make informed choices for themselves, and their families.

SIFT Source: https://nwtc.libguides.com/evaluating_resources/sift

Thanks for being here,

Jessica Malaty Rivera, MS & Dr. Lauren Hughes

Here is his timely and heartbreaking letter:

Photo credit: Carl Van Vechten Collection, Library of Congress Prints and Photographs Division (1954)

MEASLES: A dangerous illness by ROALD DAHL (1986)

“Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.

“Are you feeling all right?” I asked her.

“I feel all sleepy, ” she said.

In an hour, she was unconscious. In twelve hours she was dead.

The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her.

That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her.

On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunised against measles. I was unable to do that for Olivia in 1962 because in those days a reliable measles vaccine had not been discovered. Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.

It is not yet generally accepted that measles can be a dangerous illness. Believe me, it is. In my opinion parents who now refuse to have their children immunised are putting the lives of those children at risk.

In America, where measles immunisation is compulsory, measles like smallpox, has been virtually wiped out. Here in Britain, because so many parents refuse, either out of obstinacy or ignorance or fear, to allow their children to be immunised, we still have a hundred thousand cases of measles every year.

Out of those, more than 10,000 will suffer side effects of one kind or another. At least 10,000 will develop ear or chest infections.

About 20 will die.

LET THAT SINK IN.

Every year around 20 children will die in Britain from measles.

So what about the risks that your children will run from being immunised?

They are almost non-existent. Listen to this. In a district of around 300,000 people, there will be only one child every 250 years who will develop serious side effects from measles immunisation!

That is about a million to one chance. I should think there would be more chance of your child choking to death on a chocolate bar than of becoming seriously ill from a measles immunisation.

So what on earth are you worrying about?

It really is almost a crime to allow your child to go unimmunised.

The ideal time to have it done is at 13 months, but it is never too late. All schoolchildren who have not yet had a measles immunisation should beg their parents to arrange for them to have one as soon as possible.

Incidentally, I dedicated two of my books to Olivia, the first was James and the Giant Peach’. That was when she was still alive. The second was ‘The BFG’, dedicated to her memory after she had died from measles. You will see her name at the beginning of each of these books. And I know how happy she would be if only she could know that her death had helped to save a good deal of illness and death among other children.”

We can all agree that children shouldn’t die, especially if we have the safe and effective tools to prevent it.

FAQ 1: Why is measles so serious?

Measles is the most contagious infectious disease in the world. We use a figure R0 (pronounced R naught or reproduction number) to measure this. R0 tells us the average number of people one person can infect with a disease. It specifically applies to populations where people are either disease-free or haven’t been vaccinated. The R0 for measles is between 12-18. That means one person with measles can infect 12-18 people. For comparison, the R0 for seasonal influenza is between 0.9 to 2.1, and for COVID-19, it’s between 1.5-3.5. If you do the math on this exponential growth, measles outbreaks can grow really fast, really quick.

Source: The Lancet (1918 flu, SARS); University of Michigan School of Public Health (COVID-19, ebola, measles); Journal of Theoretical Biology (chickenpox, mumps); Proceedings of the National Academy of Sciences (HIV)

Credit: Maria Godoy, Alyson Hurt, Carmel Wroth, Michaeleen Doucleff and Adam Cole/NPR. Icon created by Alice Design from The Noun Project

If one person has measles, 90% of people close to them, with no previous immunity, will become infected. In the 1980s, 3 million children died every year from this vaccine-preventable disease. It was the single leading killer of children worldwide before GAVI massively improved global vaccine access.

Source: Matthew Ferrari, Center for Infectious Disease Dynamics at Pennsylvania State University; Texas Department of State Health Services

Credit: Maria Godoy, Alyson Hurt and Carmel Wroth/NPR. Icon created by Alice Design from The Noun Project

Measles is highly airborne, and can linger in the air for several hours after an infected person passes through. That’s why public health warnings will often be extremely specific about the time and location a confirmed case was reported, to warn folks who may have passed through during or after that window.

Measles can lead to very serious complications:

• About 1 in 5 (20%) unvaccinated children will become hospitalized

• It can cause pneumonia, which is the most common cause of measles-related death

• It can cause encephalitis (swelling of the brain), leading to permanent brain damage

• It can cause pregnancy complications like premature birth

• It can cause severe dehydration from diarrhea, neurological impairment, and hearing loss, and blindness

• It some cases it can cause something called “immune amnesia" - essentially wiping out your body’s memory of all previous infections, making people immunologically naive and susceptible to more diseases

• It can cause death–nearly 1 to 3 out of every 1,000 cases of measles will be fatal

FAQ #2: Why has it been so long since the US has had a measles-related death?

The reason why it’s been so long since we’ve had a measles-related death is because vaccination rates have been historically high. In order to prevent outbreaks, we need rates (typically measured by Kindergarten demographics) to be at least 95%. Once it dips below that rate, outbreaks emerge.

The US eliminated measles back in 2000, thanks to widespread use of the measles, mumps, and rubella (MMR vaccine). The vaccine is one of the most effective vaccines at lifelong infection prevention. Two doses of MMR prevents 97% of cases. Outbreaks like this are not normal, and based on the expected mortality rate, we are sadly not surprised to see that one death has already been reported.

This is the first death since 2015, and the first pediatric death since 2003.

FAQ #3: Are kids hospitalized for quarantine purposes?

RFK Jr. has misrepresented multiple details about this outbreak, and this tragic death. Patients are not being quarantined in the hospitals. They are taken there for clinical care (primarily respiratory support). The spokesperson (Lara Anton) for the Texas department of health and the chief medical officer (Dr. Lara Johnson) of the hospital confirmed this. It is neither policy nor standard of care to “hospitalize for quarantine.” It seems he’s trying to minimize the outbreak by presuming the hospitalizations are “mainly for quarantine” and that these are isolated cases.

He also said two kids died. Only one has.

FAQ #4: Is this really “not unusual”?

Measles outbreaks are a big deal. Here is helpful context: In 2000, nearly 40 years after the MMR vaccine became available, the disease was eliminated in the US–meaning no new cases were emerging from within the US. Any new cases were “imported” from other countries.

In the last decade, the rise in measles outbreaks is directly linked to vaccine refusal. Kindergarten vaccination rates went from 95.2% between 2010-2019 to 92.7% by 2023–under the herd immunity threshold.

• In 2019, the US nearly lost the elimination status after 1,300 cases were reported in NY and several other infections were reported in 30 additional states.

• In 2023, there were 4 measles outbreaks (involving 3 or more cases).

• In 2024, there were 16 measles outbreaks.

• Two months into 2025, and we’re on our third outbreak–the worst in 5 years.

Outbreaks of this scale are not only rare, they are entirely preventable. That said, they will become more common if our vaccination rates continue to fall short of herd immunity thresholds.

To say this is “not unusual” is dishonest and intended to downplay the severity of the disease, this outbreak, and declining vaccination rates.

FAQ #5: Can Vitamin A prevent measles?

No. This rumor is based off a misunderstanding of post-Infection guidance from the WHO which states that doctors can give 2 doses of vitamin A, 24 hours apart, to children infected with measles to restore low vitamin A levels. Excessive vitamin A intake can be very dangerous. Please do not try to treat or prevent measles with remedies like this.

FAQ #6: Is this outbreak the result of vaccine-derived measles?

No. The MMR vaccine uses a live-attenuated (weakened) virus to help train a child’s immune system to recognize the viruses. Side effects are typically mild, and no one develops measles infection from the vaccine. Additionally, the genotype used in the vaccine is type A. The genotype identified in the ongoing outbreak is D8, which confirms this is a wildtype measles outbreak.

FAQ #7: Should we be getting MMR boosters?

Most people who received 2 doses of the MMR vaccine are considered fully vaccinated and protected against measles. Pregnant people (and healthcare workers) are offered a titer test to measure antibody levels. Some of these antibodies can be passed to the baby, offering protection upon birth until the baby is age-eligible for vaccination. Because the MMR vaccine is “live”—it is not offered during pregnancy if the antibody levels are suboptimal. Instead, a booster is offered shortly after birth.

People born before the year of 1957 are considered immune to measles (as they have likely had the virus). There is no current recommendation for additional vaccination. That said, there is no harm in an additional dose. Please talk to your doctor about seeking titer tests or an additional dose.

FAQ #8: Should we vaccinate kids earlier than the recommended schedule?

The current recommendation is that the first MMR dose is given between 12-15 months of age. The second dose is given between ages 4-6 years of age, ideally so that kids are considered fully vaccinated upon entering Kindergarten.

If you live in a community that is experiencing an outbreak or if you are traveling internationally, babies may be vaccinated as early as 6 months of age. This is a decision that should be made with your pediatrician. Babies who receive their first dose “early” (before 12 months of age) will still need to get 2 more doses to complete the series.

It is not recommended to seek MMR vaccination early unless you’re in an area experiencing an active outbreak or traveling internationally to an area where the disease is endemic (parts of Africa, the Middle East, and Asia).

FAQ #9: Is measles infection ever a good thing?

No. The information landscape on measles is filled with deadly misinformation. There are claims that the disease is “just a rash” or that it can “prevent cancer” and reduce the risk of chronic diseases and autoimmune issues. None of which are true. Measles infection is never beneficial. As I mentioned above, infection can sometimes cause the exact opposite of these claims—immune amnesia.

FAQ #10: Will we still have access to MMR vaccines in light of what is happening at HHS and CDC?

Things are grim, I won’t lie. And a lot remains to be seen with RFK Jr’s intention to revisit the pediatric vaccine schedule and reshuffle the Advisory Committee for Immunization Protocols (ACIP). I hate to speculate, so I won’t. But I will be following this very closely and provide updates as they emerge.

Sadly, this measles outbreak is nowhere near over. I’m afraid there are many more cases that have not been detected or diagnosed yet.

Every measles death is preventable, and I fear that this child’s tragic death may not be the last. It’s a terrible lesson to learn, and while I understand and happily answer questions related to vaccine fear and vaccine hesitancy, I cannot understand the willful deception coming from our very only secretary of health and human services.

This is the first time we’ve had a high severity season since the 2017-2018 flu season.

While I’m relieved to see updates to FluView, we’re still not getting the full picture. In a press briefing last week, Dr. Maria Van Kerkhove, the Director of Epidemic and Pandemic Threat Management at the WHO, reported that the CDC is “not reporting influenza data through the WHO global platforms, FluNet and FluID”—something the agency has done for years. Historically, when flu seasons are particularly bad, the CDC often shares extended analysis through the Health Alert Network (HAN), which as of today, is still stalled. HAN alerts are a critical piece in public health response as they often include advice for providers and the public on how to navigate risk and clinical care.

Data lags reduce our ability to have timely responses to emerging outbreaks. Lags cause uncertainty, confusion, and contribute to the already dwindling trust in our public health infrastructure. These lags in data and analysis are a familiar lament. Many of you remember me saying these words multiple times while the COVID Tracking Project was still operating.

Even if we take the data at face value, it’s still pretty bad. An estimated 33 million cases, 430,000 hospitalizations (a 15-year high) and 19,000 deaths. Among those who died include 86 children. These deaths are preventable. No one, especially children, should be dying of the flu. That’s what makes HHS’ decision to remove CDC’s Wild to Mild campaign even more gutting.

The primary goal of flu vaccines (and COVID-19 vaccines while we’re talking about this) is to reduce the risk of severe outcomes like hospitalizations, and deaths. Those were the primary endpoints (objectives) in the COVID-19 clinical trials, which continue to be misrepresented by folks who do not understand vaccine effectiveness. Some vaccines, like the measles, mumps, and rubella (MMR) vaccine are really good at preventing infection—that’s what make the herd immunity aspect of MMR vaccination so powerful. When a population is at least 95% vaccinated, we don’t see measles outbreaks.

This campaign emphasized the power of harm reduction, especially in large populations. In fact, It was clearly noted on the CDC website that the goal was to “reset public expectations around what a flu vaccine can do in the vent that it does not entirely prevent illness.” The campaign was also in response to dwindling flu vaccination rates, especially among high risk populations (children, and pregnant people). To date, only 45% of adults and children received a flu vaccine this season.

I’m sure you remember the popular phrase, “flatten the curve.”

This was not unique to COVID-19. Our healthcare system can be easily overwhelmed, especially during respiratory virus season, when too many people require hospitalization.

I’m not here to spread panic. But, I am here to say—if you haven’t gotten your flu shot, it’s not too late.

All this, while we watch the United States’ botched response to the ongoing H5N1 avian influenza outbreak. Two new confirmed cases of H5N1 were reported this week, bringing the total number of known cases to 70. The last thing we need is for H5N1 to worsen and spread from human-to-human. We are unfortunately in a scenario in which it could—if the seasonal flu viruses circulating (H3N1 or H1N1) happen to reassort with H5N1 (swapping genes). That sort of shift in the virus could make it more capable of attaching to our upper respiratory tract. Again, it hasn’t happened yet, but if we continue to let both diseases spread with reduced visibility on cases and transmission dynamics, I fear we may be blindsided.

This did not happen overnight. For years, RFK Jr. has grown in prominence and in wealth as he peddled pseudoscience, conspiracy theories, and endless misinformation about vaccines, food, nutrition, disease—just about everything in public health. It’s fair to say that he helped transform a previously loud minority of science skeptics and cynics into a well funded and well organized anti-science industry. What makes this so troubling is the successful rebrand to Make America Healthy Again (MAHA). RFK Jr. has repeatedly denied being “anti-vaccine”—and he’s able to do so by flipping the narrative to themes like informed consent, medical freedom, and now, the chronic disease epidemic in the US.

There is not denying that there is a chronic disease problem in the the US. Public health scientists have been researching this and reporting it for years. The issue here is the disingenuous questions about why it’s happening and how it can be stopped. During RFK Jr.’s short-lived presidential campaign, he infamously said that he would give infectious disease research at the National Institutes of Health (NIH) a “break” for eight years, to focus on chronic diseases like obesity, diabetes, asthma, and cancer. He claims that chronic diseases receive “less attention” [federal funding] than infectious diseases. What he fails to understand is that infectious diseases are a leading cause of chronic diseases and to deprioritize one, is to fundamentally misunderstand how we can promote health and prevent the onset of disease. [I plan to do a deep dive on this soon]

The role of HHS Secretary carries a tremendous amount of power. I don’t want to speculate too much about what he can and cannot do while in this position, but let’s consider all of the agencies he will be in charge of: the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), NIH, the Administration for Children and Families (ACF), and the Centers for Medicare and Medicaid Services (CMS). To no one’s surprise, Trump has identified loyalists known for their contrarian views and pubic health antagonism

• Dr. Mehmet Oz for CMS Administrator

• Dr. Marty Makary for FDA Commissioner

• Dr. Janette Nesheiwat for Surgeon General

• Dr. Dave Weldon for CDC Director

• Dr. Jay Bhattacharya for NIH Director

At this point, we’ve become dizzy from the headlines about everything from research budget cuts to healthcare workforce layoffs, disappearing datasets, and even bans on words allowed on government websites. All of this makes the language of the most recent Executive Order for Establishing the Make America Health Again Commission that much more problematic.

It’s fresh from the anti-science playbook.

To the untrained eye, one might read these sentences as altruistic and sincere. But for those of us, forced to become fluent in the language of pseudoscience, these words have the power to cast enough doubt, fear, and confusion to justify re-litigating the greatest public health innovations of human history, putting millions of Americans at risk of disability, disease, and death.

RFK Jr. is not “just asking questions”—he is lying about clinical trials, the mountains of reproducible (and publicly available) data, and he’s lying about safety and efficacy findings. One of the most effective manipulation tactics from people who spread and profit off of medical misinformation is to ask questions, for which we already have the answers, and present them as mysteries they will uniquely and heroically solve.

They all do this, and now our HHS Secretary is chief among them.

For those who might be new here, welcome! My name is Jessica Malaty Rivera. I am an infectious disease epidemiologist, infodemiologist, and science communicator. I’m also the lucky mama to three young kids. You’ll notice I wear that hat in a lot of my messaging as my audience includes many parents and caregivers. I have an Master of Science (MS) degree in Biohazardous Threat Agents & Emerging Infectious Diseases from Georgetown University School of Medicine and I’m currently pursuing a Doctor of Public Health (DrPH) degree at Johns Hopkins Bloomberg School of Public Health. For the last twenty years, I’ve dedicated my career to tracking pandemics and infodemics.

I take great pride in being a science communicator and have used Sir Mark Walport’s words as my guiding motivation.

“Science isn’t finished until it’s communicated.”

My speciality is in translating complex scientific concepts into impactful, easy-to-understand, judgement-free, and accessible information for wide audiences. What good is science if it’s not used to help people and communities make evidence-based and informed choices about their health and wellbeing? It’s why I made my previously private Instagram account public in February 2020—a chance to meet the moment during the uncertain times of an emerging pandemic.

Since then, a lot has changed. Especially this week.

On February 1, 2025, the day after rumors swirled about federal websites being taken down—the public health community was stunned to see the below on cdc.gov:

This banner will be burned in my memory as a reminder of when bigotry and science denialism hijacked the premier public health agency in the world.

Multiple CDC webpages have gone dark. Data have been retracted.
CDC’s AtlasPlus, which holds 20 years of surveillance data for HIV, TB, hepatitis B and other diseases, has been heavily modified.

And for the first time in 60 years, CDC failed to publish TWO consecutive issues of the Morbidity and Mortality Weekly Report (MMWR) as their scientists scramble to comply with Trump’s overreaching and unscientific Executive Orders.

CDC scientists have been instructed to retract or pause the publication of ANY research manuscript (not just MMWRs) that include any “forbidden terms.”

The “forbidden terms” include: gender, transgender, pregnant person, pregnant people, LGBT, transsexual, non-binary, nonbinary, assigned male at birth, assigned female at birth, biologically male, biologically female.”

Other “forbidden words” lists have circulated that include:
“health equity, vaccine equity, diversity, gender equity, pregnant person, transgender, nonbinary, immigrant, and vaccine confidence.”

This is unfathomable.

Censoring public health puts people and communities in danger.

Which is why I’m here. I won’t stop translating and communicating science. I won’t stop providing the context, nuance, and evidence behind the dizzying headlines. I will say I don’t know, when I don’t and I will do so with the empathy and humility that is often lacking in science. My goal here is two fold: to increase your science literacy and to help you navigate through these unprecedented and dangerous information ecosystems. By doing that, I hope to earn your trust, and help restore your trust in public health.

Welcome to Making Science Make Sense. I’m so glad you’re here.