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Jay Bhattacharya, NIH [00:05:15]
Let me talk a little bit about a few early initiatives that I’ve worked on.
So the first is an initiative requested by the president of the United States to Secretary Kennedy and then transmitted to me to have a– to initiate a research program so that we have a better understanding of the etiology of the autism spectrum disorders, as well as associated conditions.
To do this, the NIH is launching a initiative inside the office of director where the goal is to integrate diverse data, enabling researchers to examine complex factors, influencing the rapid rise in autism spectrum disorder.
In 2022, the MMWR that CDC estimated that autism spectrum disorder of– that one in 31 children had some form of autism spectrum disorder. A very sharp increase from previous years.
Autism spectrum disorder is a highly heterogeneous condition with many potential causes and understanding its etiology is absolutely crucial to developing treatments for the range of conditions that this disorder represents.
The NIH is committed to identify causes, risk factors, and treatments, through investments in research programs, coordination of interagency activities and collaboration with the autism community.
To this end, we’re launching an initiative to accelerate the understanding of causes and improvements in treatment. This new initiative will leverage large scale existing data resources, as well as resources, data resources that are available throughout the rest of the federal government, as well as in the private sector.
If needed, we’ll generate– the researchers can generate new data that will link to these and openly query contributions, contributors, risk factors, and causes of autism.
To do this, we will use a rapid timeline of a large grant, open grant process from– that will be run through the office of the director.
We will subject the grant– the external researchers who apply will be subject to normal review processes, and have access to the data resources, which I’ll mention in just a second.
The idea would be that somewhere between 10 to 20 groups of researchers from across the country, again, run through normal NIH processes, would be able to ask questions using methods ranging from basic science to epidemiological approaches, to other more applied approaches to ask what causes autism and how best can we manage, how best can we treat and manage autism so that so many millions of families have an easier time dealing with the problems caused by having an autistic child.
Next slide, please.
I recognize, of course, that autism, there’s a range of manifestations ranging from highly functioning children to children that are quite severely disabled.
And of course the research will account very carefully for that, those distinctions, the highest quality proposals.
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Jay Bhattacharya, NIH [00:09:01]
To make this happen, what we are going to do at the NIH is launch a real world data platform.
The idea of the platform is that the existing data resources are often fragmented and difficult to obtain. The NIH itself will often pay multiple times for the same data resource, even data resources that are within the federal government are difficult to obtain, and used by researchers.
So what we’re proposing is a transformative real world data initiative, which aims to provide a robust and secure computational data platform for chronic disease and autism research.
This data platform that will be unveiled and used for the autism initiative, I mentioned earlier, will be will also be available for other research programs within the NIH, on chronic disease and other topics.
The platform will facilitate collaboration across the department of health and human services and federal government more broadly to establish comprehensive longitudinal health data sets with broad coverage in the U.S. population.
This will include claims data for Medicare, Medicaid. We are working on a memorandum of understanding with CMS to establish broader data use agreements within the NIH for that purpose.
It’ll include electronic health record data, and from the private sector, and it’ll include other other claims claims records.
It’ll include existing data resources such as the genetics data that the NIH has as well as toxicology data and environmental exposure data from across the government, and private resources, private industry.
Many leaders in the data science space have contributed to this strategy from DPCPSI offices and programs and across the ICS. And so this platform will feature the cutting edge knowledge that the NIH already has.
If you can look in this figure, you can see that the platform will integrate and link data from real world sources, such as pharmacy chains, so that you have medication records, health organizations, like the– including the VA, Defense Health Agency, Indian Health Service, clinical data, as I already mentioned, electronic health records. So you have access to labs, imaging, genomics, claims and billing data, which often provides detailed diagnostic information, as well as information about use of occupational health and other other resources, environmental data, air pollution, environmental toxins, as well as some data on sensors and wearables like smart watches and fitness trackers.
By bringing these data together in place, providing access to advanced computation resources and leveraging the latest techniques, the AI techniques, the platform will accelerate research and create new opportunities for cross agency use of data and real time health monitoring, developing national disease registries, including a new one for autism, enabling faster drug development, enabling longitudinal data sets to better understand the progression of disease and launching national competitions, as well as research programs for innovative and cutting edge research, to answer key questions such as the one on the etiology of autism.
The real world data platform will preserve the privacy of patients, sort of within the context of the platform itself. Researchers will be able to do their work on the platforms, but not be able to download the data themselves. And there are state of the art protections to make sure that that although linkages across the data sets will be permitted inside the platform, that these linkages do not in any way threaten the confidentiality of patients.
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Jay Bhattacharya, NIH [00:13:00]
To do this, we will form collaborative partnerships with federal state and private entities to expand data resources and identify opportunities.
The platform development will leverage existing programs as the foundation, such as the healthy baby child development program, the National Institute of Aging linkage program, which currently links NIH supported study data and CMS claims data, and the NCATS N3A platform, which systematically collects data derived from electronic health records from different institutions and harmonize these data into data enclaves.
We’ll use all available funding mechanisms to build new partnerships and research opportunities. The strategic approach will enable an agile implementation, engagement with nontraditional research partners and support NIH wide develop involvement to drive platform growth.
I’ve already reached out, uh, across HHS, including to CMS, and other other entities within HHS as well in the NIH itself and have had nothing but enthusiasm for participation in this. We’ve had a great conversation with some of our folks in military health who are also quite eager to get these data in the hands of researchers, so that we can ask questions, again, not just about autism, about a whole range of conditions that, that would benefit from close analysis of these data by expert researchers in the extramural community.
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Jay Bhattacharya, NIH [00:14:21]
The will pre to find milestones and checkpoints ensuring efficient operation. But the key thing is it’ll– not that we will make sure that the processes inside up to obtain and use these data inside the real world data platform, guarantee patient safety protection, patient confidentiality, so that while research access will be easy, harming patients as far as their confidentiality is concerned, will not be possible.
Marty Makary, FDA [00:00:54]
It’s a joke. They’re laughing at us. They’re laughing at the FDA inspectors.
So in line with President Trump’s America First agenda, we are switching to more surprise inspections overseas, which is what we’ve done in the United States. So why have we had a double standard, if anything, we need to focus more on foreign inspections.
So we’re going to be increasing the number of inspectors, inspecting foreign manufacturing facilities, and we’re gonna do it in a surprise basis.
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Question [00:04:44]
We talked a little bit about all the food dyes that were in my child’s potential cake icing. There’s been some moves at the state level on that, we saw Gavin Newsom do something on red dye, some other states have made some rumblings about it, anything to announce on that?
Marty Makary, FDA [00:05:01]
Nothing to announce today, but we are taking a close look at that because food companies, they’ve told us, like we want a common standard. We can’t deal with a patchwork of 30 different states that are banning some or in certain places or settings.
And so we’re looking at that and I expect an announcement soon where we’re going to take a comprehensive look at what can be done and work with the food companies to help them transition to non petrochemical food dyes that are polluting our nation’s food supply.
And it’s not the individual driver of the chronic disease epidemic, but they’re making ultra processed unhealthy foods, look attractive with vibrant colors, colors that don’t appear in nature. That’s part of it.
And the other part is that petrochemicals have health concerns that have been raised in several studies. Now we can’t blow that off.
On background: NIH is developing a proposal to launch a program to fund research to understand the multi-factorial causes of autism. As the Secretary said during the press conference Wednesday, more information will be announced in the coming weeks. The process for launching the autism program is as follows: NIH issues a Notice of Funding Opportunity (NOFO), investigators/researchers submit their projects for consideration, NIH fund those that are deemed the best science. This is standard process.
The nine states that have publicly confirmed measles outbreaks this year are: Texas/New Mexico, New Jersey, Georgia, Ohio, Kansas, Indiana, Tennessee, Michigan, and Pennsylvania. The unlisted state with an outbreak is currently under investigation with the state.
“GSA regularly sends out information regarding the procedures for displaying official portraits of the President and Vice-President in federally owned buildings and leased space during the change of administration.
Additionally, the federal COVID-19 Public Health Emergency (PHE) declaration ended on May 11, 2023. As part of our normal operations in providing updates to our tenant agencies, GSA communicated that any existing Covid-19 signage should be removed.”
Secretary Robert F Kennedy Jr [00:00:56]
I’m going to go over some of the key numbers from the ADDM report.
Overall, the autism is increasing in prevalence at an alarming rate.
The study tests eight year olds who were born in 2014, and by the way, these studies are two years later than they should be.
And one of the things that we’re gonna do is we remove this function to the Administration for Healthy America, to the chronic disease, the new chronic disease division, is we are going to have updated, real time data so that people can look at this, Americans can understand what is happening with chronic disease in this country in real time. And not have to wait two years to react.
We don’t wait two years to react to a measles epidemic and we should not, or any kind of infectious disease. We shouldn’t have to do that for diabetes or autism.
The ASD prevalence rate in eight year olds is now 1 in 31, shocking.
There’s an extreme risk for boys. Overall, the risk for boys of getting an autism diagnosis in this country is now 1 in 20 and is high in California, which has the best data collection. So it probably also reflects the national trend, 1 in 12.5 boys.
This is part of an unrelenting upward trend. The prevalence two years ago was 1 in 36.
Since the first ADDM report in 1990, which was 1992 births, autism has increased by a factor of 4.8. That’s 480%, I believe.
The first ADDM survey was 22 years ago, when prevalence was 1 in 150 children.
In all the core states, the trend is consistently upward and most cases now are severe.
So about 25% of the kids who are diagnosed with autism are nonverbal, non-toilet trained and have other stereotypical features, head banging, tactile and light sensitivities, stimming, toe walking, etcetera.
One of the things that I think that we need to move away from today is this ideology that the autism diagnosis, that the autism prevalence increase, that the relentless increases, are simply artifacts of better diagnoses, better recognition or changing diagnostic criteria.
If you look at table three of the ADDM report, it is clear that the rates are real, that they are increasing in the last 10 years, year by– which is the– beginning with the first one, year by year, there is a steady, relentless increase.
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Secretary Robert F Kennedy Jr [00:10:56]
These are kids that– this is a preventable disease.
We know it’s an environmental exposure. It has to be.
Genes do not cause epidemics. They can provide a vulnerability, but you need an environmental toxin.
And Irva Hertz-Picciotto pointed out that because of this mythology, at 10 to 20– that the amount of money and resources put into studying genetic causes, which is a dead end, has been historically 10 to 20 times the amount spent by NIH and other agencies to study environmental factors, to study exposures, to study external factors.
And that’s where we’re going to find the answer.
This is an individual tragedy as well. Autism destroys families. But more importantly, it destroys our greatest resource, which is our children.
These are children who should not be suffering like this. These are kids who, many of them were fully functional, and regressed because of some environmental exposure into autism when they’re two years old.
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Secretary Robert F Kennedy Jr [00:12:43]
I think I’m gonna have Walter Zahorodny, who is the most senior researcher for this project for ADDM, who’s been doing this for many years, to come up and say a little.
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Secretary Robert F Kennedy Jr [00:18:12]
I referred to a number of studies. There are many, many, many others in the scientific literature that absolutely explode this mythology, that this is a– that the autism epidemic is not real.
If you read the literature, it is absolutely indefensible to continue to promote this. And– but it doesn’t tak you to read the literature. It just takes a little common sense.
If autism– if the epidemic is an artifact of better diagnostic criteria or better recognition, thenwhy are we not say seeing it in older people? Why is this only happening in young people?
I asked Walter before we came out here, I said, have you ever seen anybody our age? I’m 71 years old, with full blown autism?
Head banging, nonverbal, non toilet trained, stimming, toe walking, these other stereotypical features? Where are these people walking around the mall? You can’t find them. There’re not in homes. There are no homes for them. There are no institutions for them.
Why aren’t we seeing them on the street? Anybody can look around and see that this is a canard. And then you have to ask yourself, why is it so pervasive?
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Secretary Robert F Kennedy Jr [00:27:08]
We’re going to look at all of that.
We’re going to look at obesity in the parents. We’re going to look at the age of the parents. We’re gonna look at diabetes in the parents.
We’re going to look at all of these potential exposures.
And because of AI and because of the digitalization of health records and the mass of health records that are now available to us, we can do this much more quickly than has ever been done in the past.
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Question [00:27:44]
Do you still pledge to have answers by September? Or is that gonna be the beginning of this process? And are you open to following the science of whether it confirms some of your expectations or not?
Secretary Robert F Kennedy Jr [00:27:55]
No, I mean, we’re going to follow the science no matter what it says and we’re– we will have some of the answers by September, but it’s going to be an evolving process.
We’re going to involve, we’re going issue grants the way that it’s always done to university researchers and others, we’re going to remove the taboo. People will know they can research and they can follow the science no matter what it says without any kind of fear that they’re going to be censored, that they’re going to be gaslighted, that they’re going to be silenced, they’re going to be defunded, delicensed, and we’re going to give them permission to do this research.
And then we’re going to open it up to the research community and we’re gonna task them with certain outcomes. And we’re going to have them come and bid on what, how to make, do the research.
This is all being run by Jay Bhattacharya and by, I think, Martin Kulldorff may be also working on this, on designing the grant proposals.
So it’s going to be done by credible scientists, by the most credible scientists from all over the world. And we’re going to do it very, very quickly.
09:32:22 PM HANNITY
Where is the science is pointing? Where– I mean, we are getting data. They are investigating it. Where do you think we’re going to end? What is your best guess hypothesis here, theory at this point?
KENNEDY
Well, President Trump asked me to find out what’s causing it.
And I’m approaching that agnostically. I’m looking– we’re looking at everything. We’re going to do — we’re going to be very transparent in how we design the studies.
We’re going to farm the studies out to 15 premier research groups from all over the country. And we’re going to be transparent about our protocols, about the data sets, and then every study will have to be replicated.
We’re going to look at mold, we’re going to look at the age of parents, we’re going to look at food, and food additives, we’re going to look at pesticides, and toxic exposures. We’re going to look at medicines. We’re going to look at vaccines. We’re going to look at everything. And–
HANNITY
Well, that’s the quintissential definition of science. And you’re going to get to the bottom of it. I only have about 20 seconds – how long do you think it will take?
KENNEDY
I think we’ll have some preliminary answers in six months. But we– it will take us probably a year from then before we can have definitive answers, because a lot of these studies will not go out until the end of the summer.
I’m very grateful to President Trump for putting me in this position. We are going to have an answer and we’re going to have it very quickly.
Marty Makary, FDA [00:04:55]
I am on a listening tour. We’re talking to the career scientists, we’re trying to make sure they have all the resources they need to do their job well.
We’re trying to change the culture here to make it more of a teamwork culture. It’s been very siloed. Each of the centers has developed their own fiefdom with their own communications department and lawyers and lobbyists for Congress and IT departments and the IT systems don’t talk, they’re on different systems.
So that’s why you have VAERS and FAERS and CARES and 10 different adverse event reporting systems. We probably need one really good one.
So, I’m doing an inventory right now trying to assess the lay of the land. And then we’re also trying to change the culture to a culture of teamwork, the scientific gold standard, and common sense working together.
And that is our goal right now.
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Marty Makary, FDA [00:07:25]
We are still reeling back from some of the disastrous healthcare corruption that the government was involved in.
The food pyramid, one of the greatest pieces of misinformation put out there that has informed school lunch programs, that has informed what people define as healthy. And so we now have a group that’s reevaluating the nutrition guidance.
We have a MAHA commission that is going to be putting out a massive report that doesn’t just talk about calories in calories out. It talks about food ingredients and chemicals that don’t appear in nature, that are going down the GI tracts of our nation’s children every day nonstop.
And it may not be one ingredient that is driving some of these chronic diseases. It may not be one ingredient involved in attention deficit disorder. It may be the cumulative burden of all of it.
So we’re now taking a much wider view.
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Marty Makary, FDA [00:18:49]
There’s a lot of talented people who can do that job. Well, a lot of very smart people who are, right now, who are applying for that job.
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Marty Makary, FDA [00:19:12]
We are not going to be shutting down ideas, ideas that may be different from my ideas. We should welcome that.
Science is based on challenging, deeply held assumptions, where there’s no good evidence, what we call medical dogma. That is the scientific process.
And so we shouldn’t be shutting down other ideas. We should be inviting them. And that’s why we’re going to be having round table expert panels, FDA expert panels on menopause and hormone replacement therapy, on a whole host of topics.
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Marty Makary, FDA [00:32:15]
We’re bringing in a team that is really exciting.
They’re going to use– introduce AI into the review process to help the reviewer, to make the reviewer’s process, work stream much more streamlined and summarize things.
There are parts of the drug application that are so perfunctory, that are outdated, that could be streamlined. That could be abstracted with AI to help the reviewer.
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Marty Makary, FDA [00:35:09]
There were no cuts to scientists, reviewers, or inspectors or law enforcement.
And my goal is to make sure that every one of those people has all the resources they need to do their job well.
Now, cuts are never perfect. And so we have done an assessment and there are some individuals that we have invited back.
There were a couple people who were taking the early retirement and we– were told of their sort of how well they performed here and we encouraged them to stay.
But to not report that the agency has doubled since 2006, before this cut, in my opinion is not telling the whole story.
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Marty Makary, FDA [00:38:08]
No longer are we going to say, it’s– you have to have these calories. It doesn’t matter how you get ‘em. Doesn’t matter if it’s all ultra processed foods, it’s just pure calories in, pure calories out.
That dogma, which had no scientific support, was a massively underfunded endeavor. We let the industry tell us as a government what’s healthy and what’s not healthy.
And even with the recent Biden administration suggestion to have front of package labeling, they picked sodium, saturated fat, and added sugar in there.
I think they got maybe one thing right out of those four, but they ignored a giant sloth of food ingredients. And so when you ignore a thousand chemicals, some of which are petrochemicals that have been introduced into the food supply simply because the industry has self deemed them as safe, when you ignore that, then you can’t call something healthy, just because it has a low amount of saturated fat.
That’s old dogma.
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Marty Makary, FDA [00:41:19]
I don’t know what causes autism, but I’m deeply concerned about the rise.
If I had to make a hypothesis as a scientist, not as a regulator, but as a scientist. And Dr. Bhattacharya is going to be launching a very impressive study using electronic health, big data that we’re helping curate.
I think it is the cumulative burden of all of these exposures, environmental and dietary, that alter the microbiome.
Remember 90% of the serotonin made, which is involved in mood and mental health, is from bacteria in the microbiome. That’s where it’s produced.
And when you mess up the microbiome, when you carpet bomb the microbiome with all of these ingredients that don’t appear in nature, these are novel chemicals, what are we doing?
So we’ve known for a long time as a scientific community that kids with autism have different stool composition, different biodiversity. So when you look at the billion different bacteria that live in the microbiome, there may be an association between changing the microbiome and autism and things that are changing the microbiome that we’ve not yet fully appreciated.
And that could be a whole list of things.
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Marty Makary, FDA [00:48:03]
You know, the NIH has really focused on genetics and the entire culture of the NIH, and thus the entire academic medical community in the United States, has been a culture focused on the genome based on the Francis Collins era that the gene is responsible for most of our health problems and the gene can solve most of our health problems.
And you look at the NIH individual institutes within the National Institutes of Health, and it’s geneticists all over the place. You look at the Institute for Child Health at the NIH, and it’s run by a geneticist who parades around finding a gene involved in some ultra rare gene disorder. That’s good and it’s important, but nobody is talking about the food our kids are eating in this.
Megyn Kelly [00:48:53]
By the way, there’s not much we can do about our genes.
Marty Makary, FDA [00:48:55]
The genes are not the problem of our, not the cause of our chronic disease epidemic.
It’s what we are doing or what is being done to children by adults today, unknowingly with good intentions sometimes.
You go to the National Institute of Environmental Health at the NIH, go to the website and you’ll see the director has on there that they were involved in identifying a gene that may be associated with obesity.
What are you doing? I mean, there’s value in that research. How about the ding dongs and cupcakes and donuts and french toast that the kids are eating with government tax dollars every morning at school. And nobody seems to be paying attention.
Megyn Kelly [00:49:33]
And I’ve heard you say before, if you fix your microbiome, you actually might be less hungry, less prone to obesity. Like the things you were talking about are all to set people up for a healthier lifestyle that’s a little easier. They may be victims to cravings that created by this terrible food pyramid and them following the American diet that shoved down our throats.
Marty Makary, FDA [00:49:55]
Look as a surgeon, I’ve met patients that would do everything to lose weight. They did all the right things.
They switched to better foods and they would exercise. They couldn’t lose weight. What was happening there? Can we learn from those individual patients?
Maybe the microbiome was altered in a way that is not easy to fix by just switching back. Maybe all of those years, the cumulative insult to the microbiome was altered.
Now there are some researchers doing this. I met the microbiome researcher at the NIH, and it’s like a tiny shop. Like this should be the main focus.
Megyn Kelly [00:50:26]
Yes.
Marty Makary, FDA [00:50:26]
The NIH has collected DNA, all the DNA information on 1.2 million Americans. And you’ll say, I didn’t know about this. What, you know, what, why? They have been doing it for the last six or seven years in search of a genetic basis for health disparities.
And that entire–
Megyn Kelly [00:50:49]
What does that mean?
Marty Makary, FDA [00:50:50]
It means they want to understand why certain populations have more chronic diseases than others.
And they believe that it’s in the genome. And so they collected this giant genetic library. They would pay Americans say $25. 80% are African American, Latino, or transgender, because they want to unlock why they have different rates of chronic diseases.
They have this massive library when Jay Bhattacharya came in office, the previous director moved that entire database project to another office outside of the director’s office, maybe so he wouldn’t touch it.
Megyn Kelly [00:51:27]
Interesting.
Marty Makary, FDA [00:51:27]
And what are– what are they doing? Like I’m not saying there’s no value in that, but you’re not– You can’t even tell us how to lose weight. You can’t even tell us how to– what foods are healthy for children. You can’t even tell us about seed oils or food dyes or ingredients that are added just for shelf life.
And so that has been the entire culture of the medical establishment. And when they launched that project, they went to the oldest African American church in Harlem. They went to Atlanta, Detroit, and they recruited people from minority communities and they told them no longer is our is our medical recommendations gonna be blanket.
They’re going to be custom tailored to your ethnic, to your population.
Megyn Kelly [00:52:15]
Mm-hmm. Good luck doing that with trans people.
It’s disappointing that this individual is fabricating false claims. NIH scientists have, and will, continue to conduct interviews regarding their research through written responses or other means. We remain committed to promoting gold-standard research and advancing public health priorities. Any attempt to paint this as censorship is a deliberate distortion of the facts.
David Sugerman, CDC [17:00:32]
Following the COVID 19 pandemic, we’ve had a measles resurgence due to increased measles transmission abroad, a surge in international travel and declines in measles vaccination, especially in close knit communities with already low vaccine coverage.
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David Sugerman, CDC [17:01:02]
While the number of outbreaks fluctuated from 4 to 16 over this period, the proportion of total cases that are outbreak associated increase from half to 93% this year with five outbreaks, ongoing.
We will be tracking duration, working closely with our state and local partners to ensure we don’t cross the 12 month threshold and preserve our elimination status with ongoing spring and summer travel and congregate events.
This map shows measles cases by state from light to dark blue. Half of our states are reporting measles cases. Most states are reporting no or limited further spread from importations.
Of note, there are also large measles outbreaks in the same close-knit community to our north in Ontario, Canada bordering Minnesota through New York, and to the south in Chihuahua, Mexico, bordering Texas, and New Mexico.
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David Sugerman, CDC [17:02:07]
Over 90% of the current national cases are related to the Southwest outbreak driven by transmission in close-knit under vaccinated communities with low vaccine coverage.
The non Southwest cases are largely importations with some degree of spread from all WHO regions, largely from Canada and Vietnam.
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David Sugerman, CDC [17:04:34]
Most of the sequences thus far are genotype D8, DSId 9171, which is present in Texas, Oklahoma, New Mexico and Kansas.
This same sequence has also been identified in the ongoing outbreaks in Chihuahua, Mexico in Ontario, Canada among the same close-knit under vaccinated community.
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David Sugerman, CDC [17:05:19]
At the invitation of Texas Department of State Health Services, we deployed 15 from CDC, including two from NIOSH through an Epi-Aid to provide onsite technical assistance to Texas during March 4th to April 1st, with another team of seven deploying today.
On the ground, we’ve provided infection prevention control assistance to seven healthcare facilities with ventilation assessments and proposed solutions, reviewed school infection control activities and risk mitigation strategies, developed an internal dashboard for Texas to track cases by location and exposure location, and supported measles prevention communication.
Our team at headquarters continues to provide remote technical assistance to multiple state health departments, to include laboratory diagnostics and genomic sequencing of the virus, guidance on post exposure prophylaxis, healthcare infection prevention, case investigation, and confirmation and communication support.
We’re holding biweekly national measles calls with public health partners to provide a forum for CDC and health departments to share information regarding the measles outbreak and biweekly trilateral calls with Canada and Mexico to share updates and best practices.
CDC’s immunization services division continues to make additional outbreak related MMR vaccine doses available for health departments to order at their request.
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David Sugerman, CDC [17:07:01]
We’re supporting several laboratory activities, including coordination with the Association for Public Health Laboratories, vaccine preventable disease reference centers for genotyping and sequencing.
We’re helping standardize and expand testing through wastewater surveillance for measles with the National Wastewater Surveillance system and center of excellence in Texas with multiple sites in Texas and New Mexico.
And CDC’s Center for Forecasting Outbreak Analytics is providing ongoing modeling support to determine risk to the general population and close-knit communities.
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Edwin Jose Asturias, ACIP [17:07:50]
I have been sort of tracking that the Texas outbreak a bit, and it is impressive when one looks at the two deaths of school-aged children and looks at the 41 cases that Lubbock has reported where these cases I think are coming from, one comes up with a case fatality rate of about 4.8%, which is way above what we know that is the case fatality rate of measles, which is one to two per thousand in an outbreak situation.
So, I don’t want to think that there is a higher mortality there, but– or perhaps what’s happening is a huge amount of under reporting of the cases of measles that are happening in that jurisdiction. Could you comment on that?
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David Sugerman, CDC [17:08:41]
We do believe that there’s quite a large amount of cases that are not reported and under reported in working very closely with our colleagues in Texas.
In talking with families, they may mention prior cases that have recovered and never received testing, other families that may have cases and never had sought treatment.
So we do think that there is under testing, and therefore under diagnosis and under reporting, which leads to a smaller denominator than likely is there in this.
And it’s not uncommon in close knit communities that may also have lower healthcare seeking behavior at baseline as well.
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David Sugerman, CDC [17:11:12]
So there are quite a number of resource requests coming in, in particular from Texas. There are funding limitations in light of COVID 19 funding dissipating, and they are mobilizing the resources they have and moving staff from other domains into measles, moving them from other regions into region one in particular, to help support the response, though they’re also seeing cases in outside of region one, and need to stay ready.
We are attempting to support and impart the field staff that are deploying or to augment the staff on the ground. But there are additional financial and personnel resources that we are hearing from Texas, in addition from other jurisdictions.
So we we’re trying to support where we can. But I’m assuming if this is going to be ongoing, that those will be significant financial resources needed.
The estimates are that each measles case can be 30 to 50,000 dollars for public health response work. And that adds up quite quickly.
So I don’t know if others have more to share, but I think that we are scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions.
…
David Sugerman, CDC [17:13:27]
We’re four months in, so this would be the end of January of the following year.
About 20th– around the 20th of January, of next year.
…
David Sugerman, CDC [17:14:08]
We have not had reports of still births or miscarriages.
We have tracked measles cases in pregnant women, including a case of congenital measles, who recovered. But it is, as you mentioned, a significant risk in pregnant women that can develop measles and go on to have pre-term labor, complicated deliveries, and then infants that that can have negative outcomes.
It also leads to complicated exposures in hospitals that we’ve already also seen, at one of the facilities in Texas and could be others as pregnant women come in and may not necessarily have a rash, may have minimal symptoms that then progress to additional symptoms and are not necessarily in negative pressure and then require that.
So that’s another substantial cause of, of morbidity with spread, from pregnant women that may present with symptoms.
New autism data released today shows that approximately 1 in 31 (3.2%) 8-year-old children in CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network were identified with autism spectrum disorder (ASD). Prevalence varied widely across the 16 ADDM sites – from 1 in 103 in Texas (Laredo) to 1 in 19 in California – which could reflect differences in availability of services for early detection, evaluation, and diagnostic practices in each community.
The ADDM report is an example of data for action. Healthcare providers, educators, and community leaders can use the data to advance initiatives, systems, and research to ensure that every child has access to timely evaluation and support.
CDC will continue working with partners to improve early identification and increase recognition of the need for supports for individuals with ASD and their families.
Jamie Loehr, ACIP [09:35:09]
So here it’s fairly clear that you’re saying the cost effectiveness is uncertain, but on the following slide, you’re saying that the resource use is probably yes. Did you have any kind of cost effectiveness analysis? Did you have any kind of evaluation of number of patients? I’m not seeing anything here than the way that I normally would expect a presentation to talk to me about resource use?
Faisal Minhaj, CDC [09:35:39]
No, unfortunately we didn’t have any data looking up the cost effectiveness of vaccination in this adolescent population. This population is likely a small group of adolescents that would require this, but this was not something that was conducted.
Jamie Loehr, ACIP [09:35:53]
So then my comment is that I’m very hesitant to make a recommendation without any sense of resource use.
So if we have, the slide nine, there are about 150 adolescents who had a case of mpox during the outbreak, but we’ve had 10 cases in the last two years.
If we’re making this a recommendation for people at risk, I don’t even know how many people are at risk.
For adults, men who have sex with men is about 3% a year. That would be if we took that number several hundred thousand people possibly at risk, it’s probably much lower for teenagers.
And so we’re talking about vaccinating tens to hundreds of thousands of people for 10 cases?
I also don’t know the price of the vaccine. I had to look that up. There’s about 200 to $300 of dose. And so this seems like an extraordinary expenditure of resources for a very small number of cases. And I don’t even have the information in front of me.
So it’s often a question of, from the work group to the ACIP, what information would you like before you’re making a vote? And I’m very clear that I would like much more information about resource use.
…
Tracy Beth Hoeg, FDA [09:41:52]
I just want to point out, from epidemiological standpoint, from the risk benefit ratio with this proposed recommendation, number two, that as so many people are pointing out this age group is at very, very low risk of even having a monkeypox case? It looks like we had less than 20 in the last year.
And when you consider the amount of safety data we have, from the small number of people that have received the vaccine so far in this age group, and then this 315 adolescents in the clinical trial, it’s very challenging, I think to say that we know that the benefits of this vaccine would outweigh the potential harms because we just have such a small denominator in terms of number of adolescents who have been vaccinated so far.
And I want to point out Dr. Creech’s presentation, he mentioned that they excluded adolescents with underlying significant heart conditions and significant medical conditions. So I also think that’s important for providers to keep in mind that they were excluded from the trial.
So we don’t really know about the safety in those adolescents.
Thanks, I’ll leave my comment at that.
Keipp Talbot, ACIP [09:43:06]
Thank you. And Dr. Rao, did you want to make a response?
Agam Rao, CDC [09:43:11]
I was just going to say that we just– we also did not have a cost effectiveness analysis when this was done for adults.
The purpose being that this entire vote was– the plan was for it to be revisited in a few years.
And so the thought was, we know that this is happening right now. We can do a cost effective analysis down the road.
And then also just to point out, it’s true that there are fewer cases occurring right now, but the morbidity, the mortality, all of that is pretty significant. And it was intended just to be an extension of the age, to the lower population.
So, if we had had this data, when the adult vote was considered, then the vote would’ve been for this population as well.
The risk is no different was our thought process.
…
Lakshmi Panagiotakopoulos, CDC [12:39:18]
As a reminder, in October 2024, ACIP voted to recommend an additional dose of 2024, 25. COVID 19 vaccine for adults ages 65 years and older. And for everyone ages six months and older with moderate and severe immunocompromise.
People who are immunocompromised are also eligible for additional doses under shared clinical decision making. The April 2025 meeting agenda is listed and no votes are scheduled.
And the proposed schedule for June 2025 includes votes on the 2025-26 COVID 19 recommendations, including additional dose recommendations for eligible groups.
…
Lakshmi Panagiotakopoulos, CDC [12:41:47]
One important consideration is whether to maintain the current multi-dose initial series for people ages six months to four years. And people with immunocompromised.
Another consideration is whether to maintain the universal recommendation for everyone ages six months and older or move to a risk based recommendation.
A third option is a combination of a risk based and universal vaccine recommendation. An example of this is a risk based recommendation for people ages six months to 64 years, and a universal recommendation for people ages 65 years and older.
…
Lakshmi Panagiotakopoulos, CDC [12:42:59]
If a risk based recommendation is to be considered for 2025, 26, defining who’s at risk could be complex. How much increased risk is sufficient for recommendation?
There are certain groups that increased risk of severe outcomes based on age, underlying conditions and pregnancy status and groups at increased risk of exposure, including healthcare workers and people living in long term care facilities and other congregate settings.
The CDC’s current list of conditions that conclusively increase the risk of severe COVID 19 is extensive and predominantly based on pre-Omicron data. The list of conditions brings up the question, how much of the population has one of these conditions.
An analysis of U.S. adults with conditions that put them at higher risk of severe illness due to COVID 19 was carried out using medical claims data, consumer data, the behavioral risk factor surveillance system, and the national health interview survey to enumerate the U.S. population with conditions that put them at increased risk of severe illness from COVID 19 using multi-level regression modeling.
Notably the conditions highlighted by the red boxes were not included in the analysis. The analysis showed that the population of U.S. adults with at least one condition that puts them at higher risk of severe illness from COVID 19 generally increases with age. Approximately 74% of all U.S. adults, 18 and older had at least one condition. And as a reminder, this analysis did not include people with Parkinson’s disease, physical inactivity, and steroid use, or other immunosuppressive medications, which is expected to lead to a larger percentages across all age groups.
…
Lakshmi Panagiotakopoulos, CDC [12:55:26]
The work group raised concerns about moving to a risk based only vaccine recommendation and how this would impact COVID 19 vaccination coverage among people with high risk conditions, because influenza vaccine was initially recommended for people with high risk conditions and moved to a universal recommendation in 2010, it was used as an example of what could potentially happen to coverage among people with high risk conditions, if COVID 19 vaccine recommendations were to be risk based.
For influenza vaccine coverage among 18 to 49 year olds with high risk conditions increased approximately two percentage points between 2008 to 2009 and 2010 to 2011, but plateaued thereafter, no significant changes were seen among people with high risk conditions when vaccine recommendations targeted people with high risk conditions only compared to a universal vaccine policy.
…
Lakshmi Panagiotakopoulos, CDC [13:01:52]
Based on the information presented to the work group as of February 13th, 2025, which included data on risk factors for hospitalization, trends in mortality, risk-based versus universal vaccine coverage, vaccine hesitancy, and COVID 19 and myocarditis, the majority of the work group supported a risk-based recommendation for 25-26 COVID 19 vaccination.
Among work group members who selected a non universal policy recommendation, almost all supported a risk based recommendation by conditions and exposures, a universal recommendation for certain age groups, as well as permissive language to allow anyone who wanted protection from COVID 19 vaccine to get a vaccine.
Following this poll, additional data on vaccine effectiveness, seroprevalence, long COVID vaccine coverage, and MIS-C were presented to the work group and the work group also received feedback on the recommendations from liaison organizations.
Between March and April 2025, the AAFP, AAP, AIM, ACP, APHA and ACOG provided feedback on moving to a potential risk based COVID 19 vaccine recommendation. Concerns were raised regarding implementation, communication, confidence in the recommendation and equitable access to vaccination with the potential risk based recommendation.
The work group was re-polled on April 3rd and the majority of the work group still supported a risk based recommendation for 2025-2026 COVID 19 vaccination.
Among work group members who selected a non universal policy recommendation for everyone, on April 3rd, almost all supported a risk based recommendation by condition or exposure, a universal recommendation for some age groups, as well as permissive language to allow anyone wanting protection from COVID 19 vaccination to receive one.
…
Denise Jamieson, ACIP [13:06:11]
I guess with the very high proportion of adults with risk factors that you mentioned, 74%, and COVID, although it’s dropped is still a leading cause of death among both adults and children, I guess I’m surprised we’re considering a risk based recommendation, which in general, we have not had a lot of success with implementing in the U.S.
The other thing is you mentioned hepatitis B as an example where universal recommendation did not increase, but to me it’s not really a relevant comparison. A relevant comparison is flu, and to decouple flu and COVID, you know, people are just starting to understand the importance of getting their COVID and flu vaccine every year. I worry about implementation.
I also worry about the feasibility of a permissive recommendation given healthcare financing. It may be very difficult for people to find a way to get the vaccine paid for if it’s permissive.
So I would, at this point, with the information presented, I would be in favor of a universal rather than a risk based recommendation.
…
Jamie Loehr, ACIP [13:07:40]
I’m very happy that we’re seriously considering a risk based recommendation. I’m glad that we’re taking this as a reasonable possibility.
If you could go to surround slide 14, this is the most of the population considered at risk. You had the 18 to 50 year olds in the 60% range for the people at risk. And this just does not compute with my experience with 18 to 50 year olds.
If you go back one slide here, I don’t have 60 plus percent of 18 to 50 year olds with any of these diagnoses. And so that just seems incredibly high. I could buy maybe 50 year olds, definitely the elderly, but I don’t think that’s accurate or probably ages five through 50.
I also, even though I’m very much in favor of considering a risk base, I am concerned about the feasibility of it and the message it might be sending.
COVID is still a fairly dangerous disease and very, very common. We’re not talking about 10 cases of mpox. We’re talking about thousands of hospitalizations and deaths. And so even though I’m in favor of a risk base, I still have my hesitations.
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Edwin Jose Asturias, ACIP [13:09:24]
I think given that I’m very much concentrating in the young infants and children who I think we have not taken care as we should for, so to protect them against COVID, data on the current transfer of maternal antibody will be useful.
I think most of the data that we have comes from the previous years, where basically we were trying to understand that that was offering of protection, but if there was any possibility of getting current data, given that most women now have been either infected or vaccinated will be interesting.
And then a more granular data on the hospitalization of children in the first year of life, especially, why are these kids getting hospitalized? I think some of our data from influenza shows that they get hospitalized mainly for fever and irritability, and they, even though some of them end up in the ICU, it will be interesting to sort of see what the causes of hospitalizations are.
…
Oliver Brooks, ACIP [13:10:50]
What I would want to see is modeling around long COVID. I mean, it was shown that there’s about a 3% prevalence incidence of 8%. The slide where you were asking for questions. So like the very, I want to say the last slide.
And even though let’s say to rate of COVID among, let’s say a healthy 30 year old is low. If they have the potential to get long COVID, which again was lower numbers, but still the absolute numbers may be high versus the percentages, I am concerned about them.
My primary concern through all of this at this point now is still long COVID. So what I would like to see is some modeling regarding the absolute numbers of long COVID related to the lower age groups may not receive a recommendation to get vaccinated.
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Noel Brewer, ACIP [13:12:13]
There’s not clear evidence at all that risk based approaches are less effective. It’s certainly something we’ve all talked about and something that some of the companies have shared for many years, but the data supporting that claim are not really there.
And so I used to believe that risk based approaches were problematic, but based on the data that I saw, I don’t know that I can support that, that conclusion may be true for my best guess, but it’s not an evidence based conclusion.
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Charlotte Moser, ACIP [13:12:53]
I am supportive of the risk based idea. I’m glad we’re exploring that.
I do think when we think about which groups and age was mentioned, that we should, I agree with Dr. Asturias, make sure that we’re keeping the youngest of children on our radar, because they represent a new group of large susceptible or a new large group of susceptibles to this virus every year.
And if we can vaccinate those kids, we may decrease that under one year old hospitalization rate, and we may also protect them against long COVID on their first exposure to the virus, albeit those data aren’t as strong.
And I think it’s that vaccinating those kids in the younger time period also gets us away from the concerns that we had about vaccinating adolescents around myocarditis. So those are my comments on this slide.
…
Charlotte Moser, ACIP [13:14:28]
I was wondering if, while we’re talking about COVID, maybe our FDA liaison would be able to offer an update for the members of the listening public questions about what’s happening with Novavax?
Tracy Beth Hoeg, FDA [13:14:42]
Yes, that is a good question. I actually– I don’t know to what extent I’m allowed to give an update on that, but we should– there will be an update coming out publicly very soon.
…
Sandra Fryhofer, AMA [13:15:22]
I see patients in the office every day. I’m an internal medicine physician. So a lot of my patients are older and fragile, as a new grandmother, I also worry about the very young, and I go back to that slide that you showed that 74% of patients have at least one risk factor. And then I go, what it’s– I go to what it’s like to be in practice?
And, you might have heard the expression, KISS, keep it simple. I’ll let you figure out what you want the second S to be.
But, the reality is most of these vaccines, certainly for adults are being given in pharmacies. The risk based recommendations are more difficult for pharmacists because patients have to self declare their illnesses or the pharmacists have to check their medication list. And that’s– patients may not feel comfortable with that.
So I am on the COVID vaccine work group, and I was one of the 19% that did recommend– that did suggest a universal recommendation. And, that is why.
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Jamie Loehr, ACIP [13:16:26]
I’d like to comment on Dr. Brewer’s comment. In the pneumococcal work group, we’ve been showing data that it’s pretty clear that the risk based recommendation for 50 to 65 was actually only about 20% of uptake.
Whereas the age based recommendation for 65 and over was about 65% uptake.
So for me, that does suggest that a risk based recommendation actually does not have as much uptake as a universal recommendation or age based. It still doesn’t mean that I don’t agree with the risk based, but I did want to at least put that comment out there.
…
Mehmet Oz, CMS [00:56:44]
When I was in medical school, there was no nutrition class. I actually ran for student body president and won on that campaign promise and we started one.
Today in America, most medical schools do not teach nutrition. Why does that matter? Because if you go to four years of medical school and bust your tail and learn everything and nutrition, wasn’t on the docket, what does that message to you? It doesn’t matter. It’s not important.
If it was critical, you would’ve been taught it because you learned everything else you needed to learn in medical school. If nutrition’s not on the agenda, not in the syllabus, it’s not really important for you. And I believe that we should empower folks and these executive orders will do just that to be able to navigate nutrition.
And we have plans that CMS to make that easier.
…
Robert F. Kennedy Jr. [01:01:27]
We’re in a crisis today. We’re about to announce new autism numbers.
They’ve, again, gone up dramatically just in two years. We have in some states as low as 1 out of 20 boys having autism, and 1 out of 31 kids.
And when I was in my generation today, the rate of autism is one in 10,000.
And this is just one disease. This whole generation of kids is damaged by chronic disease.
I was talking to the governor that I walked through an airport and I see these young people, who once again have hope because of what’s happening in this administration, but you can see the chronic inflammation, you can see the mitochondrial challenges that they’re facing.
…
Robert F. Kennedy Jr. [01:15:10]
I would say that CDC in this case has done a very good job at controlling the measles outbreak.
We’ve had about, under 700 cases nationally. And in Europe they’ve had 127,000 cases, 37 deaths.
The – there – people get measles because they don’t vaccinate. They get measles because the vaccine wanes.
The vaccines wane about 4.8% per year. And so– that– it’s a leaky vaccine and that problem is always gonna be around.
We need to also make sure that doctors know how to treat measles and how to treat the associated disease, the pulmonary diseases that often come with them, and bacteriological.
And we can’t rely simply on the vaccine. We also have to know how to treat measles.
Children shouldn’t die of measles. When I was a kid, before the measles vaccine was introduced, there was half a million people who got measles, as many as 2 million a year, and nobody got in the newspapers for them, for that.
But the death rate was about 400 people a year, mainly children who were malnourished, the children.
So it was a infection fatality rate of 1 in 1,200 to 1 in 10,000 children, healthy children should not die of measles.
And there’s no reason they should, if the doctors know how to treat at the hospital, that will not happen.
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Robert F. Kennedy Jr. [01:18:04]
It’s outrageous that we don’t have as surveillance system that functions.
CDC did a study on its own, the only surveillance system, it has VAERS really.
And, CDC did a study on it in 2010 and fewer than one– it captures fewer than 1% of vaccine injuries. So that’s CDC’s own study.
And they had it on the– they had, at that time, a machine counting system that they were gonna roll out to all the HMOs and they put it on a shelf and we are going to roll that out, exactly the system that you’re talking about, we’re going to do, we’re going to improve the surveillance, we’re going to get the data sets from everybody. We going to do data sharing agreements with scientists all over the world, with the best scientists.
And we’re going to find out what contribution vaccines and everything else, mold, EMF, food, all of these other exposures began in the late 1980s, which one of those are the culprits.
I suspect we’re going to see that there’s a lot of culprits, but we need to know.
You’re right, people don’t have informed consent and people don’t trust our agency anymore.
The agency– trust in the agency is at a historic nadir and the way to make it trustworthy and the way to make people to improve vaccination is to make the agency trustworthy. That’s what we’re going to do.
…
Robert F. Kennedy Jr. [01:20:34]
A lot of the negative behavior, the self-destructive behavior in both the health, the medical system, how we pay for medicine, et cetera, how we pay for healthcare and how we eat is driven by perverse incentives.
And what Dr. Oz and I are trying to do is to identify those perverse incentives. And we’re getting a lot of help from Elon and then eliminating them, so that we can realign medical choices, both individual and institutional medical choices with public health.
And it’s not aligned. It’s totally misaligned today.
We have a healthcare system that reimburses people, doctors and hospitals, for procedures, rather than for health outcomes.
We have to change that, but we also– we’re getting alone, we can’t do this, but we’re getting tremendous help from the governors, from the grassroots. You see all these warrior moms here today.
They don’t want to take this anymore. They want a change. There’s a huge, huge movement to get a change. And then we have extraordinary leaders like Governor Braun, who are doing this on a state level. And that helps us extraordinarily.
I met with the big food titans a couple of weeks ago, and they weren’t scared of me. They were scared of what’s happening in the states.
They don’t want a patchwork of regulations where one state bans dyes and one state bans bromates and one state bans titanium dioxide in the food. And now they don’t know how to market a national product.
What’s happening here in the states is driving this movement and it’s going to drive the kind of climate cultural change that you’re talking about.
On background: CDC has significant litigation, oversight, and FOIA responsibilities that require recordkeeping requirements.
The six states that have publicly confirmed measles outbreaks this year are: Texas/New Mexico; New Jersey; Georgia; Ohio; Kansas; Indiana.
The unlisted state with an outbreak is investigating an outbreak that meets the definition (three linked measles cases or more) but is currently under investigation. For full transparency, CDC included it in Friday’s update. To protect patient privacy, information has not yet been released by the state.
On background to an HHS official: Critical programs under the CDC’s Division of Reproductive Health will continue under the Administration for a Healthy America (AHA) alongside multiple agencies and programs to improve coordination of health resources for Americans.
CDC’s clinical vaccination guidance for measles outbreaks has not changed. During measles outbreaks, health departments may provide additional recommendations to protect their communities.
In addition to the routine recommendations for MMR vaccine, health departments may recommend a second dose for adults or an earlier second dose for children 1 to 4 years of age who are residing in or visiting the affected areas.
If there is ongoing community-wide transmission affecting young infants, health departments may recommend an early dose for infants 6 to 11 months of age.
Texas Department of State Health Services issued this recommendation for affected counties in Texas (see more at Health Alert Network (HAN) - 00522 Expanding Measles Outbreak in the United States and Guidance for the Upcoming Travel Season).
The decision to vaccinate should be made carefully after weighing the risks of the potential long-term impact of lower immune responses when infants are vaccinated less than 12 months of age (versus greater than or equal to 12 months of age) compared to the benefit of early protection when measles is circulating in the community.
There are no recommendations to receive a third dose of MMR vaccine during measles outbreaks.
For more information, please visit: Measles Vaccination for Specific Groups Measles (Rubeola) CDC
Secretary Kennedy [03:50:36]
We are launching requests for scientists from all over the country and all over the world to start to directly answer that question. Nothing like that has ever been done before. It should have been done 20 years ago.
You know, when I was a kid, the autism rates were about 1 in 10,000, to 2 in 10,000 today. Today they are 1 in 36 officially, but the new ADDM reports are going to come out the next week. And the preliminary numbers look like it’s dropped when extraordinary, astonishing, 1 in every 31 kids with some communities being very, very badly hurt.
Black boys it’s down to, I think about it looks like about 1 in 12 or 1 in 10. So this is an epidemic like nothing we’ve ever seen before. It dwarves the COVID epidemic. The cause to our country– these are children, COVID was killing elderly people at the end of their lives. This is disabling children of their entire lives.
Question [03:51:36]
So there for a long time there was thought that vaccines might be related to this. Then they did several studies that said that there was no connection between vaccines and autism. So what are you seeing in this data that you’re looking at or is it all going to be brand new?
Secretary Kennedy [03:51:54]
The studies that they did were very, very narrow and there were about 17 studies. The Institute of Medicine, which is part of the National Academy of Sciences, says that 14 of those studies are invalid. And the biggest weakness in those studies is they never studied vaccinated versus unvaccinated group, which is the only way that you can really make this determination.
And more importantly, none of the vaccines that are given to children during the first six months of life were ever studied. We’re going to look at vaccines, but we’re going to look at everything. Everything is on the table, our food system, our water, our air, different ways of parenting. All the kind of changes that may have triggered this epidemic.
It is an epidemic. Epidemics are not caused by genes. Genes can provide a vulnerability, but you need an environmental toxin. So we know that it is an environmental toxin that is causing this cataclysm and we are going to identify it.
We are narrowly focused on identifying it and using as many scientists as we can from universities and research centers all over the world, focus them through NIH, through Jay Bhattacharya to focus them on answering this question.
Critical programs in the CDC will continue under Secretary Kennedy’s vision to streamline HHS to better serve Americans. CDC’s Vessel Sanitation Program (VSP) continues to monitor and assist with gastrointestinal outbreaks and track and report these illnesses – this work has not stopped – as the VSP is primarily staffed by USPHS commissioned officers who were not subject to the reduction in force.
Secretary Kennedy
Finally, on the – CDC has done an amazing job at getting the measles outbreak under control. We have about 680 cases now in 22 states, compared to the same outbreak in Europe, which is 127,000 cases and 37 deaths. Our numbers in this country have now plateaued. And I want to thank CDC for that.
And we’re trying to refocus the press. We’ve had three measles deaths in this country over 20 years, and we’re trying to refocus the press to get them to pay attention to the chronic disease epidemic, as you’ve asked us to.
…
Secretary Kennedy
We have now, the autism rates have gone, now from most recent numbers, we think are going to be about 1 in 31 to 1 in 20. So they’re going up again, from 1 in 10,000 when I was a kid.
And we are going, at your direction, we are going to know by September.
We’ve launched a massive testing and research effort that’s going to involve hundreds of scientists from around the world. By September, we will know what has caused the autism epidemic, and we’ll be able to eliminate those exposures.
President Trump
So big. Think of that, it was 1 in 10,000 children had autism. And now it’s 1 in 31. Not 31,000. 31. That is a horrible statistic, isn’t it? And there’s got to be something artificial out there that’s doing this. So you think you’re going to have a pretty good idea?
Secretary Kennedy
We will know by September.
President Trump
There will be no bigger news conference than that, so that’s– if you can come up with that answer, where you stop taking something, you stop eating something, or maybe it’s a shot, but something’s causing it.
Late last week, the City Milwaukee Health Department (MHD) received formal notice that our request for CDC Epi Aid support was denied. This request, submitted earlier this year, sought federal assistance from a small team of CDC experts to support our lead response efforts in Milwaukee Public Schools.
The denial came shortly after the CDC eliminated its entire National Center for Environmental Health division — leaving no childhood lead subject matter experts in place to assist local health departments with complex environmental investigations like ours.
While we’re disappointed, MHD’s work has not stopped. This only underscores the importance of the role local public health plays in protecting communities — and the challenges we now face without federal expertise to call on.
MHD remains committed to moving this work forward and finding solutions locally.
HHS is following the Administration’s guidance and taking a careful look at all divisions to see where there is overlap that could be streamlined to support the President’s broader efforts to restructure the federal government. This is to ensure that HHS better serves the American people at the highest and most efficient standard.
Question [00:14:29]
For example, the Novavax vaccine, and that’s not an mRNA vaccine, was expected to be approved by the FDA, but there’s a delay. Why is there a delay? Is it just personnel being shuffled? Why is that?
Robert F Kennedy Jr [00:14:40]
No, we’re looking at that vaccine and it is a single antigen vaccine. And, for respiratory illnesses, the single antigen vaccines have never worked.
Question [00:14:52]
So it’s not because of lack of personnel or lack of–
Robert F Kennedy Jr [00:14:56]
No, we are actually shifting our priorities to multiple antigen vaccines. And NIH is already working on a number of those.
Question [19;09;53]
I wanted to know what your strategy is for stopping the measles outbreak in Texas that continues to grow?
Robert F. Kennedy Jr.
Our strategy has been very successful.
There are 640 cases now in Texas. The number continues to grow by the day, but the growth rate of the measles, there are 640 nationwide, about 440 in Texas, the growth rate has a diminished substantially.
I would compare it to what’s happening in Europe now where there’s a hundred– we’ve had 640 cases here, they’ve had 127,000 cases and 37 deaths.
And so what we’re doing here in the United States is a model for the rest of the world.
HHS is directing the CDC to reconvene the Community Preventative Services Task Force to study and make a new recommendation on fluoride.
Robert F. Kennedy Jr., HHS 17:27:26
Fluoride should not be in our water.
Fluoride had a strong justification in the 1940s, when it was added, and people didn’t understand the science and they thought its benefit to our teeth was systemic.
And by drinking it, it would enter your body and somehow protect their teeth.
Now we know that there is no systemic advantage, zero systemic advantage, and that the only advantage comes from topical application.
So it’s the water that passes it through your mouth. You can achieve that benefit from brushing your teeth and in the era of fluoridated toothpastes and mouth washes, it makes no sense to have fluoride in our water.
The evidence against fluoride is overwhelming.
In animals, in animal models and in human models, we know that it causes IQ loss, profound IQ loss, and it’s dose related.
So if the more fluoride you get the higher levels in your drinking water, your urine, the more likely it is you lose IQ. And also other neurological injuries like ADHD.
It affects– there’s science that indicates that it affects kidney health, that it affects liver health, that it causes hyperthyroidism, that it causes osteoarthritis.
Women who are more exposed have up to 50% more hip fractures and than women who are unexposed.
It causes fluoridasis in between 40 and 80% of our kids.
It makes no sense to have it in our water supply. And I’m very, very proud of this state for being the first state to ban it. And I hope many more will come.
…
Lee Zeldin, EPA 17:30:32
As soon as I was nominated by President Trump as administrator of the EPA, the secretary instantly reached out to start talking about issues that he is so passionate about.
And number one on that list was fluoride.
…
Question 17:35:30
You said a few days ago that HHS was going to be reinstating some jobs that were cut. Your staff then said that’s not happening. Can you clarify? Is it? Are there programs that you believe should be reinstated?
Robert F. Kennedy Jr. 17:35:37
No, the program– what I said was that there are programs that there are– the programs have been consolidated.
So we didn’t cut any core programs or any critical care programs or any scientific programs.
Those programs are being consolidated in a new agency that is going to make America healthy again.
Question 17:35:57
Nothing is being reinstated?
Mike Schultz 17:36:01
So let’s move on to another question.
…
Robert F. Kennedy Jr. 17:36:24
It evolved when I read the science.
I think I read it most carefully in the last couple of years and the science evolved.
The national toxicity program issued its report in August. And that report was devastating.
And, I don’t think– I think we need to apply the precautionary principle in this country that we should do no harm. And it clearly is doing harm.
I mean, the trade off is IQ loss in kids and what– we can’t afford that in this country, we need all the brain power that we can to handle the challenges of the future.
And then the other health impacts which are less clearly documented in the science, because they have not been completely well studied, but they are alarming enough that we shouldn’t be demanding that parents accept something for their children and in their homes, that is essentially a medication.
So they can go to the drugstore and they can get toothpaste. They can, if you want to apply it in your home, you can, you can get mouthwash.
And I believe, and I think it’s a moral imperative that we all believe, in freedom of choice in this country. It is one of the bedrock principles of our democracy that the government shouldn’t be making decisions, intimate decisions, about our own lives.
And then, just the science is overwhelming on it now. It doesn’t make any sense.
A team of three deployed yesterday to meet with county and state officials to assess the immediate needs to respond to this outbreak. The team is meeting with officials again today. Once the assessment is complete, more CDC staff will be sent to Texas per Sec. Kennedy’s order and the governor’s request.
The first teams deployed to Texas arrived on March and returned to CDC on April 1.
HHS is planning to continue the important work of the lead poisoning prevention and surveillance branch that works to eliminate childhood lead poisoning under the Administration for a Healthy America.
I’m waiting to confirm the 6th , but here are 5 of them:
Texas/New Mexico; New Jersey; Georgia; Ohio; and Kansas.
I’ll circle back on the 6th as soon as I can.
…
The sixth outbreak meets the definition of an outbreak (three linked cases or more) and is currently under investigation. For full transparency, CDC has included it in the Friday update. To protect patient privacy, information has not yet been released by the states.
CMS believes that finalizing the proposal to expand coverage of AOMs for the treatment of obesity in Medicare Part D and Medicaid is not appropriate at this time. CMS may consider future policy options for AOMs pending further review of both the potential benefits of these drugs including updated clinical indications, and relevant costs including fiscal impacts on stakeholders such as state Medicaid agencies.
Robert F Kennedy Jr [15:01:51]
In terms of FDA’s capacity, the cuts in all of our agencies are not affecting science, so that science jobs are preserved.
The frontline enforcement jobs and health delivery jobs are preserved.
We– HHS was a bloated agency and it was not doing its job.
Our health– during the past four years, we saw a 38% rise in its budget and healthcare continue to decline.
So we’re reorganizing HHS, so we can do its intended job, which is to make America healthy again.
…
Question [15:04:11]
I know you said that you want to talk about kids’ health. The CDC program that monitors lead surveillance for kids was cut. Can you explain the rationale for cutting a program like that? And why that’s not an essential service?
Robert F Kennedy Jr [15:04:24]
There were some programs that were cut that are being reinstated. And I believe that that’s one of them.
Question [15:04:30]
Interesting, and do you know why it was cut to begin with? It was–
Robert F Kennedy Jr [15:04:34]
All of these programs, all of the CDC, NIH, and CDC were not doing their jobs. And there was tremendous redundancies.
For example, we had over a hundred communications departments. We had 40 procurement departments. We had dozens of IT departments and dozens of HR departments.
Most of the cuts are to those administrative sections, which are now consolidating or eliminating the redundancies. We’re streamlining the agencies.
We’re going to make it work for public health, make it work for the American people.
In the course of that, there were a number of instances where studies that should have not have been cut, were cut. And we’ve reinstated them.
Personnel that should not have been cut, were cut. We’re reinstating them. And that was always the plan.
Part of the DOGE, we talked about this from the beginning, is we’re going to do 80% cuts, but 20% of those are going to have to be reinstated, because we’ll make mistakes.
And one of the things that President Trump has said is that if we make mistakes, we’re going to admit it and we’re going to remedy it.
And that’s one of the mistakes.
…
Robert F Kennedy Jr [15:07:34]
We’re in the middle of right now, very, very energetically, revising the nutrition guidelines.
The nutrition guidelines that were worked out during the Biden administration and that we’re supposed to be implemented on January 20th, there’s a 453 page document that looks like it was written by the food processing industry.
And we’re– we are going to come up with a document that is simple, that lets people know, with great clarity, what kind of foods their children need to eat? What kind of foods they can eat. And what’s good for them. What’s good nutrition.
And then we are collaborating with each other to make sure we get that out as quickly as possible.
Dear Network Laboratories,
Unfortunately, significant Reductions In Force (RIF), including a key
quality assurance officer, at FDA's Human Food Program Moffett Center
has caused immediate and significant impact on the Veterinary
Laboratory Investigation and Response Network (Vet-LIRN) Proficiency
Exercise Program. The RIF affected nearly all FDA staff at Moffett,
including the scientific staff that develop and issue the proficiency test
(PT) samples, analyze data, and create reports. The Moffett Center is an
ISO accredited PT provider that supports the PT needs of Vet-LIRN, the
Food Emergency Response Network (FERN), as well as FDA Grade A
Milk and Shellfish programs, and others.
We regret to inform you that the Interlaboratory Comparison Exercise for
detecting Highly Pathogenic Avian Influenza in milk (HPAI ICE-1), set to
ship later this month, is suspended.
The HPAI ICE-1, which included over 40 registered labs across the Vet-
LIRN and NAHLN networks, as well as FDA food labs and private
industry, would have been critical to ensure confidence in the laboratory
methods for food safety and animal health. We are still assessing the full
extent of the impact and will send Vet-LIRN wide messaging on this
exercise in the near future.
Additionally, we regret to share that Vet-LIRN's Proficiency Exercise
Program is suspended for at least the remainder of FY25. Since 2010,
we have conducted 40 proficiency exercises, ensuring laboratory
preparedness for major animal food safety issues, including the detection
of Salmonella and Aflatoxin in pet food. The program also supported the
implementation of new methods and technologies and was instrumental
during the COVID-19 pandemic to maintain confidence in testing for
humans and animals.
We are disappointed to share this news but wanted to keep you informed.
Thank you for your continued dedication and contribution to the Vet-LIRN
program. We will provide more updates as they are available.
Thank you,
Vet-LIRN Program Office
IOD
- Acting CDC Director – Susan Monarez
- CMO – Deb Houry
- COS – Matt Buzzelli
- Deputy Director for Public Affairs/Acting OC – Nina Witkofski
- Acting OCOO – Sara Patterson (Deb Lubar retiring 4/19)
- Senior Advisor – Stuart Burns
OD Offices
- Acting CDC W – Anstice Brand
- Acting OPPE – Noah Aleshire
- Acting OBPA – Rachel Holloway (Elizabeth Solhtalab last day 4/4)
- Acting OWH – Juanika Mainor-Harper (Leandris Liburd retiring 4/19)
- OMH – Carolina Luna-Pinta (Leandris Liburd retiring 4/19)
- OLSR – Ren Salerno
- ORR – Henry Walke
- Acting CFA – Jason Asher
- OPHDST – Jen Layden
- NCHS – Brian Moyer
- Acting OS – Althea Grant (Sam Posner retiring 4/26)
National Centers
- Acting NCHHSTP – Renata Ellington
- NCIRD – Demetre Daskalakis
- NCEZID – Dan Jernigan
- Acting NCCDPHP – Laura Parajon
- Acting NCBDDD – Deron Burton
- NCEH – Ari Bernstein
- NCIPC – Alison Arwady
- Acting NIOSH – Kelley Durst
- Acting PHIC – Andrea Young (Les Dauphin retiring on 4/19)
- Acting GHC – Paige Armstrong
Business Services Offices
- Acting OCIO – Steve Warren
- OFR – Dana Redford
- OAS – Christine Godfrey
- OBS – Jamie Greene
- OGS – Jamie Legier
- Acting OHR – Nate Wells (Sylana Tramble retiring 4/12)
- OSSAM – Jeff Williams
- OSBI – Kevin Smagh
Sara Brenner, FDA [00:04:30]
I want to briefly acknowledge and introduce those new colleagues who are here today, to you, again.
You already know Jim Traficant is our new chief of staff– now it gets fun, because I get a point to you, and you have to stand up and wave. No, I’m just kidding. It’s killing me to stay on script, but I’m doing it right. I’m doing it.
Okay, Jim Traficant, our new chief of staff and I hope you’ve had the chance to read a little bit of his bio that went out in the all hands. Suffice it to say, Jim has had extensive executive and operational leadership experience supporting federal state commercial and international healthcare organizations.
Importantly, he also happens to have a long friendship with Dr Makary and will be able to help effectively translate and advance his priorities here at FDA.
You also likely read a little bit about– thank you, very good, welcome Jim.
You’ve also likely read about our new acting head of the FDA’s human foods program, Kyle Diamantas– there he is– who has experience in the food sector and is well versed in the federal food drug and cosmetic act, as well as FDA’s operational framework.
He has extensive experience working with federal and state agencies, scientific organizations, consumer advocacy groups, and industry stakeholders. He also has a wide ranging experience spanning regulatory compliance, investigation enforcement and rule making.
The third person I want to acknowledge today is Grace Graham. Where is Grace? Other side, okay. To keep people on their toes and the cameras are swiveling. No. So Grace is with our office of policy legislation and international affairs. Grace has a distinguished history in healthcare and legislative affairs, having served in a variety of positions in both houses of Congress. Most recently as chief health counsel in the house. And before that, as health policy director of the Senate health education, labor and pensions committee, she’s also very familiar with the FDA’s work, having served as a policy advisor in the Senate on FDA matters. Grace already started working in OPLIA. And so we look forward to her continued leadership.
Most of you probably saw the all hands that went out last week, announcing another of our new members, our new deputy commissioner for operations and our chief operating officer, Dr. Barclay Butler. Barclay has more than 40 years of experience leading organizations through significant transformational change in both the public and private sectors. In addition to working in the private sector, he spent nearly a decade with the defense health agency. Most recently as assistant director for support. From 2012 to 14, Barclay was director of the interagency program office with the department of defense.
All right. We have two late breaking additions here. Dr. Tracy Beth Høeg. Did she make to the front? Second? Here we go– also very good– also joined the agency last week as special assistant to the commissioner.
Tracy has extensive experience working in vaccine science and epidemiology, including for MIT’s Sloan School of Management and as an adjunct associate professor at the University of Southern Denmark.
And then just yesterday, Dr. Scott Steele, who is virtual with us today, Scott was named FDA’s acting director for the center for biologics evaluation and research. Dr. Steele is a science technology and policy professional with extensive experience in multiple disciplines, including emerging science and technology, translational science, public health preparedness, and biodefense and medical countermeasures.
So after what’s been a very hard week and a very hard several days and hours, I’d enjoy– I’d encourage you to focus on and look forward to the future with this very strong group of leaders. We are ready to move forward and we are thrilled to be working with someone of the statue– of the stature of Dr. Makary, but we do have a lot of work to do. It is a critical time in the health of our nation with many challenges before us.
I know that Dr. Makary has many priorities that he is eager to begin work on.
…
Marty Makary, FDA [00:15:26]
Our country desperately needs you. They desperately need you and your ideas.
They need the FDA’s scientists to ensure public safety, examine root causes of other medical problems that are unforeseen, using the disciplines of toxicology, environmental health, food safety, and basic scientific methodology, you are in a unique position to address many of these problems one small piece at a time.
Our generation’s new chronic disease epidemic also means that we need novel therapies, cures, and meaningful treatments. It also means that we need new approaches. We need fresh new ideas.
To do this, we have to listen to one another, a lesson that applies in my opinion, to our broader polarized society. We need to recognize nuance, promote civil discourse. In fact, science has always been based on debating and discussing different ideas, different opinions in the scientific sphere among experts are good.
…
Marty Makary, FDA [00:17:12]
Allowing experts to debate new approaches to old problems is exactly what we need right now. Our country is sick. Obesity is not a willpower problem. Food deserts are not a genetic issue.
To address the biggest health needs of this country, we need new ideas and fresh new perspectives. We need open-mindedness and a willingness to challenge deeply held assumptions just as scientists did in challenging opioids were not addictive. That sugar is healthy. That smoking is not bad for you.
…
Marty Makary, FDA [00:19:50]
I want to be very clear. I value the career staff at the FDA enormously and the wisdom that all of you hold.
I will be meeting with many of you, as many as possible, to learn and to find out how I can best support your work as we adapt to the new world of medical innovation and discovery, at a time when we are dealing with a worsening health of the population.
I know the last few months have been difficult and the last few days have been particularly hard.
I want you to know that you have my commitment that I will do everything possible to make sure that scientists, clinicians, inspectors, investigators, and core staff central to the mission and operations of this agency will have all the resources they need to do their job.
And I will do my best.
The layoffs mentioned in this article relate to administrative staff positions within FDA. These administrative functions are being streamlined as part of HHS’ transformation initiative to make the agency more efficient and responsive. FDA inspectors were not impacted and this critical work will continue.
Last Thursday, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” This overhaul is about realigning HHS with its core mission: to stop the chronic disease epidemic and Make America Healthy Again. Despite spending $1.9 trillion in annual costs, Americans are getting sicker every year, and we must shift course.
The reorganization is being done in phases. The first phase was last week’s announcement to inform American taxpayers how HHS will produce better health outcomes for them and their families. The second phase rolled out Tuesday, was to notify roughly 10,000 employees who were impacted as part of the reduction in force. HHS leaders focused personnel cuts on redundant or unnecessary administrative positions.
Here are some of the best examples:
• Despite only having 28 divisions, HHS had 41 Chief Information Officers.
• There were 1,400 external affairs officers.
• HHS had 100 communications offices.
• HHS had 40 procurement departments.
• There were dozens of IT departments.
• There were dozens of HR departments.
• There were more than 8 Senior Finance Officials.
HHS also reduced its regional footprint by moving out of the highest cost cities, shuttering offices in Boston, Chicago, NYC, San Francisco, and Seattle. The reorganization from 28 to 15 divisions is necessary, but critical programs amongst these divisions will continue under the new operational structure.
The Department is now detailing the structure of each redefined division to streamline operations, enhance responsiveness to the American people, and ultimately improve the nation’s health as part of the Make America Healthy Again initiative.
HHS will notify external stakeholders, including Congress and will comply with all statutory requirements.
The Indian Health Service (IHS) has long faced challenges related to staffing shortages. Secretary Kennedy remains committed to prioritizing tribal health and the IHS, as reflected in his statements at the recent STAC meeting. Importantly, IHS was not impacted by the recent workforce reductions, and there are no plans to consolidate any of its offices.
To address staffing needs and support the IHS in fulfilling its mission, HHS has invited certain individuals to consider positions within the IHS. These invitations are voluntary, and individuals have the option to accept or decline. Secretary Kennedy and the Department remain steadfast in their commitment to ensuring that American Indian and Alaska Native communities receive timely, quality healthcare.
FDA Employees,
Renowned surgeon-scientist and health policy expert, Martin A. Makary, M.D., M.P.H., was confirmed by a bipartisan vote of the U.S. Senate, and took the oath of office to become the 27th Commissioner of Food and Drugs.
A national leader in medicine with impeccable credentials, Dr. Makary is imminently qualified to lead the FDA at this important time in the health of our nation. Dr. Makary’s accomplishments as a researcher, clinician, and prolific author are numerous. He has authored more than 300 peer-reviewed articles in medical literature and founded the Johns Hopkins Center for Surgical Trials and Outcomes Research.
Dr. Makary has led cross-disciplinary research on a range of subjects including cancer care, obesity, frailty and psychologic reserve in older patients, adverse event monitoring, the Orphan Drug Act, antimicrobial resistance, and Alzheimer’s. Of note, he is the co-developer of the Surgery Checklist used in many operating rooms around the world today. A member of the prestigious National Academy of Medicine, Dr. Makary has been a visiting professor at more than 25 medical schools across the U.S. and internationally. Clinically, Dr. Makary is a driven and innovative physician. He was the first to perform novel operations in surgery, including the first-in-the-world series of laparoscopic pancreas islet transplant operations. For his pioneering work, Dr. Makary was awarded the Nobility in Science Award from the National Pancreas Foundation. For the last 22 years, he has had an active clinical practice, including spending time in the operating room the day before his recent Senate confirmation hearing.
Dr. Makary co-authored postoperative opioid prescribing guidelines that were adopted broadly at the start of the opioid crisis response. During the COVID pandemic, he and his Johns Hopkins colleagues conducted landmark antibody studies on natural immunity published in JAMA. Most recently, his research has focused on vulnerable populations in health care. Dr. Makary has led national quality collaboratives, served on several editorial boards and was the first editor-in-chief of MedPage Today.
Dr. Makary is also the author of three New York Times bestselling books on health care. His book, The Price We Pay, was named 2020 Business Book of the Year by the Association of Business Journalists. His most recent book, Blind Spots, which presents the latest scientific research on the microbiome, food, and other health topics, was just named Amazon Book of the Year.
Dr. Makary is a graduate of Bucknell University, Thomas Jefferson University, and the Harvard School of Public Health. He completed his residency at Georgetown University and surgical oncology fellowship at Johns Hopkins. After six years on the faculty at Johns Hopkins, Dr. Makary was named an endowed chair in gastrointestinal surgery, and subsequently promoted to full professor with tenure. In line with his broad interests across medicine, public health, and business, he has held joint appointments at the Johns Hopkins School of Public Health and the Johns Hopkins Carey Business School.
** You are receiving this communication because you have an email account supported by the U.S. Food and Drug Administration (FDA). This email is sent from an unmonitored account. Please do not reply directly to this message. **
Dear CDC Colleagues,
We recognize that this is a difficult time for CDC employees. First and foremost, those who have been affected should know their value and commitment to public health are recognized and deeply appreciated. We want to thank all CDC staff for their hard work and dedication to public health.
On February 26, 2025, the Office of Management and Budget (OMB) and the Office of Personnel Management (OPM) issued a Memo to provide guidance on the Agency’s Reduction in Force (RIF) and Reorganization Plans requested by Implementing the President’s “Department of Government Efficiency” Workforce Optimization Initiative. In response, on Thursday, March 27, the U.S. Department of Health and Human Services (HHS) issued a press release and fact sheet outlining the Department’s plans for restructuring. Last night, HHS issued reassignments, and this morning CDC employees impacted by the RIF received emails from HHS, noting their status. Supervisors of impacted employees have been notified as well.
We understand that this news brings uncertainty and concern for you, your colleagues, and your families. Please know that we are fully committed to supporting you through this difficult period. Most impacted employees will be given 30 to 90 days notice before official agency separation. Impacted employees will be allowed physical access through end of day today, April 1, 2025, to collect their belongings from their offices and workspaces.
Below please find a list of resources that may be helpful to employees.
The Employee Assistance Program (EAP) offers a no-cost, confidential, professional counseling service for employees, which may be a helpful resource at this challenging time.
OPM’s Severance Pay Estimation Worksheet
Retirement Programs
Government and Retirement and Benefits (GRB) Platform
TSP Withdrawal Guide
Quick Reference Guide for Separating Federal Employees
Job Seeking and Post-Employment Ethics OHR
For Equal Employment Opportunity (EEO) concerns, please contact EEOSC.eeoinfo@hhs.gov
Please continue to support each other. Thank you for your hard work, dedicated service, and commitment to protecting health and improving lives.
Sincerely,
Matt Buzzelli
CDC Chief of Staff
The Department of Health and Human Services (HHS) began to notify employees on March 31, 2025 of a planned Reduction-in- Force (RIF). Even if you haven’t received a personalized RIF email from HHS yet, it is our understanding at CMS that you may be among the impacted employees. Until we have more detailed information to share, we will be taking the following actions to temporarily suspend some access beginning today, Tuesday, April 1, 2025:
…
If you are currently in a CMS office building, you should gather any personal items and your CMS- issued laptop and other devices and exit the building as soon as possible. Complete your regular tour of duty for today from your alternate duty station. A CMS official will contact you if/when these temporary suspensions are ended and you need to return to work. Thank you for your attention to this direction.
Dear Colleagues:
As I begin my tenure as the 18th Director of the National Institutes of Health, I want to first express my appreciation for all of you — the NIH scientists and staff whose work has contributed to lifesaving breakthroughs in biology and medicine. I most recently worked at Stanford University where my research in health economics was made possible with NIH support. I am honored and humbled to lead this agency and join you in service of the American people.
As a doctor, economist, and (now former) professor at Stanford University, I have always been driven by a passion for improving public health and fostering an environment where scientific inquiry can flourish. Throughout my career, I have been supported by NIH, an institution that I love.
NIH’s mission to enhance health remains vital as millions of children and adults in this country face poor outcomes due to chronic diseases like obesity, heart disease, and cancer. We must build on the agency’s track record of tackling complex challenges and recommit to our mission to addressing the chronic disease crisis. While basic research will continue to lay the groundwork for future discoveries, we will invest in innovative, cutting-edge research that has the power to transform health. Importantly, our discoveries will only make an impact if the public has confidence in our findings and trusts that we are working in their best interests.
To help us achieve these goals, I have established the following five top priorities:
Focus on Improving Population Health: The work of NIH, whether basic or applied, must address the health needs of the American people, including the chronic disease crises that have hampered the well-being of countless Americans. Reproducibility and Rigor: The research NIH conducts and supports must be rigorous, reproducible, and unbiased. NIH must address and solve the reproducibility crisis in the biomedical sciences.
Innovation and Collaboration: NIH must be at the forefront of biomedical innovation. This will involve embracing new technologies, new ideas, and new approaches to old problems.
Research Safety and Transparency: NIH must ensure that all the experiments we support pose no risk of harm to human populations and meet the highest ethical standards. We must maintain the highest standards of transparency in all our endeavors.
Academic Freedom: Advances in science require the freedom to think differently from the scientific consensus. I will foster an environment where varied perspectives are valued and encouraged at NIH and the broader scientific community.
I recognize that I am joining NIH at a time of tremendous change. Every inch of the federal government is under scrutiny—and NIH is not exempt. As a result of the Department of Health and Human Services’ streamlining effort and upcoming reorganization, NIH experienced a significant reduction in its workforce. Many of our valued colleagues are losing their jobs, which is in no way a reflection of the quality of their work. I want to express my deepest gratitude to those who will be affected for all you have contributed to the mission of NIH. These reductions in the workforce will have a profound impact on key NIH administrative functions, including communications, legislative affairs, procurement, and human resources, and will require an entirely new approach to how we carry them out. As we navigate these challenges, I will do my best to lead NIH through these reforms, implement new policies humanely, and endeavor to earn your trust.
I know we all agree that it is a privilege for us to do science to improve the health of all Americans. Thank you for your efforts and dedication to the great mission of NIH.
All the best,
Jay Bhattacharya, M.D., Ph.D. NIH Director