Setting the Record Straight: Vaccines Are Tested with Placebos, and that’s Just the Beginning Long & Thorough Safety Process

Last week, Secretary Kennedy continued to spread lies on national TV claiming that “none of the vaccines on the CDC’s childhood recommended schedule was tested against an inert placebo.” Adding that: “we know very little about the actual risk profiles of these products.”

Those claims are lies.

Vaccines licensed in the US do undergo rigorous placebo-controlled clinical trials before they ever make it to the public. This includes the childhood vaccines on the CDC’s recommended schedule.

Vaccines go through three phases of clinical trials before the FDA even considers licensing them.

  • Phase 1, a small group of volunteers receives the vaccine to assess safety and dosing.
  • Phase 2 expands the pool to hundreds to assess both safety and immune response.
  • Phase 3 involves thousands of participants and includes randomized, placebo-controlled, and blinded trials. That means some participants get the vaccine and others get a placebo, and neither they nor the researchers know who got what until the end of the trial.
  • Phase 4 is ongoing safety and effectiveness monitoring in the real world.

The FDA’s Vaccine and Related Biological Products Advisory Committee (VRBPAC)—a panel of independent experts—reviews all the data before any vaccine gets the green light.

Before and after the vaccine is licensed the FDA also closely inspects the manufacturer’s processes, batch-by-batch, to ensure the vaccine is being produced according to rigorous quality standards. Samples from each lot are assessed.

Then comes CDC review. Even after FDA approval, a vaccine isn’t added to the childhood schedule until the CDC’s Advisory Committee on Immunization Practices considers key questions:

  • How safe and effective is the vaccine at specific ages?
  • How serious is the disease it prevents?
  • What would happen if we didn’t vaccinate?

Only after these questions are carefully reviewed—and the benefit-risk ratio is clear—does a vaccine get recommended to the CDC for inclusion in the child and adult immunization schedules.

And then, to top all this off, safety monitoring continues after approval and marketing. Included in the post marketing phase are:

  • VAERS (Vaccine Adverse Event Reporting System) collects early warnings of any side effects and reports findings.
  • VSD (Vaccine Safety Datalink) lets CDC scientists analyze real-world vaccine data from millions of people for analysis and reporting.
  • CISA (Clinical Immunization Safety Assessment) conducts targeted studies to investigate safety in specific populations.

Updates to already licensed and approved vaccines like the annual influenza and COVID vaccines are sometimes evaluated against older versions instead of inert placebos. There are several reasons for this. When an effective vaccine already exists, it’s considered unethical to withhold protection by using an inert placebo in trials each year. Influenza vaccines also produce hemagglutination-inhibition antibody titers which lets researchers and regulators to approve strain updates based on immunogenicity data alone. Also, the annual flu vaccine update needs to be manufactured and distributed months ahead of winter—waiting for full Phase 3 trial data for each new strain would be impossible. Since full trials aren’t repeated annually for influenza, regulators rely on robust post-market monitoring systems to ensure safety through the VAERS, VSD, and CISA systems continuously track safety signals after rollout. They also examine real-world evidence (e.g., hospitalization reductions, side‑effect trends) to assess both safety and efficacy.

Bottom line: Vaccines are among the most rigorously tested and monitored medical products we have. For Secretary Kennedy to keep lying about this is unethical, irresponsible and dangerous. Honestly, it’s quite shocking for an HHS Secretary to continue to spout blatantly false things like this.

And for journalists: platforming Kennedy without correcting or challenging these statements is a failure of responsibility to the public.

Vaccines save lives. The science is clear. The testing is real. And the public deserves better than a steady stream of misinformation and blatant lies from Kennedy.

As Expected – New ACIP Members Picked by Kennedy Have Anti-vax Bias

After wiping out all the previous ACIP members early last week, Mr. Kennedy promptly appointed eight new members (just enough for the Committee to have a quorum).

As expected, most of the new appointees are known for their anti‑vaccine views or skepticism of mainstream immunization policy. With the next meeting scheduled for June 25, the new committee poised to dismantle the current evidence-based recommended child and adult vaccine schedules.

They know they’ve got 3.5 years to unravel the system – so expect them to take it slow at first before they step on the accelerator.

Kennedy Plows the Field to Eliminate Vaccines from the Recommended Schedule, Making them Inaccessible – AZ Public Health Association

Who are the new appointees?

  • Vicky Pebsworth: A board member of the National Vaccine Information Center (a misnomer because they don’t provide evidence-based information). This is an anti-vax group notorious for advocating vaccine exemptions and raising vaccine safety alarms without evidence.
  • Dr. Martin Kulldorff: A co-author of the Great Barrington Declaration, who has consistently recommended against vaccinating children and champions natural infection.
  • Dr. Robert Malone: A leading COVID‑19 vaccine critic, peddling conspiracy theories and misrepresenting mRNA science.
  • Retsef Levi: An ‘influencer’ and vocal mRNA vaccine skeptic who claims, without evidence, that vaccines inflict “serious harm and death,” in children.
  • Joseph Hibbeln, Cody Meissner, James Pagano, Michael Ross: These people are relatively unknown in the public sphere. Meissner has prior ACIP and FDA advisory experience. The others appear to have little vaccine expertise and have shown skepticism in related health areas – but these 4 don’t seem to be as bad as Pebsworth, Kulldorff, Malone and Levi (at least so far).

Historically, ACIP members examine data without bias. Those decades are over. Under Kennedy, the new appointees will be predisposed to confirm their anti‑vaccine stance, interpreting evidence through via “confirmation bias” – which means folks only want advice or information if it supports what you already want to do.

The upshot is ACIP will begin recommending that the CDC remove several vaccines from the child and adult vaccine schedule. The CDC director (whoever that will be) will rubber stamp the recommendations. That will prompt health plans and Medicaid (through VFC) to stop covering those vaccinations (making them cash pay) – resulting in much lower vaccination rates for the shots they remove from the schedule.

In some cases, ACIP/CDC may not totally pull vaccines off the recommended schedules – they might move the vaccine to a ‘shared clinical decision-making’ category – meaning VFC providers won’t have to stock it.

These actions may not happen right away. Kennedy knows he has 3.5 years to complete his dismantling of vaccination, and I expect him to be methodical about it.

As a public health community, we have an obligation to be a watchdog for the new ACIP’s recommendations and the CDC’s likely rubber stamping of those biased recommendations.

While we may not be able to influence the outcome of Kennedy’s decisions over the next 3.5 years – we can remain a powerful force that will be there to pick up the public health pieces in early 2029.

Kennedy Plows the Field to Eliminate Vaccines from the Recommended Schedule, Making them Inaccessible

By now all of you know Kennedy removed all the current members of the Advisory Committee on Immunization Practices (ACIP), the objective federal advisory body responsible for developing vaccine recommendations in the United States. He replaced them with a cadre of mostly well-known confirmation biased anti-vaccine zealots: As Expected – New ACIP Members Picked by Kennedy Have Anti-vax Bias.

RFK Jr. fires all 17 members of CDC vaccine advisory panel

ACIP had been composed of experts who play an important role in our immunization schedules (for kids and adults) and deciding coverage for critical programs like the VFC and affordable care act.

In Kennedy’s confirmation he promised to “maintain” the committee. Those of us who’ve followed his strident anti-vaccine zealotry over the years knew that was BS, and we were right. His end game is of course to greatly reduce the adult and child vaccine schedule and thereby stop reimbursement for vaccines via insurance plans. I don’t think his goal is to revoke vaccine licenses – he simply wants the vaccines to stop being administered to lower immunization rates.

The legal framework governing ACIP gives Kennedy tons of leeway in appointing and removing members, so there’s basically no chance legal actions can reverse this week’s decision.

The new appointees will have the power to end vaccine recommendations—changes that the CDC director will adopt without resistance.

If (when) the new ACIP recommends removing key vaccines like the HPV and meningococcal vaccine from the recommended schedule (the first two in his sights), insurers will no longer have to cover them, drastically reducing access (the PPV vaccine prevents cervical cancer while the meningococcal vaccine prevents deadly bacterial meningitis). In some cases ACIP/CDC may not totally pull vaccines off the recommended schedule – they might move the vaccine to a ‘shared clinical decision-making’ category – meaning they won’t be routine and more importantly VFC providers won’t have to stock it.

While Medicare is legally bound to cover certain vaccines, Medicaid coverage through VFC is directly tied to ACIP’s list.  Because childhood vaccines for kids who are Medicaid members (AHCCCS) is tied directly to the VFC program there would be an immediate impact for those kids, and they will no longer be protected.

The downstream effects are predictable: vaccination rates will drop. We’ve already seen troubling declines in routine immunization across the country in recent years, including in Arizona.

Arizona schoolkids’ immunization coverage declines, new numbers show

Diseases we’ve largely controlled—like measles, pertussis, and even certain cancers prevented by vaccines like HPV—could surge again. The U.S. could become a hotspot for preventable infectious diseases, reversing decades of public health progress.

Arizona confirms 4 measles cases amid national surge

When all is said and done 3.5 years from now, we’ll be able to begin to dig out of the hole Kennedy is excavating – but it’ll take time and resources and a cadre of professionals like yourselves to make it happen.

In the meantime, many people will unnecessarily suffer, and lives will be unnecessarily lost.

Note: Lawsuits have been a key (actually the only) tool for stopping some of the president’s actions this far – with over 64 Preliminary Injunctions or Restraining Orders in place. Sadly, these ACIP/CDC/Antivax actions by Kennedy appear to use existing authority and it seems to me that we won’t be able to successfully challenge the eventual wholesale scale back of the child vaccine schedule (and vaccination rates) that’s sure to result.

However, in 3.5 years we’ll hopefully be able to restore an evidence-based vaccine schedule – although there will be a lot of catching up to do because the vaccines that will shortly be removed from the schedule will become cash pay and immunization rates will plummet.

What Public Health Professionals Need to Know About Education, Advocacy & Lobbying

Properly navigating the complicated landscape of public health advocacy is more important than ever these days given Secretary Kennedy’s actions.

As a public health system, we need to engage in advocacy to tell our story – but do it in a way that doesn’t get us in trouble by violating IRS and other lobbying restrictions for nonprofits and political jurisdictions.

Thankfully, the Network for Public Health Law ‘s recently published a Q & A summarizing the basics.

Advocacy encompasses efforts to influence policies and systems to promote health equity, such as presenting research to decision-makers, while Lobbying is a specific form of advocacy that entails direct communication with legislators to influence specific legislation.

Understanding these differences is crucial for public health professionals to engage effectively without crossing legal boundaries.

Q&A: What Public Health Professionals Need to Know About Public Health Education, Advocacy and Lobbying – Network for Public Health Law emphasizes that advocacy is a core function of public health, essential for shaping policies and ensuring fair health outcomes.

What’s Actually in that House Budget Bill?

On May 22, the House of Representatives passed the “Big Beautiful Bill Act” (H.R. 1) by a 215-214 vote. This reconciliation bill proposes changes to Medicaid, the Affordable Care Act, food nutrition programs, and the nation’s debt limit, among other things.

If this bill were signed into law, several potential impacts to states include:

  • Increased coverage loss for noncompliance with work requirements.
  • Future challenges for states to fund their share of Medicaid and SNAP.
  • Limitations on how states incentivize high-quality care or improve access to care as a result of caps on future state-directed payments.
  • Potential increase in food insecurity for vulnerable populations.

For more information, view the full bill text of the legislation.

The Association for State & Territorial Health Officers (ASTHO) put together a good summary of the impact the bill would have if the Senate passes it as (which is very unlikely). Here are some of the impacts in a nutshell:

Medicaid

Work Requirements

Requires states to implement work requirements by December 31, 2026. The work requirements would require able-bodied adults aged 19-64 to work (or perform other qualifying activities) for at least 80 hours a month. There would be exemptions for certain individuals (e.g., pregnant women, those with serious medical conditions, and tribal members).

Note: The real savings here come as Medicaid members who are actually meeting the new requirements are unable or for some reason don’t properly report on their work or community engagement. Some states will make the process difficult to remove as many Medicaid members as possible.

Medicaid Expansion

Lowers the federal match for the expansion population (from 90% to 80% FMAP) if a state “provides any form of financial assistance, through Medicaid or under another program established by the state” that allows undocumented immigrants, except for children and pregnant women (doesn’t apply to AZ)

Requires states to conduct eligibility determinations for their expansion population every six months by December 31, 2026.

Provider Taxes

Prohibits states from setting up new provider taxes and freezes existing provider taxes at current rates. Modifies the criteria HHS must use to decide whether taxes are redistributive when considering a waiver of uniform tax requirement (could apply to Arizona – upsetting our Hospital Assessment that pays the state match for 500,000 childless adults).

Reproductive Health and Gender Transitions

Prohibits federal funding for Planned Parenthood and other abortion providers described as “nonprofit organizations, which are essential community providers that are primarily engaged in family planning services or reproductive services, provide for abortions other than the Hyde Amendment exceptions, and which received $1,000,000 or more.”

Food Nutrition Programs

Revises the Supplemental Nutrition Assistance Program by implementing work requirements for able-bodied adults without dependents.

Creates a state cost-sharing requirement for SNAP allotments beginning in FY 2028, with the federal share dropping to 95%. This state share would increase to 15%, 20%, or 25% when a state’s payment error rate exceeds 6%, 8%, or 10%, respectively. Would have a big impact on the AZ General Fund beginning in 2028 unless AZ decides to quit the SNAP program.

Arizona AG Mayes Defending the Rule of Law (and Public Health) with Legal Challenges

Since taking office, Arizona Attorney General Kris Mayes has initiated or joined at least 18 lawsuits against the Trump administration, focusing on defending constitutional principles and protecting the rights of Arizonans.

These legal actions (filed jointly with several other state Attorney Generals) span various sectors, including public health, education, labor, and environmental policy.

In the public health arena, Mayes is challenging administration’s decisions to cut or delay funding for critical public health and healthcare programs. For example, she joined lawsuits opposing the termination of nearly $12 billion in public health grants, which support services like telehealth, mobile vaccine clinics, and opioid treatment programs. They’ve also contested the administration’s attempts to disrupt National Institutes of Health grant processes.

Beyond health care, Mayes et.al. have gotten preliminary injunctions against the mass firing of federal probationary employees and a court order restoring over $1 billion in federal funds aimed at assisting low-income and unhoused students.

These legal efforts underscore the pivotal role of the judicial branch will be over the next 3.5 years in upholding the rule of law when executive and agency actions overstep constitutional boundaries or are in conflict with existing federal laws.

As we press through the next 3.5 years it’s crucial that the judicial branch exercise their legitimate constitutional checks and balances power to ensure that the administration adheres to the constitution and existing federal laws.

Right now, the judicial branch is the only branch of government that’s willing to act as a check on the administration’s illegal and unconstitutional actions.

For a comprehensive overview of Attorney General Mayes’ legal actions, visit the Arizona Attorney General’s Federal Action Lawsuits page: Arizona Attorney General’s Federal Action Lawsuits | Arizona Attorney General

AZPHA Breakfast & Learn Public Health Under Siege: How the American Public Health Association is Fighting Back 

Friday, June 20, 2025   9-10am

Public health is under siege. From destructive policy changes to the indiscriminate firing of experienced experts at the CDC, FDA, and other HHS agencies – decisions by Secretary Kennedy are putting the nation’s health—and the future of biomedical research—at serious risk. 

Fortunately the American Public Health Association has come to the rescue – filing lawsuits, motions and briefs in several lawsuits challenging Kennedy’s harmful decisions.

Join Rebecca Boulos, Don Hoppert and Rebecca Nevedale from APHA on Friday June 20 at 9am for our member webinar outlining how APHA is pushing back, including legal actions and advocacy efforts to limit the damage.

Hosted in partnership with the AZPHA, this session will detail what’s at stake and how public health advocates can take a stand. Don’t miss this chance to stay informed, get engaged, and help defend the future of public health.

Our Speakers:

 Rebecca Boulos

Rebecca Boulos: Chair, APHA Action Board

Don Hoppert - Washington, District of ...

Don Hoppert: APHA Director of Government Relations

Rebecca Nevedale

Rebecca Nevedale, AzPHA & APHA Council of Affiliates Chair

Register Today

Free for AZPHA Members

Investigative Journalism & Independent Auditing Spark Improvements in Assisted Living, Skilled Nursing & Dementia Care

Over the past several years AZ’s system for ensuring people who live in assisted living and skilled nursing facilities are treated properly has faced intense scrutiny—for good reason.

An (award-winning) investigative series by The Arizona Republic, titled The Bitter End, by Caitlin McGlade and Sahana Jayaraman – uncovered unacceptable conditions in care homes in Arizona.

Their reporting exposed a pattern of resident harm, neglect, and systemic regulatory failures during the Ducey/Christ/Herrington era   – when the ADHS had mostly abdicated its duty to enforce basic standards of safety and care at assisted living and skilled nursing facilities.

McGlade’s stories along with a series of damning reports by the AZ Auditor General’s Office exposed agency conduct that was failing Arizona’s seniors.

AZ failed to investigate nursing home complaints, report finds
Republic series are IRE investigative journalism award winner, finalist
Auditor General’s Office Produces Scathing Review of ADHS’ Nursing Home Complaint Investigations During the Ducey Era

The revelations eventually prompted long-overdue reforms under the Hobbs Administration including leadership changes at ADHS and a growing political will at the legislature to address the crisis—including residents living with dementia.

Now under new leadership, ADHS has been working hard to rebuild trust and strengthen oversight of assisted living and skilled nursing facilities and other healthcare institutions.

The agency has been changing policies, priorities, program leadership, improving training and rebooting the licensing division’s culture. They’ve even proposed licensing fee increases to provide the revenue needed to step up their oversight. 

Another step forward came last week when ADHS got final approval for a new set of dementia care regulations. The new rules, approved by the Governor’s Regulatory Review Council, require enhanced training for staff, better care planning, improved documentation, and more accountability mechanisms.

Arizona dementia-care rules for assisted living clear final hurdle

AZPHA commends the new ADHS leadership team for standing firm against industry pressure to water down the dementia care protections. Their willingness to prioritize patient care is a sharp contrast from the unchecked ambivalence & neglect that occurred during the Ducey/Christ/Herrington era.

The reform of ADHS’ licensing work and the new dementia care rules are reminders that investigative journalism and independent watchdog oversight (the AZ Auditor General) are critical to creating meaningful changes when agency and executive branch leadership allows a system to fail.

This kind of investigative journalism – which was key to getting the kinds of reform we’re now seeing – is only possible with reader support… so please subscribe to local journalism!

While there’s still a lot more work to do like hiring, training and mentoring the surveyors that do this work – the adoption of the new dementia care rules shows ADHS is doing what they can to protect seniors again.

Note: In another encouraging action, ADHS is adjusting their licensing fees for healthcare institutions – an important step that’ll l provide badly needed money to hire, train, and keep more and better inspectors.

The fees that pay for ADHS’ licensing work were set by me way back in 2009 and haven’t been adjusted since. Meanwhile, inflation has eroded the value of the licensing revenue by 48% since those fees were set. See the new (draft) licensing fee rules 9 A.A.C. 10 HCIs EIS Draft – Fees

ADHS – Rulemakings in Progress – Health Care Institution Fees

Will Kennedy’s Elimination of CDC’s Smoking & Health Program Make America Healthy? No.

In yet another damaging move, Kennedy eliminated CDC’s Office on Smoking and Health last week — threatening decades of progress in tobacco prevention and control even as tobacco smoking remains the number one preventable cause of death in the US.

The Office of Smoking and Health provides vital funding & technical assistance to every state in the country, supporting  quitlines, public education campaigns, data collection, and policy development.

These efforts will go up in smoke now that Kennedy has thrown the program in the trash heap. 

Lifesaving Programs to Prevent and Reduce Tobacco Use Go Up in Smoke

Tobacco remains the leading cause of preventable death in the United States, killing more than 480,000 people annually.

So much for Making America Healthy Again.

Arizona Still Has Work to Do On Tobacco Control

This week, the American Lung Association released its latest “Up in Smoke” report, a national look at how states are doing when it comes to reducing tobacco use and protecting people from secondhand smoke.

Arizona’s grades are mixed. While we’ve made progress in some areas, we still have serious gaps to address. 

The report grades states in five areas: funding for tobacco prevention, smokefree air laws, access to cessation services, tobacco taxes, and flavored tobacco product restrictions.

Arizona earned a C in smokefree air laws and a B in cessation services, but we scored a failing grade—an F—for tobacco taxes and flavored tobacco product regulations. That’s deeply concerning.

You can read the full report here.