In the aftermath of massive layoffs at HHS, a panel originally aimed at discussing vaccine science and policy quickly re-focused on the impact those cuts would have on infectious disease.

During the American Public Health Association (APHA) panel “Navigating the Vaccine Debate,” keynote speaker Paul Offit, MD, of the Children’s Hospital of Philadelphia, said the CDC, NIH, and FDA had all been instrumental in saving lives during the COVID-19 pandemic and worked through an unprecedented timeline for vaccine development and rollout.

Because of this, he said, watching the brutal HHS layoffs weaken these organizations is painful.

“I feel like, in some ways, we’ve been invaded by a foreign nation … [whose] interest … is to destroy public health agencies,” Offit said, adding that the HHS cuts will cause a significant loss of institutional knowledge that could be vital for future public health situations.

For example, though the COVID vaccines were the first mRNA vaccines to get full FDA approval, the foundational research that led to their discovery went back decades, Offit said. He cited the NIH-funded research of Katalin Karikó, PhD, and Drew Weissman, MD, PhD, that won them the 2023 Nobel Prize in Medicine.

“Because we were willing to spend money on research that, at the time, didn’t seem to be necessarily relevant, when mRNA became incredibly relevant, [it] probably saved roughly 3 million lives,” Offit said.

Anand Parekh, MD, chief medical officer at the Bipartisan Policy Center, reflected on his 7-year stint as deputy assistant secretary for health at HHS. Parekh noted that before now, “every administration in the past, democrat or republican, has supported this robust federal apparatus” for vaccines and immunizations. He emphasized the importance of keeping vaccines and public health interventions apolitical in partisan times.

The stakes are high, as two deaths of unvaccinated people have already come out of the measles outbreak that is raging in several states.

Casie Stoughton, MPH, director of public health for Amarillo, Texas, offered insight on the ongoing measles outbreak centered on the Texas panhandle. Stoughton noted the local public health response has involved inter-jurisdictional cooperation and communication, hinging on relationships with communities, trusted messenger programs, and suspected case reporting.

For other states preparing for potential measles outbreaks, she recommended identifying “populations with low vaccination rates” and utilizing this moment “as an opportunity to encourage vaccination.”

A researcher who studies public opinion of vaccines and other public health issues highlighted obstacles on this front.

Gillian SteelFisher, PhD, of the Harvard T.H. Chan School of Public Health, said she found from her research that over the last few years, people have been less likely to think that vaccine requirements for schools are a good idea. “The conversation has moved away from safety concerns,” she said, adding that the primary reason is now “a sense of rights and choice.”

Indeed, this year there has already been a surge of about 500 vaccine-related bills in state legislatures, which vary from messaging bills to health freedom. The latter “seek to remove requirements, such as those around school-required vaccines,” according to panelist Michelle Fiscus, MD, chief medical officer of the Association of Immunization Managers.

“The vast majority of these bills have not and will not pass, but a few will, and when they do, it makes it very difficult for immunization programs to work effectively, and that results in lower immunization rates and widens disparities,” warned Fiscus.

Going forward, changing the language and strategies used in vaccine-related public health initiatives may be critical for “more effective conversations and engagement with people,” suggested SteelFisher, who stressed the importance of separating the safety and personal freedom issues around vaccines.

She noted that most people live in political bubbles, and that public opinion on issues is often different than the narratives portrayed in media — or people’s own assumptions, for that matter.

With Robert F. Kennedy Jr. running HHS, who in his first few weeks in the role has already cast doubts on vaccines and made other moves to gut vaccine-related work, public health workers are up for quite the challenge.

“Everyone’s in a fire hose of information all the time,” SteelFisher said. “So it’s really about having people to find trusted sources that are providing accurate information.”