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This Is How to Win an Environmental Fight

This Is How to Win an Environmental Fight

New York Times27-04-2025

In early 2023, when the Minnesota Legislature began weighing a sweeping ban on 'forever chemicals' — a class of roughly 9,000 substances used in everything from lipstick and cellphones to cookware and clothing — many lawmakers were doubtful they could get anywhere. Several bills had failed to gain traction in the state, which was home to one of the world's largest manufacturers of the chemicals, 3M Company.
But then a young woman named Amara Strande turned up at the Capitol. Ms. Strande, who grew up near St. Paul, had been diagnosed at age 15 with a rare liver cancer, a disease she and her family attributed to drinking water polluted with per- and polyfluoroalkyl substances, or PFAS, as forever chemicals are formally known.
At hearing after hearing, she was at the statehouse lobbying lawmakers and giving testimony. Speaking faintly into the microphone, she described her excruciating pain and the gruesome surgery she endured to have a 15-pound tumor removed. She talked about the horrors of the cancer spreading throughout her chest, cracking her ribs and immobilizing her right hand. 'There are no more treatments to try,' she said. 'I can no longer braid my hair or play the piano.'
Ms. Strande died that April, just two days shy of her 21st birthday. But the following month, the State Legislature passed Amara's Law, the most aggressive PFAS ban in the country.
In recent years, forever chemicals have been increasingly recognized as one of the most significant environmental threats of our time. They persist in the environment for millenniums. They spread rapidly through air and water, polluting ecosystems and human bodies everywhere, and there they stay, with the potential to damage cells and alter our DNA. The best studied of these chemicals have been linked to obesity, infertility, testicular cancer, thyroid disease, immune suppression and life-threatening pregnancy complications, among other maladies.
But unlike another daunting environmental threat, climate change, forever chemicals have spawned a forceful bipartisan response, driven by a network of unlikely activists. Across the country, thousands of ordinary Americans whose lives have been upended by PFAS — firefighters, farmers, factory workers, veterans and suburban moms — are fighting to turn off the tap on these chemicals. Their efforts, which often differ from those of conventional environmental groups, have helped ignite a chain reaction that has led to numerous congressional hearings and hundreds of bipartisan bills in Washington and statehouses, as well as federal regulations. The Environmental Protection Agency has set near-zero caps on several PFAS in drinking water.
Some of these measures may fall victim to the budget cuts and deregulatory fervor enveloping Washington under President Trump. But most should survive since they're outside the direct reach of the federal government.
So far, 30 states have adopted their own restrictions on PFAS, including at least 14 full or partial bans on the chemicals in consumer goods. And this trend seems to have only accelerated since Mr. Trump's election in November. More than 200 PFAS-related bills have been introduced in state legislatures, and dozens more are in the pipeline. Even deep-red states such as Mississippi, Montana and Texas are weighing crackdowns.
This movement has also helped engender a sprawling legal battle that is expected to surpass asbestos litigation, one of the largest, most costly legal battles in U.S. history. Already, manufacturers like DuPont and 3M have been hit with more than 15,000 claims, many of them personal-injury based, though dozens of states and multiple municipalities have also brought cases.
As a result of all this, large parts of the economy are voluntarily migrating away from PFAS, and it seems to be happening far faster than it would with regulation, a promising sign for others fighting to protect human health and the environment amid the attack on the federal bureaucracy.
The dangers of PFAS first came to light in the 1990s, after a family of West Virginia farmers whose land adjoined a DuPont landfill noticed that their cattle were sprouting tumors and vomiting blood. Soon the cows were dying faster than the farmers could bury them, and family members were landing in the hospital with mysterious chemical burns. Convinced that the landfill was to blame, the family sued the company.
That case helped expose a decades-long cover-up involving the forever chemical PFOA, which DuPont used to make Teflon. It also inspired a class-action lawsuit and a flurry of scientific research.
But PFAS didn't attract much attention outside scientific circles until 2016, when contamination in the upstate New York village of Hoosick Falls made national headlines. There the instigator was a young man named Michael Hickey, who had started questioning the safety of the local drinking water after losing his father and several friends to cancer. When officials refused to investigate, he tested his own tap water and discovered dangerous levels of PFOA.
Mr. Hickey wasn't your typical activist. A clean-cut insurance underwriter with a fear of public speaking, he had no interest in environmental issues generally. He liked to joke that he got his news from ESPN. And yet he wound up spearheading a fight against several giant multinational corporations and government agencies to get his community clean drinking water.
Other residents with little interest in politics found themselves enmeshed in the same battle: A doctor who had documented unusually high rates of rare, aggressive cancers among his patients before being diagnosed with cancer himself. A high school music teacher who decided to run for public office after learning his 2-year-old daughter had PFAS blood levels 50 times the national average. A young mother named Emily Marpe who had put everything she had into a dream home for her family, only to learn that her well was contaminated.
Ms. Marpe, who had only a high-school education, developed a command of the sciences and a talent for boiling complex concepts into simple language, making her a favorite among local reporters. She also helped organize forums for lawyers and scientists to speak with residents and recounted her story in testimony before government agencies and at private meetings with lawmakers. 'The American dream was ripped out from under us,' she told one congressional staff member.
The stories of Ms. Marpe and others have resonated with Republicans and Democrats alike. By 2018, states were embracing a raft of bold policies. New York had designated two PFAS as hazardous substances, a move that gave the state the power to investigate the breadth of the pollution and force those responsible to pay for the cleanup. Other states were developing strict limits for PFAS in drinking water, and bills banning them in food packaging and consumer goods were cropping up in legislatures nationwide.
With the help of environmental organizations, citizen activists scored victories on the national level. In 2017, Mr. Trump nominated a scientist who had helped chemical makers fend off PFAS regulation to head the E.P.A.'s Office of Chemical Safety. Environmental groups responded by inviting Americans who had been harmed by these chemicals to Washington to tell their stories, among them Ms. Marpe and a former Marine sergeant who lost his 9-year-old to cancer and learned his family had been drinking tainted water. In the end, several Republican senators announced they would vote against the nominee, forcing him to withdraw.
As more activists from around the country arrived in Washington and bombarded lawmakers with emails and phone calls, something important began to happen. Republicans representing polluted communities — among them Lee Zeldin, now the E.P.A. chief but at the time a congressman from Long Island — began pushing strict PFAS legislation and demanding that federal agencies move swiftly to regulate these chemicals.
In response, the Trump administration, which was otherwise bent on cutting regulation, unveiled a detailed plan to 'aggressively address' PFAS contamination. Congress began weighing bipartisan PFAS legislation. Mr. Hickey was called to testify before lawmakers, along with a Virginia man who had been born with serious facial deformities, a youth ministry director from North Carolina, an Army veteran from Colorado and a rural Michigan woman who reportedly has the highest PFAS ever detected in a human.
Many PFAS activists focused their efforts largely on institutions that, historically at least, tended to be less polarized and more responsive: the courts and state governments. Firefighters can be exposed to high levels of PFAS on the job and have unusually high rates of certain cancers that have been linked to PFAS. In some states, firefighting unions have dispatched their members to lobby for bans on PFAS-based firefighting foam, partly by sharing stories about their own battles with cancer or losing co-workers to the disease. As a result, at least 15 states have banned the use of these substances, which until recently were a staple at firehouses, airports and military bases.
In Maine, farmers led the charge. After an investigation revealed that sections of rural land were polluted with PFAS from sewage sludge, growers came together to lobby for a ban on using sludge as fertilizer. Adam Nordell, who was forced to shut down his vegetable farm because of contamination, later took a job at the nonprofit group Defend Our Health, where he has rallied Maine farmers behind legislation, including a near-total ban on PFAS in consumer goods.
Even before the PFAS bans take full effect, manufacturers are being forced to provide regulators with detailed information about how they're using these chemicals. For a growing number of companies, this information is such a liability that they are giving up these substances. At least 40 major retail chains with $1.7 trillion in combined annual revenue have committed to eliminating or reducing forever chemicals in their packaging and products. Among them are Amazon, Starbucks, Apple, Target, McDonald's, Dick's Sporting Goods and Home Depot.
Some chemical manufacturers are abandoning PFAS, too; 3M, which owes more than $10 billion for PFAS settlements so far, has announced it will quit producing the chemicals by the end of 2025, citing mounting regulation and pressure from investors. Other chemical makers are getting similar pushback.
This doesn't mean the battle is over. Right now, the chemical industry is fighting aggressively to protect the most lucrative types of PFAS — namely, specialized plastics such as Teflon and fluorinated gases, which together account for a market worth tens of billions of dollars. States have mostly resisted industry efforts to exempt these substances from legislation. But, as of a few years ago, the E.P.A. office charged with vetting chemicals for safety had adopted an industry-backed definition that would exclude the one type of PFAS most abundant in the environment.
In the end, however, no amount of industry lobbying can counter the economic pressures bearing down as the regulations take effect in the United States, as well as Europe, and PFAS litigation hits consumer brands like Band-Aid and Trojan condoms, whose parent companies have been sued by customers. Manufacturers are scrambling to find safer alternatives. All of which pushes us closer to the kind of economic tipping point that could lead to the virtual elimination of these chemicals.
We have ordinary citizens to thank for most of these shifts. People who set out to protect their families and communities and wound up building the most powerful grass-roots environmental movement since Rachel Carson's groundbreaking 1962 book 'Silent Spring.' Their story offers hopeful lessons for other movements struggling to gain traction. One is the potential for citizen movements to drastically alter market forces, leading to meaningful change.
Another is the power of working on the state level, where the federal government's influence is limited. During the first Trump presidency, other movements made major headway using this approach. Teachers organizing strikes in states such as West Virginia managed to score crucial victories, emboldening the labor movement even as Mr. Trump was rolling back worker protections.
This time, the Trump camp is more organized and determined to crush opposition. Even so, advocates of PFAS legislation continue to make rapid progress. That should give everyone who cares about the environment at least a modicum of hope.

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5 Common Causes of Impotence
5 Common Causes of Impotence

Health Line

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  • Health Line

5 Common Causes of Impotence

Key takeaways The risk of impotence increases with age and is higher in males who have been diagnosed with heart conditions. Other causes include endocrine diseases like diabetes, neurological disorders, certain medications, and lifestyle or emotional factors like depression and anxiety. What is impotence? Impotence occurs when you're unable to achieve an erection, maintain an erection, or ejaculate on a consistent basis. It's used interchangeably with ED. Several factors can contribute to the condition, including both emotional and physical disorders. According to the Urology Care Foundation, an estimated 30 million Americans experience ED. A 2007 study published in the American Journal of Medicine noted the risk of impotence increases with age. Research suggests it's even higher in men who have also been diagnosed with one or more cardiovascular risk factors. Impotence can often have a negative effect on your sex life, and it can also cause depression, additional stress, and low self-esteem. Impotence and erectile dysfunction symptoms A common misconception about erectile dysfunction is that you cannot achieve an erection at all. This is not always the case. Erectile dysfunction can also include symptoms like: being unable to achieve an erection inconsistently being able to achieve an erection each time you have a sexual encounter not being able to maintain an erection for the entire sexual encounter Impotence can begin to affect your quality of life and relationships with your sexual partners over time. However, there are several treatment options available for many of the root causes of ED. If you are experiencing any of these symptoms, consider talking with your doctor about what might be causing your ED and what treatment options might be best for you. What causes impotence? Understanding the most frequently diagnosed potential causes can help you identify why you may be experiencing the condition. Here are five common causes of impotence: 1. Endocrine diseases The body's endocrine system produces hormones that regulate metabolism, sexual function, reproduction, mood, and much more. One of the complications associated with chronic diabetes is nerve damage. This affects penis sensations. Other complications associated with diabetes include impaired blood flow and hormone levels. Both of these factors can contribute to impotence. 2. Neurological and nerve disorders Several neurologic conditions can increase the risk for impotence. Nerve conditions affect the brain's ability to communicate with the reproductive system. This can prevent you from achieving an erection. Neurological disorders associated with impotence include: Alzheimer's disease Parkinson's disease brain or spinal tumors multiple sclerosis (MS) stroke temporal lobe epilepsy If you've had prostate surgery, you can also experience nerve damage, resulting in impotence. Long-distance bicycle riders can experience temporary impotence. Repeated pressure on the buttocks and genitals can affect nerve function. 3. Taking medications Taking certain medications can affect blood flow, which can lead to ED. You should never stop taking a medication without your doctor's permission, even if it's known to cause impotence. Examples of medications known to cause impotence include: alpha-adrenergic blockers, including tamsulosin (Flomax) antihistamines, such as cimetidine (Tagamet) beta-blockers, such as carvedilol (Coreg) and metoprolol (Lopressor) chemotherapy medications central nervous system (CNS) depressants, such as alprazolam (Xanax), diazepam (Valium), and codeine CNS stimulants, such as cocaine and amphetamines diuretics, such as furosemide (Lasix) and spironolactone (Aldactone) selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and paroxetine (Paxil) synthetic hormones, including leuprolide (Eligard) 4. Cardiac-related conditions Conditions that affect the heart and its ability to pump blood well can cause impotence. Without enough blood flow to the penis, you cannot achieve an erection. Atherosclerosis, a condition that causes blood vessels to become clogged, can cause impotence. High cholesterol and high blood pressure (hypertension) are also associated with an increased risk for impotence. 5. Lifestyle factors and emotional disorders To achieve an erection, you must first go through what's known as an excitement phase. This phase can be an emotional response. If you have an emotional disorder, it can affect your ability to become sexually excited. Depression and anxiety are associated with an increased risk for impotence. Depression is a feeling of sadness, loss of hope, or helplessness. Fatigue-related to depression can also cause impotence. Performance anxiety can also cause impotence. If you haven't been able to achieve an erection in the past, you may fear you won't be able to achieve an erection in the future. You may find that you cannot achieve an erection with a certain partner. If you've been diagnosed with ED related to performance anxiety, you may be able to have full erections when masturbating or when sleeping, but unable to maintain an erection during intercourse. Substance use disorder involving drugs such as cocaine and amphetamines can also cause impotence. Alcohol misuse or alcohol use disorder (AUD) can affect your ability to achieve or maintain an erection as well. See your doctor if you suspect that you may have a substance use problem. Erectile dysfunction treatment Treatments are available for impotence, including medical interventions, natural remedies, and lifestyle changes. Medical interventions There are a variety of medical interventions that can be used to treat impotence. Prescription treatments for impotence include: alprostadil (Caverject, Edex, MUSE), which is available as an injection or as a suppository avanafil (Stendra) sildenafil (Viagra) tadalafil (Cialis) vardenafil (Staxyn, Levitra) testosterone replacement therapy (TRT) You may also want to consider vascular surgery (to improve blood flow in the penis) or penile implant surgery. Find Roman ED medication online. Natural remedies If you want to avoid prescription medication, there are a variety of natural remedies known to help treat impotence. It's important to note that the efficacy of these alternative remedies is not always tested or verified by the FDA so you may not see the advertised results of these products. Before you use any natural remedies, make sure you consult your doctor first. Some alternative remedies for impotence include: Penis pumps Penis pumps are another option if you're looking for noninvasive, nondrug treatments. They may be most effective if you have moderate ED. Lifestyle changes Whether your impotence has a physical or an emotional cause, there are many cases where lifestyle changes can reduce problems with ED. According to an article in the Journal of Restorative Medicine, examples of these lifestyle and behavioral changes include: quitting smoking if you smoke drinking alcohol in moderation practicing supportive communication in a romantic relationship exercising eating a well-balanced, nutritious diet reducing anxiety You may also want to consider meeting with a mental health professional if you feel your ED is due to psychological causes. How to increase blood flow to the penis naturally Naturally increasing blood flow to the penis often requires a combination of lifestyle changes. Here are a few changes that you can consider trying: If you smoke, consider quitting. Smoking can affect your blood flow and worsen erectile dysfunction. Engage in regular physical activity. 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If you experience problems achieving or maintaining an erection, consider talking with a doctor. Both primary care professionals and urologists can help you create a treatment plan for erectile dysfunction. However, if your condition is related to an underlying medical condition, they may refer you to a specialist. It's completely understandable if you feel self-conscious about speaking with a doctor about erectile dysfunction. However, it's important to keep in mind that sexual health is an important part of your overall health and how you feel about yourself. It's important that you are able to talk with healthcare professionals openly and honestly about your symptoms and to get help for any underlying medical conditions. Frequently asked questions about the causes of impotence How long can the average person with a penis stay erect? There is not a specific answer for how long the average person with a penis can stay erect. 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How RFK, Jr.'s Dismissal of CDC Immunization Committee Panelists Will Affect America's Vaccine Access
How RFK, Jr.'s Dismissal of CDC Immunization Committee Panelists Will Affect America's Vaccine Access

Scientific American

time2 hours ago

  • Scientific American

How RFK, Jr.'s Dismissal of CDC Immunization Committee Panelists Will Affect America's Vaccine Access

In a striking move on Monday, Robert F. Kennedy, Jr., secretary of the U.S. Department Health and Human Services, announced the dismissal of all sitting public health experts of an independent vaccine committee that counsels the U.S. Centers for Disease Control and Prevention. Called the Advisory Committee on Immunization Practices, or ACIP, the group holds public meetings to review the latest scientific evidence on vaccine safety and effectiveness and to make clinical recommendations for people in the U.S.—guidance that greatly influences access to disease-preventing shots. In his announcement in a Wall Street Journal op-ed, Kennedy— who has a long history of as an antivaccine activist —framed the firings as taking 'a bold step in restoring public trust by totally reconstituting the Advisory Committee for Immunization Practices.' He also alleged there were 'persistent conflicts of interest' among committee members. Public health experts had been bracing for such a move. 'This was everybody's fear about having RFK, Jr., as our HHS secretary,' says Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University. On supporting science journalism If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today. ACIP's decisions shape immunization schedules —affecting which groups will be recommended vaccines, when and how often they should get them and whether health insurance will cover costs. The panelists hold three open meetings each year to assess and vote on the clinical use of various existing and new vaccines, including ones that protect people against pneumonia, chicken pox, shingles, measles, mumps and rubella (MMR), polio, respiratory syncytial virus (RSV), influenza and COVID. According to the agenda of ACIP's next meeting, slated for June 25–27, members are expected to vote on highly anticipated recommendations that would influence the next winter respiratory illness season—including guidance for COVID, flu and RSV vaccines for adults and children. In response to various questions about the plans for ACIP, an HHS spokesperson directed Scientific American to the agency's statement about the announcement and said the committee is still scheduled to meet on June 25–27. According to the statement, new committee members are currently under consideration. The secretary of health and human services gives the final approval of newly appointed ACIP members. 'I cannot imagine that they could compose a new ACIP that has been sufficiently vetted in [less than] three weeks,' Nuzzo says. 'One of the reasons why there's so much concern right now is that changing the composition of ACIP, potentially stacking it with antivaccine members, as many fear could happen, could make it harder for Americans to access vaccines that they want, that their doctors think are beneficial for them.' Scientific American spoke with Nuzzo about how the ACIP dismissal may affect vaccine policy and access and people's health. [ An edited transcript of the interview follows. ] What is the primary role of ACIP? There are a few features of the committee that make it important. One is expertise. The membership of the committee is somewhat diverse to represent a range of expert backgrounds because when you're talking about vaccines, there are pediatric issues, adult issues—a lot of different types of expertise need to be brought to bear. It's also an independent group, meaning that it's not populated by any particular political party. ACIP's members are outside experts who are appointed through a very transparent, open process, up to a fixed term. These are independent, nonpolitical actors who also have their conflicts of interests managed. Who they get money from is public knowledge. [ Editor's Note: Members withdraw themselves from deliberations and voting on any product for which they have disclosed a conflict of interest. ] How does ACIP make its decisions? During the meeting, [the members] have documents, they have people giving presentations. Sometimes those presentations are given by government scientists who have reviewed evidence, or sometimes [the members will look at] evidence from studies on vaccines. All of the meetings are open: either you could show up in public or, usually, [see a] broadcast on the web. So all of the data that are used in the discussion about vaccines and vaccine policies are made public, and they are reviewed. And not only are they reviewed, but the rationale and the interpretation of those data are public. So the public can see, interrogate, and vet the conclusions and the data that the committees use to base their conclusions. It's a very open [process], and that openness adheres to a governance structure has existed throughout multiple presidential administrations, multiple political parties presiding [over] it. It's also important to note that the CDC director does not have to accept ACIP's recommendations—the CDC director usually does, but the CDC director does not have to. My worry is not just that politics enters into ACIP; it's also just that 'Will the will of ACIP be adhered to?' How do ACIP's recommendations affect people? ACIP is one of two key advisory committees that serve the U.S. government related to vaccines [the other is the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee (VRBPAC) ]. ACIP makes recommendations regarding vaccine policies and utilization—and those recommendations are important, not just because they represent the scientific consensus that exists at the time but also because they usually influence people's access to vaccines. One real concern is: if ACIP doesn't recommend a vaccine, insurers may decide not to cover the cost , and some of these vaccines have important out-of-pocket costs. Some of us can afford that, but a lot of us can't. And so there are real issues about who is going to be able to benefit from vaccines, and it creates a real inequity. It may also have an effect on the market and companies' willingness to incur the risks of making vaccines. Vaccines are not like making a car. There are a discovery process and research-and-development process that have to occur. If vaccine manufacturers fear that they're not going to be able to sell vaccines, that people aren't going to be able to access them, then they may simply decide not to make them. They might decide that the U.S. market is not where they want to invest their resources and may decide to instead serve other countries. So it's not just that ACIP provides advice that the American public can use to make their own vaccine decisions but also [that it] is often the basis by which [vaccine] providers and insurers make vaccines available. So it's not just about information; it's also about access. What does this action potentially mean for future vaccine policies? I'm worried about all vaccines at this point. I can't rule out that that isn't just the first warning shot. Some of the rationale around who should or should not get COVID boosters, in my view, feels like an opening to removing the availability of flu vaccines. We've seen the secretary of HHS wrongly malign MMR vaccines amid one of the worst measles outbreaks the U.S. has seen in decades. So I fear that everything's fair game.

RFK Jr. Purging the CDC Advisory Committee Will Put Lives at Risk
RFK Jr. Purging the CDC Advisory Committee Will Put Lives at Risk

Yahoo

time3 hours ago

  • Yahoo

RFK Jr. Purging the CDC Advisory Committee Will Put Lives at Risk

Robert F. Kennedy Jr. testifying during his Senate Committee on Health, Education, Labor and Pensions confirmation hearing on January 30, 2025 in Washington, DC Credit - Kevin Dietsch—Getty Images When Secretary Robert F. Kennedy Jr. began his tenure as Health and Human Services Secretary, he pledged, 'We won't take away anyone's vaccines.' However, recent policy changes under his leadership—coupled with the unprecedented dismissal of all 17 members of the CDC's Advisory Committee on Immunization Practices (ACIP) on June 9—have proven that statement false, raising grave concerns for our nation's COVID-19 response and broader vaccine policies. These shifts not only jeopardize public health but also threaten to erode trust in our health institutions at a critical time. In May 2025, the Food and Drug Administration (FDA) introduced a new COVID-19 vaccine framework, limiting access to updated vaccines for Americans aged 65 and older or those with specific risk factors. Furthermore, Secretary Kennedy announced that the Centers for Disease Control and Prevention (CDC) would no longer recommend COVID-19 vaccines for 'healthy' children or pregnant women—bypassing the standard ACIP review process. Compounding these changes, the abrupt removal of ACIP's entire panel of independent experts, who have guided evidence-based vaccine policy for decades, risks destabilizing a cornerstone of public health. These actions collectively restrict access to a vital tool for saving lives and undermine confidence in our health systems. Read More: What to Know About RFK Jr. Removing All Experts From CDC Vaccine Advisory Committee During my tenure as Surgeon General under the first Trump administration, we faced significant public health challenges, from addressing the opioid epidemic by increasing access to Naloxone to launching Operation Warp Speed for the COVID-19 vaccine development effort. The vaccines developed under Trump's first term have proven to be one of our most effective defenses against COVID-19; yet, the current administration's new policies limit their availability, potentially leaving millions vulnerable. The dismissal of ACIP's experts—without a clear plan for replacing them with qualified scientists—further jeopardizes trust in the institutions tasked with protecting Americans. The major flaw in the new vaccine framework is its narrow assessment of risk. Although the immediate dangers of COVID-19 have lessened, it remains a leading cause of death and hospitalization, claiming nearly 50,000 lives in the U.S. in 2024—more than breast cancer or car accidents. The fact is, 75% of Americans have risk factors, such as obesity or diabetes, that increase their vulnerability to severe COVID outcomes. However, the burden is now placed on individuals to self-identify as high risk, creating confusion and inconsistency in access. Unlike other countries with centralized systems for identifying at-risk individuals, the U.S. expects patients—many of whom lack easy access to healthcare—to navigate eligibility alone. Risk assessment should also consider individual circumstances beyond underlying health conditions. A 58-year-old bus driver or healthcare worker faces significantly greater exposure than someone working remotely. By limiting vaccines to specific groups based solely on preexisting health status, the policy overlooks these critical contextual differences. Secretary Kennedy's team argues that there is insufficient evidence to support updated COVID-19 vaccines for healthy Americans under 65, but this claim is flatly unfounded. Years of real-world data demonstrate that vaccines save lives and reduce hospitalizations across all age groups. During the 2023 to 2024 fall and winter season, 95% of those hospitalized for COVID had not received an updated vaccine. While the administration cites other countries' more restrictive vaccine policies, such comparisons ignore the unique health landscape in the U.S., which includes higher obesity rates, worse maternal health outcomes, and uneven healthcare access. The policy also neglects the issue of Long COVID, which affects millions with debilitating symptoms lasting months or years. Though older adults are at higher risk for severe acute infections, Long COVID disproportionately impacts adults aged 35 to 49—and children are also affected. Vaccination reduces the risk of developing Long COVID, an essential reason many healthy individuals choose to stay up-to-date with their vaccines. Read More: What's the Risk of Getting Long COVID in 2024? Particularly concerning is the decision to end COVID vaccine recommendations for 'healthy' pregnant women, which contradicts the FDA's own guidance. Pregnant women face heightened risks of severe COVID outcomes, including death, pre-eclampsia, and miscarriage. Vaccination during pregnancy is crucial—not just for maternal health but also for protecting infants under six months, who cannot be vaccinated and rely on maternal antibodies for protection. Decades of research confirm that vaccines, including COVID vaccines, safely transfer antibodies to newborns, lowering their risk of severe illness. The dismissal of ACIP's members amplifies these concerns. ACIP has been a trusted, science-driven body that ensures vaccines are safe and effective, saving countless lives through its transparent recommendations. Its members, rigorously vetted for expertise and conflicts of interest, provide independent guidance critical to public health. Removing them without clear evidence of misconduct risks replacing qualified scientists with less experienced voices. This move fuels vaccine hesitancy and skepticism about public health decisions, particularly when paired with the bypassing of ACIP's review process for the new COVID vaccine policies. These changes create uncertainty about who can access vaccines. Without clear CDC recommendations, insurance companies may impose their own coverage criteria, potentially increasing costs for a vaccine that was previously free for most Americans. Healthcare providers, lacking federal guidance and ACIP's expertise, may struggle to advise patients, leading to a confusing and inequitable system that limits choice—hardly the 'medical freedom' Secretary Kennedy claims to champion. Ultimately, these actions threaten to erode trust in public health. FDA officials argue the new framework enhances transparency, yet bypassing ACIP's review and dismissing its members undermines that aim. Extensive data demonstrate that updated vaccines lower hospitalization and death rates, yet this evidence was sidelined. Such actions breed skepticism, making it harder to unite Americans around shared health goals. The stakes are high, but a better path is possible. Restoring trust requires transparent, evidence-based policymaking that prioritizes access to life-saving tools. I urge Secretary Kennedy and the administration to reconsider this framework, reinstate ACIP's role in vaccine policy, and ensure any new appointees are qualified, independent experts. If concerns about ACIP exist, they should be addressed through reform, not dissolution. Healthcare providers and community leaders must also educate patients about vaccination benefits, particularly for vulnerable groups like pregnant women and those with high exposure. Individuals can take action by staying informed, discussing vaccination with their doctors, and advocating for clear, equitable access to vaccines. By working together—government, providers, and citizens—we can protect lives, reduce the burden of Long COVID, and rebuild confidence in our public health system. We must seize this opportunity to unite around science and ensure a healthier, safer, and prosperous future for all Americans. Contact us at letters@

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