Yes, your allergies are getting worse
is a correspondent at Vox writing about climate change, energy policy, and science. He is also a regular contributor to the radio program Science Friday. Prior to Vox, he was a reporter for ClimateWire at E&E News.
The warming spring air is a welcome relief from the bitterly cold winter across much of the US, but millions of seasonal allergy sufferers are getting buried under a pollen tsunami, with sneezing, headaches, watery eyes, and stuffed sinuses sending them right back indoors.
Already, Atlanta has broken its pollen count record, with 14,801 grains per cubic meter spewing from pine, oak, and birch trees. Houston also reported its highest pollen counts since 2013, when records began.
Related Get ahead of allergy season this year
The Asthma and Allergy Foundation of America (AAFA) projects that 2025 will be yet another brutal year for seasonal allergies across the country, with the worst-afflicted cities in the southern US. Your red eyes and runny noses don't deceive you — seasonal allergies are getting worse, a miserable reality for nearly one in three US adults and one in four children.
Why? Sneezing and sniffles are some of the sirens of climate change. In fact, because of warming, pollen is now a nearly year-round menace in some parts of the US. Pollen, the main seasonal allergy trigger, is emerging earlier in the year, in higher concentrations, and lasting longer year after year. 'In the springtime, the first pollen allergens are from trees, and that is starting 20 days earlier than it did 30 years ago,' said Kenneth Mendez, CEO of AAFA. Rising concentrations of carbon dioxide in the atmosphere are directly inducing plants to produce more pollen while extending the temperature conditions that trigger pollen production in plants.
'We hear all the time, 'I've never had allergies before and now I suddenly feel like I have allergies,' or 'I feel like my allergies are getting a lot worse' and that's because the allergic load is that much higher because of climate change,' Mendez said.
For most people, seasonal allergies are an unpleasant nuisance. But with millions feeling blergh at the same time, it adds up to a huge economic burden in lost productivity. Asthma, allergic rhinitis — the condition you probably know of as hay fever — and related allergy conditions cost the economy billions of dollars each year in lost work days, medications, and doctor's visits.
There are also people for whom pollen is a more serious problem and can lead to dangerous complications or exacerbate other health issues. One study found that tree pollen allergies lead to 25,000 to 50,000 emergency room visits per year, two-thirds from people under the age of 18.
Over time, as pollen counts increase, more people with a higher sensitivity threshold are finding out the hard way that these tiny grains are a hazard. Other people are also finding out that doors and windows can't protect them as some of the tiniest pollen grains seep in.
'If the trendlines continue, I think more people are going to feel miserable from allergies,' Mendez said.
How we keep making allergies worse for ourselves
The problem for allergy sufferers is that their body's defense mechanisms sometimes overreact to something benign. Usually, it leads to mild, easily treatable symptoms. But allergens can also trigger more serious complications like asthma attacks, causing wheezing, chest tightness, and shortness of breath. In rare cases, they can lead to anaphylaxis, a whole-body reaction where the airways can swell shut and blood pressure drops to dangerously low levels.
The vast majority of pollen allergies are more annoying than dangerous, but seasonal pollen is so ubiquitous that it's almost impossible to avoid, sneaking indoors through vents, window seals, on clothing, and in pet fur.
Some people are more sensitive than others, but the relentless, growing exposure can add up to misery even for those with mild allergies. Pollen grains range in size from 100 down to less than 10 microns, allowing them to penetrate deep into the lungs and irritate airways. Many types of plants release pollen as part of their reproductive cycle. Generally, trees spread pollen in the spring, grasses over the summer, and ragweed in the autumn.
Airborne cloud of pine pollen from male pine cones in Arizona. Wild Horizons/Universal Images Group via Getty Images
However, the historical pollen timing patterns have already shifted.
Tree pollen is wafting off of branches earlier in the season almost every year. Some grass species have seen their pollen release days delayed by almost a month while their overall season has grown longer. As a result, grass pollen increasingly overlaps with the ragweed pollen season, which itself has been extended by more than three weeks in some parts of the country since 1995.
There are two key mechanisms driving this trend, both induced by humanity's appetite for fossil fuels. Increasing concentrations of carbon dioxide in the atmosphere from burning coal, oil, and natural gas directly induce many plant species to produce more pollen. Carbon dioxide can make plants grow bigger and faster, and produce more flowers, which leads to more pollen. More pollen leads to more seeds, which means even more plants spraying pollen the next season.
Higher levels of carbon dioxide in the atmosphere are also warming the planet and changing the climate. In general, that means warmer, shorter winters and earlier springs, which leads to longer growing seasons for plants. These trends will continue as global average temperatures go up, making allergies a significant public health burden.
Some parts of the country, such as Texas, are on track to see pollen counts almost double by 2050 compared to 2000.
It's not just pollen you have to worry about
For many people, allergies are an added complication on top of other health and environmental conditions. Air pollution from ozone, particulates, sulfur, and nitrogen compounds can cause their own breathing problems, but when they intersect with allergies, they can make symptoms even worse. Pollution from roads can make pollen from nearby plants more potent at triggering allergic reactions. Smoke from wildfires can also exacerbate allergies.
Cities may not offer much refuge. Changes to the landscape like urbanization can create a more favorable habitat for plants like ragweed. City centers also tend to warm up faster than their rural surroundings and experience higher concentrations of air pollutants, compounding the effects of allergies. These factors are especially potent in low-income and underserved communities.
Pollen isn't the only allergen changing with the climate either. Rising temperatures and precipitation in some areas are increasing the number and duration of allergenic mold spores. Extreme weather further worsens the problem, as the damage and destruction create conditions for more mold. That was evident in New Orleans last year as storms like Hurricane Francine soaked the city.
'When these storms come through, they create so much damage over the landscape of the state. Some communities have resources to immediately move in and repair roofs and patch windows, and then we have a lot of folks that simply don't have those resources. With leaking roofs, you have mold growth indoors,' said John Carlson, who leads the high-risk allergy division at the Ochsner health system in New Orleans. 'Because it's so warm here, we can grow mold year round as long as there's moisture.'
High winds from storms can also whip up dust, which can then trigger asthma. Additionally, there's a phenomenon called thunderstorm asthma, where the weather conditions can rupture pollen grains into smaller, more allergenic fragments, triggering asthma attacks.
It's not clear whether the overall number of people with seasonal allergies is increasing. The US may be approaching a plateau in the number of people who are susceptible to pollen, Carlson said. At the same time, there are other conditions that can present with allergy-like symptoms, and at high enough concentrations, even people without allergies will wheeze.
'In New Orleans, we have a ton of oak pollen — I mean, just so much oak pollen in the air — and you commonly have a lot of people who don't have oak pollen allergy nevertheless with itchy eyes and the sneezing from just the irritant effect of the particles,' Carlson said.
The good news is that there are ways to contain the worst effects of seasonal allergies. For people with a history of bothersome seasonal allergies, seeing an allergist and finding out what their specific triggers are and what medicines work is key. It may make sense to start taking medications like nose sprays or over-the-counter allergy drugs before pollen ramps up.
Related 4 tips for dealing with a ferocious allergy season
'We generally say to have your medications in your system close to two weeks ahead of time because it takes some time to build up,' Mendez said. For people who don't know if they have allergies but are concerned about the threat, pay attention to your symptoms and see an allergist if you do start to experience irritated eyes and airways. There are also more aggressive interventions for people with severe allergies who don't respond to other medicines like desensitization therapy, also known as allergy shots.
Some of the same measures for avoiding air pollution also work for pollen. Pay attention to pollen forecasts in your local area. Avoid being outside and close doors and windows during high pollen release times, particularly in the morning. Leave your coat and shoes outside or locked away before you settle down at home. Wipe down your dog after a walk. Use a HEPA air filter in your living spaces.
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Vox
18 hours ago
- Vox
The one drug RFK Jr. should actually ban
is a senior reporter for Vox's Future Perfect section, with a focus on animal welfare and the future of meat. Pigs fed ractopamine has been linked to their inability to stand up, difficulty breathing, and even death. It also carries a number of environmental and human health becoming secretary of the US Department of Health and Human Services and leader of the Make America Healthy Again movement, Robert F. Kennedy Jr. was a swashbuckling environmental attorney who regularly took aim at the meat industry. He sued large meat companies and the Environmental Protection Agency over water pollution from factory farms, and criticized factory farming for its 'unspeakable' animal cruelty and overreliance on feeding animals hormones and drugs. For over a decade, a group of food safety, environmental, and animal welfare nonprofits has petitioned the US Food and Drug Administration — which Kennedy now oversees — to ban the use of one of the most controversial of those drugs: ractopamine hydrochloride. Fed to pigs in the final weeks of their lives, ractopamine speeds up muscle gain so that pork producers can squeeze more profit from each animal. But the drug has been linked to severe adverse events in pigs, including trembling, reluctance to move, collapse, inability to stand up, hoof disorders, difficulty breathing, and even death. It also carries a number of environmental and human health concerns. Earlier this year, the FDA denied the petition to ban the drug, arguing that current regulations ensure a 'reasonable certainty of no harm to consumers.' While the agency doesn't dispute that ractopamine can harm animals, and it halved the maximum dose in pigs in 2006, it has argued welfare issues can be mitigated by simply asking meat producers to handle ractopamine-fed animals more carefully — a response that the petitioning organizations called 'toothless.' This story was first featured in the Processing Meat newsletter Sign up here for Future Perfect's biweekly newsletter from Marina Bolotnikova and Kenny Torrella, exploring how the meat and dairy industries shape our health, politics, culture, environment, and more. Have questions or comments on this newsletter? Email us at futureperfect@ The FDA didn't respond to a request for comment in time for publication. Elanco, the pharmaceutical company that developed ractopamine, didn't respond to an interview request for this story. While 26 countries have approved ractopamine use in livestock, more than 165 have banned or restricted it, and many have set restrictions on or have altogether prohibited the import of pork and beef from ractopamine-fed animals — actions that have set off trade disputes. The bans stem primarily from concerns that the trace amounts of the drug found in meat could harm consumers, especially those with cardiovascular conditions, since ractopamine belongs to a class of drugs (beta-agonists) that can increase people's heart rates. There's only been one tiny study on ractopamine in humans who took the drug directly, which European regulators — prone to taking a precautionary approach with new food additives — say is insufficient to prove its safety. Chinese scientists are concerned about the drug because its residues concentrate at higher rates in pigs' organs, which are more commonly consumed in Chinese diets. The heated international debate led one team of biotechnology researchers to call ractopamine 'the most controversial food additive in the world.' An inflatable pig has the words 'I am a ractopamine pig' written on it during a march in Taipei, Taiwan, in November 2020, as thousands demand the reversal of a decision to allow US pork imports into the country, citing food safety issues. Chiang Ying-ying/Associated Press Daniel Waltz, managing attorney of the Animal Legal Defense Fund — one of the organizations petitioning the FDA to ban ractopamine — told me it seems like just the kind of thing Kennedy would want to prohibit. 'So why isn't the FDA jumping at the opportunity to do something about ractopamine?' Waltz said. Kennedy and the broader MAHA movement have long elevated fears over pharmaceuticals and food chemicals, and it can sometimes be difficult to parse their valid concerns from their dangerous conspiracy theories. But he doesn't appear to have ever publicly criticized ractopamine, and it's unknown whether it's even on his radar. Given the lack of trials, ractopamine's threat to human health is unclear, and reasonable people can disagree on how government agencies should handle it. But there's a clear case to be made that ractopamine ought to be banned because of its awful effects on animals. The FDA's decision to continue to allow it in meat production represents a missed opportunity to challenge the factory farm system that Kennedy has long railed against, and to ban a chemical that no one — except the industry — really wants. Related Why Big Pharma wants you to eat more meat 'Ractopamine divides the world' There's ample real-world evidence that ractopamine can be terrible for pigs. Over an 11-year period, the FDA received reports that over 218,000 pigs fed ractopamine suffered adverse events, like trembling, an inability to stand up, hoof disorders, and difficulty breathing. That's a relatively small share of the billion or so pigs raised and slaughtered for meat during that time period, but the number only includes adverse events reported to the FDA — many more could've occurred without being reported. The next most reported drug had a little over 32,738 cases spanning 24 years. The FDA has said that reports of adverse events don't establish that the drug caused the effects — essentially that it's correlation, not proof of causation. But shortly after the drug came onto market, the FDA also received reports of an uptick in ractopamine-fed pigs unable to stand or walk at slaughterhouses. Some studies, including a couple conducted by the drugmaker — Elanco — have shown that ractopamine is associated with a number of issues in pigs, including hoof lesions, fatigue, increased aggression, and metabolic stress. Over the years, Elanco has added warning labels that ractopamine-fed pigs are at an increased risk of fatigue and inability to walk. A 'downer pig' — a pig unable to walk or stand — is dragged at a slaughterhouse that supplies to Hormel. When ractopamine first came onto the market, the FDA received reports of an uptick in ractopamine-fed pigs unable to stand or walk at slaughterhouses. Animal Outlook At the same time, a literature review by Elanco employees and university researchers looking at ractopamine studies found it had minimal effect on pig mortality, inconsistent effects on aggression and acute stress, and mixed results on a number of physiological responses, like cortisol and heart rate, with some research showing little to no effects, and others showing moderate effects. The size of the dose — and how workers handle the animals — were often important factors. Elanco has updated its label to clarify that there's no benefit to feeding pigs more than the lowest dose. There's also some evidence to suggest ractopamine negatively impacts the welfare of cattle, some of whom are fed the drug. Even more than concerns over animal welfare, the uncertainty over ractopamine's effect on consumers' health has courted international controversy. Those concerns have led to countries rejecting shipments of US pork and beef; Taiwanese lawmakers throwing pig intestines at one another and mass protests in a dispute over the country's decision to allow US pork imports from ractopamine-fed pigs; and a highly contentious, multiyear debate at the United Nations-run Codex Alimentarius Commission, which sets food standards important for international trade. By the late 2000s, numerous countries had restricted imports of meat from ractopamine-fed animals, which posed a financial threat to the US meat industry. So the US Department of Agriculture spent five years advocating for the Codex commission to approve maximum residue levels of ractopamine in beef and pork as safe, which would give the US more legal leverage to challenge other countries' import bans. The commission's fight over ractopamine was 'really, really ugly,' Michael Hansen, a senior scientist at Consumers Union — the publisher of Consumer Reports — who attended commission meetings, told me. European Union officials argued there wasn't enough data to ensure consumers would be safe from ingesting trace amounts of ractopamine. While the drug had been tested on various animal species, only one human clinical trial had been conducted in 1994, which included just six healthy young men taking the drug, one of whom dropped out after complaints that his heart was pounding. Related The myths we tell ourselves about American farming In response to the trial, an FDA official at the time stated that 'the data from this study do not provide adequate assurance that the expected ractopamine levels in meat products will be without cardiovascular pharmacological effects in man.' In 2012, the UN commission narrowly voted to set maximum safe ractopamine residue levels in beef and pork by a margin of just two votes — an unusual outcome for a commission that historically ran on consensus. China and EU representatives, Hansen told me, were furious. US meat industry groups and the USDA secretary at the time, Tom Vilsack, cheered the decision. Writing about the commission fight, trade lawyer Michael Burkard wrote that ractopamine 'divides the world.' However, ractopamine remains controversial and the subject of trade disputes; just last year, China blocked shipments of US beef that contained traces of the drug. Make animals suffer less The fight over ractopamine is a microcosm of a broader problem in the meat industry: The government's reluctance to regulate it. Over the last century, meat companies have transformed how animals are raised for food. They've packed animals into crowded, sprawling warehouses; bred them to grow bigger and faster to the detriment of their welfare; stored vast amounts of their manure in open-air lagoons that leach into the environment; and designed complex drug regimens to keep them alive in unsanitary conditions or, like in the case of ractopamine, make a little more money off each animal. Whenever consumers and advocacy groups raise concerns over the problems factory farming has created, more often than not, a government agency tasked with regulating it takes action to defend the meat industry, not reform it.
Vox
a day ago
- Vox
The moms trying to delay their daughters' periods
is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of four novels, including the forthcoming Bog Queen, which you can preorder here This story originally appeared in Kids Today, Vox's newsletter about kids, for everyone. Sign up here for future editions. Getting your first period can be one of the most fraught experiences of adolescence. It can be exciting, scary, painful, messy, embarrassing, or all of the above. And though the adults in your life can help you prepare for and understand what's happening, they can't do much to predict or control it when it does. Except that now, some parents are trying to take a more active role. 'Delaying my daughter's first period is a goal I have in motherhood,' wrote Nicky Skinner, a nurse and health coach, on Instagram last month. Skinner has been concerned for years about the effects of certain chemicals on girls' puberty, she told me in an email. Now that she's a mom to a 4- and 7-year-old, she's working to eliminate those chemicals from their lives. Her post, which got more than 70,000 likes, is one of a few offering tips on pushing back the onset of menstruation (also called menarche), often involving changes to diet, personal care products, and even screen time. The parents involved are responding to a nationwide trend: The average age of menarche in the US has shifted earlier, from 12.5 between 1950 and 1969 to 11.9 between 2000 and 2005, according to a 2024 study. The percentage of kids who get their first period before age 9 is also on the rise, more than doubling between the 1950s and the 2000s. Researchers are concerned about these trends because getting a first period earlier is associated with an increased risk of some health conditions, including breast cancer. Even Health and Human Services Secretary Robert F. Kennedy Jr. has weighed in on the matter, claiming in an April appearance on Fox News that 'girls are hitting puberty six years early.' He appeared to link the issue to children's diets, arguing that 'the food our kids are eating today is not really food.' But experts say the shift toward earlier periods likely stems from a variety of factors, including increased nutrition, higher body weight, stress, and environmental influences. Researchers are particularly concerned about the impact of chemicals called endocrine disruptors, which can mimic the activity of hormones in the body, said Shruthi Mahalingaiah, a professor of environmental, reproductive, and women's health at Harvard University. These chemicals include phthalates, which can be present in shampoos, lotions, and other common products. Some experts say it makes sense for parents to try to limit kids' exposure to endocrine disruptors, but it's impossible to avoid these compounds completely. And some say that expecting families to reverse a large-scale health trend — especially one involving something as intimate as menstruation — forces parents to become hypervigilant and could even put their kids at risk of eating disorders. 'I definitely don't think that it should be on individual parents to save their daughters from this possibly overblown idea of early menarche being a problem,' Christy Harrison, a registered dietitian and host of the podcast Rethinking Wellness, told me. Why earlier periods could be a problem Experts are worried about the shift toward earlier menstruation because an earlier age at first period is linked with a variety of health risks, including cardiovascular disease and several reproductive cancers. Some research also suggests an increased risk of anxiety and depression, Roopa Kanakatti Shankar, a pediatric endocrinologist at Children's National Hospital in Washington, DC, told me. Getting a period at a younger age than their peers can also be stressful for kids. 'Physically, they are reaching an adult-like state, but the cognitive development is still ongoing,' Shankar said. Managing the mechanics of pads, tampons, and tracking your cycle can be more difficult for younger kids, Mahalingaiah said (honestly, it remains a challenge for some adults). Younger children may have a harder time handling the mood shifts that can come with the menstrual cycle, Shankar said. Girls who go through puberty earlier are also more likely to experience sexual harassment, according to some research. For these reasons (and others), creators like Skinner, who lives in New Zealand, are taking matters into their own hands. 'The idea of delaying my daughter's first period (menarche) as long as naturally possible isn't about artificially controlling or fearing puberty — it's about supporting long-term health and well-being in the face of modern environmental stressors,' she writes in her Instagram post, inviting readers to comment 'DAUGHTER hormone support checklist' to learn more. Skinner also offers a variety of health coaching and 'low tox' education services. Skinner clarified to me that 'it's not about 'delaying' their period,' but rather 'creating an environment for them that doesn't bring it on prematurely.' For her, that includes 'eliminating personal care products with synthetic fragrance chemicals as well as swapping to glass and stainless steel in the kitchen in place of plastic.' She also focuses on feeding her kids 'whole, real, and homemade food' about 80 percent of the time. Bec Kinderman, a mom of four and homebirth advocate living in Australia, posted a similar message in April: 'Let's normalize pre teen girls being young, enjoying playgrounds and slowing down the onset of puberty.' Kinderman, who did not respond to Vox's request for comment, goes on to advise that parents choose whole foods over 'convenience foods' that are 'loaded up on seed oils and artificial ingredients.' 'While as parents we can't control everything in our child's environment & their life experiences & circumstances, there are things we can do to try to minimize these concerns,' Kinderman writes, in a post that received over 60,000 likes. 'I will be daring and say that household toxins and diet are NUMBER ONE.' Can parents control kids' periods? Several experts told me it's reasonable for parents to try to limit endocrine-disrupting chemicals in their homes, such as by avoiding unnecessary fragrances or choosing safer cleaning products. 'If you have the knowledge that you have a product that has these endocrine disruptors, and there is an alternative, to me it is reasonable to choose the one that doesn't,' Aviva Sopher, a pediatric endocrinologist at Columbia University, told me. However, Sopher said, it's impossible to completely avoid these chemicals because they also occur outside the home, such as in products used on lawns and gardens. Products made without phthalates and other endocrine disruptors can also be more costly, making it harder for lower-income families to avoid them, Sopher added. Meanwhile, trying to influence the timing of a child's period through diet could have unintended consequences, some say. 'One of the biggest problems that can cause delayed menarche is disordered eating,' Harrison said. Indeed, a very late first period, like a very early one, is associated with health risks, possibly because of links with eating disorders, Shankar said. 'I worry that the goal of delaying girls' periods unintentionally encourages restricting their eating, and also potentially masks the signs of disordered eating,' Harrison said. Banning all processed foods from the home could also backfire. Kids who never have access to such foods often binge when they do encounter them, Harrison said. 'I see that so often in kids who are restricted and deprived of sugar or snack foods, where they end up going to friends' houses and just like staying around the snack drawer the whole time.' Skinner agrees there's a risk of children developing eating disorders 'if parents are too fanatical about ONLY eating 'good' foods,' but says her 80–20 approach does not carry such a risk. 'In our home we don't demonize ANY food groups. We talk about how food makes them feel.' She doesn't want concern about eating disorders to become an 'excuse' for parents 'not to take ownership for their role' — which, she says, 'is to set their child up for the best chance of a healthful life.' Others, however, say that placing the onus on families to prevent early menarche puts an 'unfair blame and shame on parents, and especially moms,' who are still disproportionately in charge of what kids eat, Harrison said. Scientists still aren't sure what role endocrine disruptors play in early puberty, and they are difficult to study, even for professionals because they can occur in extremely low amounts that may or may not add up over time, Shankar said. Parents who are concerned that their daughters are going through early puberty — defined as breast development beginning before age 8 — should consult a doctor, Shankar said. On a societal level, we need more research into environmental influences on puberty, including endocrine disruptors, she added. Changes to public policy could also encourage companies 'to be more aware and more sensitive about what they're putting into the products that we're all using,' Sopher said. Stricter laws around air and water quality could be another way to address environmental factors along with 'environmental justice regulations that keep certain groups from being disproportionately impacted by pollution,' Harrison said. (Despite Kennedy's stated concern about earlier puberty, the Trump administration has actually rolled back dozens of laws around clean air and water.) 'To the extent that things in our environment are affecting this trend, it's on politicians and society,' Harrison said. 'At the collective level, we need to make these changes, not put it on the individual.' What I'm reading Gun deaths of children rose in states that loosened gun laws after a 2010 Supreme Court decision, according to a new study. In states that kept restrictions in place, deaths remained flat or even decreased. An 11th-grade New York City student was detained by immigration authorities at an asylum hearing last week, school officials said. Just 45 percent of 7th–12th graders saw college as their most likely next step after high school in 2024, down from 73 percent in 2018, according to a new survey. My older kid and I have discovered the Area 51 Files series, about a middle-schooler forced to relocate to a top-secret base full of aliens. I especially enjoy the character of Elvis, an alien who looks like a human kid — but only because our human brains cannot comprehend his true appearance. From my inbox A few weeks ago, I wrote about kids' hopes and dreams for the future. We got some responses we weren't able to include in the final story, and one of my favorites came from a 15-year-old, who hopes to become a mechanic and create a new car 'that can save the world (somehow).' As a millennial, I am constantly disappointed by the lack of flying cars, and I look forward to the lifesaving variety. As always, you can reach me with questions or story ideas at
Vox
2 days ago
- Vox
RFK Jr.‘s mass firing of the government's vaccine experts, explained
covers health for Vox, guiding readers through the emerging opportunities and challenges in improving our health. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo, and STAT before joining Vox in 2017. For the past 60 years, a committee of independent experts has advised the federal government on vaccine policy, providing guidance on which shots people should get and when. Government public health officials have almost always followed the panel's recommendations, all but making it the final word on public health policy in the US for most of its existence. And over those decades, the United States has made tremendous health gains over that time through mass vaccination campaigns. But on Monday, Health Secretary Robert F. Kennedy Jr. fired every sitting member of the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP), a move that stunned doctors and scientists across the country. And it means that the CDC's days as the clear and unchallenged authority on US vaccine policy appear numbered. 'Up until today, ACIP recommendations were the gold standard for what insurers should pay for, what providers should recommend, and what the public should look to,' Noel Brewer, a health behavior professor at the University of North Carolina, who was a member of the panel until this week, told the Associated Press. 'It's unclear what the future holds.' Today, Explained Understand the world with a daily explainer plus the most compelling stories of the day, compiled by news editor Sean Collins. Email (required) Sign Up By submitting your email, you agree to our Terms and Privacy Notice . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. New committee members will be announced at some point, but as of Tuesday morning, even top US senators did not know who the replacements would be. The panel is supposed to hold one of its periodic public meetings in late June to discuss the Covid-19 vaccine, as well as shots for RSV and HPV, among others. This is a watershed moment in US public health, one that seems sure to sow confusion among patients and health care providers. The deepening divide between Kennedy's Make American Healthy Again (MAHA) movement and mainstream medicine could make it harder for people who want vaccines to get them, while encouraging more doubt about the value and safety of shots among the general public. Here's what you need to know. Why is Kennedy doing this? The vaccine advisory committee was first convened by the surgeon general in 1964, but it is not enshrined in federal law. That means that Kennedy — as the top official at the US Department of Health and Human Services, which contains the CDC — can change its membership or dissolve the panel entirely if he so desires. Kennedy framed his decision to clear out the members as necessary to restore public trust in the government's vaccine recommendations. In a Wall Street Journal op-ed, Kennedy asserted the committee 'has been plagued with persistent conflicts of interest and has become little more than a rubber stamp for any vaccine.' As health secretary, he has made overhauling vaccine policy a centerpiece of his agenda, both through his rhetoric and policy. Over the past few months, while the worst measles outbreak in 30 years has spread through the US, Kennedy has equivocated in public comments on the value of the measles vaccine, which doctors say is far and away the best tool to combat the disease. He directed an anti-vaccine researcher to scour federal data for evidence of a vaccine-autism link. His department's recent MAHA report on childhood chronic disease named vaccines as one example of how the US overmedicalizes its children and exposes them to artificial agents that could do harm to their body. Then in late May, Kennedy oversaw a revision of the federal government's Covid-19 vaccine guidance, limiting the shots to elderly people and those who are immunocompromised. He ended the recommendation that pregnant women and kids get a Covid vaccine shot, even though studies have shown they help confer immunity to infants, who are at a higher risk from the virus and cannot be vaccinated until they are 6 months old. The move plainly circumvented ACIP's accepted role in setting vaccine policy, presaging this week's mass firing. Whatever his intentions, Kennedy's gutting of the federal vaccine committee seems likely to sow even more distrust — and certainly more confusion. People are reasonably left to wonder whether they can trust forthcoming CDC guidance on vaccines, and just what vaccines they'll be able to get. How will I know which vaccines to get? In the past, ACIP would typically meet a few times a year to discuss any additions or changes to the country's vaccine schedule. Their recommendations have usually been adopted without alterations by the CDC director, and then became the standard for state and local health departments across the country. Importantly, most health plans are required to cover any shots that the committee recommends. Now there is far more uncertainty. Will doctors follow the CDC guidance, even if it changes under a new advisory panel staffed by Kennedy loyalists, or will they stick with the earlier vaccine schedule? Will health insurance plans cover the cost of a vaccine that professional medical organizations support but the CDC does not? Once-unthinkable questions could soon be something doctors and patients must deal with every day. Some doctors already believed, before the firings at ACIP, that the CDC was no longer trustworthy under Kennedy's leadership; his unilateral change to the Covid vaccine guidance in May was enough to convince them. In a media call last week, experts from the Infectious Disease Society of America urged patients and providers in the short term to consult with professional medical societies — not the CDC — on vaccine recommendations. They considered those groups, as well as guidance from European health authorities, the best substitutes we currently have for information on vaccines if the CDC's recommendations can no longer be taken at face value. 'It's been a confusing several days, confusing last two weeks, and I'm not sure that confusion is going to be abated in the near future,' John Lynch, an infectious disease doctor at the University of Washington, said on the call. 'These are evidence-based guidelines developed by experts in the field using transparent methods and published publicly,' Lynch said. Kennedy, in explaining his change to the Covid vaccine guidelines, said he wanted to encourage shared decision-making between providers and their patients. The CDC guidance would be only one consideration in the decision whether to vaccinate, rather than a firm recommendation. The doctors from the IDSA said that such conversations are already to be considered best practice among physicians — and noted Kennedy's undermining of trust in the federal vaccine policy would now make them more important. 'I would just emphasize the need to have a good source of information when this situation occurs. If indeed shared decision making is going to occur, we always do our research,' Dr. Flor Muñoz-Rivas at Baylor College of Medicine said. 'But go to the proper sources.' What are the long-term risks? There is a lot we don't know right now: Who will be named to the new panel? Will they change existing vaccine recommendations? Will they approve new ones? But the experts warned that Kennedy's rhetoric alone risks undermining people's confidence in vaccinations. 'All health care decisions are shared decision-making; this is not a special concept that's only rolled out for conversations like vaccination,' Lynch said on the IDSA call. 'As an infectious disease doctor, when I talk to a patient about treatment or diagnostics, it is a conversation. It is shared decision-making.' Kennedy has quickly disrupted decades of public health consensus. Anyone who watched the sometimes contentious ACIP meetings during the pandemic saw the members grappling with genuinely vexing questions about who should be prioritized for vaccination in a public health emergency. The pandemic featured rare examples of Biden CDC director Rochelle Walensky overruling the panel in certain cases in which the experts actually recommended against more vaccinations. (Walensky said she overrode the guidance to align the CDC with a separate recommendation from the FDA's advisory committee, and cited the narrow 9-6 vote against the recommendation.) Those scenes should have helped dispel the notion that they were acting as a rubber-stamp for any new shot Big Pharma produced. But the nation's top health official is now telling Americans that they should never have trusted the ACIP, which risks pushing more people to skip routine immunization. Shortly after the country declared measles eradicated in 2000, 94 percent of adults said childhood immunizations were extremely or very important. But that consensus has since weakened: 69 percent of Americans said the same in 2024. If changing opinion leads to declining vaccination rates, diseases that we successfully stamped out through vaccines to rebound — which is exactly what we are seeing now with measles. The US is experiencing its highest number of measles cases since the 1990s, nearing 1,200 as of this writing. One outbreak that accounts for most of those cases took off in a small Texas community where vaccination rates had fallen far below the 95-percent threshold that is considered necessary to stop the virus's spread. Other knock on effects could hurt Americans who still want to get vaccinated. Pharma companies, the target of so much of Kennedy's criticism, could decide to stop pursuing new vaccines if they believe the federal government will limit access as much as possible, shrinking the world's biggest pharmaceutical market. Vaccines are not big moneymakers for drug companies, and they have often relied on the US government's support to develop new ones. Kennedy, however, has canceled major vaccine development contracts during his first few months as health secretary, including a $700 million contract with Moderna, one of two companies that produced the mRNA Covid vaccines, to work on a universal flu shot. Kennedy has quickly disrupted decades of public health consensus. For now, the best reaction is, oddly enough, for patients and providers to take him at his word when he says people should not take medical advice from him — and make their own decisions in collaboration with their doctors.
