JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – April 23, 2026 – ACIP
The nominee, Dr. Erica Schwartz, has publicly supported immunizations and drawn applause from mainstream public health leaders.
“If Dr. Schwartz is confirmed, will you commit on the record today to implement whatever vaccine guidance she issues without interference?” Representative Raul Ruiz, Democrat of California, asked Mr. Kennedy during a tense hearing on Capitol Hill, the secretary’s fourth congressional hearing since last Thursday.
“I’m not going to make that kind of commitment,” Mr. Kennedy replied. In response to other questions from Dr. Ruiz, a physician, Mr. Kennedy said that he approved of Dr. Schwartz’s nomination and had spoken to her multiple times, but had not spoken directly to Mr. Trump about her selection.
During the hearing before the House Energy and Commerce Committee, Mr. Kennedy pushed back on Democrats’ assertions that he bore some responsibility for the measles outbreak in the United States, the worst the country has experienced in decades. He told members of the panel that the outbreak is global, that it started before he took office and that those who were sick were mostly 5 or older, which meant their parents had decided against vaccination before he was in office.” (1)
“Over the last 16 months, the Trump Administration has championed the Make America Healthy Again (MAHA) agenda open_in_new within HHS — with Secretary Robert F. Kennedy, Jr., leading the department. He was confirmed by the Senate and sworn in on Feb. 13, 2025, and has since worked to implement sweeping changes in the department and MAHA priorities (e.g., addressing chronic disease and childhood allergies, removing specific food dyes, and increasing transparency within the agency).
Significant changes within HHS over this period include the termination of 10,000+ employees via Reductions in Force and more departures via voluntary separation incentives. This has left many agencies and offices to adjust and impacted how state and territorial health departments collaborate new with partners at HHS agencies like CDC. Alongside these major ongoing changes (and more proposed) to the department are the appointments and alterations to HHS leadership by President Trump.”
“The flux within HHS — a side effect of the administration’s desired changes within the department — has had ongoing impacts on the process for issuing public health guidance, approving and altering vaccine recommendations, and more. Congress remains interested in understanding the impact of reforms occurring within HHS, including in hearings centered around agencies and nominees. ASTHO will continue to track changes within HHS as well as responses from legislators, and work to be a resource to Congress on best practices for public health.” (2)
1.Kennedy Refuses to Commit to Backing New C.D.C. Director on Vaccines, By Christina Jewett and Sheryl Gay Stolberg, https://www.nytimes.com/2026/04/21/us/politics/rfk-jr-vaccines-erica-schwartz.html?smid=nytcore-ios-share
2.Recent HHS Leadership Changes That Impact Public Health, April 20, 2026, by Catherine Murphy, https://www.astho.org/communications/blog/2026/recent-hhs-leadership-changes-impacting-public-health/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai