The Vaccine Intelligence Report: February 25-March 3

The Vaccine Intelligence Report—brought to you by Vaccinate Your Family—provides clear, fact-based updates on vaccine policy, research, and public health each week. This report is part of Viral Truths, a resource designed to cut through the noise, offering concise information to help navigate the evolving immunization landscape.

THIS WEEK AT A GLANCE

  • HHS announced agenda items for ACIP’s March meeting, which will include Covid vaccine injuries and Long Covid, as well as two new committee members
  • The Senate HELP Committee held a hearing for Surgeon General nominee Casey Means, who face questions regarding vaccines, and her path to confirmation remains unclear
  • Strong public support for immunization requirements contrasts with calls from some MAHA allies for more aggressive action, underscoring the issue’s political sensitivity ahead of the midterms
  • The WHO announced its recommendation for 2026-27 flu vaccine strains after its annual meeting, which the U.S. participated in despite officially withdrawing from the organization in January
  • The status of a planned study on hepatitis B vaccination in newborns in Guinea-Bissau is unclear following conflicting reports about whether the project was canceled or suspended pending further review
  • A GAO report found that nearly $900 million in HHS funding for preparedness lacks coordinated oversight, which could hamper response to health threats and impact to ensure consistent vaccine delivery and surveillance
  • Arizona and Florida advanced proposals to roll back vaccine requirements, while the Washington legislature passed a bill to decouple state vaccine coverage from ACIP
  • Measles continues to spread across the U.S., raising economic concerns and leading Acting CDC Director Bhattacharya to endorse the MMR vaccine
  • Hepatitis B vaccination of newborns has declined significantly in the last two years, prompting concerns about potential increases in infection among children, particularly in light of the CDC’s decision to end the longstanding universal birth dose recommendation

NEED TO KNOW

HHS Announces Agenda Items for March ACIP Meeting and Two New Committee Members

  • The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) is slated to discuss Covid vaccine injuries and Long Covid during its upcoming March meeting, per a Federal Register notice (Feb. 25).
    • ACIP is responsible for developing recommendations on the use of vaccines in the U.S., which the CDC uses as the basis for the recommended childhood and adult immunization schedules.
    • Notably, vaccine injuries fall under the purview of other federal agencies/committees and are not directly within ACIP’s remit, according to vaccine policy expert Dorit Reiss. The panel considers risks as part of its immunization recommendations, and new risks may lead ACIP to change its recommendations. See this week’s Reality Check below for more.
    • However, there is no evidence of new safety concerns associated with Covid vaccines. A recent evidence review found that Covid vaccination has shown “consistent effectiveness and safety” and significantly reduces the risk of severe disease and hospitalization across populations.
  • Under Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., the ACIP has narrowed its Covid vaccine recommendation, and the panel may vote to further refine its recommendation.
    • In September, ACIP voted to remove the broad recommendation for Covid vaccination and instead adopt shared clinical decision-making (SCDM)—meaning vaccination decisions are made in consultation with a healthcare provider based on individual risk factors.
    • Kennedy had previously ended the CDC’s recommendation for Covid vaccination of healthy children and pregnant women.
    • The changes prompted significant pushback. Major medical organizations, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians & Gynecologists (ACOG), continue to recommend Covid vaccination.
  • The committee will also discuss “ACIP recommendation methodology,” which could signal potential changes to how evidence is weighed, how recommendations are categorized (e.g., routine, SCDM), or how broader policy considerations are incorporated into decision-making.
    • ACIP has historically used a structured, evidence-based method to develop vaccine recommendations. This includes reviewing clinical trial and post-licensure safety and effectiveness data, assessing disease burden, evaluating benefits and risks across populations, and considering implementation factors such as feasibility.
  • Kennedy announced (Feb. 27) the appointment of two new ACIP members: Dr. Sean Downing, a primary care physician, and Dr. Angelina Farella, a pediatrician. Farella has previously criticized Covid vaccines and called for their removal from the market.
  • The committee now has 15 voting members (including Chair Dr. Kirk Milhoan), all of whom have been appointed since June 2025, when Kennedy fired all 17 sitting members.

Surgeon General Nominee Casey Means Pressed on Vaccines, Qualifications at HELP Hearing

  • Last week (Feb. 25), the Senate Health, Education, Labor and Pensions (HELP) Committee held a confirmation hearing for Casey Means, MD—President Trump’s nominee for U.S. Surgeon General.
    • Means attended Stanford medical school but left her surgical residency program in 2018. She has since become a wellness influencer and prominent voice in the “Make American Healthy Again” (MAHA) movement.
  • To date, the position of Surgeon General has always been held by a practicing, actively licensed physician with substantial clinical experience. Means does not hold an active medical license, did not complete her residency, and confirmed she does not plan to reactivate her license because she does not intend to treat patients.
  • While Means focused her opening remarks on what she described as a national “chronic disease crisis,” much of the hearing centered on vaccines. Key exchanges included:
    • On childhood vaccines, Means said that “vaccines save lives,” and that she supports CDC guidance, but declined to directly urge parents to vaccinate their children against measles, influenza (flu), or pertussis (whooping cough)—instead emphasizing SCDM between parents and physicians.
    • When asked about long de-bunked claims tying vaccines to autism, Means said she accepts evidence showing they are not implicated but added that “science is never settled” and that “we do not know what causes autism.”
    • After repeated questioning on whether she believes the flu vaccine reduces serious illness and death, Means said she thought flu shots could reduce hospitalization “at the population level.”
    • Regarding the hepatitis B birth dose, Means conceded that the vaccine was “important” and “lifesaving,” but declined to clearly endorse universal vaccination at birth, stating that universal vaccination “at some point during childhood” is a “worthy goal.”
  • Means stated that vaccines are “not the core” of her message and she does not intend to “complicate” vaccine policy if confirmed. However, several senators underscored that the Surgeon General plays a central role in national health messaging during outbreaks and public health emergencies, with HELP Committee Chair Dr. Bill Cassidy (R-LA) pointing to the recent measles outbreak and the country’s pending loss of its measles elimination status.
  • Means currently faces a narrow path to confirmation. While Democrats on the committee signaled expected opposition, several Republicans pressed her on vaccines and have yet to commit to supporting Means’ nomination.
  • The committee has not yet scheduled a final vote. If advanced, the nomination would proceed to the full Senate, where Republican control gives Means a plausible—though not guaranteed—path to confirmation.

Administration Faces Competing Pressures on Vaccine Policy 

  • Recent polling shows that Americans largely support vaccines and immunization requirements and that over half of respondents viewed Kennedy unfavorably, indicating there may not be broad support for the administration’s immunization policy changes.
    • 3 in 4 respondents said the government should require children to be vaccinated to attend school, and less than a third supported reducing the number of vaccines recommended for children.
  • There are indications that the administration may be recalibrating its approach to vaccine policy ahead of November midterms.
    • A February memo from MAHA Action President Tony Lyons to Republican strategists similarly acknowledged political risk, highlighting commissioned polling results showing that “breaking up” the children’s immunization schedule was the least popular of 11 health policies surveyed.
    • The MAHA Action memo recommended reframing such discussions around “medical freedom” and “parental choice,” rather than direct criticism of vaccines.
    • In recent months, Kennedy has shifted his public focus to food policy, which Lyons encouraged, and has largely avoided vaccine-specific messaging.
    • Leadership changes at HHS have also included the departure of more vaccine-skeptical senior officials and the elevation of staff focused on food policy and drug pricing.
      • Kennedy allies with a history of anti-vaccine advocacy remain at HHS. For example, Stuart Burns, is a senior advisor in the Office of the CDC Director and has played a key role in shaping the administration’s immunization agenda.
  • At the same time, some MAHA allies have grown increasingly critical of the administration, arguing it has not gone far enough in reshaping federal vaccine policy.
    • The Food and Drug Administration’s (FDA) decision to reverse course on reviewing the Moderna messenger RNA (mRNA) flu shot has been called “a betrayal of the base.” The reversal followed a meeting between President Trump and FDA Commissioner Dr. Marty Makary, during which the president reportedly expressed frustration over the agency’s handling of vaccine issues. Makary has since defended the FDA’s actions.
    • There has also been tension between the FDA and MAHA allies, including among members of ACIP. Vice Chair Dr. Robert Malone has advocated for revoking Covid vaccine licenses altogether and has accused Makary of blocking such efforts.
  • The developments highlight the continued political sensitivity of vaccine policy heading into the midterm cycle.

WHO Sets 2026-27 Flu Vaccine Strains; U.S. Remains Engaged Despite Withdrawal

  • The World Health Organization (WHO) announced (Feb. 27) its recommendation on which flu virus strains should be included in vaccines for the 2026-2027 Northern Hemisphere flu season, following a four-day meeting to review global surveillance data.
    • Flu vaccines are updated annually to match evolving viruses, and the WHO’s recommendations help guide regulators and manufacturers worldwide in formulating vaccines that match currently circulating strains as closely as possible.
    • Seasonal influenza impacts millions in the U.S. each year: during the 2024-2025 season alone, there were approximately 51 million illnesses, 710,000 hospitalizations, and 45,000 deaths. Vaccination remains the most effective tool to reduce severe illness.
  • The decision was shaped largely by the rapid global spread of a new influenza A(H3N2) variant—known as subclade K—that emerged in August 2025 and contributed to a more severe flu season in many countries, including the U.S.
  • Notably, this year’s meeting took place after the U.S. formally withdrew from the WHO in January, raising questions about U.S. participation. However, earlier this month the administration confirmed CDC staff would participate virtually to share surveillance data and technical expertise, while maintaining its position on withdrawal.
  • The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) is scheduled to meet on Mar. 12 to advise on the strains for U.S.-licensed vaccines before the FDA makes the final selection.
    • Because flu vaccine production takes several months, continued coordination across global surveillance networks, regulators, and manufacturers is essential to ensuring doses are ready in time for the upcoming season.

Future of Controversial Hepatitis B Vaccine Study Remains Uncertain

  • The status of a CDC-funded controversial hepatitis B newborn immunization study in Guinea-Bissau remains unclear amid conflicting statements from government officials. Some reports indicate the study has been canceled after the country’s Foreign Minister, João Bernardo Vieira, stated (Feb. 18), “It’s not going to happen, period.”
    • Funded by the CDC, Danish researchers had planned to conduct a randomized controlled trial involving 14,500 infants. Half would receive a hepatitis B vaccine at birth, while vaccination would be withheld from the control group. Researchers intended to monitor early-life mortality, illness, and developmental outcomes.
  • However, Africa Centres for Disease Control and Prevention (Africa CDC) Director General Dr. Jean Kaseya said (Feb. 26) the trial had not been canceled but remained under review: “For now, the official position of Guinea-Bissau that was shared with me is the study is suspended.”
    • The study was initially suspended in January pending further review by Guinea-Bissau authorities. In a letter to Kaseya, government officials stated they plan to continue reviewing the study protocol and will issue a final decision on whether the trial can proceed.
  • The $1.6 million CDC grant supporting the study has drawn significant criticism. Experts have raised concerns about the grant award process, the researchers’ credibility, the study’s scientific design, and its ethical implications.
    • The WHO condemned the trial last month, stating it would “[expose] newborns to serious and potentially irreversible harm.” The WHO, like the AAP, recommends all babies receive the hepatitis B vaccine within 24 hours of birth.
  • Most recently, an investigation into the study’s approval process raised additional concerns about the adequacy of scientific and ethical review within both the CDC and Guinea-Bissau.
    • Lyn Redwood—former leader of Children’s Health Defense (CHD), the anti-vaccine group founded by Kennedy, and later hired as an expert at HHS—and Stuart Burns reportedly helped secure funding for the Danish researchers. Burns, who has a history of anti-vaccine efforts, said that the grant was a “funding priority for CDC/HHS.”

GAO Finds Gaps in Oversight of $900M in HHS Preparedness Funding

  • A new Government Accountability Office (GAO) report found that nearly $900 million in annual HHS preparedness funding lacks coordinated oversight, raising concerns about the nation’s readiness for future public health emergencies—including large-scale vaccine distribution efforts.
    • The report examines two major programs—the CDC’s Public Health Emergency Preparedness (PHEP) program and ASPR’s Hospital Preparedness Program (HPP)—which together distributed about $900 million in FY2024 to support state and local emergency response capacity.
    • GAO found HHS does not have a formal mechanism to coordinate the two programs or to comprehensively assess preparedness across jurisdictions.
  • The report suggests that HHS cannot fully assess whether states and hospitals are collectively prepared for large-scale outbreaks or other emergencies.
    • The lack of coordinated oversight could also complicate efforts to ensure consistent vaccine delivery, surveillance, and response capacity nationwide.
  • GAO issued recommendations aimed at improving coordination and establishing clearer oversight mechanisms across the two programs. HHS concurred with the recommendations, signaling potential steps toward more integrated preparedness planning going forward.

STATE POLICY SPOTLIGHT

Arizona, Florida Advance Bills to Roll Back Immunization Requirements

  • In Arizona, the House passed HCR 2056, a state constitutional amendment—which would require a vote by the public—that would make it illegal for the government to require any medical products or treatments, including vaccines, as a condition of education, employment, or entry to a public space.
    • The bill now moves to the Senate. If passed, it could not be vetoed by the Governor, and voters would decide whether to enshrine the bill as constitutional law in November.
  • In Florida, a bill (SB 1756) that would expand exemptions from child immunization requirements now heads to the full Senate after passing both the Senate Appropriations Committee and the Senate Rules Committee.
    • The legislation has received bipartisan pushback, with one Republican lawmaker stating, “I truly believe this is a dangerous bill and I cannot support it.”

Washington Legislature Passes Bill to Decouple Vaccine Coverage from ACIP

  • Washington state passed legislation (HB 2242) that will tie vaccine coverage to recommendations from the state Department of Health instead of ACIP, requiring insurers to cover state-recommended vaccines without patient cost-sharing.
    • It is expected that Governor Bob Ferguson will sign the bill into law in the coming days.

OUTBREAK OUTLOOK

Measles Continues to Spread Across the Country, Raising Economic Concerns

  • As of February 27, the U.S. has reported 1,194 measles cases so far in 2026—surpassing half the total measles cases recorded during all of 2025. Several states to watch:
    • South Carolina’s ongoing upstate outbreak added 11 cases (Feb. 24—Mar. 3), bringing total case numbers to 990 since last October, and to nearly 700 in 2026.
      • Weekly cases have been trending downward since January, indicating that the outbreak is easing earlier than expected, though spring break travel could increase exposures.
    • Arizona (56 cases) and Utah (159 cases) continue to experience elevated measles activity this year.
    • Florida has recorded 114 measles cases (Jan. 1 through Feb. 21), the third highest of any state this year. Cases jumped by 25% from the week prior, with the majority of cases located in Collier County where the Ave Maria University outbreak is ongoing.
    • Ohio is experiencing its second measles outbreak this year, with six new cases reported among children in Columbus, bringing the state’s 2026 total to nine.
    • Texas has reported 13 measles cases at an El Paso immigration detention center.
    • Additional 2026 cases have been confirmed in California (21), North Dakota (21), Pennsylvania (12), and Washington (26).
  • Experts warn that measles outbreaks bring significant economic costs. An estimated $244 million was spent on measles outbreaks in 2025 and these costs are expected to rise if vaccination rates continue to drop.
    • A Yale School of Public Health study found that a sustained 1% annual decline in measles, mumps, and rubella (MMR) vaccination rates would cost the U.S. $1.5 billion each year and result in over 17,000 measles cases and 36 preventable deaths by 2030.
      • Expenses would include $41 million in direct medical costs, $947 million in public health response costs, and $510 million in lost productivity across the workforce.
    • Reminder: Between the 2019-2020 and 2024-2025 school years, the share of children claiming an exemption from one or more vaccinations rose from 2.5% to 3.6%—the highest national exemption rate to date. Studies have shown that higher exemption rates are associated with an increased risk of disease outbreaks.
  • Acting CDC Director Dr. Jay Bhattacharya has recommended the MMR vaccine as “the most reliable and effective way” to prevent measles, echoing recent statements by Makary and CMS Administrator Dr. Mehmet Oz.
  • The Pan American Health Organization (PAHO) announced Monday (Mar. 2) that its planned April review of the U.S. and Mexico’s measles elimination statuses will now occur during the Regional Verification Commission for the Elimination of Measles, Rubella, and Congenital Rubella Syndrome’s (RVC) annual meeting in November.

Influenza B Circulation Growing, Other Respiratory Illness Activity Remains Moderate

  • CDC data for the week ending February 21 show that flu activity remains elevated, though positive test rates and hospitalizations have decreased from the previous week.
    • 25 states are currently reporting high or very high flu activity, down slightly from 26 states the week prior.
    • Eight pediatric flu deaths were reported in the past week, increasing this season’s total to 79. Recent flu-related deaths were reported in several states including Colorado (the state’s fifth pediatric flu death this season).
    • The proportion of influenza B cases continues to increase nationwide, accounting for over half (55%) of positive flu tests for the week ending February 21.
  • More broadly, national respiratory illness activity remains moderate as of February 27.
    • Respiratory syncytial virus (RSV) activity is elevated and growing in some parts of the U.S. Hospitalizations remain elevated and increasing.
      • In Wisconsin, RSV cases are declining for the second winter in a row, with health experts attributing much of this success to uptake of the RSV vaccine.
      • In New York, doctors say the vaccine has kept infant RSV hospitalizations much lower this season than in recent years, even as cases surged.
    • Covid activity is elevated in some areas of the U.S., but decreasing overall, and hospitalizations continue to decline.

U.S. Newborn Hepatitis B Vaccination Rates on a Two-Year Decline

  • A study of more than 12.4 million U.S. newborns found that rates of hepatitis B vaccination within 30 days of birth have fallen by more than 10 percentage points in the past two years—from 83.5% to 73.2%—following a prior six-year upward trend.
    • Researchers chose to estimate birth-dose trends beginning in July 2023, a time of heightened public and media discourse surrounding childhood vaccination.
  • Infants infected with hepatitis B in their first year of life have a 90% chance of developing chronic infection, which is known to cause chronic liver disease and liver cancer. The hepatitis B birth dose protects infants at a critical time, significantly reducing rates of hepatitis B-related disease and death.
    • These findings have important implications for future hepatitis B vaccination and infection rates, especially after the CDC’s December 2025 decision to halt the longstanding universal hepatitis B birth dose recommendation. The AAP continues to recommend giving newborns a dose of hepatitis B vaccine within 24 hours of birth with additional doses at 1-2 months and 6-18 months.

REALITY CHECK

These fact checks respond to several recent claims made by different groups and individuals.

CLAIM: ACIP has a broad role that includes overseeing vaccine injury issues and informing broader vaccine policy that extends beyond the development of immunization recommendations.

  • REALITY: According to the committee’s official charter, ACIP’s role is to advise the CDC on the “use of vaccines and related agents for effective control of vaccine-preventable diseases in the civilian population of the United States.”
  • Specifically, ACIP is responsible for reviewing data on safety, efficacy, disease burden, and implementation considerations, and for making recommendations about who should receive vaccines, as well as the appropriate circumstances and dosing schedules for their use.
  • Recently, ACIP posted a Federal Register notice with agenda topics for the March meeting, highlighting planned discussions on Covid vaccine injuries and Long Covid and noting that recommendation votes may be scheduled on these topics.
    • Given ACIP’s specific mandate, votes on these issues move beyond the committee’s scope.
  • While ACIP routinely reviews vaccine safety data as part of its recommendation process, its charter does not authorize the committee to adjudicate vaccine injury claims, determine whether specific medical conditions were caused by vaccination, oversee compensation programs, nor set broader policy for non-immunization conditions, like Long Covid. These responsibilities fall to other federal entities and programs, for example:
    • The National Vaccine Injury Compensation Program (VICP) is the congressionally established body responsible for evaluating vaccine injury petitions and determining eligibility for compensation. The Advisory Commission on Childhood Vaccines (ACCV) is responsible for overseeing implementation of the VICP.
    • Research, surveillance, and clinical guidance on Long Covid—a post-infection condition that can occur following illness and is not vaccine-related—are led by the National Institutes of Health (NIH), CDC, and other expert groups.
  • This is not the first time the current ACIP members have taken actions that have prompted questions about scope and process:
    • In September of 2025, before its December vote to end the universal hepatitis B birth dose, ACIP voted to recommend that all pregnant women be tested for the hepatitis B virus—a move outside of the committee’s remit, as screenings and preventive service recommendations are under the authority of the U.S. Preventive Services Task Force (USPSTF).
    • At the same September meeting, ACIP recommended that CDC revise its Covid Vaccine Information Statements (VIS) to include language on disputed “risks and uncertainties”—which, as legal experts pointed out, is done through a separate CDC regulatory process.
  • Because ACIP decisions shape the national immunization schedules and directly impact insurance coverage, a clear observance of and adherence to defined roles and responsibilities is critical. Movement beyond or outside of that scope risks confusion, erosion of trust, and further politicization of vaccine policy.

CLAIM: We are facing a worsening autism crisis, and until we know its root cause, possible links between vaccines and autism should not be ruled out.

  • REALITY: The claim that we cannot rule out a possible link between vaccines and autism is a misrepresentation of scientific evidence—in fact, no other environmental factor has been better studied as a potential cause of autism than vaccines.
    • While autism diagnoses have increased over the past several decades, researchers attribute much of this rise to expanded diagnostic criteria, improved screening, increased awareness, and broader access to services.
  • Decades of evidence show no causal link between any vaccine and autism. The issue has been extensively reviewed, including through U.S. government supported, taxpayer funded research and dozens of high-quality studies, all of which have found no association.
  • Leading autism researchers, medical experts, and professional societies—including the AAP, the Autism Science Foundation, and the Autism Society of America—support routine childhood vaccination as safe and essential and emphasize that vaccines are not associated with autism.
  • Studies often cited as evidence that such a link exists have been discredited due to flawed research methods or ethical misconduct. For more on retracted studies linking vaccines to autism, see a previous newsletter edition here.

WHAT TO WATCH

Recent Supreme Court Decision Could Shape ACIP Lawsuits

  • A recent Supreme Court ruling may impact two ongoing lawsuits challenging Kennedy’s overhaul of ACIP and recent changes to the childhood immunization schedule.
    • In July, several medical associations led by the AAP filed a lawsuit, which has since been amended to incorporate more recent HHS actions.
    • In late February, 15 Democratic-led states filed a separate challenge. Plaintiffs include Attorneys General from Arizona, California, Colorado, Connecticut, Delaware, Maine, Maryland, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, and Wisconsin, as well as Pennsylvania Governor Josh Shapiro.
  • Plaintiffs argue the changes violate the Federal Advisory Committee Act (FACA) and the Administrative Procedure Act (APA). However, the federal judge overseeing the AAP suit has questioned whether ACIP still qualifies as a FACA-governed advisory body under recent Supreme Court precedent, which could alter standards related to independence and undue influence.
  • A preliminary ruling in the AAP case is expected before the March ACIP meeting, as plaintiffs have requested an injunction to pause the committee’s proceedings while litigation continues. The second round of arguments resume today (Mar. 4) in Boston.
    • Last week, the judge denied CHD’s motion to intervene.

Postponed ACIP Meeting Rescheduled for Mid-March

  • The next ACIP meeting has been rescheduled for March 18-19. Public comments may be submitted March 2-12.
  • Committee members will discuss, and may vote on, Covid-19 vaccine injuries, Long Covid, and potential changes to ACIP’s recommendation methodology.

Federal Interagency Autism Coordinating Committee to Meet Mar. 19

  • The federal Interagency Autism Coordinating Committee (IACC) will meet on Thursday, March 19—the committee’s first meeting since Kennedy overhauled its membership in January.
    • The IACC, which was previously comprised of leading scientists, advocates, and public servants in the autism community, now includes 21 new members appointed by Kennedy—many of whom have falsely linked vaccines to autism.
  • On Tuesday (Mar. 3), a group of autism researchers and advocates announced the formation of the Independent Autism Coordinating Committee (I-ACC), a separate advisory body established to maintain a science-driven autism research agenda following recent changes to the federal committee’s membership.
    • The I-ACC is comprised of several past IACC members including Joshua Gordon, former National Institute of Mental Health director, and Alison Singer, president of the Autism Science Foundation.
    • The group plans to primarily determine which topics within autism research deserve the most attention, and to inform the decisions of non-governmental funders. It will meet on the same schedule as the IACC, with its first meeting March 19, in an effort to halt misinformation emerging from the federal body.

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