Science Friday - How Did Vaccine Policies Actually Change In 2025?

Episode Date: December 22, 2025

Since 1955, when Congress passed the Polio Vaccination Assistance Act, the federal government has been in the business of expanding access to vaccines. That is, until this year.2025 has been filled with almost daily news stories about federal agencies, under the direction of Health Secretary Robert F. Kennedy Jr., casting doubts about vaccine safety, including unsubstantiated claims about links to autism. These agencies have also been taking steps that could roll back access to vaccines, including for hepatitis B and COVID-19.But we’ve found it very hard to sort out what these talking points and recommendations mean in practice. KFF Health News journalists Jackie Fortiér and Arthur Allen join Host Flora Lichtman to discuss, one year in, what this administration’s stance on vaccines has meant practically—for vaccine access, and vaccine uptake.Guests: Arthur Allen is senior correspondent at KFF Health News and author of Vaccine: The Controversial Story of Medicine's Greatest Lifesaver.Jackie Fortiér is a Peggy Girshman fellow covering health policy at KFF Health News.Transcripts for each episode are available within 1-3 days at sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

Hey, I'm Flor Lickman, and you're listening to Science Friday. Since 1955, when Congress passed the Polio Vaccination Assistance Act, the federal government has pretty much been in the business of expanding access to vaccines. That is, until this year, 2025 has been filled with almost daily news headlines about federal agencies under the direction of Health Secretary Robert F. Kennedy Jr., casting doubt on vaccine safety, while taking steps that could roll back access. So how do we sort out what's just talk and what has teeth? A year in, we are asking,

what has this administration's stance on vaccines meant practically for vaccine access and vaccine uptake? Here to tell us more are two reporters from KFF Health News, the journalism arm of the nonprofit Health Research Foundation, KFF, Jackie Fortier and Arthur Allen. Welcome to Science Friday. Thanks for having us. Happy to be here. Let's start with the recent news on the Hep B vaccine, Jackie. Just this week, the CDC ended its nearly 35-year recommendation that infants receive the vaccine for hepatitis B, you know, right after birth. What does this recommendation change mean in practice? It's important to know what hepatitis B is. So hepatitis B is a highly infectious virus that attacks the liver, it's transmitted through contact with infected bodily fluids, including blood. It can also be passed from mother to baby in late pregnancy and during birth. There is no cure for hepatitis B. It can

scar the liver and cause liver failure and liver damage. So it can eventually kill you. That's what we're trying to prevent. And there's a three-dose vaccine that does an amazing job of preventing hepatitis B for decades. And also, if a baby is born with hepatitis B, it can actually make sure that that virus doesn't spread, as long as it's given within the first 12 hours of life. Okay, so the timing matters. Yes, timing is very, very important, especially for babies born to mothers whose viral status is unknown. So if they don't know if they have hepatitis B or not, this changes the universal birth dose recommendation to a risk-based one and kind of reverts us to pre-1991.

The decision wasn't really evidence-based, and hepatitis B vaccine has one of these, you know, very well-established safety records of any vaccine. So as a consequence of this, there's going to be more misinformation and I think more questioning of the hepatitis B vaccine, especially the birth dose. So the insurance does still have to cover it, though? Yes, they do. Does this mean that you have to ask for it now? Parents always had the choice of whether or not to give the birth dose of the hepatitis B vaccine. But it's, I think, causing a lot more people to question that in a way that they didn't before. Right. It was like never, you weren't ever going to be not allowed to take your baby home if you didn't get them vaccinated against hepatitis B. It was just recommended very strongly.

What I've heard is that, you know, 95% of hospitals that have been vaccinating routinely against hepatitis B are going to continue doing so. However, there may be some. They may not offer it. They may only provide it when asked. And so, you know, most people aren't going to know about hepatitis B vaccine at birth. And they may be sort of alarmed by the idea of their baby getting a shot because they don't really understand why. And that's the biggest fear, I think. Arthur, you've been covering the speed for decades. Can you put this change in context for us? I just think that what's happened is that the CDC has been turned on its head. The fringe is now in power. These are people who have been skeptical of vaccines, almost all of them on the ACIP, which is the advisory committee, lots of the leadership of FDA and others in HHS, are very skeptical of vaccines.

They attribute all kinds of risks to them. And whereas before, you know, policymaking on vaccines was based on actual risks and benefits seen in research. Now what they're doing is they're fitting the policy to their belief system. Let's talk about the COVID vaccine. I know the recommendations also changed this year. Can you walk us through how they're different and how that's changed whether people are getting access or taking the COVID vaccine? I mean, it's very complicated and confusing because it's incredibly complicated. Yeah, yeah. And I mean, I think that that's in some ways that's the strongest point to make is that it's really confusing.

But if you're determined to get a COVID vaccine, I think it might take some effort depending on where you're living, but you probably can get it. you know, they are required to provide it. But I think it's going to be harder to get. And there's a lot of contradictory information. I mean, Kennedy has said that pregnant women and children shouldn't get it. If you look at the CDC website, their latest update from like two weeks ago says pregnant women should get it. Really? Yes. This is November 29th CDC guidance on COVID vaccine on who should get it. But that kind of is part of the confusion. The other confusion, is of course that sort of the mainstream medical societies are all very strongly in favor of vaccination, you know, usually at all ages. The biggest problem with getting COVID vaccine now is going to be because this climate of, you know, suspicion of the vaccine, plus the government's action, plus the public's just feeling like, you know, COVID is over, has reduced a demand so much that there are going to be.

be some pharmacies, some doctor's offices are just not going to carry it anymore because they don't, there's not enough demand. And so, you know, they don't want to buy a bunch of vaccine and have it just, you know, be thrown away after a couple of months. And that's exactly the problem with pediatricians especially, because younger children, babies, anyone over the age of six months can can get vaccinated against COVID. And they recommend especially that children who have never had COVID get vaccinated against it because every year COVID puts children in the hospital, just like it does a really good point. So it's extremely difficult I've been hearing anecdotally from people to get their younger child vaccinated because a lot of people go to a pharmacy, you know, CBS Walgreens to get their

vaccines. They don't go to doctor's offices too often. That works fine if you have an older child or you're an adult. It doesn't work if you have a younger child because pharmacists can't vaccinate babies and toddlers in most states. So that means the parents have to go and see a pediatrician if they want to get their child vaccinated. And when they're that age, it's two to three doses of the vaccine over a period of months in order to get them fully vaccinated. But the COVID vaccine is expensive. It's a lot more expensive than the flu vaccine for these pediatrician practices to buy. And it doesn't have a very long shelf life. The flu vaccine lasts for months.

COVID, not so much. And they don't get reimbursed at a very high rate for the vaccines that go bad and they can't use. So it's this conglomeration of people not being as interested in getting their kids vaccinated, which means the pediatricians see fewer people asking for it. So they don't order as much of the vaccine. and then, you know, the vaccine is, or sometimes they just don't carry it at all, and then the vaccine isn't available. I mean, I heard about a couple that had to drive an hour and a half south of where I live because their pediatrician's office just didn't offer the COVID vaccine, and they wanted their seven-month-old vaccinated. Are there other changes that you have seen to vaccine access or uptake this year?

I've been reporting on sort of one kind of interesting development, which is kind of sad, which is, that in a lot of cities where the public health department offers back-to-school vaccination or catch-up vaccination for older kids, the clinics are seeing about half as many as they did last year. And I don't have demographic data, but my understanding is that some of it is, you know, CDC has not been advertising, you know, go get vaccinated. And ice raids and other sort of fear of immigration are keeping Latino and some other immigrant populations away from public clinics to get vaccinated because they're no longer protected from raids. So ice raids are preventing people from going to public health clinics to get vaccinated?

Well, you know, we don't have like solid proof of that. All we have is sort of correlations of ice raids in certain cities and then seeing dramatically declining rates of people showing up for these clinics. And I mean, it's possible that these people are getting vaccinated elsewhere. but it seems clearly, you know, anecdotally to be one of the factors that's really cut these vaccination rates at public health clinics down quite a bit. And also, like, the COVID vaccine rate is down this year. It's like in the single digits for children. And older adults are not getting vaccinated.

And they're, you know, 65 and older are especially vulnerable to being hospitalized or even dying from COVID. And their immune systems don't remember the viruses as, you know, efficiently. So that's really worrying. Even at risk, even like really sick people with disabilities, the rate is falling, I've heard. Yeah, right. Yeah. So if we have a low vaccination coverage, you know, we could be facing a more severe

hospitalization season as winter transmission ramps up. You know, we have been inundated this year with headlines about this administration skepticism around vaccines and possible changes and possible rollbacks. do you have tips for us on what we should really be paying attention to? Well, I think it all needs to be paid attention to because, I mean, these are the attack on vaccines. Whether it affects you personally and your ability to get a vaccine, it's going to affect all of our communities. I mean, right now there's measles, you know, swamping various places in the country like northern part of South Carolina. And, you know, we've had almost 2,000 cases at least this year.

there's a terrible whooping cough epidemic going on. Babies are dying. And, you know, that affects, you know, who shows up at school. But I think concretely, it's, you know, Kennedy has said that he's not taking vaccines away from anybody. And I think what he means, and I don't know if this is going to be really hold true entirely, but I think what he means is, you know, they'll say it's up, the decision is up to you. And under sort of vaccine law, that means that insurance should cover these vaccines that are recommended to the extent of get it if you want it. And so in theory, I think at least so far, you know, if you want a hepatitis B shot for your infant, your newborn, if you want to get a COVID vaccine, you know, you can get it. It's just, you know, is it going to be available?

at how bad do you want it? And in some cases, how much do you want to spend? Insurance so far has the voices that we've heard from the insurance industry have all said they are going to cover the vaccines pretty much the way they've been covered historically. But, you know, the devil's in the details. We'll see how it pans out. Arthur Allen is a senior correspondent at KFF, an author of Vaccine, the controversial story of medicine's greatest lifesaver. And Jackie Fortier is a health Policy Reporter at KFF. Thank you to you both for joining me. Thanks so much. Thank you. This episode was produced by John Dancosky. I'm Flora Lickman. We'll see you tomorrow.