L.E. Gomez, MD, MBA, MPH
Posted on September 8, 2025
Dr. Gomez is a physician and public health leader with extensive experience in emergency medicine, health policy, and health equity. He has presented nationally on systemic inequities in health care delivery and is committed to advancing community-driven solutions.
The Centers for Disease Control and Prevention (CDC) has long served as the foundation of evidence-based public health. Yet in June 2025, that foundation was destabilized when all 17 members of the Advisory Committee on Immunization Practices (ACIP) were dismissed—a historic rupture in science-driven vaccine guidance. For the past 60 years, ACIP has played a crucial role in shaping national immunization standards, especially for underserved communities assisted by the Vaccines for Children program.
Recognizing that the reconstituted ACIP was no longer trustworthy, the American Academy of Family Physicians (AAFP) joined other medical groups in reviewing nongovernmental sources of evidence to support its vaccine recommendations. The Vaccine Integrity Project, sponsored by the Center for Infectious Disease Research and Policy at the University of Minnesota, recently summarized publicly available data on influenza, COVID-19, and RSV vaccine effectiveness and safety. Notably, the AAFP’s immunization schedules continue to recommend routine COVID-19 vaccination for children starting at 6 months of age, as well as pregnant people. However, whether insurers will provide coverage for vaccines no longer recommended by the ACIP and whether these vaccines will be available to patients in national pharmacy chains remains unclear.
The One Big Beautiful Bill Act (H.R.1) that was signed into law in July 2025 deepens the vaccine policy crisis by weakening public health infrastructure. The legislation imposes Medicaid work requirements, introduces cost-sharing for office visits, limits clinician reimbursement models, and defunds clinics that offer both abortions and preventive services. According to the Congressional Budget Office, more than 10 million people could lose coverage under Medicaid or the Affordable Care Act Marketplace. Consequently, many federally qualified health centers and other safety net providers will struggle to stay open. Fragmented guidance and diminished access to immunizations and screening will worsen disparities, especially in rural and minoritized communities that already face high vaccine hesitancy and strained public health capacity.
This shift coincides with other damaging rollbacks to federal public health agencies. The CDC has shuttered specialized laboratories for monitoring hepatitis and antimicrobial resistance. More than 20,000 positions at the Department of Health and Human Services—including key roles at CDC, US Food and Drug Administration, and National Institutes of Health—have been eliminated.
Public health must remain grounded in science—not ideology. Rebuilding trust in health institutions will require sustained investments and repair, particularly for vulnerable populations. States can alleviate the damage by mandating insurer coverage of evidence-based vaccines recommended by the AAFP and other medical societies and by establishing their own expert advisory panels to safeguard vaccine access. Political interference with established immunization policy processes risks lives, especially those who are least protected by our fractured health systems.
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