Monday, June 10, 2024

How Trump could upend vaccines

Presented by HCA Healthcare: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Jun 10, 2024 View in browser
 
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By Chelsea Cirruzzo and Ben Leonard

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Driving The Day

Former President Donald Trump speaks at a campaign rally

A second Trump administration could mean changes to vaccine policies. | John Locher/AP

VACCINE BOOSTER TURNS CRITIC — Public health experts don’t think former President Donald Trump is personally opposed to immunization. But they fear he’ll worsen the country’s backslide on immunizations if he’s elected to a second term, POLITICO’s Megan Messerly reports.

On the campaign trail, Trump has promised to pull funding from schools with vaccine requirements. His ramped-up rhetoric on immunization comes as independent presidential candidate Robert F. Kennedy tries to draw support from the former president’s increasingly vaccine-skeptical MAGA base.

While most vaccine policies are set at the state level, Trump or another president has many tools in the executive branch toolbox that could chart a new course on immunization, including the following measures:

The CDC could pare back the number of vaccines it recommends children receive or eliminate those recommendations.

The CDC could change the paperwork required to be shared with parents to make vaccines sound less safe than they are.

The FDA could increase the number of years of safety testing required for new vaccines.

Trump could also appoint someone who opposes the government’s traditional role in promoting vaccines, such as Kennedy or Florida Surgeon General Joseph Ladapo, who called for a pause in the use of mRNA vaccines for Covid-19 and didn’t encourage parents to vaccinate their children during a recent measles outbreak.

Kennedy’s campaign didn’t respond to a question about whether he would consider joining a future Trump administration. The Florida Department of Health didn’t respond to requests for comment from Ladapo.

The Trump campaign has previously said that the former president threatens to take away funding only from schools that mandate the Covid-19 vaccine but not from schools that mandate other vaccines. The campaign didn’t answer specific questions about what other vaccine policies the former president would or would not adopt or whether he’d consider appointing vaccine-skeptical individuals to his administration, pointing back to his promise to defund schools with vaccine mandates.

Paul Mango, former deputy chief of staff for policy at HHS under Trump, said it’s unlikely Trump would prioritize anti-vaccine policies or appoint anti-vaccine officials in a second administration. Trump did, after all, champion Operation Warp Speed, a public-private partnership that helped develop the Covid vaccine in record time.

“I guess it’s always a possibility, but I think it’s an extremely low probability,” Mango said. “I really can’t imagine that despite the political rhetoric and the campaign rhetoric.”

WELCOME TO MONDAY PULSE. Several members of Congress commemorated D-Day by jumping from planes and parachuting over Normandy on Friday. Not my idea of a relaxing start to the weekend. We hope yours was a bit less thrilling! Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

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In Congress

One side of the Pentagon is pictured.

A House vote this week could impact the Pentagon's abortion policies. | Saul Loeb/AFP via Getty Images

MILITARY ABORTION UP FOR VOTE — The House will vote this week on the fiscal 2025 National Defense Authorization Act, which could include amendments to restrict the Pentagon’s abortion policies, POLITICO’s Connor O’Brien, Lee Hudson and Joe Gould report.

The bill cleared the House Armed Services Committee last month with near unanimous support. But whether that broad coalition holds in the full House will depend on the more than 1,300 amendments lawmakers have offered.

What the GOP wants: Republicans have filed amendments aimed at restricting the Pentagon’s policies to provide leave and reimburse costs for people who must travel to seek abortions.

Though Republicans largely oppose the policy, meant to shore up troops’ access to abortion and reproductive care after Roe v. Wade was overturned, GOP leaders might be circumspect about the proposal this year. The defense policy bill took a hard-right turn last year after Republicans added an amendment blocking the policy. The amendment, opposed by the Senate and White House, didn’t make it into the final bill.

Rep. Beth Van Duyne (R-Texas) leads more than 30 Republicans in a bid to repeal Defense Secretary Lloyd Austin’s policy and prohibit funding to reimburse travel costs related to reproductive care. Rep. Marjorie Taylor Greene (R-Ga.) filed a similar amendment to block money to reimburse abortion-related travel costs.

What the Dems want: Democrats look to protect abortion access with many military personnel serving in states where it’s illegal. Rep. Mikie Sherrill (D-N.J.) has offered amendments to repeal laws that prohibit defense funding or the use of military medical facilities to perform most abortions except in cases of rape and incest or when the life of the mother is endangered.

RADIATION AMENDMENT EFFORT — A bipartisan group of House lawmakers wants Speaker Mike Johnson to put an amendment to the NDAA on the floor that would reauthorize a program compensating people who’ve been harmed by nuclear radiation.

Funding for the Radiation Exposure Compensation Act expired Friday, leaving people who have been exposed to nuclear radiation — including those who live “downwind” of the Nevada Test Site, uranium workers and veterans exposed to atomic weapons — without the ability to request compensation for medical treatment they seek for radiation-related illnesses.

“When Congress passed the original [law in 1990], it was the right thing to do,” Rep. Teresa Leger Fernandez (R-N.M.) told reporters Friday. “It was the absolutely right thing to do for the United States to say we made a mistake and we did not take enough care of our Americans, of our communities, when we were testing and exploding these nuclear bombs. So it's our job now to compensate those who are harmed.”

The Senate has already passed a bill reauthorizing the legislation, but Speaker Johnson has yet to bring it to the House floor for a vote.

Johnson’s office didn’t respond to requests for comment.

FIRST IN PULSE: DEMS WANT STI ACTION — Amid a surge in syphilis and shortages of a key treatment, Rep. Jamie Raskin (D-Md.), ranking member of the House Oversight Committee, and nearly 20 other Democrats are pushing HHS to declare a public emergency, Ben reports.

The CDC has called for “urgent action” to take on a tenfold rise in congenital syphilis — when the life-threatening infection is passed during birth — in the past decade. Syphilis cases overall have close to doubled over the past five years. Shortages of an antibiotic treatment because of a spike in demand are expected to persist beyond this year.

Raskin and his colleagues argued in a letter to HHS Secretary Xavier Becerra that declaring an emergency would allow the FDA to take more action to address the shortages — which committee Democrats are investigating — and HHS to use additional funds.

The outlook: It’s not clear whether HHS will heed their calls. An HHS spokesperson said the agency has received the letter and will respond to Raskin.

Declaring a public health emergency is rare. Outside of natural disaster-related emergencies, only Covid-19, the opioid epidemic, the Zika virus, the H1N1 flu and mpox have received such a declaration in the past two decades.

 

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In the Courts

LIBRARY VS. MEDICAL DEVICE MAKERS — Medical device makers won in court Friday against the Library of Congress in a case about whether the library can use third-party services to probe medical devices for research purposes.

The U.S. Court of Appeals for the District of Columbia ruled in favor of the Medical Imaging & Technology Alliance and the Advanced Medical Technology Association.

How we got here: Federal copyright regulations prevent organizations, such as hospitals, from using their own service providers to troubleshoot or fix copyrighted medical devices — instead, they have to rely on the device manufacturers’ technicians.

However, the Library of Congress can apply for certain exemptions from the copyright law and did so in 2020, which it was granted. Medical device manufacturers sued, claiming the Library of Congress is subject to the Administrative Procedure Act, which requires certain procedures be followed before a rule is changed.

The court ruled that the Library of Congress is subject to the APA, meaning the case now goes back to a lower court. AdvaMed applauded the decision in a statement.

“This decision is a significant victory for the medical technology industry and the principles of good governance,” said Christopher White, chief policy officer and general counsel of AdvaMed, in a statement.

The Library of Congress would not comment on ongoing litigation.

What’s next? A lower court will reconsider whether the exemption should be tossed out.

 

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Names in the News

Mary Beth Terry is now executive director of the Silent Spring Institute. She previously was a professor of epidemiology at the Columbia University Mailman School of Public Health.

 

JOIN US ON 6/13 FOR A TALK ON THE FUTURE OF HEALTH CARE: As Congress and the White House work to strengthen health care affordability and access, innovative technologies and treatments are increasingly important for patient health and lower costs. What barriers are appearing as new tech emerges? Is the Medicare payment process keeping up with new technologies and procedures? Join us on June 13 as POLITICO convenes a panel of lawmakers, officials and experts to discuss what policy solutions could expand access to innovative therapies and tech. REGISTER HERE.

 
 
WHAT WE'RE READING

The Washington Post reports on the wellness shadow market some families have turned to.

The New York Times reports on violence and conflict in long-term care settings.

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