The Department of Health and Human Services (HHS) recently announced the cancellation of a $760 million contract with Moderna for a bird flu vaccine, citing scientific and ethical concerns.This decision follows positive interim data from a trial testing the safety and effectiveness of Moderna’s H5N1 bird flu vaccine candidate.

This move underscores the administration’s apparent skepticism towards mRNA vaccines. Representative Adam Schiff previously accused Robert F. Kennedy, Jr, the Secretary of HHS, of promoting the “lie that mRNA vaccines alter human DNA.” Several states have also proposed legislation to ban or limit mRNA vaccines, further fueling mistrust in vaccines. Kennedy has previously voiced concerns about the safety of mRNA COVID-19 vaccinations.

Bird Flu Vaccine Development Halted

The nation’s ability to combat bird flu through vaccination is limited, with inadequate vaccine supplies and insufficient egg supplies for customary vaccine production.Experts have advocated for a shift to mRNA-based platforms, but Kennedy’s concerns have stalled progress, leading to the cancellation of a leading vaccine candidate.

Finland has already begun offering bird flu vaccines to high-risk farmworkers. Some experts suggest the U.S.should follow suit.

Saskia Popescu, an Assistant professor of Biodefense at George Mason University, has criticized the administration’s bird flu preparedness, stating, “Cutting surveillance in that [bird flu] and then cutting budget to USDA and CDC is a sure fire way to ensure that spread is occurring and will only continue to occur because we don’t have eyes on it and we don’t have any containment measures.”

Elizabeth (Beth) Cameron,Senior Advisor to the Pandemic Center at Brown University,echoed Popescu’s concerns,highlighting the government’s and the Coalition for epidemic Preparedness Innovations’ goal of the “100 day mission.” This mission aims “to be able to make any countermeasure within 100 days of emergence of the pathogen and be able to deliver it.” Cameron believes the cancellation of the vaccine sets back this goal.

Cameron also emphasized the importance of surveillance, stating, “We also need to be able to detect that threat really early. That means bio surveillance networks and data,but it also means people that can actually understand what’s happening around the world and then be able to translate that data into quick public health action.”

According to Cameron,funding and staffing cuts at the FDA,CDC,and other agencies shift more duty to states,cities,and tribes,perhaps without a united federal effort.She added, “Funding is being taken back from the COVID response funding that states have, and so states are actually losing thier capability, not gaining their capability at a time when more might actually fall on them to be to be more prepared.”

Kennedy’s changes throughout HHS are affecting far more than our response to bird flu. It affects our entire public health and pandemic preparedness.

In March, Kennedy “announced drastic cuts” that would eliminate 20,000 jobs, including 2,400 at the Centers for Disease Control, 3,500 at the Food and Drug Administration, and 1,200 at the National Institutes of health. A major restructuring of agencies is also planned. Popescu observed,”You have people coming in here who have no experience,no understanding of what these departments,agencies,divisions,etc,are doing.” She added their “lack of knowledge is making it really hard for people to get the basics done. So I’m very concerned with capacity.”

FDA and COVID-19 Vaccines

The FDA traditionally grants final approval to vaccines after consulting with experts on its Vaccines and Related Biological Products Advisory Committee (VRBPAC) and the CDC’s Advisory Committee on Immunization Practices (ACIP).

the VRBPAC assesses vaccine safety, effectiveness, and appropriate use, while the ACIP provides recommendations on vaccine recipients.

however, the Health and human Services Department, under Kennedy, has diminished the decision-making power of these expert groups.

For instance, the release of the Novavax vaccine has been delayed, reportedly due to Kennedy’s preference against single-antigen vaccines.

Kennedy has previously called “mRNA COVID-19 vaccinations “dangerous.”

Moderna also withdrew its application for a “combined flu/Covid vaccine,” delaying the availability of an updated COVID vaccine for the fall.

Kennedy, Marty Makary, Commissioner of the FDA, and Jay Bhattacharya, Director of the NIH, have stated that vaccines must be supported by placebo-controlled clinical trials. Manny experts consider it unethical to conduct placebo-controlled trials for effective treatments, suggesting comparisons to existing vaccines instead.

Recently, Kennedy decreed that Covid boosters are not recommended for pregnant women and children, without consulting the CDC, which recommends these vaccines.There is abundant evidence that pregnant women are at increased risk of death and disability from Covid, and newborns rely on maternal antibodies from vaccination for protection.

The “American college of Obstetricians and Gynecologists” is strongly opposed to this decision.ACOG further notes, “the vast majority of hospitalized infants less than six months of age-those who are not yet eligible for vaccination-[are] born to unvaccinated mothers.”

If a vaccine is not on the government’s recommended list,it may not be covered by insurers,potentially limiting access.Kennedy’s decision could also create confusion among patients and physicians.

Popescu also expressed concerns about the U.S.’s ability to respond to threats due to the weakening of local,state,and federal health departments. She said, “We will have a population that feels like they really can’t trust any guidance that’s given to them. And on top of that, I genuinely do worry that any guidance that is given to them may not be evidence-based.”

Growing vaccine hesitancy, fueled by the current administration, and an anti-science stance are contributing to measles and whooping cough outbreaks. The potential lack of an updated COVID-19 vaccine for the fall, coupled with newly announced vaccine restrictions and the emergence of the new COVID-19 variant, NB.1.8.1, raises concerns about public health.