From DOGE’d to Determined: Rebuilding After Cuts
PLUS: Vitamin A toxicity, autism, experts pushed out, and personal choice.
Hi community,
I’m David Higgins, a pediatrician, preventive medicine specialist, researcher (soccer coach- it’s relevant for this one), and dad. This newsletter is where I share clear science, smart policy, and meaningful conversations about vaccines and public health. If you haven’t already, hit the button below so you don’t miss a weekly update.
Let’s jump into it…
What You Need to Know This Week
Last week was one of the most turbulent weeks in public health since the height of the COVID-19 pandemic. There was so much happening, so fast, that I shared a mid-week update just to keep up. Here are the most urgent developments before I turn to what we do next.
Public Health Funding Is Cut: At an alarming and cruel pace, public health funding is being gutted across the board. These aren’t just policy shifts or efficiency tweaks. They feel targeted and designed to dismantle public health quickly and painfully. I wrote more about this mid-week here.
A Vaccine Cynic Tapped to Lead a Vaccine-Autism Study: David Geier, a long-time vaccine cynic and discredited researcher, who has been disciplined for practicing medicine without a license, was hired to head a federal study about the long disproven myth that vaccines cause autism.
I teamed up with
last week to break down why this choice to lead this study is so outrageous here:The very premise of the study is infuriating, and Geier’s appointment is outrageous. As I told Axios this week:
“We have already answered that many times over. It wastes valuable resources to revisit the same question instead of using them to address critical health challenges. Reexamining settled questions that have already been repeated, replicated, and tested many times is not healthy skepticism; it’s cynicism and science denial.”
Peter Marks Forced Out at the FDA: The FDA’s top vaccine official, Dr. Peter Marks, has been forced out. This is an enormous loss for vaccine approval and safety in the U.S. In his resignation letter, he wrote this chilling statement: “It has become clear that truth and transparency are not desired by the secretary, but rather he wishes subservient confirmation of his misinformation and lies.”
Global Vaccine Funding Cut: The U.S. is ending global vaccine support for lower-income countries, including a $2.6 billion cut to Gavi, the Vaccine Alliance. It’s a moral failure and a public health disaster in the making. As I said on CNN last week:
“Viruses like measles don’t stop at borders. Investing in global immunization programs is both a moral responsibility and smart, strategic public health for America. Protecting children around the world protects all of us."
Measles and Toxic Vitamin A: In communities affected by measles outbreaks, several children are now showing signs of liver damage from excessive Vitamin A supplementation. Vitamin A toxicity is real, even from “natural” sources. Vitamin A is not a substitute for the MMR vaccine. Measles is a highly contagious, potentially deadly virus, and the best protection remains the safe, effective MMR vaccine.
We Got DOGE’d—Now What?
Last week, one of our research projects got DOGE’d.
And yes, I’m using the term intentionally. These reckless, abrupt cuts to research and public health are driven by a select few with money and power. In most cases, if the American public truly understood what was being cut, I believe the answer would be a resounding “no.”
While measles spreads across the U.S., our community-based project was cut, which focused on improving measles vaccination by helping providers communicate better with families. The irony is tragic.
I know many other public health professionals and researchers who have also been affected. These cuts are painful, not only for researchers but also for the communities we serve. As I wrote last week:
“These cuts aren’t just about changes in priorities or improving efficiency; they’re being carried out with speed and cruelty that feel intentional, calculated to cause maximum harm. And it’s working. We are devastated, confused, and angry.”
But instead of dwelling on the pain more here, I want to ask an urgent question:
What do we do now?
This question is being asked in every meeting, email, and conversation I have had lately. And truthfully, I have been dissatisfied with many of the proposed answers: “Hope the courts step in,” “Switch your research to a topic that is politically acceptable for now,” or “Go back to seeing more patients until things blow over.”
But I’ve spent over two decades in science, medicine, and public health. Several years ago, I stepped away from full-time clinical care because I believed I could make a broader impact through research and systems change. I’m unwilling to sit on the sidelines for four years (or more) while things potentially settle down. The communities we serve don’t have that kind of time.
So, I turned to another one of my interests for insight: coaching youth soccer.
Yes, really.
What I’ve Learned from Coaching (and What It Means for Us)
Coaching youth soccer teaches you a lot about resiliency, teamwork, and what it means to keep playing when the game gets rough.
When a player falls or misses a shot, my proudest moments as a coach are when they get back up and when their teammates help them do it.
When a player shouts, “That call wasn’t fair!” I hear them; then I remind them: You can’t control the ref or the other team. But you can control how you respond.
When our game plan isn’t working, we don’t keep forcing it. We adapt.
These lessons apply to vaccine delivery research and public health, too. The game isn’t over. So get back up with your teammates’ help and get back into the game because our communities need it.
Concrete Ideas to Get Back in the Game
Let’s be concrete here. These examples are neither exhaustive nor original. And they are not easy. But I believe these are places we can start:
Collaborate & Consolidate
Partner with non-traditional colleagues and organizations to share resources, staff, or infrastructure. For academics, this means getting outside of our bubble- something we should have always been doing more of, but now we must do to survive.
Create multi-site or interdisciplinary proposals that align with high-priority areas that may still be funded.
Join or initiate coalitions that amplify reach and impact while reducing administrative burden.
Diversify Funding Sources
Reimagine funding beyond federal sources. Explore foundations, local and state government grants, philanthropic partnerships, and crowdsourced science funding.
Consider industry collaborations that align with your values, particularly for translational or applied work.
Apply for bridge or transition grants from organizations and professional societies to cover gaps.
Stay Grounded in Mission
Remind yourself (and your team) why you do this work. It’s never just about the funding; it’s about the people and communities your work impacts.
Lean into community engagement and trust-building, which can generate new opportunities and even attract new funders who value real-world relevance.
Self-Critique and Course-Correct
We must reflect honestly on our performance in the game. Where have we lost trust and why? Where have we fallen short in our communication?
Acknowledge where we can do better: dismissiveness, overpromising, patronizing, crisis fatigue, and politicized messaging have been detrimental to our efforts. We can do better.
Innovate
Public health and health services research must innovate to survive and thrive. That means rethinking how we do the work, not just how we fund it.
Tap into technology not just for data collection but for storytelling. Use digital tools, apps, and short-form media to educate, build trust, and bring communities closer to the science.
Harness new methods and technology to do our work more efficiently and effectively.
Speak Out
Use your platform to write op-eds, post on social media, send letters to the editor, etc. Testify during public comments.
Call, write, or show up to town hall events to let your representatives hear you - this will become even more relevant as we get into the midterm elections and the pressure on elected leaders ramps up.
Show how these cuts hurt real people in our communities. If you haven’t seen this, check out The Impact Project’s map to see how local communities are affected.
I know these ideas are not new. Some may be fanciful thinking. And none of them are easy to implement.
The sports analogy breaks down in one critical way: we are ALL on the same team. We ALL share a common goal of helping people live healthier, safer lives. Harness this shared goal to find common ground as we move forward.
The work hasn’t ended, and the game isn’t over. We need to get back in it together.
One Last Thing: Personal Choice Isn’t the Opposite of Recommendation
One more thing happened this week that raised my blood pressure a little, and I can’t let it go unaddressed.
According to reports, the CDC buried a measles forecast that stressed the need for vaccinations. What’s even more shocking is that in a statement, the agency said: “The decision to vaccinate is a personal one”.
I want to be clear: Yes, vaccination is a personal decision, but it’s not just personal. It’s also a community one. In the case of measles, it’s a life-or-death decision for others in the community.
Even if we imagine a world where vaccine choices affect only the individual (they don’t), recommending a proven, evidence-based action that protects someone’s health is not coercion. By that logic, should we stop publicly recommending breast cancer screenings? Colonoscopies? Preventive medications for diabetes, asthma, or high blood pressure?
Vaccine cynics are trying to hijack our society’s values of “individual freedom” and “personal choice” to twist them into excuses for denial and delay. Childhood vaccine messaging from public health isn’t about coercion—it’s about delivering trustworthy information to support informed decisions.
As a pediatrician and public health physician, I talk to patients and families every week who are trying to make the best decisions for their kids. I respect their autonomy to make a personal decision, which should be informed by real evidence, not misinformation.
Families deserve clear, honest, evidence-based guidance about the known risks and overwhelming benefits: vaccines prevent disease, save lives, and protect entire communities.
Last week, you filled out a poll about what you want to hear more about, and “informed consent”, “effective communication strategies”, and “vaccine hesitancy and misinformation” surfaced to the top of things you want me to dive into more. In the coming weeks, I will be doing that, and I appreciate your feedback because I want this to be a conversation and useful for you, not just more noise in an already noisy world!
Thanks for being part of this community. Let’s keep pushing for truth, compassion, and science that saves lives—together.
-David
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Community Immunity is a newsletter dedicated to vaccines, policy, and public health, offering clear science and meaningful conversations for health professionals, science communicators, policymakers, and anyone who wants to stay informed. This newsletter is free for everyone, and I want it to be a conversation, not just a broadcast. I’d love to hear your feedback, questions, and topic suggestions—let me know what’s on your mind! And if you find this valuable, please help spread the word!