Public Health Isn't a Faucet You Can Just Turn On and Off
PLUS: Mass HHS layoffs, NIH lawsuit, and another preventable measles death
Hi community,
I’m David Higgins, a pediatrician, public health/preventive medicine specialist, and health services researcher. 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 to avoid missing a weekly update.
Let’s jump into it…
What You Need to Know This Week
This week, with another preventable measles death, 10,000 public health layoffs, and more research cuts, one thing became clear: America’s health is going in the wrong direction. Before diving into the dangers of treating public health like a faucet (on, off, on again), here is what you need to know and why it matters:
HHS Cuts: A Devastating Blow to Public Health. On Tuesday, 10,000 public health professionals (25% of the HHS workforce) were laid off without warning. Entire divisions at the CDC, FDA, and NIH were shuttered. That day will be remembered as a turning point: the day America abandoned its commitment to public health. Make no mistake: the speed, scale, and recklessness of these cuts will harm every single American.
Scientists Sue the NIH. This week, scientists sued the National Institutes of Health (NIH) over the abrupt defunding of their research that “no longer effectuate agency priorities”. I’m not a lawyer, but I can tell you this: halting research midstream, especially for political, not scientific, reasons, wastes taxpayer dollars and undermines public trust. Unfinished projects mean lost data, lost value, and lost impact. Even if the courts intervene (and I hope they do), the damage is already underway. More on that below.
Measles Outbreak Escalates: Two Dead and Colorado at Risk. Another child has died from measles in Texas. That makes two pediatric deaths in a fast-growing U.S. outbreak that has already sickened at least 500 people this year. This is almost certainly an undercount. These are among the first measles deaths in the U.S. in more than a decade. All were preventable with vaccines. Meanwhile, just days after I warned on CNN that “measles is only a plane ride away,” Colorado confirmed its first case of 2025—linked to international travel. The infected individual exposed many community members, and I fear this is only the beginning.
A Rare Bright Spot: Shingles Vaccine May Cut Dementia Risk. Finally, some brief good news! A study in Wales found that the herpes zoster (shingles) vaccine was associated with a lower risk of developing dementia. This study showed a 3.5 percentage point absolute reduction, or 20% relative reduction. While not definitive, it is encouraging and warrants further study.
Public Health Is Not a Faucet
“Public health isn’t a faucet you can just turn on and off.”
That’s what I said in an interview this week after the Department of Health and Human Services abruptly laid off 10,000 employees as part of a sweeping restructuring plan and then later discussed rehiring some.
The cuts were sudden and devastating. They hit the heart of our public health infrastructure: the CDC, FDA, and NIH. Entire programs focused on maternal and child health, worker safety, infectious disease prevention, and vaccine delivery were wiped out overnight. On Tuesday alone, I heard from colleagues across the country who had their jobs—and more importantly, their life-saving work—suddenly cut.
After these cruel, chaotic layoffs, our nation’s top health official said that 20% of the fired workforce might be rehired. “That was always the plan,” he said.
Let’s be clear: If one in five of those roles were critical enough to restore, they were never expendable in the first place. You can’t burn down a house, rebuild one room, and call it “renovation”. Even when positions or programs are restored, the damage is already done. Relationships are already disrupted, momentum lost, and trust eroded.
It doesn’t matter who you voted for, where you live, or how much money you make. Measles doesn’t care. Cancer doesn’t wait. And we all breathe the same air.
How can destroying public health possibly make America healthier?
What We Lost
One of our own community-based projects was abruptly defunded recently. Then, a week later, we were told we might be able to get funding back. But by then, we had already started shutting things down by reallocating time, notifying community partners to stop the work, and dismantling collaborations we’d spent months building.
This isn’t just frustrating; it’s destabilizing. How do we plan, build, or commit when the faucet is turned on and off again? Funding cliffs are nothing new in public health and research, but this is different: funding was promised, abruptly withdrawn, and then dangled again with vague talk of reinstatement. You can’t build trust or a functioning public health system on that kind of uncertainty.
And when funding suddenly disappears, the effects ripple far beyond staff. It takes months, even years, to rebuild capacity and community trust. In the meantime, outbreaks spread faster, immunization gaps widen, and misinformation fills the vacuum.
This Week’s Heartbreaking News
These cuts are not happening in a vacuum. Just yesterday, we learned that another child has died from measles in Texas, the second pediatric death in a fast-growing outbreak that has already sickened at least 500 people this year. These are the first U.S. measles deaths in over a decade.
Here’s the context in which this is occurring:
Measles vaccine clinics are being shut down.
Outreach and education efforts are vanishing.
Vaccine confidence research has been defunded.
Evidence-based messaging is being censored or distorted while misinformation spreads unchecked.
Children are dying. Families are grieving. When we fail to act, viruses win.
A Failure of Federal Health Leadership
In response to this latest tragic measles death, the Secretary of Health and Human Services, a longtime figure in the anti-vaccine movement that helped fuel the vaccine doubt behind outbreaks like this one, attended the child’s funeral.
He also visited several “extraordinary healers” in the community and commended them for treating and healing measles using aerosolized budesonide and clarithromycin. Let’s be clear: these are not proven treatments.
While steroids like budesonide can be used in rare cases to manage specific complications from respiratory viruses, steroids can also suppress the immune system, and when misused, they can make things worse.
As for clarithromycin, it’s an antibiotic. Antibiotics might be prescribed if a measles patient develops a secondary bacterial infection, but even then, it wouldn’t be the first-line antibiotic choice. There is no credible evidence that clarithromycin treats measles itself. Neither of these “treatments” are replacements for vaccination.
A few weeks ago, a journalist who visited these same “healers” told me they were encouraging families to give children excessive amounts of vitamin A through cod liver oil, falsely claiming that “you can’t overdose on natural sources.” That’s not only wrong, it’s dangerous. Children in that community have already shown signs of liver damage and clear evidence of vitamin A toxicity.
To his credit, the Secretary posted on X yesterday that “The most effective way to prevent the spread of measles is the MMR vaccine.” But it’s hard not to think: too little, too late. This outbreak has been building for months. As a public official trusted by some, he has the platform to make a difference. If he spoke loudly, clearly, and consistently about the importance of vaccination, he could help save lives and protect communities.
That’s the kind of leadership this moment demands.
Where Do We Go From Here?
I am heartbroken and outraged at the unfolding events. And I know I’m not alone. But our response cannot be driven by outrage. We must lead with the values we want to see reflected in our communities, including strength, compassion, integrity, and hope, or risk perpetuating the very mistrust we are trying to heal.
Entire volumes will be written about this moment—the dismantling of public health, the chilling effect on science, the abandonment of lifesaving programs. But for now, here’s what I want to leave you with:
The thousands of public servants who were laid off this week are not just numbers. They are scientists, educators, community health workers, epidemiologists, and support staff who showed up every day to protect and serve their communities.
They didn’t do this work for money or prestige. They did it because they believed in something bigger: that every person deserves the chance to live a healthier life.
Even now, as programs are gutted and morale sinks, the mission continues. It lives on in the resolve of those who remain and in the millions who still believe that health is a public good.
Public health is not a faucet.
You can’t just shut it off, turn it back on, and expect water to flow.
But we can rebuild. We must.
A Final Note: It’s National Public Health Week
Amid these crises and the dismantling of public health, it’s tragically ironic that this week is National Public Health Week (NPHW). Organized annually by the American Public Health Association (APHA), NPHW brings together communities nationwide to recognize public health contributions and address key health issues. This year’s events will focus on priority areas such as climate change, misinformation, and the innovations that will shape the future of public health. Check it out here.
Thanks for being part of this community. Let’s keep pushing for truth, compassion, and science that saves lives—together.
-David
Do you like this newsletter?
You can also follow me on Substack Notes, LinkedIn, Instagram, and Bluesky.
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!