With CDC in chaos, scientists and physicians piece together replacements for agency's lost work

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With CDC in chaos, scientists and physicians piece together replacements for agency's lost work

2025-08-30 04:51 Last Updated At：05:01

NEW YORK (AP) — The CDC is in chaos and some groups are starting to step in and take over work the agency was doing.

The moves come in response to Health Secretary Robert F. Kennedy Jr.'s extensive — and some say illegal — restructuring and downsizing of the Atlanta-based Centers for Disease Control and Prevention.

Many public health veterans see an agency wracked by a leadership crisis, staff cuts, budget cuts and unprecedented levels of political meddling. The concern hit a crescendo when the White House moved to oust the agency's director and some top CDC leaders resigned in protest.

But even before CDC Director Susan Monarez was fired, some organizations started pursuing new ways to do jobs formerly handled by the CDC.

Some are working to preserve longstanding vaccination recommendations. Some are trying to release information that CDC has stopped providing. Others aim to maintain health data collections at risk of being lost.

But these outside efforts don't have the federal funding, resources, legal mechanisms or platform that have been the underpinning of the nation's public health system. As noble as they are, these patchwork efforts probably won't cut it, some experts say.

“There may be some workarounds,” said Dr. Megan Ranney, dean of the Yale School of Public Health. “But I'm not sure it's fair or appropriate that people feel like they have to turn to private groups instead of the government.”

For decades, the CDC has set the nation’s standards on vaccines — which ones are recommended and who should get them.

The recommendations were guidance, not law. But they were automatically adopted by doctors, school systems, health insurers and others.

They were the result of a lengthy data review process involving a panel of outside experts, the Advisory Committee on Immunization Practices.

But in May, Kennedy — a longtime leader in the anti-vaccine movement — announced COVID-19 vaccines would no longer be recommended for healthy children and pregnant women. He made the decision without input from the ACIP.

In June, he abruptly dismissed the entire panel, accusing them of being too closely aligned with manufacturers. He replaced them with a handpicked group that included several vaccine skeptics, and then shut the door to several doctors groups that had long helped form ACIP recommendations.

It’s not clear what other changes are in store for ACIP, but a number of medical groups say Kennedy can’t be counted on to make decisions based on robust medical evidence.

The moves sparked a group of public health researchers and others to form the Vaccine Integrity Project, based at the University of Minnesota, which aims to become the kind of compiler and reporter of medical evidence that the CDC and ACIP have been in the past.

In mid-August, the group held an ACIP-like Zoom meeting, in which subject-matter experts presented lengthy reviews of recent research about the safety and effectiveness of COVID-19, flu and RSV vaccines for children, pregnant women and people with weakened immune systems.

It also featured a four-person panel of experts, including the editor-in-chief of the New England Journal of Medicine. Like ACIP members, they asked presenters questions about their analyses.

Presenters made clear that they had to base their presentations on what had appeared in medical journals and was publicly available; they weren’t privy to unpublished surveillance and safety data that CDC collects.

The group is not making vaccination recommendations itself. But it is working with doctors organizations that are. One is the American College of Obstetricians and Gynecologists, which has said pregnant women should continue to get COVID-19 shots — counter to what Kennedy announced. Another is the American Academy of Pediatrics continuing to recommend them for children ages 6 months to 2 years.

But as medical societies split from CDC, it’s not yet clear which recommendations insurers will heed when making coverage decisions. And there remain a number of other questions, such as: What will happen in states that have vaccination policies tied to ACIP recommendations?

In Massachusetts, Democratic Gov. Maura Healey included language in a $2.45 billion supplemental budget bill that gives the health department authority to set its own recommendations and requirements if the federal government “fails to maintain a robust schedule of vaccine recommendations.”

Some other efforts now underway:

During the COVID-19 pandemic, the CDC teamed up with researchers at Boston Children’s Hospital and Harvard Medical School on www.vaccines.gov. The website told about newly developed vaccines recommended to protect against the coronavirus and served as a search engine to help people find nearby pharmacies that had the shots in stock.

But the site gradually dropped information about vaccines and why they were recommended, and this year became a stripped-down version that simply said: “Find a pharmacy near you” and a box to type in your zip code. When the government's contract with Boston Children's Hospital ended in late July, the site stopped working altogether.

Researchers at Boston Children's Hospital this month restarted a version of the site that existed before the pandemic, www.vaccinefinder.org.

“We're turning back to what it was,” said John Brownstein of Boston Children's, who founded the site. “Obviously, as a (government) site it carries more weight. But if that isn’t in the cards, we’re very happy to carry the torch.”

Last month, the Association for Dental Safety launched a new institute for dental safety that was designed to pick up some of the work done by the CDC’s Division of Oral Health, which was eliminated in the spring. The new institute is first focused on updating infection controls guidelines for dental offices, which the CDC last updated in 2003.

“Without a doubt, ADS is the best choice to continue oversight of dental infection prevention and control guidelines, ensuring recommendations are current, scientifically sound, translated into lay terms and disseminated to those who need them on a daily basis,” said Nicole Johnson, former associate director in the CDC’s Division of Oral Health, in a press statement.

The CDC's Pregnancy Risk Assessment Monitoring System, which annually surveys women across the country, lost its entire staff — about 20 people — in layoffs this year. It was the most comprehensive collection of data on the health behaviors and outcomes before, during and after childbirth. Researchers have been using its data to investigate the nation’s maternal mortality problem.

Some states that have the money and motivation might decide to run similar surveys, just within their borders. California runs its own, PRAMS-like survey.

But “if states are doing their own thing, then we don't have national, comparable data across jurisdictions and across time,” meaning its not possible to see where problems are most severe and which policies to reduce maternal deaths are working, said Jamie Daw, a Columbia University health policy researcher focused on pregnancy.

Kennedy recently fired about 100 CDC staffers who provided training, education, and advice to state and local violence prevention programs, and evaluate how well they were working.

“What's the point in knowing the about the rates of violence if you're not going to do anything about it?” said Sarah DeGue, one of the laid-off CDC researchers.

But existing programs still need technical guidance and expertise. In May, DeGue founded Violence Prevention Solutions, a consulting firm, to help community organizations develop and evaluate programs.

“It's us trying to rebuild what we had somewhere else, in a different way, so that all the knowledge and experience and resources that we had can still be available,” she said.

AP reporter Michael Casey in Boston contributed.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

A look at some of the worst fires in bars, nightclubs and music venues

A fire at a bar in the Swiss ski resort of Crans-Montana in the early hours of New Year's Day has left dozens of people presumed dead and around 100 injured, according to authorities. Here is a look at some other nightclub, bar and music venue fires that have led to significant death tolls:

— March 2025: A fire and ensuing stampede at the crowded Pulse club in Kocani, North Macedonia, killed 63 people, most of them young revelers, and injured more than 200. It was set off by a pyrotechnic flame that engulfed the roof of the club.

— April 2024: A blaze at the Masquerade nightclub in Istanbul, Turkey, trapped workers and employees while the venue was closed for renovations, leaving 29 people dead. It was located on the ground and basement floors of a 16-story residential building.

— October 2023: A fire that started at a nightclub in the southeastern Spanish city of Murcia and spread to two other clubs left 13 people dead.

— January 2022: A nightclub in Sorong, in Indonesia’s West Papua province, burned after two groups attacked each other inside the building. Nineteen people were killed.

— January 2022: A blaze at Liv’s Nightclub Yaouba in Yaounde, the capital of Cameroon, set off explosions that killed 17 people. The government suggested that fireworks set the roof alight and the fire then spread to areas where cooking gas was stored.

— December 2016: Thirty-six people died in a fire at a warehouse in Oakland, California that had been converted into a residence and event space for artists dubbed the “Ghost Ship.” The blaze, which broke out during an electronic music and dance party, moved so quickly that victims were trapped on the illegally constructed second floor.

— October 2015: A blaze that broke out during a rock band’s pyrotechnics display at the Colectiv nightclub in the Romanian capital, Bucharest, killed 64 people and left some 190 injured.

— January 2013: A fire killed more than 200 people at the Kiss nightclub in the city of Santa Maria in southern Brazil. Investigators said soundproofing foam on the ceiling caught fire and released poisonous gases that quickly killed those attending a university party.

— December 2009: Some 152 people died when a blaze broke out at the Lame Horse nightclub in Perm, Russia. It started when an indoor fireworks display ignited a plastic ceiling decorated with branches.

— January 2009: An indoor fireworks display after a New Year’s countdown ignited a blaze in the Santika club in Bangkok, Thailand, killing 67 people and injuring many more. Victims died from burns, smoke inhalation, and from being crushed.

— September 2008: A fire killed 44 people at the jammed King of Dancers nightclub in Shenzhen, China, when a stampede broke out after a fireworks show ignited the ceiling.

— December 2004: In Buenos Aires, Argentina, a fire killed 194 people at the crowded Cromagnon Republic club after a flare ignited ceiling foam. Club owner Omar Chaban was sentenced to 20 years in prison for causing the deadly fire and for bribery. Others received lighter sentences.

— February 2003: A fire at the Station nightclub in West Warwick, Rhode Island, in the United States, killed 100 people and injured more than 200 others. Fireworks being used by the band set fire to flammable foam inside the club.

— January 2001: A fire at a cafe in the Dutch town of Volendam where people were celebrating the New Year killed 14 people and injured more than 200.

— December 2000: A fire that was blamed on a welding accident killed 309 people at a disco in the central Chinese city of Luoyang.

— October 1998: An arson attack against an overcrowded youth disco in the Swedish city of Goteborg killed 63 people and left around 200 injured. Four people were later convicted for starting the fire.

— March 1996: A fire at the Ozone Disco Pub in Quezon City, Philippines, killed 162 people. A large proportion of the victims were students partying to mark the end of the academic year.

— March 1990: An arson attack at the Happy Land nightclub in the Bronx borough of New York City killed 87 people. It started when a man angry with his girlfriend threw gasoline on the club’s only exit and set it on fire, then jammed down the metal front gate so people were trapped.

— December 1983: A fire at the Alcala dance hall in Madrid, Spain, left 78 people dead and more than 20 injured.

— May 1977: A fire at the Beverly Hills Supper Club in Southgate, Kentucky, killed 165 people and injured more than 200.

— November 1942: The deadliest nightclub fire in U.S. history killed 492 people at Boston’s Cocoanut Grove club. The fire at what had been one of Boston’s foremost nightspots led to new requirements for sprinkler systems and accessible exits.

— April 1940: A fire ignited the decorative Spanish moss draping the ceiling of the Rhythm Night Club in Natchez, Mississippi, killing 209 people. The windows had been boarded up to prevent people from sneaking in.