BOSTON — After a full day of oral arguments in a packed courtroom, Boston federal judge Brian E. Murphy did not rule from the bench on a lawsuit from the American Academy of Pediatrics, the professional body representing the country’s pediatricians, against the Department of Health and Human Services, focused on vaccines.

The judge asked for more information before he decides on the legality of changes to the childhood vaccine schedule and to the federal committee that advises on vaccine recommendations. Murphy asked the government’s lawyers to respond to declarations that the plaintiffs submitted the evening before the hearing — including a declaration from immediate past AAP president Susan Kressley. Murphy asked that the DOJ submit its response by the end of the day Wednesday.

The suit was filed in federal district court in Boston after Kennedy announced via a video posted on X that Covid vaccines would be removed from the childhood immunization schedule. The scope of the suit has since expanded to include challenges to Kennedy’s reconstitution of the panel that advises the Centers for Disease Control and Prevention on vaccines, as well as to the pared down vaccine schedule published in January.

The AAP, along with other medical and public health groups and three anonymous women, accused the Trump administration of violating the Administrative Procedures Act, which lays out how the government should make policy changes. The plaintiffs argue that the changes were “arbitrary and capricious,” meaning that sufficient care was not taken to understand the repercussions of its actions.

A study published recently in Annals of Internal Medicine confirmed what many clinicians had begun to suspect: Nearly half of the Centers for Disease Control and Prevention’s regularly updated surveillance databases have gone dark. Of 82 databases that were updated at least monthly at the start of 2025, 38 have stopped — no new data, no explanation, no timeline for resumption. Eighty-seven percent of the paused databases are vaccination-related.

Physicians have relied on that data for 40 years. Every morning before walking into the ICU, my colleagues and I checked flu activity levels, RSV hospitalizations, drug-resistant organism patterns. This wasn’t academic curiosity — it was how we kept patients alive. When influenza surged, we had antivirals ready. When adult RSV spiked, we warned colleagues in pediatrics. When resistant pathogens emerged, we adjusted our antibiotic choices before culture results returned.

That surveillance data was the nervous system of American medicine — constantly sensing, constantly warning us what was coming. Now it’s falling silent, and the CDC isn’t even telling us why. (Some of these databases are updated seasonally and may have been affected by the government shutdown at the time the researchers checked.)

I’ve seen what happens when public health infrastructure goes quiet. In 1981, when young men started dying of strange infections, there was no surveillance system to connect the dots. It took months — months of preventable deaths — before anyone recognized we were facing a new epidemic. Those of us in public health and clinical medicine built surveillance systems precisely so that would never happen again. Those systems worked: They caught H1N1 in 2009, tracked Ebola’s spread, and gave us week-by-week Covid-19 data that shaped hospital surge planning nationwide.

Now the federal government is dismantling them with nary a congressional vote or public debate.

WASHINGTON — Two top health officials are leaving their jobs amid a shakeup at the Department of Health and Human Services aimed at refocusing HHS on politically popular aspects of health secretary Robert F. Kennedy Jr.’s agenda in advance of the midterm elections.

Deputy Secretary Jim O’Neill and General Counsel Mike Stuart are exiting a year into Kennedy’s reign, according to a person familiar with the matter. HHS and the White House didn’t respond to requests for comment on Friday. The news was first reported by Politico.

The White House directed the changes to overcome dysfunction at the agency that had been attributed, in part, to poor management, the person said. The new leaders, trusted by top administration officials, are expected to smooth out problems that have added to chaos during a period of historic upheaval.

The departures come as leaders of the MAHA movement make the case to the White House that they will be crucial to winning over key voters in the midterms, leading officials to home in on health policy issues that poll well.

WASHINGTON (AP) — The Trump administration on Thursday revoked a scientific finding that long has been the central basis for U.S. action to regulate greenhouse gas emissions and fight climate change, the most aggressive move by the president to roll back climate regulations.

The rule finalized by the Environmental Protection Agency rescinds a 2009 government declaration known as the endangerment finding that determined that carbon dioxide and other greenhouse gases endanger public health and welfare.

The endangerment finding by the Obama administration is the legal underpinning of nearly all climate regulations under the Clean Air Act for motor vehicles, power plants and other pollution sources that are heating the planet.

President Donald Trump called the move “the single largest deregulatory action in American history,” while EPA Administrator Lee Zeldin called the endangerment finding “the Holy Grail of federal regulatory overreach.”

The top federal prosecutor in upstate New York was fired by the White House just hours after federal judges appointed him to the post.

It’s the latest tug-of-war between the Trump administration and the judiciary over President Trump’s efforts to install loyalist U.S. attorneys across the country, skirting approval from both the Senate and the courts.

Veteran prosecutor Donald Kinsella was sworn in as U.S. attorney for the Northern District of New York in a private ceremony Wednesday, according to an announcement from the district court.

Later that evening, Deputy Attorney General Todd Blanche wrote on the social platform X that Kinsella was removed from the role.

When Kulindu Vithanachchi’s phone lit up with an update from the National Science Foundation about his application for a high-profile early-career fellowship, he couldn’t wait to open the message, hopeful for big news. But not this news.

Vithanachchi, a University of Arizona undergraduate and budding microbiologist, was in the lab when he learned that his application for NSF’s Graduate Research Fellowship Program had been “returned without review,” turned back before outside experts had a chance to judge the scientific merit of the proposal. The agency’s email said his submission included proposed research that made him ineligible for the program — and that the decision was final. The email did not specify further.

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When NSF announced a second batch of 500 GRFP recipients last year, none was in the life sciences, even though the field has historically been among the leaders in applicants and recipients. Students in computer science and physics, however, had better odds of success, and the Trump administration has made artificial intelligence and quantum information science key parts of its scientific agenda. The former program directors recently performed a statistical analysis suggesting that the 2025 award pattern was the result of selection bias.

A GRFP award isn’t a golden ticket, but it offers some security in academia, where funding can make or break careers. Corbin Schuster, a microbiologist at Oregon State University, had been hopeful a Ph.D. student in his lab would receive the award, as the fellowship combined with startup funds would have covered the student’s stipend for the length of her dissertation project. But Schuster, whose trainee had her application returned without review, says the student will probably need to do teaching assistantships to cover part of her pay, which will slow down the pace of her project.

Big changes are coming to the Medicaid system this time next year — and I fear they will quietly but profoundly decimate the unpaid workforce that already props up our long-term care system.

At first glance, the new requirements seem like a no-brainer: force non-disabled adults on Medicaid to work or volunteer at least 20 hours a week to encourage employment and reduce public spending.

But many of the 39.2 million adults on Medicaid have a very good reason not to be working or volunteering.

According to the AARP, nearly 8 million people who work as unpaid caregivers to a loved one rely on Medicaid for their insurance. These caregivers are not disconnected from work; they are performing essential labor every day. By forcing people to choose between going back to work or providing lifesaving care to their loved one, the end result is going to be higher health care costs for everyone, thanks to an increased demand for paid caretakers and institutional care.

Drug reviews are a frustratingly opaque process, so absent subpoena power, one cannot fully discount the possibility that Regenxbio’s Hunter syndrome gene therapy data were weak, totally screwed up, or some combination of both. If that’s what happened, the Food and Drug Administration’s decision to reject the therapy was justifiable.

But it’s hard to ignore a broader and more troubling trend: The Regenxbio treatment, called RGX-212, joins a growing list of cell and gene therapies for rare diseases that have been rejected or delayed since the appointment of Vinay Prasad as the head of the FDA center that regulates them.

Prasad has also wrested control of vaccine regulation. This week, he refused to review a flu vaccine candidate from Moderna, overruling the agency’s staff who deemed the company’s submission acceptable.

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Prasad changed jobs but his conservative regulatory doctrine remains the same, particularly for cell and gene therapies. The approval bar is much higher than it ever was before. Constantly shifting FDA goal posts is going to kill investment in rare diseases. I said this three weeks ago in this space. I’m saying it again.

Perhaps the most surprising trade policy development of 2025 wasn’t President Donald Trump’s tariffs but rather foreign governments’ refusal to respond in-kind. Although such abstinence is economically optimal, politicians typically embrace tit-for-tat retaliation for political and strategic reasons. So, when only China and Canada followed Trump’s protectionist lead, the relative quiet was an unusual, albeit welcome, result.

It didn’t mean, however, that governments, companies, and even many individuals were standing still. Instead, they “retaliated” in a smarter way: reducing their future reliance on a US that has increasingly embraced protectionism since at least 2016 – protectionism that, ironically, might be helping the very country tariffs were supposed to contain.

America’s departure from the epicenter of global trade began years ago and has accelerated in recent months. According to the World Trade Organization, the US share of global merchandise trade (imports plus exports) in the third quarter1 was the lowest for that period of the year since 2014, and the drop from 2024 was larger than the cumulative loss between 2015 and 2024. Bloomberg News adds that inbound container volumes through North America — some 80% of which is the US — went “from a world leader to a laggard” last year. Boston Consulting Group projects the trend will continue in the years ahead, with the US’s share of world trade falling from 12% in 2024 to 9% by 2034 because of “policies pursued by the Trump administration.”

Even bigger moves are happening beneath the surface, especially regarding China. When Trump fired his opening tariff salvo in 2018, the US absorbed roughly 19% of Chinese exports, but the share tumbled to 11% by the end of last year. China’s total exports and trade surplus have nevertheless continued to grow because exporters there targeted other markets, notably in Southeast Asia (Asean) but also in Africa, Europe and Latin America – a move trade economists have dubbed “the great reallocation.”