Over the past year, cuts to vaccine research funding and significant changes to federal vaccine recommendations under the Trump Administration’s Health and Human Services department have drawn alarm from scientists, doctors, major medical organizations and public health experts.
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. has stepped up efforts to upend longstanding federal vaccine recommendations this year.
In January, advisers appointed by Kennedy on the Advisory Committee on Immunization Practices narrowed recommendations for certain vaccines for high-risk children or after consulting with a physician. Federal guidance used to recommend that children be routinely inoculated against 17 diseases, but now it is recommended for 11 diseases.
The changes were made to align the U.S. with other countries’ vaccination schedules and encourage individualized decisionmaking, according to the administration. On Wednesday, 15 states sued the administration over the changes, contending that they weren’t based on any scientific evidence.
Kennedy’s administration also previously cut $500 million in federal funding for mRNA vaccine research. In November, Kennedy directed the U.S. Centers for Disease Control and Prevention to abandon a statement on its website that vaccines don’t cause autism. The website now claims that such a statement is not “evidence-based,” despite a large body of evidence and scientific consensus that no causal link between childhood vaccines and autism exists.
And late last month, the chair of the federal panel that makes vaccine recommendations, Dr. Kirk Milhoan, said the group would review the evidence and recommendation framework for all vaccines on the U.S. schedule, including immunizations such as those against polio and measles.
Those comments prompted a response from Dr. Larry Schlesinger, the president and CEO of Texas Biomedical Research Institute, who stressed the importance of maintaining evidence-based immunization schedules.
Diseases such as measles, mumps, rubella, chickenpox, pertussis and polio are no longer the major public health threats they were in the 20th century, thanks to the advent of vaccines and widespread immunization efforts.
Not all have disappeared. Pertussis (whooping cough) continues to circulate and has resurged in recent years. Measles cases are also climbing, threatening the nation’s elimination status. An outbreak of the virus in West Texas last year killed two children.
Texas Biomed has a long history of vaccine research. Researchers at the institute have supported COVID-19 vaccines through animal model work and testing during the coronavirus pandemic, as well as the hepatitis B vaccine used today, among others.
Schlesinger, a physician and infectious disease researcher, has led Texas Biomed since 2017. Amid the changing federal vaccine schedule, increasing vaccine hesitancy, and U.S. measles outbreaks, the San Antonio Report spoke with him last week about the changes and his concerns.
The interview has been edited for length and clarity.
Can you talk about the impacts of vaccines on human health and lifespan over the last century?
Today, life expectancy is in the 70s, in relatively large part due to vaccines. At the turn of the 20th century, life expectancy was in the 40s [in the U.S.] People were dying of, largely, infectious diseases, gastrointestinal disorders and childhood viruses. [The] discovery in the 20th century that vaccines can help prevent some of these childhood infections … led to a national program of vaccinating children.
Largely as a result of that work in the 1940s and ‘50s, we have a world now in which those diseases — measles, mumps, rubella, chickenpox, pertussis, polio — are really not part of American life any longer. We now have a generation of individuals who are young enough not to remember that. And yet their health was as a result of the impact of the discoveries of vaccines.
It’s been estimated that since the 1970s, over 150 million people’s lives have been saved by vaccines. So it is still the singular most powerful way to handle an infection, and that is to prevent it, if possible, in the first place; or secondarily, to limit the severity of that disease.
How much of the growing skepticism toward vaccines comes from the new administration? Is there a larger and perhaps older undercurrent of public distrust in science and the health system that you’re concerned about?
It’s been kind of smoldering for quite a while now. There’s always been a small population of individuals who have been skeptical of vaccines, so that’s not new. There was a growing concern about the formulation of the measles vaccine that led to particularly affluent populations of families beginning to question their efficacy. And then social media started taking over and talking about vaccines.
It’s important to state that no vaccine is 100% safe. The way to evaluate vaccines is … to put them through very large clinical trials that have tens of thousands of individuals — a big enough volume of individuals to be able to, with rigor, identify the percentages of people that have mild, moderate and severe side effects to a vaccine.
Vaccines cannot be presented to the FDA until they’ve undergone rigorous testing to determine what is considered to be a relatively rare, serious side effect, but never zero. You have a backdrop of some concern, and then you start reading stories about individuals who have had adverse effects, and you start thinking that the vaccine does it all the time. [As a result], we’ve experienced a tremendous growth in what’s called vaccine hesitancy, or concerns about vaccines.
After that problem, then of course, there’s nothing more important than leadership on the topic. Then you started hearing from leadership in the country that we should be reevaluating vaccines. And to someone who has spent their career focused on preventing infection and limiting infection to improve human health, this is very concerning to me. Because we know that populations need to be vaccinated on a population scale — at a very significant level — to enable that population to start feeling safe in terms of even [sending] their children to school.
As a physician, when I was practicing, at one point in my training … I took care of patients in the iron lung, which is a device that’s very uncomfortable and is required for people who have polio and can no longer breathe. I remember vividly what that is like.
What might be the public health and research consequences of the changes to the vaccine schedule?
When you’re making public policy decisions about vaccines or even treatment recommendations, one of the aspects that is not talked about enough is compliance. That is the likelihood that a family will understand the recommendations and feel like they can do them simply. It’s more or less: the simpler, the better.
The recent changes to childhood vaccination schedules — we can talk about whether there’s actual science behind that or something else — but adding complexity and adding individual responsibility will, and is [already leading] to a drop in vaccine use.
The vaccine schedule that’s been in place for decades was built upon science and also compliance. Once you add complexity to that schedule, and you make it more of an individual decision [to] go to your doctor, I think the end result is less vaccines are taken. And when less vaccines are taken for highly communicable diseases, then you have what you have today, which are outbreaks of measles and the potential loss of the eradication standard in the U.S.
It’s not the only infection that’s rising today. And I just think that we’re not in a good direction. We need strong leadership. We need clear messaging, we need simple vaccine schedules to enable more and more people to be comfortable taking them.
You hinted at this, but are there any legitimate scientific reasons to reevaluate the vaccine schedule?
As best I can tell, the current desire to reevaluate is really based on a belief that not enough rigorous clinical studies have been done, and as a physician scientist, I’m having a hard time reconciling that with the numerous studies that have been published on the safety and efficacy of these longstanding vaccines.
We’re talking about vaccines that have been used for decades and have already proven efficacy in saving lives. So although no vaccines are 100% safe, when you evaluate the benefits versus the risk, the benefits for these, particularly childhood vaccines, far outweigh any of the risks that are talked about these days on social media.
The most visible part of this discussion is this question, in 2026, of whether childhood vaccines cause autism. There is absolutely no research to reevaluate that link based on the numerous studies.
The original study that people talk about that had just a handful of individuals that have been totally debunked and disproven is the only literature out there. There is no other literature that would make a scientist like myself truly feel like there’s a need to reevaluate this. My bigger concern is the consequences of even suggesting reevaluation, because that immediately leads to less vaccines being given.
Does Texas Biomed have a role in efforts to rebuild public trust in vaccine science?
There’s no easy solution. I think that Texas Biomed really does want to place itself in a leadership role as content experts. [We] spend significant time in our educational programs, and that includes our STEM K-12 programs. We have a very active educational program where we talk about what vaccines are. First we have to describe vaccines, what they actually are, how they actually work.
Recently we had an event, and there were over 100 women with young children in the audience, and we presented information about vaccines. And it was really to [ask], “What are your questions? What are your concerns? Where’s the information coming from?” The answer is not, “I’m a scientist” or “I’m a doctor and know what’s right.” I think it’s a matter of trying to understand how individuals have developed their concern and try to meet that and then try to provide information to them.
You said during a bigcitysmalltown episode in May that Texas Biomed was largely insulated from the federal funding cuts to research. Is that still true?
It is. We continue on the back half of a 10-year strategic plan in modernizing our campus and continuing to recruit talent to the institute. So in many ways, it is continuing business as usual.
There is a lot of research going on in vaccines, despite what we’re reading. Pharmaceutical companies remain highly committed to developing vaccines. Our military, and we have a large military presence in San Antonio, understands the dangers that our troops [face] with regard to infection, and are highly committed to vaccinating or reducing the severity of illness in our folks in the military.
Although there’s been cutbacks at the [National Institutes of Health] on mRNA technology, there certainly has not been cutbacks in pharma. So research continues, despite what we read.
However, what we spend more time on now is uncertainty about federal funding. Policy decisions come out pretty frequently, and then there are follow ups to those policy decisions to try to add more clarity, and we have to follow that very closely to ensure that we’re using the right approach and strategy to fund our science.
What has been really very important for Texas Biomed is the fact that we are nimble and efficient in our science practices, and that we’re growing our research in a much more diversified way, with work in the private sector and with other arms of the government that continue to fund the science more predictably, and that has helped us stabilize our revenue into the institute. But the uncertainty is disturbing, and it requires constant communication among our scientists.
And we feel perhaps more of an urgency given the outbreaks that are occurring. We have a contract now to test a new therapeutic for measles. I’d say even five years ago, that would have been unheard of because of the fact that we vaccinate our children at a very high level, and measles cases [were] few and far between. That’s not the case anymore. If anything, we have more work to do, not less, a year later.
