Over the last four decades, the federal government's recommendations for childhood vaccination have exploded in number, following the creation of blanket no-fault liability protections for vaccine manufacturers under the National Childhood Vaccine Injury Act (NCVIA), passed in 1986. This provided a special federal court process to shield pharmaceutical manufacturers from legal liability arising from injury or death from routine injections. With no economic incentives to innovate or improve product safety, it is not surprising that pharmaceutical companies have brought many dozens of products to the protected legal cocoon that is the vaccine market in the United States.
In that comfortable cocoon, reimbursement for vaccines is guaranteed by the federal government under the Vaccines for Children program, which provides all ACIP-recommended vaccines on the CDC schedule at no cost to eligible children—those who are on Medicaid or do not have coverage through insurance. VFC supplies between 50–55% of all childhood vaccines in the U.S. through this legally required mechanism, a situation no other drug class or type enjoys.
Compounding this, vaccine manufacturers are served predictable revenue once inside this cocoon, and broad legal immunity assures near-zero chance of market disruption—all for products that the federal government recommends, that most states mandate for school entry, and that the federal government recognizes as dangerous. For covid-19 injections, emergency PREP Act legislation—still in place—provides even more protection on top of this to the manufacturers and administrators of the "countermeasures" used against SARS-Cov-2. It has been an enviable position for vaccine developers and manufacturers, going all the way back to the Reagan administration.
Despite the decades of calm for these products in this artificially-protected drug market, the chronic childhood disease epidemic across the country has meanwhile exploded, and the public is searching for answers. Covid vaccine mandates sold under false pretenses have undermined public trust. Now there are contentious discussions occurring at the Advisory Committee on Immunization Practices (ACIP), an external expert group convened by the Centers for Disease Control and Prevention (CDC), as it examines the future of the growing childhood vaccine schedule, with an eye on its potential long-term health impact on children—looking beyond the disease-specific prevention claims of the injections to the whole body of evidence. ACIP is now considering not just one indicator—the antibody response in a child for a new injection—but also the adjuvants, the additives, the dosage, the timing, the relative risk of the diseases in question, and the potential risks of the vaccine itself. This is a dangerous turn for pharmaceutical companies.
Historically, the ACIP committee was overwhelmingly deferential to industry, and the CDC quickly rubber-stamped its findings into recommendations which were in turn taken up by the states—and once in place, the product is quite secure for the foreseeable future. It was rarely a cause for concern for the pharmaceutical industry. States' "rights" to impose vaccine mandates seemed permanently secure, enshrined in court cases from over a century ago from Jacobson v. Massachusetts in 1905 to Zucht v. King in 1922, which are cited by states to impose vaccine mandates, even without a clear danger from the disease in question.
In fact, in the modern era, just once has an injectable vaccine been withdrawn from this liability-free comfort zone, and that was only when one of the ACIP committee members, Dr. Paul Offit, conveniently held the valuable patent for the very replacement for the rotavirus vaccine Rotashield®[1] that was being removed for safety reasons. Personal profit seems to be an excellent motivator to examine, trust, and act upon data received in VAERS (Vaccine Adverse Events Reporting System), a system much maligned and disregarded by mainstream medicine once it became inconvenient during the covid-19 vaccine debacle.
Dr. Offit claims he made between six and ten million dollars on the sale of his RotaTeq® patent to Merck, but estimates range as high as 29 million.[2][3] Somehow, despite this incredible conflict of interest, Dr. Offit is a regular commentator on national news media hurling invective at the reforms taking place at the CDC and HHS today, presented by broadcasters as a neutral scientist with no motivation beyond helping children.
In contrast, today the ACIP is taking strides toward open scientific debate, and away from industry-funded and ethically conflicted "experts" like Dr. Offit. This in turn has upset the various industry-financed "non-profit" trade groups like the American Academy of Pediatrics (AAP), who have tried to convince state officials to ignore the federal government's advice should it prove too skeptical of pharmaceutical companies’ claims of safety and efficacy, and that states should never allow any non-medical exemptions to vaccination.[4] AAP publicly admits that it receives direct funding as a non-profit from the top four major vaccine makers Merck, Moderna, Pfizer, and Sanofi.
States are Shrouding Citizen Abuse in Federalism
With HHS and daughter agencies scrutinizing the true risk and benefits of vaccines in a way never before seen, many state officials in the northwest and west coast of the US are issuing statements[5] about coordinating their vaccine recommendations, freezing them in place, and peeling away from concordance with new federal vaccine guidance as it is released.[6] On the East coast, the Northeast Public Health Collaborative has formed, which is an informal working group of health directors and commissioners at the state and city levels, who share information and promote "evidence-based" public health. However, it is not binding, as members "may choose to participate in or adapt those specific initiatives consistent with their particular needs, values, objectives, and statutory or regulatory requirements."[7]
On the other side of the country, the similar West Coast Health Alliance is "beginning the process" to combat the "politicization of science" by forming a political bloc with formal, "unified" recommendations of their own, "regarding who should receive immunizations and to help ensure the public has access and credible information for confidence in vaccine safety and efficacy."[8] Surely this group has considered that public "confidence" should only be present when justified by inert placebo-controlled, double blind clinical trials for safety and efficacy, a distinction no current vaccine on the childhood schedule enjoys. Confidence should also stem from advice given freely, without coercion, and without regulatory capture of relevant agencies reviewing the evidence underpinning that advice.
And yet, for both of these groups, their public statements indicate that they will be relying equally, or more so, on industry-funded groups like AAP to drive their findings and guidance as the federal bureaucracy is now addressing that very regulatory capture in a rigorous and public way.
It is a bizarre irony that in many states where residents are intrinsically opposed to the idea of states' rights, their representatives are suddenly all in favor of the concept when it is applied to restrict their own residents' medical freedom and choices. This move is clearly and publicly designed to create new state-specific or pooled funding streams for vaccine reimbursement, and to protect the states' overall power to impose their own, more severe mandates than what the federal government recommends itself.
This is not a phenomenon entirely limited to those on the other side of the aisle from the current administration. Professional associations in every state are under pressure to side with pharmaceutical lobbyists and their allies. Even in states like Texas[9], trade groups like the Texas Medical Association (TMA) this week shared an announcement that they, like California[10], would be incorporating evidence from pharmaceutical industry-financed advocacy groups like the AAP and/or the federal government (when they prefer to listen) to adjust for recent changes in guidance from the CDC and ACIP in their own recommendations. Fortunately, Texas Attorney General Ken Paxton did push back against the "decision by TMA to brazenly reject patient choice for COVID-19 vaccines" on October 6th.[11]
Statements like these have unbelievably elevated AAP alongside the now independent and publicly transparent ACIP. For reference, this is the same AAP that released "Guidelines for Adolescent Depression in Primary Care" without mentioning in the document that their authors were also consultants for the companies that made Zoloft and Lexapro in 2018. ACIP, in contrast, requires all conflicts be stated publicly and all deliberations are recorded and publicly available.
In fact, ACIP Chair Martin Kulldorff noted on July 25th that recusal is required not only from votes but from discussion—"[a]s per our updated guidelines post-reconstitution, we reiterate that no member shall participate in discussions or votes where they hold financial or professional ties to vaccine manufacturers. This ensures our recommendations are driven solely by evidence and public health needs, not industry agendas." Even industry news publications agreed that stated conflict of interest is now at an all-time low at ACIP meetings (0% of members) vs the 2000s average (43% of members) being conflicted.[12]
Industry-funded “non-profit” trade groups like the American Medical Association, the AAP and others, were formally dis-invited from ACIP working groups this summer[13], but were still able to call in as participating observers during the ACIP meetings as liaison organizations. In one communication, the ACIP stated clearly that these organizations are “special interest groups and therefore are expected to have a ‘bias’ based on their constituency and/or population that they represent.”[14] To a rational observer, the difference could not be more stark between the regional state health groups’ deference to industry-dominated organizations in their recommendations, and the obvious improvement of the conflicted environment in Washington D.C. bureaucracies, compared to the past. States may indeed choose their own path, but certainly cannot reasonably claim superiority in terms of fighting conflict of interest or industry influence.
How might the ideas of medical freedom and bodily autonomy apply in such a situation? When states like Idaho or Florida move toward more medical and health freedom at the state level, it represents the best hope for the use of federalism for the public good as it challenges a stronger federal power in the name of local autonomy. When sovereignty of the state is used to weaken the sovereignty and choice of the individual, and is used primarily to restrict freedom, it is an affront to the spirit of local control and federalism as it takes away personal autonomy using pressure and coercion from above.
For Health Freedom Defense Fund (HFDF) and like-minded organizations that believe genuinely in more local and personal control over health choices, state-level protections to assure health autonomy and individual freedom are a critical tool.
But this cynical approach, using the state to limit individual freedom, creates less choice and difficult challenges for the families in those states. Many are effectively under duress, and do not have access to any form of exemptions, and therefore lack informed consent to choose their medical path forward. Disturbingly, the newly elevated AAP shares strategies with pediatricians to grant less exemptions, never support any non-medical exemptions informally, and make sure that any exemptions expire quickly so children must come back and periodically prove their allergies, show their eczema, and presumably recreate their post-vaccine fevers and seizures again on demand. As the AAP states in their sadistic policy statement:
The AAP further recommends that all pediatric health care providers understand bona fide reasons for granting medical exemptions, as detailed in the Red Book, only grant exemptions when medically justified, and recertify the need for these exemptions on a regular basis.[15]
In many states where pervasive skepticism of pharmaceutical companies was a way of life for decades, that inquisitive nature has been all but extinguished under a flood of lobbying funds, at least at the leadership level. HFDF hopes that citizens in these states use all the legal, political, and social tools at their disposal to change this reality. To this end, HFDF has released a toolkit including "Medical Freedom Act" model legislation, for coalitions and lawmakers to draw upon based on successful efforts in Idaho earlier this year.
[1] Replacement: Rotateq(e.g., US patents 5,626,851; 5,750,109; 6,113,910; 6,290,968)
[2] https://www.ageofautism.com/2009/12/counting-offits-millions-more-on-how-mercks-rotateq-vaccine-made-paul-offit-wealthy.html$182 million patent sale and a ~30% inventor share policy.
[3] https://www.cbsnews.com/news/how-independent-are-vaccine-defenders/
[4] https://publications.aap.org/aapnews/news/32619/AAP-Nonmedical-exemptions-to-school-immunization?autologincheck=redirected
[5] https://www.gov.ca.gov/2025/09/03/california-oregon-and-washington-to-launch-new-west-coast-health-alliance-to-uphold-scientific-integrity-in-public-health-as-trump-destroys-cdcs-credibility
[6] https://www.nyc.gov/site/doh/about/press/pr2025/announce-northeast-public-health-collaborative.page
[7] https://www.nyc.gov/site/doh/about/press/pr2025/announce-northeast-public-health-collaborative.page
[8] https://www.gov.ca.gov/2025/09/03/california-oregon-and-washington-to-launch-new-west-coast-health-alliance-to-uphold-scientific-integrity-in-public-health-as-trump-destroys-cdcs-credibility/
[9] Texas Medicine Today, September 29, 2025
[10] California AB 144
[11] https://x.com/KenPaxtonTX/status/1975203115193548931 (with image of public letter)
[12] https://www.fiercepharma.com/pharma/conflicts-interests-cdcs-vaccine-panel-historic-low-when-rfk-jrs-hhs-purged-committee-remove
[13] https://apnews.com/article/vaccine-committee-cdc-cfbdcab84b2a919a6131d471959c3431
[14] https://www.fiercehealthcare.com/regulatory/major-medical-groups-barred-cdc-vaccine-workgroups
[15] Ibid. Recommendation 3.
