| |  | The Lead Brief | The U.S. has fractured into competing camps over how to manage public health. And if you’ve been confused about the contradictory nature of vaccines and other areas of health policies in the past few months, you’re not alone. A new KFF poll released this morning found that a majority of Americans are unsure whether the Trump administration’s warning of a potential link between taking Tylenol during pregnancy and autism in children is true. The poll also revealed a continued decrease in confidence in the Centers for Disease Control and Prevention — with public trust, including among Republicans, dropping to its lowest level since the beginning of the coronavirus pandemic. Let’s break down where the power centers stand right now: — THE NEW GUARD President Donald Trump, Health and Human Services Secretary Robert F. Kennedy Jr. and the “Make America Healthy Again” bully pulpit in action. In the eight months since Kennedy took the helm of HHS, both he and his deputies have amplified skepticism of federal health bureaucracy. Kennedy has courted input from alternative medicine supporters, pushed out top officials who disagreed with him and replaced members of a federal vaccine advisory panel with his handpicked choices, many of whom have expressed skepticism about vaccines. Kennedy has also cast aside expertise from established medical groups and voices, arguing they are rife with corruption and conflicts of interest. The administration claims it’s operating in the pursuit of “gold-standard science.” Trump, meanwhile, has used his platform to question vaccine mandates, promote “medical freedom,” and revive unproven theories about vaccines contributing to an increase in autism rates in children. — THE MEDICAL ESTABLISHMENT Former surgeons general and professional medical organizations, such as the American College of Physicians, have been pushing back. This week, six former U.S. surgeons general wrote an op-ed for The Washington Post that argued Kennedy’s actions atop the agency are “endangering the health of the nation” — emphasizing the public warning is a move they’ve never had to take before. “We are clear-eyed about the fact that [public health] systems need to be improved, including paying more attention to areas such as disease prevention, mental health and chronic illness. But reform must be grounded in truth, transparency and scientific evidence,” they wrote. Jason Goldman, the president of the American College of Physicians, has called for Kennedy’s removal, arguing he has “shown a blatant disregard for decades of evidence-based, proven science, and [has] spread dangerous medical misinformation, sowing chaos and confusion and putting lives at risk.” — THE PHARMACEUTICAL INDUSTRY Drugmakers are trying to navigate this landscape without losing access or credibility. Many of them are simultaneously negotiating drug pricing deals with the Trump administration — in an effort to secure tariff relief and stave off additional regulatory threats — while scrambling to respond to the statements Trump and his top health officials are making about vaccine safety. Pharma giant Eli Lilly, which doesn’t manufacture any vaccines, drew the ire of the MAHA world this week when it hired Peter Marks, the former vaccine regulator who Kennedy had forced to resign in March. Marks now serves as the senior vice president of molecule discovery at Lilly and as the head of its infectious-disease unit. Calley Means, a Kennedy ally and brother of Trump’s nominee for surgeon general, called it “a scandal.” — THE BLUE STATE DIVIDE The West Coast Health Alliance and the Northeast Public Health Collaborative, two collections of states led by Democrats that have broken from the federal government on public health guidelines, together represent a dozen states signaling they have lost confidence in federal health officials’ ability to craft immunization policies. It’s a dramatic departure from historical precedent, in which the CDC set recommendations that were followed by private sector companies and state and local health departments. (Many insurance plans also said they would be continuing coverage of the coronavirus pandemic, regardless of the administration’s final recommendations.) — THE BOTTOM LINE How this all resolves into coherent policy — or consistent medical guidance — remains unclear. Kennedy and his allies want to disrupt the system and, in their view, regain the public’s trust in health care institutions and guidance that’s been jeopardized by moneyed interests over time. But his approach could end up widening the divide. Indeed, the fight is unlikely to end: Major health industry players — including drug companies, insurers, provider groups and hospitals — have spent more than $429 million to lobby the federal government during the first half of 2025, according to a tally from the Center for Responsive Politics. Ultimately, it may depend less on the science and more on where you live, your politics and the relationship you have with your doctor. A vast majority, 83 percent, of respondents to today’s KFF poll said they trust their own doctors “a great deal” or a “fair amount” to provide reliable information about vaccines — a far higher score than any other source. (Just 35 percent of adults overall trust Kennedy.) | 
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