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Health Affairs This Week places listeners at the center of health policy’s proverbial water cooler. Join editors from Health Affairs, the leading journal of health policy research, and special guests as they discuss this week’s most pressing health policy news. All in 15 minutes or less.
Hello and welcome to Health Affairs This Week. I'm your host, Jeff Beyers. We're recording on 08/21/2025. Health Affairs has a lot of virtual events coming up in the next couple of weeks. So just wanna tell you quickly about all of them.
Rob Lott:A lot of them are free. There is one insider event. On August 26, we have a free virtual event that will explore independent dispute resolution for our provider prices in the commercial sector series. On September 3, we have a free issue briefing for our next month's theme issue on the insights about the opioid crisis. On September 17, we have a lunch and learn that's also free on the current opioids policy landscape and what's ahead.
Rob Lott:And on September 23, for insiders, we have a panel to discuss prior authorization, its current state, and potential reform. So we hope you'll join us for at least one of those. We're excited to, see you in the fall. Today on the pod to talk about mRNA vaccine policy, we have Kathleen Haddad. Kathleen, welcome back to the program.
Kathleen Haddad:Hey, Jeff. Nice to be here.
Rob Lott:So HHS this month terminated 22 mRNA projects. So that equals about 500,000,000 in contracts. Kathleen, what can you tell us about the details of that, and what was the agency's reasoning?
Kathleen Haddad:So, Jeff, this is, a decision under the Biomedical Advanced Research and Development Authority, which is an HHS agency. Secretary Kennedy announced that they will terminate these projects that include contracts with Moderna and Pfizer, the two pharma companies who worked with the government to develop COVID vaccines in record time that saved millions of lives in The US and globally. Secretary Kennedy said that the mRNA vaccines failed to provide effective protection against upper respiratory infections like COVID and flu, and they posed more risk than benefit. This contradicts peer reviewed scientific evidence, however. But before we discuss further, should we take a moment to refresh how these mRNA vaccines work?
Rob Lott:Yeah. Yeah. Please do.
Kathleen Haddad:Okay. I'm not a bench scientist, but I have been a journalist, so I'll give this a shot. So mRNA is messenger ribonucleic acid, and it's found naturally in every cell of the body to help our DNA do what it's supposed to do, which is make proteins that repair cells and carry chemicals around to accomplish basic biological functions that are needed to sustain life, like, you know, build proteins and things like that I mentioned. This would
Rob Lott:science things.
Kathleen Haddad:Yeah. The science y things. It was identified in the nineteen sixties from mRNA. And for decades, scientists have been studying it as a way to treat cancer and as a vaccine platform. This was ramped up about a decade ago when the Zika virus blew up.
Kathleen Haddad:Then when COVID hit, the vaccine platform quickly was pulled into action and tested, under all the routine FDA clinical trials and found to be safe and effective to prevent serious illness and death from the COVID virus. So the advantage of mRNA as opposed to, let's say, whole virus or attenuated viruses that have been standard as a vaccine platform is that it can quickly and flexibly be designed to counter viral threats as soon as the DNA of the enemy virus is sequenced. This only took days when COVID hit. And so under operation warp speed, companies manufactured synthetic mRNA, designed to mimic the spike protein that COVID creates on the surface of cells and do to do this before COVID the COVID virus can do it. And that's, so the vaccine's protein then stimulates the body's immune system to wage war on COVID should it enter the scene.
Kathleen Haddad:I hope that was somewhat clear.
Rob Lott:If you're a scientist, if you wanna send, email to me, you know, where we got wrong.
Kathleen Haddad:Yes. Please correct us, but I I at least scientists to help inform us on that one.
Rob Lott:So how has this move fit into HHS's current policies on vaccines? There's been a lot this year.
Kathleen Haddad:Right. So secretary Kennedy said the government will focus resources on wholesale vaccines, which have been around for about a century, which I find confusing because secretary Kennedy has criticized wholesale vaccines in the past and cited problems with them as the reason for pulling US funds from Gavi, the global vaccine alliance. The cut to mRNA research comes after other moves by HHS to change US vaccine policy. In June, the secretary fired 17 members of the whole the whole committee of the CDC's advisory committee for immunization practices known as ACIP and installed new members, some with anti vaccine views. In May, HHS cut 600,000,000 for research on a bird flu vaccine.
Kathleen Haddad:And also in May, the CDC withdrew its recommendation for COVID vaccines for children and pregnant women. And interestingly, in response to that, just this week, the American Academy of Pediatrics issued updated vaccine recommendations that do call for COVID vaccines for children six months and older and healthy pregnant women. I believe those were their previous recommendations.
Rob Lott:Yeah. And just, as a quick note for all the stock heads out there, Moderna, who primarily works with mRNA technologies, they their stock took a hit or it's been down month over month about by 13% for a month over month from current date. I was looking at their stock prices just before we got on the call, and I will note that their stock prices is up from an all time. They went public in about 2018, and their stock price currently is up from $8 to $26 per share roughly from that 2018 date to today. But it is significantly down from their big highlight of about $450 per share in 2021, which is, if you remember, that's when we were kinda in the thick of COVID nineteen vaccine.
Rob Lott:So definitely down from $450 a share roughly, but just kinda interesting to It is up max, but definitely has been going down. So you see the market kind of, like, reacting differently to the stock prices, and also compared to Pfizer who also had a COVID nineteen vaccine, they have a lot different products work in different areas of the biosciences area, so they they weren't didn't seem to be as effective as much from the stock prices.
Kathleen Haddad:In addition, Jeff, I you know, some of these actions by HHS have just discouraged vaccine take up, which is, I guess, a reason for the stock prices falling as well.
Rob Lott:Yeah. And it should be noted that on August 12, Jay Bhattacharya, who is the director of NIH, published a opinion piece in WAPO or Washington Post, if you're formal, talking about some of this stuff. And the stock price for Moderna did go up. And is it a cause or a correlation in response to that opinion piece? You know, who's to say?
Rob Lott:But, Kathleen, can you tell us a little bit about, like, what Badicaria wrote about and, like, what's been the reaction from politicians when it comes to this mRNA reversal?
Kathleen Haddad:Yeah. Well, what he did was try to kind of not walk back the argument so much as refashion, secretary Kennedy's argument. He said that the reasoning for the rescission was that the government disseminated mRNA vaccines before gaining the public's trust. And so at the same time, well, several days later, the Post also published an opposing op ed from surgeon general Jerome Powell, who was president Trump's first surgeon general and one of the shepherds of operation warp speed. The back and forth of these two arguments are very interesting, and I can go over some points in each.
Kathleen Haddad:Would you should I do that? Yeah. Okay.
Rob Lott:Yeah. Please
Kathleen Haddad:do. Okay. So, Jay Bhattacharya, made several points in his op ed. He said that, quote, the MRNA platform failed to earn the public trust. He said the Biden administration chose a strategy of mandates rather than a risk based approach and did not properly acknowledge Americans' growing concerns regarding safety and effectiveness.
Kathleen Haddad:He said, quote, we lack clarity on how much antigen each mRNA molecule produces, where in the body the mRNA product winds up, how long it stays in the body, and whether unintended proteins are created. From a regulatory perspective, getting approval for a vaccine with such inherent uncertainty should be difficult, unquote. He said NIH would invest in new vaccine technologies based on whole inactivated vaccines, quote, which offer a broader immune response and have a longer track record of safety and public acceptance, unquote. He called the mRNA effort, quote, wishful thinking and performative consensus. So former surgeon general Jerome Adams, now a professor at Purdue University, did not take all this lightly.
Kathleen Haddad:He said he was outraged by brat bratakaria's arguments. Yep. He he called the NIH directors, quote, conflation of vaccine mandate politics with a proven science of mRNA technology, irresponsible, a betrayal of public trust, and a direct threat to US biosecurity. He said multiple vaccine types were studied at the outset of COVID, and mRNA triumphed because it was the fastest, most effective, and had the cleanest safety profile. I think, his next point here is important.
Kathleen Haddad:He said, peer reviewed studies confirm the safety and efficacy of mRNA vaccines, which saved twenty million lives worldwide in their first year of distribution. He said claims about uncertainties and antigen dosing are baseless, and similar concerns apply to live attenuated vaccines such as the MMR, which has been safely used for decades. And he called the assertion that the mRNA vaccines turn the body into an antigen factory nonsense, his words, that is contradicted by evidence that mRNA degrades rapidly post vaccination. He said that China's use of whole virus inactivated vaccines during COVID failed and that this technology has been abandoned by modern scientists. Quote, its endorsement is what fuels public distrust, unquote.
Kathleen Haddad:So, I did do some other reading and about the biosecurity argument, and there were some interesting issues brought up there. Scientists, have said that failing to move forward on mRNA research may threaten US biosecurity for several reasons. One is that China may try to poach US experts to work on mRNA, that the technology could be useful for us in combating biological weapons, and that having the technology itself just discourages enemies from using bioweapons in The US.
Rob Lott:Yeah. And I'll just note, you know, this is one article published on August 8 in Politico, but Politico wrote how the headline was industry frets Kennedy's mRNA decision will curb cancer breakthrough. So with the the sub deck being scientists and industry executives fear investors and consumers will shy away from the technology, end quote. So kinda interesting you do see, based on one article that I'm that I'm sharing, a little bit of skepticism of, like, what this could mean for for industry. So it will be interesting to see how this moves forward.
Rob Lott:But look beyond that, what might the future of mRNA be, Kathleen?
Kathleen Haddad:Well, you know, it's interesting that you mentioned some reticence or reluctance perhaps that industry might feel in response to these decisions by HHS. The decision for rescinding the 500,000,000, for mRNA vaccines applies to vaccines against flu and COVID, that research, but it does not apply, HHS says, against, to vaccines that are being studied to fight cancer. And so those contracts, will continue. But, you know, it's interesting you said that maybe there's some distrust in industry that those could be at risk in the future. One other thing that I, came upon is, you know, some distrust perhaps that maybe there are some additional change that might be recommended by HHS in the normal vaccine schedule for children.
Kathleen Haddad:You know? And, again, these, like you say, have impacts on industry and their involvement in this research. So, one other point, is that I think that there has been a fair amount of work on studying mRNA to actually figure out how to rid the body of HIV, and I believe that's going to be wound down as well. So that's about, all I know on this topic.
Rob Lott:Yeah. So it sounds like there's a lot of different stakeholders that have different, potentially competing interests in mind when it comes to this thing. So it'll be interesting to see how that plays out. And speaking of one particular set of stakeholders, just as a note, on August 20, it was reported that more than 750 employees from the Department of Health and Human Services sent a letter, a signed letter, to members of Congress and health secretary Robert F. Kennedy junior on Wednesday, so on August 20, calling on the secretary to stop spreading misinformation, and they noted in the letter about potential claims to mRNA vaccines and how it quote unquote failed to protect effectively against COVID nineteen and the flu.
Rob Lott:So another set of stakeholders that are wanna see an outcome in this situation. But just as a note, there is it's interesting to see how how charged this issue is. And with that, I'll I'll I'll stop there. Well, thanks, Kathleen, for joining us. To you, the listener, if you enjoyed this episode, send it to the researcher in your life, and we will see you next week.