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As Health and Human Services Secretary Robert F. Kennedy Jr. intensifies his drive to reverse decades of vaccine policy, the medical profession joins a growing list of fields and institutions facing unprecedented threats from the federal government under President Donald Trump. But this time the administration may have chosen an adversary with more capacity to fight back than the law firms, major universities and media organizations it has targeted so far.

To many medical professionals, Kennedy’s hostility toward vaccines represents the greatest threat to the nation’s public health system in memory. Medical groups fear that Kennedy’s wide-ranging actions — such as firing all the members of a prestigious advisory committee that advises the federal government on vaccine policy; narrowing access to the latest Covid vaccine; and pledging to soon release a study that will probably reexamine the widely debunked claim that childhood vaccines cause autism — will trigger a resurgence of deadly diseases, particularly among children.

“It’s overwhelming; it’s a complete frame shift,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “It’s not only that people are declaring their own scientific truths; it’s that science is losing its place as a source of truth. I could never imagine that something like this would ever happen. It’s a war on expertise.”

Medical groups are expressing increasing alarm that Kennedy’s rhetoric and actions will increase the already-growing number of parents demanding medical or religious exemptions from state vaccine mandates for school attendance and potentially encourage conservative states to repeal those mandates altogether. That concern became much more immediate last week after Florida’s Surgeon General Dr. Joseph Ladapo and Republican Gov. Ron DeSantis announced their intent to eliminate all state vaccine mandates, including those for school attendance. If implemented, that will make Florida the first state to do so.

Other institutions that Trump has targeted have struggled to mount an effective resistance to his efforts. But the medical profession may have more advantages than most.

Although confidence in medical professionals has declined since the Covid pandemic, particularly among Republicans, they still enter the debate over vaccine access with a much deeper well of credibility with the public than many of the other groups Trump has targeted, polls show.