Issue Category: Prevention and Public Health Policy

TFAH’s Statement on the Impact of the Loss of CDC Grants

(Washington, DC – February 11, 2026) — TFAH is deeply alarmed at the most recent cancellation of hundreds of millions of dollars in CDC grants to states and communities.  These funds support the core public health infrastructure that keeps Americans safe, including early detection of outbreaks, preventing injuries and HIV, reducing health disparities, strengthening the public health workforce, and modernizing outdated data systems.

These abrupt cuts undermine the ability of health departments, clinics, researchers, and community-based organizations to protect lives and respond to health threats.

Protecting the health and well-being of all Americans requires sustained, predictable investment, not sudden reversals that leave communities vulnerable.  We urge HHS to reverse these cancellations and restore these life-saving programs.

CDC Slashes Universal Vaccine Recommendations

(January 7, 2026)

As flu cases in the U.S. are rising dramatically, the Centers for Disease Control and Prevention, overseen by the Trump Administration’s Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., a noted vaccine skeptic, announced that it is endorsing fewer routinely-recommended vaccinations for all children.

As part of the new schedule, HHS will no longer broadly recommend influenza, COVID-19, rotavirus, and other previously recommended immunizations. It now recommends 11 vaccines for all children, down from previously recommending vaccinations to protect against 18 different diseases in 2024.

That’s happening as flu cases in the U.S. have reached their highest levels since the COVID-19 pandemic, according to new data from the CDC, with children and teenagers among the worst affected.

Read the full article.

Advancing Policies that Create Conditions for Good Health

Trust for America’s health hosted a national webinar on the recently released report,  Advancing Policies that Create Conditions for Good Health: Opportunities, Barriers, and Strategies, a report of TFAH’s Promoting Health and Cost Control in States (PHACCS) initiative.

How can we advance the public’s health in an era of diminished federal and state public health infrastructure and funding? The report shares strategies and trends about how states are addressing policies beyond traditional public health infrastructure that promote residents’ health and create return on investment. The webinar highlighted perspectives from national, government, and advocacy partners about the federal and state implications of policies that can help improve community health. As the current policy environment shifts responsibility to address non-medical drivers of health from federal to state governments, states will need to embrace new strategies, collaborate across sectors, and act creatively to continue advancing policies that support residents’ health.

We discussed how states have and can continue to advance health promoting policies in a variety of policy environments, ensuring that improvements are experienced in all communities amid a weakened public health infrastructure.

Public Health Leaders’ Joint Statement in Response to Announced Changes to U.S. Childhood Vaccine Schedule

(Washington, DC – January 5, 2026) — Together, the National Association of County and City Health Officials (NACCHO), Trust for America’s Health (TFAH), and the Big Cities Health Coalition (BCHC) issued the following statement in response to today’s announcement by the U.S. Department of Health & Human Services (HHS) of significant changes to the U.S. childhood vaccination schedule:

Our nation’s vaccine schedule has been built upon extensive scientific evidence and continuous safety monitoring to best protect children as they grow. It has been deliberated and studied to ensure safety while protecting our nation’s children from diseases that can significantly harm their health and wellbeing. For decades, each change to the schedule was discussed openly by experts, with both benefits and risks considered. However, today’s announcement places increased burden on parents and health providers to navigate an increasingly complex system and assure access to these life-saving products.

Immunizations are the most effective defense we have against a host of deadly and painful illnesses. Ensuring all children receive the vaccines they need on time stops diseases from spreading in the community and ensures healthy childhood development. We see the positive impact each day, as diseases once commonplace are now rare, and kids are in school instead of being home sick or hospitalized due to preventable illness. Creating new barriers to immunizations, as today’s announcement does, will make it harder for children to have the opportunity to grow up healthy and strong.

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Trust for America’s Health
Trust for America’s Health is a nonprofit, nonpartisan public health research, policy, and advocacy organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

About NACCHO
The National Association of County and City Health Officials (NACCHO) represents the over 3,300 local governmental health departments across the country. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information, visit www.naccho.org.

About the Big Cities Health Coalition
The Big Cities Health Coalition (BCHC) is a forum for the leaders of America’s largest metropolitan health departments to exchange strategies and jointly address issues to promote and protect the health and safety of their residents. Collectively, BCHC member jurisdictions directly impact more than 61 million people, or one in five Americans. www.bigcitieshealth.org

 

 

 

Immunizations are a Critical Public Health Tool to Support Both Individual and Community Health

Observed annually in August, National Immunization Awareness Month (NIAM) highlights the importance of vaccination for people of all ages. Some vaccines prevent the spread of diseases, while others protect people from serious illness. Vaccines have saved millions of lives worldwide.

This awareness month is an opportunity to understand vaccines’ role in our overall health, their safety record, and how they fit into the larger picture of individual, community, and public health.

Childhood vaccinations
Infants and children are vaccinated against numerous infectious diseases based on a schedule recommended by pediatricians and vaccine experts. Following the recommended vaccine schedule gives children the best protection from preventable diseases and protects communities against outbreaks. Children often receive vaccines during well-child care visits or in preparation for a new school year.

Vaccines during adulthood
Vaccines aren’t just important for kids – adults need them too. Vaccination is recommended throughout life to prevent vaccine-preventable diseases and the complications of these diseases. Vaccines may be administered as an annual shot, to update waning immunity, or because a new vaccine was developed in response to a disease threat. Some vaccines are recommended for receipt during adulthood as the risks of certain diseases increase later in life. Adult vaccine recommendations may be based on age, health history, underlying risk factors, travel, occupation, and previous vaccinations.

Immunization supports healthy communities
Vaccinations function as a core element of public health infrastructure. Much like clean water systems or food safety regulations, immunization programs operate in the background to reduce the risk of disease across entire populations. When maintained effectively, they prevent disease spread, reduce demand on healthcare systems, and support uninterrupted access to work, school, business activities, and community life.

The strength of any vaccine infrastructure is rooted in convenient, no-cost access, reliable public communication, public confidence, and sustained uptake. Disruptions, whether due to healthcare access gaps, shifting policy priorities, or declines in public trust, can lead to the return of diseases that had achieved elimination status. Elimination status means that cases of the disease are not naturally occurring within a specific geographic area, however, infections can still happen when an infected person travels from one area to another. Elimination status is jeopardized when vaccination rates drop, and illnesses begin to circulate in communities. Recent increases in measles and pertussis cases in parts of the United States reflect the consequences of uneven vaccination rates in some U.S. communities or in other countries.

Disease elimination requires continued vigilance
Vaccines have significantly reduced the incidence of many infectious diseases in the U.S., with some being eliminated. However, it’s important to note that elimination is not the same as eradication. Disease eradication is when a disease is permanently eliminated, with no new cases from any source. Unfortunately, recent data indicate a resurgence of certain illnesses:

These trends emphasize the need for continued vigilance in vaccination efforts to prevent the reemergence of preventable diseases.

Immunization’s role in overall health and emergency preparedness
Vaccines serve not only as a means of individual protection, but also as a mechanism for ensuring community health and supporting a strong economy. Investing in the immunization pipeline and infrastructure means investing in the long-term resilience of communities.

To strengthen the role of immunization in supporting health and community resilience, TFAH’s  reports Pathway to a Healthier America: A Blueprint for Strengthening Public Health for the Next Administration and Congress and  Ready or Not 2025: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism outline several policy recommendations aimed at reinforcing the nation’s immunization infrastructure and access, including:

  • Ensuring access to and affordability of health insurance.
  • Preserving access to recommended vaccines without cost sharing. Research shows that even small co-payments can be barriers to people getting preventive services like vaccines.
  • Investing in the Centers for Disease Control and Prevention (CDC) workforce and infrastructure, which work with states and communities to detect and prevent outbreaks.
  • Sustained funding for CDC’s National Immunization Program, which supports vaccine infrastructure, outreach, and access and outbreak response at the federal, state, and local levels. The Vaccines for Children program, which provides free vaccines to children in the U.S. whose families couldn’t otherwise afford them, also relies on the infrastructure and public health workforce funded by this program.
  • Providing resources for public health communications strategies, including effective communications about the safety and efficacy of vaccines.
  • Ongoing funding for the Antimicrobial Resistance Solutions Initiative, which includes prevention strategies tied to immunization.
  • Accelerated development, stockpiling, and distribution capacity for vaccines in response to emerging threats.
  • Enhanced demographic data collection and analysis to ensure vaccine efforts reach communities that experience health and economic disparities.

These priorities reflect the role of immunization not just in public health response, but in prevention at the population level. When vaccine systems are well-funded and equitably implemented, they allow for stronger disease protection in everyday life and community level resilience during public health emergencies.

Maintaining continuity in immunization
Immunization is not a one-time decision; it is an ongoing element of preventive healthcare. Over time, the immunity created by a vaccine can weaken making a booster dose important. In addition, a virus can change or mutate making the original vaccine less effective and a reformulated dose necessary. Also, as new data emerges showing changes in disease patterns, vaccine recommendations may change.

Like other foundational aspects of health, such as preventive care, good nutrition, physical activity, and healthy environments, vaccination is most effective when integrated consistently over time. It is one part of a broader health strategy, supporting both individual well-being and community health.

Recommended resources:

The National Count for Measles Cases for 2025 is Over 1,100 and Approaching a Thirty-Year High

Health officials remind the public: Measles is serious and very contagious; being vaccinated is the best defense.

Measles is an airborne, highly contagious disease that can be very severe. However, people have the power to protect themselves and their children with the measles-mumps-rubella (MMR) vaccine.

As of June 5, the number of measles cases in the U.S. topped 1,000 and were reported in 34 jurisdictions. The growing case count illustrates that the illness can spread easily in communities with pockets of unvaccinated people. If the rate of new cases continues at its current pace, we could reach a thirty-year high in the annual number of cases this summer. Of the cases reported in 2025, 95 percent were people who were unvaccinated or with unknown vaccination status, and 12 percent of cases have resulted in hospitalization.

Sadly, three deaths have occurred as a result of the current outbreaks in Texas and New Mexico. In late February, the Texas Department of State Health Services reported the first death resulting from the state’s outbreak. The death occurred in a child who was not vaccinated. A second death of a New Mexico adult who tested positive for measles and was also unvaccinated, was reported in early March. Any measles death is particularly tragic because such deaths are preventable.

Here’s what you need to know about measles.

  • Measles is highly contagious. You can contract measles by breathing air contaminated by an infected person or touching an infected surface. The measles virus can linger in the air for several hours after an infected person coughs or sneezes.
  • Measles symptoms usually include a fever, rash, cough, and red eyes. Someone who is infected with measles can spread the infection to others before they notice symptoms, especially in the four days before or after a rash develops.
  • Measles can lead to serious health consequences especially for babies and young children including hearing loss, brain swelling, pneumonia, and even death. Anyone who is not protected against measles is at risk, but children under the age of five, pregnant women, and people with weakened immune systems are particularly susceptible and are at risk for more serious outcomes.
  • Data show that unvaccinated people have a 90 percent likelihood of contracting measles if they are exposed. One out of five people who contract measles will require hospitalization.
  • If you have been exposed to someone with measles or display symptoms, like a rash that spreads from the face to the rest of the body, you should isolate and contact a healthcare provider immediately.
  • Vaccination is the most effective way to avoid contracting measles. The measles-mumps-rubella (MMR) vaccine has been in use since 1971 with the measles vaccine dating back even further to 1963. The MMR vaccine has been shown to be 97 percent effective for people who have received the full series (two doses). After the measles vaccine was introduced, reported cases in the U.S. dropped by 97% in just three years.
  • Children between the ages of 6 – 11 months can be given the MMR vaccine in areas with measles cases, but most children receive their first dose between 12 and 15 months. Babies younger than 6 months are not yet ready for vaccination, which is why older children and adults who interact with infants should be fully vaccinated.

 

Resources for further information:

Measles Symptoms and Complications | Measles (Rubeola) | CDC

Measles Vaccination | Measles (Rubeola) | CDC

Vaccinate Your Family: Measles Resources (Vaccinate Your Family)

Measles Vaccination: Know the Facts  (Infectious Disease Society of America)

 

Revised May 27, 2025

COVID-19, Five Years Later: Will We Heed the Public Health Lessons?

(Washington, DC – April 17, 2025) – March 2025 marked the five-year anniversary of the declaration of COVID-19 as a pandemic. This milestone offers an opportunity to reflect on the heroic work of healthcare providers and the public health workforce in limiting the pandemic’s impact on Americans’ health. Public health professionals across the country worked tirelessly on the frontlines—often facing unprecedented challenges, personal risk, and even harassment—while providing essential services such as contact tracing, coordinating testing, distributing and administering vaccines, and offering life-saving guidance to communities. Their dedication and expertise were vital to the national response and demonstrated the indispensable role of public health infrastructure in protecting American lives during a crisis.

It is also a time to remember the pandemic’s toll in illness, lives lost, and social and economic disruption. Finally, this anniversary presents an opportunity to consider what can be learned from the pandemic and how those lessons can be applied to protect the nation’s health and economic security during future emergencies.

According to the World Health Organization, COVID-19 deaths worldwide have exceeded seven million. In the U.S., at least 1.2 million people have died from COVID-19, according to the Centers for Disease Control and Prevention (CDC).

While the public health emergency has ended, COVID-19 infections are still occurring, albeit at a much lower rate. Staying up to date with vaccination remains one of the most effective tools to prevent severe illness, hospitalization, and death from COVID-19—especially when combined with other preventive measures, as appropriate, based on current community transmission levels and individual risk factors.

We continue to face numerous public health risks that demand action, including a multi-state measles outbreak, a tuberculosis outbreak, bird flu, and environmental threats. All of this is happening as federal budget cuts threaten the capacity of federal, state, and local public health departments to respond to emergencies, while workforce reductions risk the loss of sorely needed public health expertise and experience.

COVID-19 Funding Ended the Emergency and Strengthened Public Health Readiness

The COVID-19 pandemic demanded an unprecedented public health response, including funding to modernize the nation’s public health infrastructure and expand its workforce. New funding for CDC’s Data Modernization Program increased the number of healthcare facilities using electronic case reporting (eCR) to report infectious disease cases to public health agencies—from 153 in January 2020 to over 50,000 in February 2025. eCR enables real-time disease tracking, allowing for a faster response to outbreaks. Additional examples include the Public Health Infrastructure Grant, which provides funding to health departments nationwide to support innovative investments in workforce, systems, and services tailored to meet their communities’ specific health priorities and challenges; the establishment of a new Center for Forecasting and Outbreak Analytics at the CDC to model and predict outbreak trends; and the expansion of CDC’s National Wastewater Surveillance System, now implemented in 46 states and the District of Columbia. These critical new capacities are at risk due to federal budget cuts.

What the Pandemic Taught Us

The lessons of the pandemic are numerous and should be applied to strengthen the public health system. Doing so would help ensure that the nation is better prepared for future risks. These lessons include:

  • Protecting CDC’s mission—including its comprehensive focus on both chronic and infectious diseases—is essential, because healthier communities, particularly those with a lower burden of chronic disease, are more resilient during emergencies and recover more quickly.
  • A modernized and interoperable health data infrastructure is critical for real-time disease tracking. Such systems allow healthcare and public health officials to target resources where they are needed most. The progress made in data modernization since 2020 must be sustained.
  • Public health and healthcare readiness, along with surge capacity, are critical in an emergency. Healthcare workforce shortages during the acute phases of the pandemic placed tremendous strain on the system’s ability to manage the surge of patients. The emergency readiness of the healthcare delivery system must be fortified. State public health laboratories were also vital in identifying cases and tracking disease spread. Most states have laboratory surge plans that helped them expand testing capacity during peaks in pandemic transmission. Telehealth was a critical platform for healthcare access during the pandemic, and reimbursement for telehealth services should be preserved.
  • A strong emergency preparedness system is vital to the nation’s economic security. The COVID-19 emergency led to major economic disruptions and the largest employment loss in the U.S. since World War II. A 2023 study by a team of economists estimated that the pandemic’s impact on the U.S. economy through the end of 2023 was $14 trillion. Going forward, protecting the nation’s economy will require systems and capacities that can prevent a small number of disease cases from escalating into an outbreak—and eventually a pandemic.
  • The pandemic highlighted the nation’s health and economic disparities and their impact on health outcomes during emergencies. While all communities may face health emergencies, the impacts are not felt equally. Communities with higher rates of chronic disease and underlying health conditions often experience worse outcomes—disparities rooted in systemic barriers such as income inequality, housing instability, discrimination, poor air and water quality, and gaps in healthcare access. Advancing health equity by addressing these challenges is essential to building a more resilient and prepared nation.
  • The COVID-19 vaccines saved lives and reduced the severity of illness. The rapid development of the vaccines, along with an expansive system to administer them, played a critical role in the national response. According to a Commonwealth Fund study published in December 2022, COVID-19 vaccines prevented an estimated 18.5 million hospitalizations, 3.2 million deaths, and at least $1 trillion in healthcare spending in the U.S. during the first two years of the vaccination program (December 2020 through November 2022). Continued investment in vaccine development, manufacturing and distribution readiness, and other medical countermeasures is essential. mRNA vaccine technology is well-positioned to quickly produce effective vaccines against future virus variants.
  • The pandemic exacerbated misinformation and disinformation about vaccine safety, particularly on social media. Vaccine education that shares accurate information and builds confidence is essential. These programs should acknowledge that some people—while open to learning more—have questions and want space to make their own decisions. Healthcare and public health officials should seek opportunities to listen and respond to individuals’ questions and concerns.

We Need to Act on the Pandemic’s Lessons

  • Increased, sustained, and flexible public health funding is essential. The pattern of boom-and-bust funding cycles has left the system with serious preparedness gaps. Funding levels must be increased, and flexible funding is critical because it allows state and local health officials to quickly target and deploy resources where they are most needed. Investment in workforce growth and retention is also crucial.
  • Invest in prevention to improve health and reduce healthcare spending. As a nation, we don’t spend enough on public health and prevention. Investments in these areas yield healthier communities and significant long-term savings. Typically, less than five percent of the nation’s nearly $5 trillion in annual health spending is directed to public health and prevention programs.
  • Numerous sectors have a role to play in improving the public’s health. These partnerships should include public health, healthcare, educators, community–based organizations, faith leaders, the business community, and others. Strong relationships established before a crisis are central to an effective emergency response.
  • Public trust in government is critical during health emergencies. The politicization of public health has weakened the system and threatens its ability to respond effectively to future crises. Upholding scientific integrity—empowering public health experts to make recommendations based on the best available information—is essential for effective emergency response. Public health authorities must be preserved, and public health agencies must be effective communicators who can clearly explain the rationale behind their guidance. Timely and transparent communication with the public is essential. Public health officials also understand the importance of maintaining strong, ongoing relationships with community organizations and leaders—not just during emergencies. A diverse public health workforce that reflects the communities it serves is also key to building trust.

Closing Thoughts

The COVID-19 pandemic was a tragic event, worsened in part by an inadequate early response. Failing to learn from the pandemic experience would only compound the tragedy. The task now facing policymakers at all levels is to invest in policies and programs that will fortify our public health system—ensuring it is fully prepared to respond quickly to future emergencies—and to restore trust in the system so it can function effectively when lives are on the line.

TFAH’s annual report series, Ready or Not: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism, identifies key strengths, areas for improvement, and recommendations to enhance the nation’s emergency preparedness.

To learn more about TFAH’s recommendations for a stronger public health system, read our 2024 report: Pathway to a Healthier America: A Blueprint for Strengthening Public Health for the Next Administration and Congress.

Support for Prevention and Public Health Fund Remains Strong

Over 200 public health and health organizations urge Congress to support the Prevention and Public Health Fund as the nation faces growing public health threats

(Washington, DC – February 28, 2025) – At a time of increasing healthcare costs and uncertain funding for public health, the Prevention and Public Health Fund (Prevention Fund) is more important than ever. A guaranteed source of funding for public health programs, the Prevention Fund has invested more than $13.5 billion in every state and territory to improve health and help restrain the rate of growth in healthcare costs.

Recently, Senator Richard Blumenthal and Congresswoman Doris Matsui introduced the Public Health Funding Restoration Act which would restore the Prevention and Public Health Fund to its original $2 billion allocation as established by the Affordable Care Act (ACA). Under its original allocation, the Prevention Fund should have risen to $2 billion by FY 2015. After multiple cuts over the years, the Prevention Fund will not reach that number until FY 2030, a full fifteen years later than intended. In total, the Prevention Fund has been cut by $12.95 billion over FY 2013 – 2029.

Again, the Prevention Fund has been proposed as a possible offset as part of the FY25 budget reconciliation process. Yet, support for the Prevention Fund remains strong. Last week, 200 organizations joined TFAH in sending a letter to congressional leaders urging them to avoid further cuts to the Fund.

Proven Track Record of Success

While the majority of its investments are at Centers for Disease Control and Prevention (CDC), the Prevention Fund also supports programs at the Administration for Community Living and the Substance Abuse and Mental Health Services Administration for suicide prevention, Alzheimer’s disease prevention, falls prevention, and chronic disease self-management.

Prevention Fund-supported programming has been shown to reduce the significant healthcare costs associated with chronic disease in the United States. For example, The Tips from Former Smokers campaign, aimed at encouraging smoking cessation, helped 1 million smokers successfully quit between 2012 and 2018, prevented an estimated 129,000 early deaths, and saved roughly $7.3 billion in smoking-related healthcare costs. In addition, the Diabetes Prevention Program has saved $1,146 per participant in related healthcare costs. Both programs are either partially or fully supported by the Prevention Fund.

The Prevention Fund also keeps the nation prepared against emerging threats. With experts raising concerns over the spread of H5N1 bird flu, the Prevention Fund supports CDC’s National Immunization Program as well as epidemiology and laboratory capacity grants in every state and U.S. territory to detect and investigate outbreaks and prevent further infections.

Maintaining support for the Prevention Fund is critical as the United States navigates rising chronic disease costs, higher rates of suicide, and decreasing life expectancy. Continued cuts will only impede the nation’s ability to protect communities.

For more information on how the Prevention Fund helps safeguard health and economic security in every state visit  Prevention and Public Health Fund State Fact Sheets – TFAH.