In this edition of AcademyHealth’s Situation Report, we provide the latest updates on the potential government shutdown and examine AHRQ’s recently released research priorities, which illustrate how the future of health services research is being reshaped from both the top down and the ground up. Further, discredited claims linking autism to Tylenol and vaccines have reignited public confusion and drawn sharp criticism from scientists and health services researchers. At the same time, canceled negotiations with congressional leaders increase fears of a government shutdown that could disrupt key agencies like HHS and VA. In response to eroding federal leadership, states and independent medical networks are filling in the gaps, including issuing evidence-based vaccine guidelines, forming regional alliances, and launching new initiatives to safeguard public health. These developments signal an urgent need for the health services research community to remain vigilant, engaged, and proactive in defending evidence and informing policy.
In today’s issue:
- AHRQ’s Strategic Priorities Released Amid Unprecedented Disruption
- Linking Autism to Tylenol and Vaccines Prompts Expert Pushback
- Escalating Tensions Increase Fears of Government Shutdown
- Beyond Government: Doctors Build Independent Public Health Networks to Tackle Key Issues
- States Clarify Vaccine Guidelines, Prioritize Evidence and Collaboration in Regional Groups
AHRQ’s Strategic Priorities Released Amid Unprecedented Disruption
On Tuesday, AHRQ released a new strategic priorities document outlining areas of focus including patient safety, antimicrobial resistance, replication studies, responsible use of AI, and research on long COVID. These are important and timely issues, and they reflect the kinds of contributions AHRQ has historically made to improving health care quality and safety.
But the document also raises serious concerns. It explicitly dismisses whole areas of inquiry — from equity and racism to patient experience and gender-affirming care — as “ideological” or “unmeasurable.” This narrow view of science runs counter to decades of progress in patient-centered care and implementation research, risking a health system that looks strong on paper but fails to meet the diverse needs of patients in practice. At the same time, with more than 80 percent of AHRQ’s staff laid off or sidelined, the Agency currently lacks the capacity to carry out its statutory responsibilities. Extramural grantmaking has effectively collapsed, leaving researchers and health systems without the support Congress intended.
AcademyHealth continues to actively elevate these concerns. We continue to work with Congress, the Government Accountability Office, the Administration, stakeholders, the media, and legal counsel to ensure that the research community’s voice is heard. We will keep members updated as we push for accountability and a restoration of AHRQ’s ability to deliver on its mission. You can access AHRQ's updated strategic plan here.
Linking Autism to Tylenol and Vaccines Prompts Expert Pushback
Recent public statements have suggested a link between prenatal acetaminophen use, vaccination schedules, and autism, drawing pushback from the scientific community. Autism researcher Helen Tager-Flusberg denounced the White House rhetoric as a “very significant distortion” of the evidence, reaffirming that the genetic contribution to autism is far stronger than any hypothesized environmental factors. She emphasized there is no credible support for a causal link between measles-mumps-rubella (MMR) vaccine and autism.
Amid this controversy, GOP senators, including Sen. Bill Cassidy, are breaking ranks, urging HHS to release the data underpinning the claims and warning that careless messaging could sow fear in pregnant patients who rely on acetaminophen as a safe option.
Kennedy’s broader leadership of vaccine policy has also come under scrutiny following the abrupt firing of CDC Director Susan Monarez, who testified that she was pressured to approve vaccine schedule changes absent supporting science.
For researchers seeking to surface this debate in accessible form, Healthcare Triage’s summaries and video explainers offer a practical bridge, translating epidemiologic nuance into clear narratives that clinicians, journalists, and the public can grasp. Such resources can help counteract misleading claims by walking through causal inference, effect sizes, and the difference between correlation and causation, including a previous Healthcare Triage video highlighting that there’s no link between acetaminophen use during pregnancy and autism, ADHD or intellectual disability in children.
Notably, one of our ARM planning committee members recently joined Katie Couric to discuss these debates, helping place the evidence in the public eye and showcasing the value of communicating health services research in a clear, accessible way. For those interested in the research infrastructure and ethical considerations of autism studies, our April blog explored NIH’s proposed real-world data platform and its implications for patient registries, governance, and research design.
Escalating Tensions Increase Fears of Government Shutdown
In a post on social media, Trump announced he would cancel a scheduled Thursday meeting with Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries, increasing the likelihood of a government shutdown next week. The demands of Democrats to prevent a government shutdown include a permanent Affordable Care Act subsidies extension, canceling Medicaid cuts, and restoring rescissions cuts.
With less than a week before the deadline, Trump’s cancellation adds to growing tension building to a government shutdown. If the shutdown happens, Republicans are prepared to deploy extreme tactics that could include closing parts of the government such as Health and Human Services (HHS) and Veterans Affairs and even requiring federal workers to report to work without scheduled pay. Additionally, the Office of Management and Budget Director Russell Vought is threatening to fire large swaths of the federal workforce in a shutdown, similar to existing indiscriminate Reductions in Force (RIFs) over the last eight months. While House leaders canceled scheduled votes early next week, Jeffries noted in a letter to House Democrats that he would convene a virtual meeting Friday and a caucus meeting Monday to discuss next steps.
Health services research remains steady in the crossfire. While a government shutdown could impact daily operations of vital health infrastructure such as HHS, demands from Democratic leaders provide some hope of reversing or at least lessening the impacts of Medicaid cuts.
Beyond Government: Doctors Build Independent Public Health Networks to Tackle Key Issues
Amidst growing concerns about the direction of health care under Secretary Robert F. Kennedy Jr., health experts are developing initiatives outside of federal oversight. Central to the controversy is the new Advisory Committee on Immunization Practices (ACIP), criticized for prioritizing ideology over scientific evidence. This has led to the creation of independent projects like the Vaccine Integrity Project. Under the leadership of Dr. Michael Osterholm, a respected epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, this initiative aims to ensure the ongoing dissemination of evidence-based vaccine information, countering shifts in official stances.
As vaccine guidelines change and Kennedy replaces longstanding ACIP members with vaccine skeptics, some states and medical societies are crafting their own guidelines. The West Coast Health Alliance, for instance, has issued recommendations opposing these federal changes. Supported by philanthropists and a committed volunteer network, the Vaccine Integrity Project provides credible vaccine data analysis for state health departments and medical organizations. This shift from federal guidelines signifies a new approach to managing public health information outside traditional structures.
Projects such as the Vaccine Integrity Project showcase how health services researchers can restore the credibility of public health practices beyond federal systems. With the federal government viewed with skepticism by some, researchers are instrumental in forming independent expert groups dedicated to advancing evidence-based public health strategies.
States Clarify Vaccine Guidelines, Prioritize Evidence and Collaboration in Regional Groups
The recent meeting of the CDC’s Advisory Committee on Immunization Practice (ACIP) has left patients, providers, and policymakers confused about which populations are eligible for different vaccines. ACIP’s vaccine recommendations play a large role in the public’s access to vaccines, as insurers and federal programs use them to determine coverage; however, the recommendations are not binding for states, who can choose not to follow them. Because public health authority resides primarily with the states, state policymakers have broad power to diverge from the ACIP recommendations.
This is exactly what some states are doing – multiple states have joined forced in regional blocks to issue joint recommendations on vaccines. The West Coast Health Alliance, for example, issued a joint recommendation on COVID, flu, and RSV vaccines, and is exploring coordinated lab testing, data sharing, and group purchasing. Across the country, the Northeast Public Health Collaborative has already recommended broad eligibility for the COVID-19 vaccine and created their own workgroups spanning vaccines, labs, emergency preparedness, and surveillance. However, this public health authority cuts both ways – Florida’s surgeon general has moved to entirely eliminate childhood vaccine requirements. To ensure that state policymaking is based on science, health services researchers can continue to share the evidence on the safety and efficacy of vaccines with their state policymakers.
Previous Editions
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
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