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The Trump administration’s broadsides against scientific research have caused unprecedented upheaval at the National Cancer Institute, the storied federal government research hub that has spearheaded advances against the disease for decades.

NCI, which has long benefited from enthusiastic bipartisan support, now faces an exodus of clinicians, scientists, and other staffers, some fired, others leaving in exasperation.

After years of accelerating progress that has reduced cancer deaths by a third since the 1990s, the institute has terminated funds nationwide for research to fight the disease, expand care, and train new oncologists. “We use the word ‘drone attack’ now regularly,” one worker said of grant terminations. “It just happens from above.”

The assault could well result in a perceptible slowing of progress in the fight against cancer.

Nearly 2 million Americans are diagnosed with malignancies every year. In 2023, cancer killed more than 613,000 people, making it the second leading cause of death after heart disease. But the cancer fight has also made enormous progress. Cancer mortality in the U.S. has fallen by 34% since 1991, according to the American Cancer Society. There are roughly 18 million cancer survivors in the country.

That trend “we can very, very closely tie to the enhanced investment in cancer science by the U.S. government,” said Karen Knudsen, CEO of the Parker Institute for Cancer Immunotherapy and a globally recognized expert on prostate cancer.

“We’re winning,” Knudsen said. “Why we would let up, I really don’t understand.”

This article is based on interviews with nearly two dozen current and former NCI employees, academic researchers, scientists, and patients. KFF Health News agreed not to name some government workers because they are not authorized to speak to the news media and fear retaliation.

“It’s horrible. It’s a crap show. It really, really is,” said an NCI laboratory chief who has worked at the institute for three decades. He’s lost six of the 30 people in his lab this year: four scientists, a secretary, and an administrator.

“If we survive I will be somewhat surprised,” he said.

After a mandate by the Department of Health and Human Services and the Department of Government Efficiency to slash contract spending by more than a third, the cancer institute is cutting contracts to maintain precious biological specimens used in their research, according to three scientists. “The required contract cuts are going to be devastating,” a senior scientist said.

On the NCI campus in Bethesda, Maryland, scientists describe delays in getting essential supplies — “literally anything that goes into a test tube or a petri dish,” a recently departed clinician said — because of staffing cuts and constant changes in policies about what they can order.

Even the websites that publish new evidence on cancer treatment and diagnosis aren’t being updated, because HHS fired workers who managed them. And when NCI scientists do communicate with outsiders, what they say has been severely restricted, according to documents viewed by KFF Health News. Forbidden topics include mass firings, President Donald Trump’s executive orders, and “DEIA” – diversity, equity, inclusion, and accessibility.

The turmoil at the National Institutes of Health’s largest arm could haunt the country and the world for years to come.

“I really, really don’t understand what they’re trying to achieve,” said Sarah Kobrin, chief of NCI’s health systems and interventions research branch. “It just doesn’t make sense.”

“Efforts that are lifesaving now are being curtailed,” one scientist said. “People will die.”

Years of bipartisan support

Initially, some workers said, they thought the cancer institute might be spared. HHS Secretary Robert F. Kennedy Jr. has called chronic disease — cancer is one — “an existential threat” to the country. Cancer research, with multiple NCI-funded breakthroughs in genetics and immunotherapy, has sidestepped the political minefields around other public health issues, like vaccination.

“People who care about cancer might be the biggest lobby in the country,” said Paul Goldberg, editor and publisher of The Cancer Letter, which has monitored oncology science and policy since 1973.

Count Mike Etchamendy, 69, of Big Bear Lake, California, as part of that lobby. Since 2013 he’s flown to the East Coast scores of times to participate in five clinical trials at the cancer wing of NIH’s Clinical Center.

“They call it the House of Hope,” Etchamendy said. Between drugs, therapeutic vaccines, and expert treatment for his rare bone cancer, called chordoma, he said, he believes he’s gained at least 10 years of life. He’s proud to have served as a “lab rat for science” and worries about NCI’s future.

“People come from all over the world to learn there,” Etchamendy said. “You cut funding there, you’re going to cut major research on cancer.”

In response to a list of detailed questions from KFF Health News about the cuts and chaos at NCI, HHS spokesperson Andrew Nixon said the reporting amounted to a “biased narrative” that “misrepresents a necessary transformation at the National Cancer Institute.” Nixon declined to elaborate but said research into cancer and other health conditions continues to be a high priority “for both NIH and HHS.”

“We are refocusing resources on high-impact, evidence-based research — free from ideological bias or institutional complacency. While change can be uncomfortable for those invested in the status quo, it is essential to ensure that NCI delivers on its core mission,” he said.

Much of NCI’s work is authorized by the National Cancer Act of 1971, which expanded its mandate as part of President Richard Nixon’s “War on Cancer.” Three of four of the cancer institute’s research dollars go to outside scientists, with most of the remainder funding more than 300 scientists on campus.

And Congress was generous. Harold Varmus, one of more than 40 Nobel laureates whose work was funded by NCI, said budgets were usually handsome when he was NIH director from 1993 through 1999. President Bill Clinton “would say to me, ‘I’d like to give you a bigger increase, Harold, but your friends in Congress will bring it up.’ He’d offer me a 5% increase,” Varmus recalled, but “I’d end up getting more like 10%” from Congress.

Congress appropriated $2 billion to NCI in fiscal 1993. By 2025, funding had risen to $7.22 billion.

Rat on your colleagues

During a May 19 town hall meeting with NIH staff members, Jay Bhattacharya, the institute’s new director, equivocated when asked about funding cuts for research into improving the health of racial and ethnic minorities — cuts made under the guise of purging DEI from the government.

According to a recording of the meeting obtained by KFF Health News, Bhattacharya said the agency remained “absolutely committed to advancing the health and well-being of every population, including minority populations, LGBTQ populations, and every population.”

Research addressing the health needs of women and minorities is “an absolute priority of mine,” he said. “We’re going to keep funding that.” But a study considering whether “structural racism causes poor health in minority populations” is “not a scientific hypothesis.”

“We need scientific ideas that are actionable, that improve the health and well-being of people, not ideological ideas that don’t have any chance of improving the health and well-being of people,” he said. That comment angered many staffers, several said in interviews. Many got up and walked out during the speech, while others, watching remotely, scoffed or jeered.

Several current and former NCI scientists questioned Bhattacharya’s commitment to young scientists and minorities. Staffing cuts early in the year eliminated many recently hired NCI scientists. At least 172 National Cancer Institute grants, including for research aimed at minimizing health disparities among racial minorities or LGBTQ+ people, were terminated and hadn’t been reinstated as of June 16, according to a KFF Health News analysis of HHS documents and a list of grant terminations by outside researchers.

Those populations have higher rates of certain cancer diagnoses and are more likely to be diagnosed later than white or heterosexual people. Black people are also more likely to die of many cancer types than all other racial and ethnic groups.

Jennifer Guida, a researcher who focuses on accelerated aging in cancer survivors, said she recently left NCI after a decade in part because of the administration’s DEI orders. According to several workers and internal emails viewed by KFF Health News, those included an HHS edict in January to report their colleagues who worked on such issues, and flagging grants that included DEI-related terms because they didn’t align with Trump’s priorities.

‘I’m not going to put my name attached to that. I don’t stand for that. It’s not OK,” said Guida, who added that it amounted to a “scrubbing of science.”

Racial discrimination is one factor that contributes to accelerated aging. “There are a growing number of cancer survivors in the U.S.,” Guida said, and “a significant number of those people who will become cancer survivors are racial and ethnic minorities.”

“Those people deserve to be studied,” she said. “How can you help those people if you’re not even studying them?”

In May, NCI informed leaders of the Comprehensive Partnerships to Advance Cancer Health Equity, a program that links 14 large U.S. cancer centers with minority-serving colleges and universities, that their funding would be cut. The project’s Notice of Funding Opportunity — the mechanism the government uses to award grants — had been suddenly taken offline, meaning NCI staffers couldn’t award future funding, according to three sources and internal communications viewed by KFF Health News. These “unpublishings” have often occurred without warning, explanation, or even notification of the grantee that no more money would be coming.

The cancer partnerships have trained more than 8,500 scientists. They’re designed to address widely documented disparities in cancer care by having top medical schools place students from rural, poor, and minority-serving schools and community clinics in research, training, and outreach.

Research shows that patients from racial and ethnic minorities receive better medical care and have improved outcomes when their clinicians share their background.

“I’m from an immigrant family, the first to graduate in my family,” said Elena Martinez, professor of family medicine and public health at the University of California-San Diego, who leads one of the partnerships with colleagues at largely Hispanic Cal State-San Diego. “I wouldn’t be here without this kind of program, and there won’t be people like me here in the future if we cut these programs.”

Silencing the science communicators

In early April, when the dust settled after mass firings across HHS, workers in NCI’s communications office were relieved they still had their jobs.

It didn’t last. A month later, HHS fired nearly all of them, three former workers said. Combined with retirements and other departures, a skeleton crew of six or seven remain of about 75 people. “We were all completely blindsided,” a fired worker said. NCI leadership “had no idea that this was happening.”

As a result, websites, newsletters, and other resources for patients and doctors about the latest evidence in cancer treatment aren’t being updated. They include Cancer.gov and NCI’s widely used Physician Data Query, which compile research findings that doctors turn to when caring for cancer patients.

Gary Kreps, founding director of the Center for Health and Risk Communication at George Mason University, said he relied on Physician Data Query when his father was diagnosed with advanced stomach cancer, taking PDQ printouts when he met with his dad’s doctors. “It made a huge difference,” Kreps said. “He ended up living, like, another three years” — longer than expected — “and enjoyed the rest of his life.”

As of May 30, banners at the top of the Cancer.gov and PDQ websites said, “Due to HHS restructuring and reduction in workforce efforts, the information on this website may not be up to date and pages will indicate as such.” The banners are gone, but neither website was being updated, according to a fired worker with knowledge of the situation.

Outdated PDQ information is “really very dangerous,” Kreps said.

Wiping out NCI’s communications staff makes it harder to share complex and ever-changing information that doctors and patients need, said Peter Garrett, who headed NCI’s communications before retiring in May. Garrett said he left because of concerns about political interference.

“The science isn’t finished until it’s communicated,” he said. “Without the government playing that role, who’s going to step in?”

A budget to ‘destroy clinical research’

Following court decisions that blocked some NIH grant cancellations or rendered them “void” and “illegal,” NIH official Michelle Bulls in late June told staffers to stop terminating grants. However, NCI workers told KFF Health News they continue to review grants flagged by NIH to assess whether they align with Trump administration priorities. Courts have ordered NIH to reinstate some terminated grants, but not all of them.

At NCI and across NIH, staffers remain anxious.

The White House wants Congress to slash the cancer institute’s budget by nearly 40%, to $4.53 billion, as part of a larger proposal to sharply reduce NIH’s fiscal 2026 coffers.

Bhattacharya has said he wants NIH to fund more big, breakthrough research. Major cuts could have the opposite effect, Knudsen said. When NCI funding shrinks, “it’s the safe science that tends to get funded, not the science that is game changing and has the potential to be transformative for cures.”

Usually the president’s budget is dead on arrival in Congress, and members of both parties have expressed doubt about Trump’s 2026 proposal. But agency workers, outside scientists, and patients fear this one may stick, with devastating impact.

It would force NCI to suspend all new grants or cut existing grants so severely that the gaps will close many labs, said Varmus, who ran NCI from 2010 to 2015. Add that to the impact on NCI’s contracts, clinical trials, internal research, and salaries, he said, and “you can reliably say that NCI will be unable to keep up in any way with the promise of science that’s currently underway.”

The NCI laboratory chief, who has worked at the institute for decades, put it this way: “If the 40% budget cut passes in Congress, it will destroy clinical research at NCI.”

KFF Health News Correspondent Rae Ellen Bichell contributed to this report.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

American children’s health has declined profoundly over the past few decades, a new study shows, and the issues are so serious that children in the US are dying at a much higher rate than those in similar high-income countries.

What’s particularly frustrating is that the bulk of the health problems are avoidable, said Dr. Chris Forrest, co-author of the study published Monday in the journal JAMA. There isn’t a genetic defect unique to American children and it’s not about socioeconomics within the United States, he said: The results were applicable to the total pediatric population.

“I think we all should be disturbed by this,” said Forrest, a professor of pediatrics at Children’s Hospital of Philadelphia and director of the Applied Clinical Research Center. “Kids in this country are really suffering.”

From 2007 to 2022, children ages 1 to 19 were 1.8 times more likely to die than children in other high-income countries, the study found. The biggest disparities were in deaths from gun violence and traffic accidents; kids in the US were 15 times more likely than their counterparts in other countries to die by firearms and more than twice as likely to die in motor vehicle crashes.

But US children are also sicker because of chronic conditions, Forrest said, and that’s a newer phenomenon. In the ’90s, when he started taking care of children, he said, he hardly ever saw one with a chronic condition. Today, nearly half of children are getting medical care for a chronic health problem, the study says.

The researchers, who analyzed hundreds of millions of health records from five nationally representative surveys and electronic health records from 10 pediatric health systems, found that a child in 2023 was 15% to 20% more likely to have a chronic condition than a child in 2011.

Asthma was the one chronic condition for which rates improved in the studied time period, but it was an outlier. Rates of mental health problems such as depression, anxiety and loneliness increased, as did rates of autism, behavioral conduct problems, developmental delays, speech language disorders and attention-deficit hyperactivity disorders.

Rates of physical issues also increased significantly, including problems with obesity, difficulties with limitations in activity, problems with sleeping and early menstruation. A period before age 12 is associated with immediate health problems including type 2 diabetes, but in the long term, it may also raise the risk of heart and blood pressure problems, studies show.

Chronic conditions were the focus of a recent federal government report from the Make America Healthy Again Commission that said chronic disease had made children “the sickest generation in American history.” That report blamed ultraprocessed food, exposure to chemicals in the environment, pervasive technology use and the overprescription of medicine.

The new study doesn’t pinpoint what’s driving the increase in chronic conditions, but Forrest doesn’t believe it’s just what’s on the MAHA list. Rather, he believes the nation’s entire approach toward caring for children needs to change.

“Our kids are being raised in a very toxic environment, and it’s not just the chemicals. It’s not just the food and the iPhones. It’s a much broader. It’s much deeper. It’s what we call the developmental ecosystem, and it makes it very challenging to change it,” Forrest said. “That’s a hard answer for people who want a pithy message that tells them how to fix the issues. It’s about where they’re growing up, where they’re going to school, they’re playing, where their families live, their neighborhoods, and it’s not just one population. It’s the whole nation that needs help.”

In the 1960s, children in the US were dying at about the same rate as in countries with similar incomes, but that started to change in the 1970s. The US now has about 54 excess child deaths per day compared with 18 other wealthy countries.

“This means the same kid born in this country is much more likely to die than if they were born in Germany or Denmark. Why are we allowing this to happen?” Forrest asked.

In an editorial that published alongside the study, pediatricians from Virginia and Washington wrote that there’s reason to worry the health of US children will continue to fall behind, and political winds are shifting in the wrong direction.

“While the administration’s Make America Healthy Again movement is drawing welcome attention to chronic diseases and important root causes such as ultra-processed foods, it is pursuing other policies that will work against the health interests of children,” they wrote, noting massive budget cuts at the US Department of Health and Human Services, including injury prevention, cancelled funding for safe sleep programs, Medicaid reductions, shrinking mental health funding and new initiatives that fuel vaccine hesitancy among parents.

The study found that from 2007 to 2022, babies in the US were 1.78 times more likely to die than children in 18 other high-income nations. The biggest disparities in deaths were from prematurity and sudden, unexpected infant death, which is accidental suffocation and strangulation in bed and other deaths from unknown causes.

But it’s not just children who are at risk, Forrest said. “Kids are not getting great start in life because women are also suffering in this country.”

Maternity deserts, where pregnant people don’t have easy access to a doctor, have become a growing problem. According to the March of Dimes, about 35% of counties in the US are maternity deserts, a number likely to grow as states pass stricter abortion laws, driving doctors toward states where it’s less complicated to provide care. In 2020-22, there were an excess of over 10,000 preterm births among people living in maternity care deserts or limited-access counties, the group says.

Dr. Colleen Kraft, a pediatrician at Children’s Hospital Los Angeles who did not work on the research, said the study provides good data on broad problems.

“Nothing here surprises me at all,” said Kraft, former president of the American Academy of Pediatrics, who wasn’t involved in the new research.

Over 35 years of practice, she has seen the change in her own patients. At the beginning, she treated mostly infectious disease, but vaccines for conditions like meningococcal disease changed that. Now, she fears that anti-vaccine sentiment could erode much of that progress.

She also treats a lot more children now for chronic conditions that the community can help prevent, she said.

For example, schools could restrict mobile phones so kids interact more, easing problems with loneliness, anxiety and depression. Families can implement a media plan where all devices are plugged into a central location – not a bedroom – so children can get more sleep. Parents can also encourage kids to play outside and engage in more unstructured time to be social and develop their imaginations.

“There are some very common-sense things families can do,” Kraft said.

To see major improvement in childhood health in the US, Forrest believes the country will need to undergo a major transformation. In other countries, for example, day care workers are professionals who get paid a living wage, so kids get quality care. Parents also get more time off when they have a child.

“It’s time to rethink how we treat kids and how we’re supporting families,” Forrest said. “Children in our nation our like the proverbial canary in the coal mine. When their health is deteriorating, that means the foundation of our nation is also deteriorating.”

Falling childhood vaccine coverage and a large, smoldering outbreak that was kindled in an undervaccinated pocket of West Texas have driven the United States to a troubling new milestone: There have been more measles cases in the US this year than any other since the disease was declared eliminated a quarter-century ago.

There have been at least 1,277 confirmed cases of measles reported in the US in 2025, according to data from the Johns Hopkins University Center for Outbreak Response Innovation. Just halfway through the year, the case tally has already surpassed the last record from 2019, when there were a total of 1,274 cases.

Experts say this year’s cases are likely to be severely undercounted because many are going unreported. Three people have died from measles this year – two children in Texas and one adult in New Mexico, all of whom were unvaccinated – matching the total number of US measles deaths from the previous two and a half decades.

Measles was declared eliminated in the US in 2000, meaning there has not been continuous transmission for more than a year at a time. Reaching this status was “a historic public health achievement,” according to the US Centers for Disease Control and Prevention, possible in large part because of vaccine development. The measles-mumps-rubella (MMR) vaccine that is most commonly used first became widely available in the US in the 1970s.

Before this year, there have been an average of about 180 measles cases reported each year since the disease was declared eliminated, according to CDC data.

In 2019, large outbreaks in New York threatened elimination status; those outbreaks were concentrated in Orthodox Jewish communities in Brooklyn and Rockland County that had been targeted with anti-vaccine disinformation for years.

This year, the vast majority of measles cases have been in Texas, with more than 750 confirmed cases associated with one outbreak that started in late January. If cases associated with that outbreak continue to accumulate through January of next year, the US could lose its measles elimination status.

Most of those cases – more than 400 since the start of the year – have been in Gaines County, according to the state health department, where vaccination rates are well below the recommended level. In the 2024-25 school year, nearly 1 in 4 kindergartners in Gaines County did not have their required MMR vaccine, one of the worst rates in the state.

Dozens of cases in New Mexico and Oklahoma have also been linked to the West Texas outbreak, and cases reported in Kansas may also be connected.

Special vaccination clinics that have been stood up in response to the outbreak have led to additional coverage for thousands of people. Many of the affected counties have also introduced expanded vaccination guidance, allowing infants to get their first shot as early as 6 months old instead of waiting until 1 year. In New Mexico, nearly twice as many MMR vaccines have been administered this year than there were at this point last year, according to data from the state health department.

And a recent analysis of health records by Truveta, a health-care data and analytics company, shows that early vaccination rates jumped among infants in Texas. MMR vaccination rates among 6-month-olds in Texas this year are more than eight times higher than they were in 2019, and in March and April, about 1 in 5 children who received their first measles shot in Texas had gotten it early, before their first birthday.

But as the pace of new cases associated with the West Texas outbreak has slowed, cases have continued to accumulate across the country. There have been at least 27 total outbreaks – defined as three or more related cases – and at least 38 states have reported at least one case this year.

Cases rose quickly in Colorado last month when an out-of-state traveler flew while infectious, leading to multiple cases among passengers on the same plane, and others among people who were in the airport at the same time and broader community spread from those cases.

Other cases among Colorado residents were linked to travel to Chihuahua, Mexico, where there is also a large outbreak concentrated among the local Mennonite population. There is another large outbreak happening in Ontario, Canada, which was linked to multiple cases in Michigan. At least one person has died from measles this year in Canada, and there have been nine deaths in Mexico.

In April, Mexico issued a warning for people traveling to the US and Canada due to high measles case rates. The CDC has also stepped up its guidance for travelers, advising that anyone traveling internationally should be vaccinated with two doses of the MMR vaccine.

Most cases are in unvaccinated people

The vast majority of cases in the US this year have been in people who are unvaccinated; only about 8% of confirmed cases have been in people who had received one or two doses of the MMR vaccine, according to the CDC. At least 155 people with measles – about 1 out of every 8 cases – have been hospitalized this year, CDC data shows, and 28% of cases have been in children younger than 5.

The MMR vaccine is safe and extremely effective – one dose is 93% effective against measles, and two doses are 97% effective – but measles is one of the most highly transmissible diseases in the world.

The US Department of Health and Human Services has set a goal that at least 95% of children in kindergarten will have gotten two doses of the measles-mumps-rubella (MMR) vaccine, a threshold necessary to help prevent outbreaks of the highly contagious disease. The US has now fallen short of that threshold for four years in a row.

A record share of US kindergartners had an exemption for required vaccinations in the 2023-24 school year, leaving more than 125,000 new schoolchildren without coverage for at least one state-mandated vaccine, according to data published by the CDC in October.

When the measles case count reached its previous record in 2019 – under the first Trump administration – both the HHS secretary and CDC director at the time released statements emphasizing the safety and effectiveness of the MMR vaccine and encouraging Americans to get vaccinated.

However, the CDC still does not have a director, and HHS Secretary Robert F. Kennedy Jr. has a long and complicated history with measles vaccines.

In April, when there had been about 600 measles cases in the US, Kennedy made his strongest endorsement of vaccination yet – but it stood in stark contrast to years of work against measles vaccines. And last month, Kennedy dismissed an expert panel of vaccine advisers that has historically guided the federal government’s vaccine recommendations, a move that concerned public health officials across the country.

“With an ongoing measles outbreak and routine child vaccination rates declining, this move will further fuel the spread of vaccine-preventable illnesses,” Dr. Bruce A. Scott, president of the American Medical Association, said in a statement at the time.

The US Food and Drug Administration’s top vaccine official overrode agency experts in May to recommend against the broad use of two Covid-19 vaccines, newly released documents show.

Dr. Vinay Prasad, director of the agency’s Center for Biologics Evaluation and Research, said in two memos that he disagreed with reviewers’ conclusions about the vaccines’ safety and about the ongoing threat of the virus that causes Covid-19, particularly for young and healthy people.

Prasad’s decisions are in line with broader Trump administration efforts, under the leadership of US Health and Human Services Secretary Robert F. Kennedy Jr., to restrict availability of coronavirus vaccinations. Kennedy said in May that the shots will no longer be recommended for healthy children and pregnant people; the FDA said earlier that month that it would approve a new Covid-19 vaccine but only for older people and those in higher-risk groups.

In a memo that week, Prasad had rejected a recommendation from about 30 FDA scientists to approve that vaccine, Novavax’s Nuvaxovid, for people 12 and older. He cited limited data and “a diminishing risk” of severe Covid-19 infection and safety concerns.

He cited similar safety concerns in a May 30 document, entitled “override memo,” regarding wide recommended use of Moderna’s latest version of its mRNA vaccine, mNexspike. The company had applied for approval of the updated version in people 12 and older.

Prasad wrote that despite the totality of data submitted by Moderna, he was unable to conclude that the manufacturer had improved the shot’s safety or conclusively addressed concerns about risks of myocarditis, or heart inflammation, in teenage and young men.

Earlier that week, the FDA had advised Moderna and another maker of mRNA Covid-19 vaccines, Pfizer, to update their labels to include warnings about this rare condition.

“Novavax is focused on ensuring that vaccination for COVID-19 is available to those who are at highest risk and who choose to be vaccinated,” the company said in a statement Wednesday. “We believe it is important that consumers have choice in selecting the vaccine that is right for them.”

Moderna declined to comment for this story.

Experts see ‘major overreach’

Dr. Daniel Griffin, an infectious disease specialist at Columbia University, said the memos reflect wider talking points among health officials.

“They seem obsessed with myocarditis, and they made a decision on that which they just have a fixed ideology that they keep looking for confirmation bias on,” he said. “And the data there, I think, is really clear. Early on, we saw, let’s say, 20 to 65 [cases] per million doses when we were giving the initial [vaccine] doses three to four weeks apart. … We really, actually haven’t seen very much since it was spaced out. And what we have seen is that now everyone is getting Covid – it’s really kind of a question of how often per year – and the risk of ending up with myocarditis being unvaccinated is tenfold higher than if you’re protected by a vaccine. So their their argument of restricting access to the vaccines to protect us against myocarditis is flawed. They’re increasing our chance tenfold by restricting our access.”

The memos also mark a break from typical agency responsibilities, Griffin said.

“The role of the FDA is to make a decision based upon the safety and efficacy of a product, whether or not it should be licensed or not. But as far as restricting access, as far as providing guidance on who should specifically get a vaccination, that has fallen to the [US Centers for Disease Control and Prevention] and a number of professional societies for decades. So I think most of us would view this as a major overreach of the of the responsibility of the FDA. The FDA is is not supposed to have the power to restrict access to safe and effective products.”

Dr. Peter Marks, who was director of CBER before Prasad, said in a text message Wednesday that “In the past, the center Director override memos were rare and only done after very careful consideration – and usually after consultation with other center directors. During the nearly decade that I was at FDA, there were only a few that I authored – certainly less than one a year on average during my tenure at CBER – and that included all the various types of decisions that could be overridden.”

Dr. Peter Lurie, a former FDA associate commissioner who’s now president and executive director of the Center for Science in the Public Interest, said overrides like Prasad’s tend to err on the side of being less restrictive – making a product available when reviewers are more cautious. He’s never seen one restrict the use of a product that reviewers have deemed safe and effective.

“It’s very hard to escape the conclusion that antipathy towards these Covid vaccines is playing a significant role in this extremely rare override,” he said. “I think the concern remains that, yes, they were making policy decisions that should have been reserved for the CDC.”

Prasad’s memos were first reported by the New York Times.

Prasad questioned approval process

Prasad assumed his role as CBER director on May 8, a little over a month after Marks said he had been forced out of the role due to Kennedy’s vaccine strategy. More recently, FDA Commissioner Dr. Marty Makary also elevated Prasad to be the agency’s chief medical and scientific officer.

Prasad is a hematologist-oncologist and outspoken critic of what he’s argued as groupthink in medicine. The former University of California San Francisco professor became a prominent voice during the pandemic for challenging Covid-era mandates but has also questioned the drug approval process and developers’ reliance on secondary results, or surrogate endpoints, in clinical trials.

Prasad has called previous FDA commissioners — under both Democratic and Republican administrations — “pro-corporate, sell-outs” who have not required enough randomized clinical trial data in approval decisions.

Biotech stocks tumbled in the hours after his announcement as CBER director, with some industry analysts calling Prasad an “anti-establishment” pick to lead the department overseeing vaccines and biologic products.

He seemed to nod to those concerns in a May 20 town hall with Makary, suggesting a flexible approach that speeds up drug approvals.

“We have to, and we will, always embrace surrogate endpoints for people who have very concerning diseases, very rare conditions, few treatment options,” he told FDA staff at the agency’s Maryland campus. “We have an obligation at FDA to expedite those products to those patients who desperately want them. We also have an obligation to check on the back end and make sure that we’re actually achieving what we thought we were.”

Prasad also signaled his approach to Covid-19 vaccines during that town hall.

“The risk of severe disease and hospitalization, thank goodness, has fallen among the American people. The efficacy of repeat doses … of these vaccines to further reduce severe disease and symptomatic illness is uncertain, and there are important safety considerations whose long-term impact is not fully known,” he said. “We will continue to monitor those closely.”

An international team of researchers may have just cracked the code for what makes someone “cool.”

And no matter where you live, the personality traits that make someone “cool” appear to be consistent across countries, according to the study, published this week in the Journal of Experimental Psychology.

The researchers found that, compared with people considered to be “good” or “favorable,” those considered “cool” are perceived to be more extroverted, hedonistic, powerful, adventurous, open and autonomous.

“The most surprising thing was seeing that the same attributes emerge in every country,” said Todd Pezzuti, an associate professor of marketing at Universidad Adolfo Ibáñez in Chile who was a co-lead researcher on the study.

“Regardless of whether it’s China or Korea or Chile or the US, people like people who are pushing boundaries and sparking change,” he said. “So I would say that coolness really represents something more fundamental than the actual label of coolness.”

‘Cool’ isn’t the same as ‘good’

The researchers – from Universidad Adolfo Ibáñez, the University of Arizona and the University of Georgia – conducted experiments from 2018 to 2022 with nearly 6,000 people across a dozen countries: Australia, Chile, China, Germany, India, Mexico, Nigeria, Spain, South Africa, South Korea, Turkey and the United States.

The participants were asked to think of a person in their lives whom they perceive to be “cool,” “uncool,” “good” or “not good.” They were then asked to rate that person’s personality using two scales: the Big Five Personality scale, a widely used scientific model that helps describe personality traits, and the Portrait Values Questionnaire, intended to measure an individual’s basic values.

The study participants consistently associated being calm, conscientious, universalistic, agreeable, warm, secure, traditional and conforming with being a good person, more than with being a cool person. Being capable was considered to be both “cool” and “good” but not distinctly either. But the formula for being “cool” was having the six character traits – more extroverted, hedonistic, powerful, adventurous, open and autonomous – no matter the person’s age, gender or education level.

Pezzuti doesn’t think these “cool” traits are something that can be taught.

“We’re born with those attributes,” he said. “Five of those attributes are personality traits, and personality traits tend to be fairly stable.”

The research showed that cool people and good people aren’t the same, but there may be some overlapping traits, said co-lead researcher Caleb Warren, an associate professor of marketing at the University of Arizona.

“To be seen as cool, someone usually needs to be somewhat likable or admirable, which makes them similar to good people,” Warren said in a news release. “However, cool people often have other traits that aren’t necessarily considered ‘good’ in a moral sense, like being hedonistic and powerful.”

A limitation of the research was that only people who understood what “cool” means were included in the study. Pezzuti said it would be interesting – but difficult – to determine whether the findings would be similar among more traditional cultures or remote groups of people who may be less familiar with the term.

“We don’t know what we would find in supertraditional cultures like hunting-and-gathering tribes or sustenance farming groups,” Pezzuti said.

“One thing we would propose is that in those cultures, ‘cool’ people don’t have as important of a role because innovation, or cultural innovation, isn’t as important in those cultures,” he said. “So I would say that cool people are probably present in those cultures, but their role isn’t as big, and they’re probably not as admired as they are in other cultures.”

‘Cool’ can be controversial

When asked to think of a public figure or celebrity who embodies “coolness” based on his research, Pezzuti immediately said Tesla and SpaceX CEO Elon Musk.

“He’s a controversial figure, but someone who comes to my mind is Elon Musk,” Pezzuti said, adding that he checks all the boxes of the six attributes identified in the study.

Musk is “undeniably powerful” and autonomous, he said, and appears to be extroverted due to his presence on social media platforms and in the media.

“I hear that he’s timid, maybe more timid than he seems, but from an outsider, he seems very extroverted. He’s entertaining. He’s on podcasts and always in front of cameras,” Pezzuti explained.

Some of Musk’s behavior also appears to be hedonistic, he said. “He smoked marijuana on the most popular podcast in the world, ‘The Joe Rogan Experience.’”

And Pezzuti added that Musk’s ideas about colonizing Mars show him to be open and adventurous.

The new paper is one of the few empirical studies that examines what exactly makes people “cool,” said Jonah Berger, an associate professor of marketing at the University of Pennsylvania’s Wharton School of Business.

“While people have long wondered (and theorized) about what makes people cool, there hasn’t been a lot of actual empirical research on the topic, so it’s great to see work exploring this space,” Berger, who was not involved in the new paper, wrote in an email.

“While coolness might seem like something you are born with, there are certainly steps people can take to try and move in that direction,” he said. “Given how many people want to be cool, and how much money is spent with that goal in mind, it certainly seems worth studying.”

Future research in this space could evaluate coolness in tandem with goodness and badness rather than in isolation from it, said Jon Freeman, an associate professor of psychology at Columbia University.

“In real life, coolness can be a positive quality but can also have a negative connotation in certain social contexts. It may be valuable for future work to examine the differences between good coolness and bad coolness, and this study’s approach offers a great foundation,” Freeman, who also was not involved in the new study, wrote in an email.

“From a scientific standpoint, cool would seem far more a product of inference and social construction than genetics, although low-level temperament informed by genetics could feed into ongoing personality construction,” he said.

“‘Cool’ is deeply ingrained in our social vocabulary because it serves as a shorthand for complex inferences. It encapsulates signals of status, affiliation, and identity in ways that are instantaneous yet deeply stereotyped. From a scientific perspective, studying coolness is important precisely because it reveals how rapid, schematic trait inferences influence behavior and social dynamics, especially in the age of social media and influencer culture.”