Health
How Lagging Vaccination Could Lead to a Polio Resurgence

Most American parents hardly give thought to polio beyond the instant their child is immunized against the disease. But there was a time in this country when polio paralyzed 20,000 people in a year, killing many of them.
Vaccines turned the tide against the virus. Over the past decade, there has been only one case in the United States, related to international travel.
That could change very quickly if polio vaccination rates dropped or the vaccine were to become less accessible.
Robert F. Kennedy Jr., a longtime vaccine skeptic who may become the secretary of health and human services, has said the idea that vaccination has nearly eradicated polio is “a mythology.”
And while Mr. Kennedy has said he’s not planning to take vaccines away from Americans, he has long contended that they are not as safe and effective as claimed.
As recently as 2023, he said batches of an early version of the polio vaccine, contaminated with a virus, caused cancers “that killed many, many, many, many, many more people than polio ever did.” The contamination was real, but research never bore out a link to cancer.
Aaron Siri, a lawyer and adviser to Mr. Kennedy, has represented a client seeking to challenge the approval or distribution of some polio vaccines on the grounds that they might be unsafe.
Those efforts appear unlikely to succeed. And there is widespread support for vaccination among prominent Republicans, including President-elect Donald J. Trump and Senator Mitch McConnell, who had polio as a child.
But the secretary of health and human services has the authority to discourage vaccination in less direct ways. He or she could withdraw federal funds for childhood vaccination programs, hasten the end of school mandates in states already disinclined toward vaccines or fuel doubts about the shots, exacerbating a decline in immunization rates.
If polio vaccination rates were to fall, scientists say, the virus could slip into pockets of the country where significant numbers of people are unvaccinated, wreaking havoc once more. The virus may be nearly eradicated in its original form, but resurgence remains a constant threat.
Any decision the Trump administration makes regarding the polio vaccine is likely to ripple across the globe, said Dr. David Heymann, an infectious disease physician at the London School of Hygiene and Tropical Medicine and former leader of polio eradication at the World Health Organization.
“If the U.S. takes away the license, then many other countries will do the same thing,” he said. To have polio resurge when it is so close to eradication “would be very, very, very, very sad.”
Before 1955, when the vaccine was introduced, polio disabled more than 15,000 Americans each year and hundreds of thousands more worldwide. In 1952 alone, it killed 3,000 Americans after paralysis left them unable to breathe.
Many of those who survived still live with the consequences.
“People really underestimate how horrific polio was,” said Dr. Karen Kowalske, a physician and polio specialist at University of Texas Southwestern Medical Center in Dallas.
Many who recovered now suffer “post-polio syndrome”: Some of the original symptoms, including muscle weakness and respiratory problems, return.
Dr. Kowalske tends to about 100 post-polio patients who need braces, wheelchairs or other devices to cope with progressive weakness. Some are older adults who became infected before the vaccine was available; others are middle-aged immigrants from countries where polio remained a problem for much longer than in the United States.
To some survivors, the idea of polio’s return is unfathomable.
Carol Paulk contracted the disease in 1943, when she was just 3. Her right leg never recovered, and for the rest of her life she has walked with a pronounced limp and has been in near-constant pain.
Ms. Paulk is among the luckier ones. Until recently, she did not suffer the breathing, swallowing or digestive problems that often torment polio survivors.
She has had “a wonderful, wonderful life” with a husband and three daughters, a law degree and extensive travel abroad.
But always, everywhere, she is calculating how far away the next seat is, how long her energy will hold out and whether a given activity is worth debilitating pain the next day.
She didn’t participate in the 1963 March on Washington or play sports, as she desperately wanted to, or go hiking, skiing and bicycling with her husband.
If there were a public hearing about the polio vaccine now, “I would go, and I would take off my brace, and I would let them see my leg and ask them, is that what they want for their children?” she said.
Polio disables many fewer children now. Vaccination has scrubbed the virus from most of the planet, slashing the number of cases by more than 99.9 percent and preventing an estimated 20 million cases of paralysis.
Still, the virus has turned out to be a stubborn enemy, and eradication has been set back over and over again.
In 2024, 20 countries reported polio cases, and the virus was detected in wastewater in five European countries, decades after its official elimination from the region, and in Australia.
“Any reduction in coverage rates increases the risk of polio anywhere,” said Oliver Rosenbauer, a spokesman for the World Health Organization’s polio eradication program.
There are three types of polioviruses, and eradication requires that all three disappear. For years, the goal has been tantalizingly close.
Type 2 was declared vanquished in 2015, and Type 3 in 2019. Type 1 now circulates only in Afghanistan and Pakistan. In 2021, the two countries together had just five cases; in 2024, they had 93.
But those figures tell only part of the story. In a surprising twist, an oral vaccine used in some parts of the world has kept poliovirus circulating long after it should have died out.
In most low- and middle-income countries, health officials still rely on an oral vaccine given as two drops on the tongue. It is inexpensive and easy to administer, and it prevents transmission of the virus.
But it contains weakened virus, which vaccinated children can shed into the environment through their feces. When there are enough unvaccinated children to infect, the pathogen slowly spreads, regaining its virulence and eventually causing paralysis.
The problem is this: Since 2016, the oral vaccine used for routine immunization has not protected against Type 2 virus. Global health authorities made a deliberate decision to reformulate the vaccine on the grounds that naturally occurring Type 2 virus had disappeared.
That turned out to be premature. More Type 2 virus had been shed by orally vaccinated children in some parts of the world than officials had anticipated. When some nonimmunized children, or those given the newer oral vaccine, encountered this “vaccine-derived” Type 2 virus, they became infected and paralyzed.
Vaccine-derived poliovirus now paralyzes more children than naturally occurring virus does. For example, Nigeria eliminated all so-called wild-type polio in 2020. But in 2024, the country saw 93 cases of Type 2 vaccine-derived virus, more than one-third the global total.
None of this is a problem for Americans — as long as they are vaccinated.
The inactivated polio vaccine (I.P.V.) used for routine immunization of American children protects against all three types of polio. These formulations contain dead virus, and so cannot cause disease or revert to a dangerous form.
But like some other vaccines for infectious diseases, they do not fully prevent infection or transmission of the virus. This aspect is among the criticisms of Mr. Siri, Mr. Kennedy’s adviser.
Still, it is less important than the vaccines’ near-perfect power to prevent paralysis, experts said.
“Yeah, yeah, it’s true, I.P.V. doesn’t prevent transmission,” said Dr. William Petri, an infectious diseases physician and past president of the W.H.O.’s polio research committee. “But, boy, that’s the best thing since sliced bread at preventing paralysis.”
It does mean, however, that people vaccinated with I.P.V. can keep the virus circulating, even when they themselves are protected against illness and paralysis.
So here’s a realistic scenario that worries researchers: Someone who was vaccinated with the oral polio vaccine in another country might bring the virus into the United States and then shed it, in its weakened form. This has already happened in other countries.
So long as most of the population remains vaccinated, this is not likely to set off an epidemic. But if the virus makes its way into communities with low vaccination rates, it may spread, and then revert to a virulent form that can cause paralysis.
That is what happened in New York in 2022, when polio struck a 20-year-old unvaccinated member of an ultra-Orthodox Jewish community in Rockland County.
The vaccination rate in that county was just over 60 percent, compared with the national average of 93 percent.
The virus that paralyzed the young man had been circulating for months, and it was later detected in the sewage of multiple New York counties with vaccination rates hovering around 60 percent, prompting the state to declare an emergency.
Genetically related polioviruses were detected in wastewater samples in Britain, Israel and Canada, suggesting widespread transmission. The authorities later found two distinct vaccine-derived Type 2 polioviruses in New York wastewater, suggesting two separate importations.
If polio were to re-emerge in the United States, it is unlikely to be as horrific as it was in the pre-vaccine decades. Many older adults still remember that as children they were not permitted to swim in rivers or pools, or anywhere the virus might lurk.
“The reason we weren’t allowed to play in rivers in the ’50s is because raw sewage was dumped into the rivers,” Dr. Heymann said.
That is no longer the case, so there “wouldn’t be massive transmission immediately in the U.S.,” he added.
But even if just a few children were to become paralyzed, “it would be awful.”

Health
C.D.C. Study Finds Silent Bird Flu Infections in Dairy Veterinarians

Three dairy veterinarians, including one who worked only in states with no known bird flu outbreaks in cows, had recent, undetected bird flu infections, according to a new study from the Centers for Disease Control and Prevention. The results are based on antibody testing of 150 veterinarians working in 46 U.S. states.
The findings were not entirely surprising, experts said, but did suggest that the virus, known as H5N1, could be infecting cows and people in more states than have been officially reported.
“We do not know the extent of this outbreak in the U.S.,” said Seema Lakdawala, a virologist at Emory University. “There are clearly infections happening that we’re missing.”
Since the bird flu outbreak in dairy cows was first reported last March, the virus has been confirmed in more than 950 herds in 16 states. It has also been detected in 68 people, 41 of whom had contact with sick cows. Most people have had mild symptoms.
The new study, which was published in the C.D.C.’s flagship Morbidity and Mortality Weekly Report, was initially slated for publication several weeks ago but was delayed by the Trump administration’s pause on public communications from health and science agencies.
“It’s important for public health preparedness that we have this data,” said Dr. Nahid Bhadelia, the director of the Boston University Center on Emerging Infectious Diseases.
The study was conducted at a veterinary conference last September; participating vets practiced in 46 different states, as well as in Canada. Of the 150 veterinarians enrolled in the study, 25 of them reported having worked with cows who were either known to have or suspected of having bird flu.
Three of the vets tested positive for antibodies to the virus. None of those three vets had reported working with cows believed to have bird flu. (One had worked with infected poultry.) None recalled any flulike symptoms.
One of the vets worked with cows only in Georgia and South Carolina, states that had not reported any affected herds.
“I think we’ve all suspected that there are many more states, potentially, where the virus is that are not being detected,” Dr. Bhadelia said.
Dr. Lakdawala said that she was surprised that none of the 25 veterinarians who knew that they had worked with infected cows had tested positive for antibodies. But it’s possible that those who knew they were working with infected animals “were taking more precautions,” she said.
None of the three vets who tested positive for antibodies reported wearing masks or goggles. Such precautions are not recommended when working with healthy animals in unaffected regions, the study notes.
Precisely how veterinarians are being infected remains unclear, and vets may have less contact with virus-laden milk than the farm workers who spend their days in milking parlors, Dr. Lakdawala said.
“The vets that we’ve talked to on these farms are involved in all aspects of care for these animals,” she said. “They’re all over these cows, looking at everything.”
The findings highlighted the need for far more testing, experts said, including testing of asymptomatic dairy workers and bovine vets, as well as expanded testing of the nation’s milk supply.
The U.S. Department of Agriculture announced a national program to test bulk samples of milk in December. As of Feb. 7, 40 states were enrolled and actively conducting testing. In Nevada, the bulk testing of milk recently revealed that dairy herds had been infected with a new version of the virus, distinct from the one that had been spreading in dairy cows over the past year.
“The states that haven’t onboarded bulk milk testing should do that, just not assume that because they haven’t had infected herds reported that they have a little bit of leeway,” Dr. Bhadelia said.
When the study was conducted last fall, the virus had been detected in dairy herds in 14 states, as well as in 14 people, four of whom had contact with dairy cows.
Apoorva Mandavilli contributed reporting.
Health
‘I'm a cancer survivor – here's what I've cut from my kitchen’

The threat of cancer looms large for many people, yet consumers can take certain smart and preventative steps to lower the risks.
Michelle Patidar, an integrative nutrition and cancer recovery coach in Chicago, recently shared in an Instagram post that she’s continuing her own fight against cancer even after surviving it — and the specific steps she’s taken since then.
In a recent video she posted on social media, Patidar shared a list of “things you will never find in my kitchen after being diagnosed with cancer at 32.”
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The recovery coach said that after she finished her cancer treatments, she did a “total kitchen overhaul.”
She wrote, “But don’t get me wrong, I slowly made changes. As things ran out, I replaced them with non-toxic versions.”
Michelle Patidar (pictured above) has replaced ultra-processed foods with more whole foods — and made other changes in her kitchen and home as well. (Michelle Patidar; iStock)
“It took some time, but I feel so much more in control of my health knowing I eliminated harmful, toxic products from my kitchen!”
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Here’s the full list of items that Patidar said she’s eliminated — and her replacements for them.
Items gone from her kitchen — and their replacements
1. Refined oil is replaced with extra virgin olive oil, avocado oil, coconut oil, ghee and grass-fed butter.
2. Nonstick cookware is replaced with stainless steel and cast-iron cookware.
3. Aluminum foil is replaced with non-bleached parchment paper.
4. Plastic containers and sandwich bags are replaced with glass containers and paper bags.

The cancer survivor avoids nonstick cookware, instead opting for stainless steel and cast-iron options. (iStock)
Patidar considered this one an “easy swap,” by the way, saying she tries to “say no to plastics as often as possible.”
5. Scented candles are replaced with “delicious” essential oils.
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6. Plastic water bottles are replaced with glass and stainless steel.
7. Plastic cutting boards are replaced with wood cutting boards.
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8. Ultra-processed foods are replaced with whole foods and snacks “without added sugars, food dyes and harmful preservatives.”
9. Toxic kitchen cleaning supplies are replaced with non-toxic cleaning products.
“And wow, what a difference it’s made,” she said.

“I try to say NO to plastics as often as possible,” said the cancer survivor. (iStock)
Patidar told Fox News Digital she’s “come to understand the importance of viewing health from a holistic perspective” as a seven-year cancer survivor.
“While nutrition and exercise are vital components, it’s crucial to consider other factors, such as our environment and the products we use daily,” she said.
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“Our choices, including the cleaning products we use, the quality of indoor air and water, and the types of cookware we select play a significant role in our overall well-being.”
She added that “even seemingly innocuous items” such as plastic water bottles and storage containers can “contribute to our broader health picture.”

Patidar posted her video on Instagram in Oct. 2024. “It’s important to note that even a single swap from this list,” she said, “can enhance your overall health and is a step toward better cancer prevention.” (Instagram/@revival.health.wellness)
She said she believes that making these changes, “along with switching to safer cookware, has decreased my exposure to harmful chemicals and plastic particles.”
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Focusing on “quality fats and oils” instead of processed foods has allowed Patidar to lower chronic inflammation, she reported — “crucial for cancer prevention and recovery.”
“Additionally, replacing candles with essential oils has improved my indoor air quality,” she said. “The ‘convenience’ of toxic products often carries a substantial penalty.”
“It’s important to note that even a single swap from this list can enhance your overall health and is a step toward better cancer prevention.”
Health
Behind R.F.K. Jr.’s Vow to ‘Follow the Science’ on Vaccines

Robert F. Kennedy Jr. spent the first day of his back-to-back confirmation hearings deftly avoiding questions about his views on vaccines. On the second day, when a prominent Republican senator insisted there was no link between vaccines and autism, Mr. Kennedy shot back that a new study “showed the opposite.”
“I just want to follow the science,” Mr. Kennedy declared.
Following the science has been a familiar refrain for Mr. Kennedy, whose confirmation as health secretary appears all but assured in a vote expected Thursday. But the exchange in the Senate raises questions about just what type of science Mr. Kennedy is consulting. It foreshadows how, if confirmed, Mr. Kennedy could continue to sow doubts about vaccines.
Academics have pounced on the study that Mr. Kennedy cited during the hearing, shredding it as methodologically faulty and biased. The study emanated from a network of vaccine skeptics who share some of Mr. Kennedy’s views — an ecosystem that includes the author of the study, the editor of the journal that published it and the advocacy group that financed it.
“We authors were delighted and honored that R.F.K. Jr. referred to our work in his confirmation hearing,” the study’s lead author, Anthony Mawson, said in an email. A spokeswoman for Mr. Kennedy did not respond to a request for comment.
Dr. Mawson, an epidemiologist, said he first met Mr. Kennedy at an autism conference in 2017. Mr. Kennedy cites Dr. Mawson’s research 33 times in his 2023 book, “Vax-Unvax: Let the Science Speak.”
His study was rejected “without explanation” by several mainstream medical journals, Dr. Mawson said. So he turned for advice to Andrew Wakefield, the author of the 1998 study, now retracted, that sparked the initial furor over vaccines and autism. Mr. Wakefield encouraged him to submit the study to a new journal called Science, Public Health Policy and the Law.
That publication is led by some notable vaccine critics, including three who headlined a Washington rally in 2022 with Mr. Kennedy to protest Covid vaccine mandates.
As the nation’s health secretary, Mr. Kennedy “would have wide powers to advance his favored research studies, publications, or scientific data,” according to Lawrence O. Gostin, a public health law expert at Georgetown University. Mr. Kennedy’s critics fear that the public will have neither the time nor the training to sort through a war that seems to pit one study against another, and that the result will be a rapid decline in confidence in vaccines.
“The Mawson paper epitomizes Kennedy’s consistent inability to distinguish junk science from reliable information,” said Dr. John P. Moore, professor of microbiology and immunology at Weill Cornell Medical College, who said that study and some of the others Mr. Kennedy has cited in the past are published by “fringe journals.”
Mr. Kennedy has said that he is not anti-vaccine, but rather in favor of vaccine safety.
“I support the measles vaccine. I support the polio vaccine,” Mr. Kennedy said on the first day of his confirmation hearings. “I will do nothing as H.H.S. secretary that makes it difficult or discourages people from taking it.”
Mr. Kennedy’s insistence that more research is necessary when it comes to vaccine safety has drawn support from some Republicans, who say they welcome his skepticism.
“I don’t understand why my colleagues all of sudden say we can’t question science,” Senator Markwayne Mullin, Republican of Oklahoma, said during one of Mr. Kennedy’s hearings. He added, “When you start looking at the rise of autism, why wouldn’t we be looking at everything?”
But Michael T. Osterholm, an epidemiologist at the University of Minnesota who has advised administrations of both parties, said Mr. Kennedy’s demands for additional data go too far when they concern vaccines and autism. Mainstream scientists say the issue is settled.
“That’s the equivalent of me saying until Newton comes back and shows me that apple falling from the tree, I do not believe gravity exists,” Dr. Osterholm said.
Doctors who have examined the way Mr. Kennedy uses scientific research say he also has a tendency to cherry-pick particular findings from prominent researchers, as he did during a podcast in 2022.
During that appearance, he cited a study published in the journal Pediatrics in 2000 to suggest that improvements in sanitation and hygiene — and not vaccines — fueled a drop in deaths from infectious diseases during the first half of the 20th century. That is true. But Mr. Kennedy failed to note that the study also reported that vaccines introduced in the second half of the 20th century had “virtually eliminated” deaths from diseases including polio and measles.
During one of his confirmation hearings, Mr. Kennedy cited work by a well-known vaccine scientist, Dr. Gregory Poland, to suggest Black people should follow a different vaccine schedule because they needed fewer antigens, the vaccine components that provoke an immune response.
Dr. Poland did not respond to requests for comment. But he told National Public Radio that his work did not support Mr. Kennedy’s assertion.
Mr. Kennedy and Dr. Mawson have long aired similar concerns about vaccines.
In an appearance before the Mississippi legislature in 2009, Dr. Mawson called for more vaccine safety research and “a more flexible approach to vaccination requirements for school attendance.” In a 2011 lawsuit, Dr. Mawson said the testimony had cost him his job as an epidemiologist at the University of Mississippi Medical Center.
In 2017, Dr. Mawson published a pilot study comparing vaccinated to unvaccinated children.
The study relied on a survey of parents who home-schooled their children and found higher rates of autism among vaccinated children, compared with those who had not been vaccinated. The study was funded in part by Generation Rescue, a nonprofit associated with Jenny McCarthy, a television personality who has promoted claims of a link between vaccines and autism.
Dr. Mawson by that time had established the Chalfont Research Institute, a charity that operates out of his home in Jackson, Miss. The institute reported revenue of just $57 in 2021, the most recent figures available.
In 2019, it received charitable contributions of $160,000, tax records show. The bulk of that money, $150,000, came from the National Vaccine Information Center, a group whose mission includes supporting research on “vaccine-associated deaths, injuries and chronic illness.”
Like Mr. Kennedy, the group’s president and co-founder, Barbara Loe Fisher, has long called for research comparing “total health outcomes” including the risk of autism, in vaccinated and unvaccinated children. When Dr. Mawson approached her group with a proposal, she said, the center reviewed his pilot study of 2017, approved his plan and provided $150,000 in funding.
That money paid for the paper Mr. Kennedy cited at the hearing, during an exchange with Senator Bill Cassidy, Republican of Louisiana and a doctor.
The journal that published the study, Science, Public Health Policy and the Law, advertises itself as peer-reviewed, meaning its research is evaluated by anonymous independent experts before publication. Dr. Mawson said his paper had undergone review by two such experts.
Some people associated with the journal are also associated with Mr. Kennedy.
James Lyons-Weiler, the journal’s editor in chief, described himself as a longtime ally of Mr. Kennedy’s in a yearslong “fight across 20 states” for vaccine exemptions.
“Honored to call him my friend,” he wrote on social media last year.
The journal’s editorial board includes the chief executive and the chief scientific officer of Children’s Health Defense, the nonprofit that Mr. Kennedy led until he began his presidential campaign in 2023.
The board also includes members who sell products or services for people who are concerned about vaccines. One of its editorial board members offers $2,350 telehealth appointments for “post-vaccine syndrome.” Another sells $90 “spike detox” supplements marketed for “vaccine injury syndrome” that is meant to get “you back to that pre-Covid feeling.”
The study by Dr. Mawson that Mr. Kennedy cited at the hearing focused on about 47,000 children enrolled in Florida Medicaid from 1999 to 2011 and looked at billing data to determine their vaccination status.
The study found very few billing records for unvaccinated children with autism — eight who were born prematurely and 54 overall. It concluded that vaccination was significantly associated with higher rates of neurodevelopmental disorders, including autism, particularly in infants who were born prematurely.
By contrast, large-scale studies in respected medical journals, including an analysis of five studies involving more than 1.2 million children, have found no association between vaccines and autism.
But even as Dr. Mawson’s research took shape, problems emerged. The paper notes that researchers lost access to the database they used to perform the study. Dr. Alex Morozov, an expert on clinical trial design who met with Dr. Mawson to discuss the study, said he viewed that as a red flag.
Dr. Morozov also said the study had a “fundamental flaw”: It failed to account for the possibility that vaccinated children might have more encounters with the medical system than unvaccinated children, whose illnesses would not be captured by billing data.
The study also failed to account for factors like family history of autism, the child’s gender (boys are diagnosed with higher rates of autism than girls) or the possibility that children might have been vaccinated outside the Florida Medicaid system, said Bertha Hidalgo, an associate professor of epidemiology at the University of Alabama at Birmingham.
Dr. Mawson strongly defended the work, noting that the study “carefully documents both its strengths and limitations,” but contending that critics focused only on the limitations. “Nevertheless,” he said, “further research is needed to replicate the findings and to unravel the mechanisms involved.”
At the Senate hearing, Mr. Cassidy pressed Mr. Kennedy to accept that the vaccines and autism debate was settled. He reminded Mr. Kennedy that he had been shown the study of 1.2 million children that found no link between the two.
“I’m a doc, trying to understand,” Mr. Cassidy said, adding, “Convince me that you will become the public health advocate, but not just churn old information so that there’s never a conclusion.”
To that, Mr. Kennedy replied, “I’m going to be an advocate for strong science. You show me those scientific studies, and you and I can meet about it. And there are other studies as well. I’d love to show those to you.”
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