An employee at French nuclear fuel company Orano has died from meningitis, French health authorities said Friday, adding that there is seemingly “no link” with the ongoing outbreak in the U.K. The Normandy Regional Health Agency said it received a report of a case of invasive meningococcal disease in La Hague, Normandy, on Thursday, and that the death was announced on Friday. Authorities are currently identifying at-risk contacts, who will be offered antibiotics “as soon as possible.” The employee worked at Orano, the health authority said. “Around 50 potential contact cases have been identified and contacted by their managers in order to receive a specific preventive antibiotic treatment,” Orano told POLITICO. The patient died at Cherbourg hospital. Cherbourg is a key port for ferries to and from the U.K. The health authority said “no link can be established with the meningitis epidemic currently underway in the United Kingdom.” The U.K. is grappling with an ongoing outbreak of meningitis in the southeast county of Kent, linked to a local nightclub. As of Friday, 29 people have fallen ill and two people have died, the U.K. Health Security Agency said. Health Secretary Wes Streeting described the outbreak as “unprecedented.” Health officials have rolled out preventive antibiotics and vaccination to those who attended the nightclub between March 5-7, to close contacts of cases and to local university and school students. France reported one case to the U.K. last weekend in someone who had also visited the university then travelled to France. The French health ministry told POLITICO the patient was “stable,” that close contacts had been alerted and offered antibiotics, and that no further cases had been reported.

LONDON — Britain will reduce its aid sent to Africa by more than half, as the government unveils the impact of steep cuts to development assistance for countries across the world. On Thursday the Foreign Office revealed the next three years of its overseas development spending, giving MPs and the public the first look at the impact of Labour’s decision to gut Britain’s aid budget in order to fund an increase in defense spending. Government figures show that the value of Britain’s programs in Africa will fall by 56 percent from the £1.5 billion in 2024/25 when Labour took office to £677 million in 2028/9. It follows the move to reduce aid spending from 0.5 to 0.3 percent of gross national income. However, the government did not release the details of the funding for specific countries, giving Britain’s ambassadors and diplomats time to deliver the news personally to their counterparts across the world ahead of any potential backlash from allies. Foreign Secretary Yvette Cooper told MPs that affected countries want Britain “to be an investor, not just a donor” and “want to attract finance, not be dependent on aid,” as she pointed to money her department had committed to development banks and funds which will help Africa raise money. The decision shows a substantial shift in the government’s focus, moving away from direct assistance for countries, and funneling much of the remaining money into international organizations and private finance initiatives. Chi Onwurah, chair of the All Party Parliamentary Group for Africa, told POLITICO that she was “dismayed at the level and extent of the cuts to investment in Africa and the impact it will have particularly on health and economic development.” She added: “I hope the government recognizes that security of the British people is not increased by insecurity in Africa and increased migration from Africa, quite the opposite.” Ian Mitchell from the Center for Global Development think tank noted the move was “a remarkable step back from Africa by the U.K.” NEW PRIORITIES Announcing the cuts in the House of Commons, Cooper stressed that the decision to reduce the aid budget had been “hugely difficult,” pointing to similar moves by allies such as France and Germany following the U.S. President Donald Trump’s decision to dramatically shrink America’s aid programs after taking office in January 2025. She insisted that it was still “part of our moral purpose” to tackle global disease and hunger, reiterating Labour’s ambition to work towards “a world free from extreme poverty on a livable planet.” Cooper set out three new priorities for Britain’s remaining budget: funding for unstable countries with conflict and humanitarian disasters, funneling money into “proven” global partnerships such as vaccine organizations, and a focus on women and girls, pledging that these will be at the core of 90 percent of Britain’s bilateral aid programs by 2030. A box with the Ukrainian flag on it awaits collection in Peterborough, U.K. on March 10, 2022. | Martin Pope/Getty Images Only three recipients will see their aid spending fully protected: Ukraine, the Palestinian territories and Sudan. Lebanon will also see its funding protected for another year. All bilateral funding for G20 countries will end. Despite the government’s stated priorities, the scale of the cuts mean that even the areas it is seeking to protect will not be protected fully. An impact assessment — which was so stark that ministers claimed they had to rethink some of the cuts in order to better protect focus areas such as contraception — published alongside the announcement found that there will likely be an end to programs in Malawi where 250,000 young people will lose access to family planning, and 20,000 children risk dropping out of school. “These steep cuts will impact the most marginalized and left behind communities,” said Romilly Greenhill, CEO of Bond, the U.K. network for NGOs, adding: “The U.K. is turning its back on the communities that need support the most.” Last-minute negotiations did see some areas protected from more severe cuts, with the BBC World Service seeing a funding boost, the British Council set to receive an uplift amid its financial struggles, and the Independent Commission for Aid Impact (ICAI) — the aid spending watchdog that had been at risk of being axed — continuing to operate with a 40 percent budget cut. GREEN THREAT Though the move will not require legislation to be confirmed — after Prime Minister Keir Starmer successfully got the move past his MPs last year — MPs inside his party and out have lamented the impact of the cuts, amid the ongoing threat to Labour’s left from a resurgent Green Party under new leader Zack Polanski. Labour MP Becky Cooper, chair of the APPG on global health and security said that her party “is, and always has been, a party of internationalism” but today’s plans would “put Britain and the world at risk.” Sarah Champion, another Labour MP who chairs the House of Commons international development committee said that the announcement confirmed that there “will be no winners from unrelenting U.K. aid cuts, just different degrees of losers,” creating a “desperately bleak” picture for the world’s most vulnerable. “These cuts do not aid our defense, they make the whole world more vulnerable,” she added. Her Labour colleague Gareth Thomas, a former development minister, added: “In an already unsafe world, cutting aid risks alienating key allies and will make improving children’s health and education in Commonwealth countries more difficult.” The announcement may give fresh ammunition to the Greens ahead of May’s local elections, where the party is eyeing up one of its best nights in local government amid a collapse in support for Labour among Britain’s young, progressive, and Muslim voters. Reacting to the news that Britain will cut its aid to developing countries aimed at combatting climate change, Polanski said: “Appalling and just unbelievably short-sighted. Our security here in the U.K. relies on action around the world to tackle the climate crisis.”

LONDON — A deadly outbreak of meningitis in the United Kingdom linked to a nightclub in England’s southeast has killed two people with new cases being reported daily. Health officials are rolling out preventive antibiotics to those who attended the nightclub earlier this month, to close contacts of cases and to local university students. The latter are also being offered a vaccine. But as U.K. health officials move to contain the outbreak, it has added to proliferating cases of meningitis across Europe — and has exposed patchy access to vaccines to prevent the disease. Since 2021 Europe has seen increasing rates of invasive meningococcal disease, which is caused by a bacterial infection. The majority of cases have been linked to the same “group B” family of bacteria that caused the outbreak in England.  POLITICO looked into how prepared EU countries are for a similar outbreak. WHAT HAPPENED IN THE UK? From March 13-18 some 27 cases of invasive meningococcal disease were identified in the southeast of England, the U.K. Health Security Agency said Thursday. Nine have been confirmed as Neisseria meningitidis group B.  At least 10 people who caught the illness had attended a nightclub in Canterbury from March 5-7. Most are students from the University of Kent in Canterbury or are upper-year students from local secondary schools.  The illnesses have been severe with rapid deterioration. Two young people have died: an 18-year-old high school student and a 21-year-old university student. Health Secretary Wes Streeting described the cases as “an unprecedented outbreak.” France reported one case to the U.K. in someone who had also visited the university then travelled to France, Streeting told parliament on Tuesday. “The patient has been hospitalized and is in stable condition,” a health ministry spokesperson told POLITICO, adding that close contacts had been alerted and offered antibiotics, and that no further cases had been reported. HOW IS THE UK RESPONDING? Health officials have set up four centers in and near Canterbury for students and those who attended the nightclub to receive preventive antibiotics. Family doctors in the region have been advised to offer treatment to anyone who visited the nightclub. “This is the main intervention that will help protect people and halt the spread of the outbreak,” said Trish Mannes from the U.K. Health Security Agency. In addition, “as a further precaution,” 5,000 university students are being contacted and offered a vaccine to protect against meningitis group B, Mannes said.  Nearby hospitals and schools have been told how to spot symptoms, how to prevent infection and respond.    A student receives an injection at the University of Kent campus in Canterbury, U.K. on March 19, 2026. | Gareth Fuller/PA Images via Getty Images HAVE CASES BEEN RISING ELSEWHERE? Since 2021, cases of invasive meningococcal disease in Europe have been rising. In 2023 there were 1,895 confirmed cases, including 200 deaths in the EU plus Norway, Iceland and Liechtenstein. Group B remains the major cause of the disease, accounting for 57 percent of cases with known type, and was the dominant group in all ages under 65 years. “Its notification rate has been increasing since 2021,” a European Centre for Disease Prevention and Control report said. France, Germany and Spain accounted for 57 percent of all confirmed cases, while Belgium, the Netherlands and Lithuania reported the second highest notification rate. Group Y infections were the second-most reported (20 percent of cases with known serogroup) and the most reported in those over 65. Group W infections were the third-most reported overall (15 percent of cases with known serogroup). Around 20 percent of young people carry the MenB bacteria in their noses and throats; the disease happens when the bacteria enter the bloodstream and when a person’s immune system is low. It causes a high fever, headache, vomiting and drowsiness, and can lead to inflammation of the brain and sepsis. It has a mortality rate of around 10 percent. Those that survive are at risk of lifelong disability due to the amputations or brain damage caused by the infection. WHO CAN GET THE VACCINE? GlaxoSmithKline’s MenB vaccine Bexsero was approved in Europe (including the U.K.) in 2013 and was rolled out as routine vaccination in the U.K. to infants in 2015. Infants are most at risk due to their lack of immunity. There are over 100 different strains of MenB; the vaccine covers between 75 percent and 80 percent of them, said Adam Finn, professor emeritus of pediatrics at the University of Bristol. “The level of protection after 2 doses is very high and lasts for some years at least,” he added. Infections also arise in adolescents, but the U.K. hasn’t offered MenB vaccinations in older children since it was launched.  In Europe, 12 countries routinely offer the vaccine to infants for free —  the Czech Republic, Finland, France, Germany, Greece, Ireland, Italy, Lithuania, Luxembourg, Malta, Portugal and Spain. Croatia and Poland offer it to children and adults with compromised immune systems. Austria recommends the vaccine in infants but doesn’t fund it. Meanwhile, 12 countries — Belgium, Bulgaria, Cyprus, Denmark, Estonia, Hungary, Latvia, the Netherlands, Romania, Slovakia, Slovenia and Sweden — don’t offer the vaccine at all. Seventeen EU countries offer vaccination against meningococcal serogroups A, C, Y and W. British Health Secretary Wes Streeting arrives in Downing Street in London for a Cabinet meeting on Jan. 17, 2026. | Zeynep Demir/Anadolu via Getty Images WHY ISN’T VACCINATION UNIVERSAL?  Each EU country takes advice from their independent immunization committees, which recommend which vaccines to offer citizens. “National epidemiology — based on surveillance data — and cost effectiveness considerations determine these decisions,” Beate Kampmann, professor of pediatric infectious diseases and immunology and professor of global health, told POLITICO. That means vaccine schedules in EU countries “differ as a result.” “MenB meningitis is a rare disease and the vaccine is expensive,” Brendan Wren, professor of microbial pathogenesis at the London School of Hygiene & Tropical Medicine, said of the U.K. position. “Although given to young children who are the most vulnerable to MenB, it is not freely available to the whole population.”  In light of the ongoing outbreak, however, Streeting told parliament that the country’s vaccination committee was reviewing whether to expand eligibility for the MenB jab. In 2019, Belgium’s immunization experts decided not to offer the vaccine to infants or adolescents, citing the low incidence of the disease, the need to administer three shots, and the fact the vaccine “is not very cost-effective.” The Netherlands said in 2022 that its Health Council wasn’t recommending the MenB vaccine “due to the relatively small burden of disease, the side effects of the vaccine and need for several doses, as well as cost.” But the council is now reviewing its position again, with a decision expected in the next quarter, a ministry spokesperson told POLITICO. COULD THE EU BUY VACCINES? The EU can procure vaccines for groups of countries, with the Health Emergency Preparedness and Response Authority acting as a negotiator with drugmakers in such cases.  This could be an option for vaccines like Bexsero, should there be interest. “The Netherlands had a positive experience with the EU role in the procurement of COVID-19 vaccines and is open to discussing a role for the EU in other joint procurement procedures,” the Dutch health ministry said. Meanwhile, the vaccine is available for private purchase in most EU countries, but supplies in the U.K. are limited.  The EU can procure vaccines for groups of countries. | Alicia Windzio/picture alliance via Getty Images “Pharmacies are being inundated by requests from concerned patients for MenB vaccination, which the vast majority of our members across the country have no stock currently available to fulfil,” said Olivier Picard, chair of the National Pharmacy Association. COULD THE OUTBREAK SPREAD TO EUROPE? That’s unlikely since it’s not as easily transmitted among people. “This outbreak is caused by a bacterial infection and by its nature it is a lot less infectious compared to Influenza, Measles or SARCOV-2,” said Bharat Pankhania, senior clinical lecturer at the University of Exeter Medical School. “These bacterial infections require close contact and it is a heavy droplet aerosol spread, thus not very infectious and you need to be in close prolonged contact with a case, a family member, or a kissing contact,” he said, adding there is no need for restrictions on movement. In Belgium, the health ministry said it is convening its scientific risk-assessment group “to evaluate the situation for our citizens and country.” Meanwhile, ECDC issued a statement Wednesday evening saying the risk to the general population in Europe from the British outbreak was “very low.” “Outbreaks of meningitis caused by Neisseria meningitidis typically occur in small clusters around cases or in places where many people gather. Although some secondary cases can occur among close contacts of cases, the disease does not spread in the community like, for example, a respiratory virus,” the disease agency said. Claudia Chiappa contributed to this article. Update: This article has been updated with UKHSA data issued March 19.

BRUSSELS ― European governments are irritated over what they see as Ursula von der Leyen’s move to position herself as the EU’s chief representative abroad, saying that during the opening days of the U.S.-Israeli campaign against Iran she went beyond her mandate. In conversations with POLITICO, nine diplomats, EU officials and lawmakers, hailing from small and large European countries, criticized what they described as the European Commission president’s diplomatic overreach. Disapproval of her handling of the Iran crisis comes on top of carping about other foreign policy issues, including the Commission’s efforts to speed up Ukraine’s entry into the EU and von der Leyen’s approach to Donald Trump’s “Board of Peace.”   With the Middle East conflict entering its second week, the EU has struggled to speak with a common voice. Several governments are irked that von der Leyen seems to be playing the role the EU’s foreign affairs chief, Kaja Kallas ― meant to represent the 27 capitals ― should normally do. In the first days of the crisis, von der Leyen signaled support for regime change in Tehran and held no fewer than a dozen calls with EU and Gulf state leaders. She’s repeatedly staked out public positions that go well beyond the consensus between the bloc’s members, her critics said. “I felt I was hallucinating … watching Ursula von der Leyen call the heads of Gulf states,” said Nathalie Loiseau, a centrist French lawmaker on the European Parliament’s Foreign Affairs Committee. “She has no diplomatic service, speaks without a mandate or intelligence briefings. Her words have no value beyond her individual statement.” The role of coordinating the bloc’s foreign policy, the diplomats who spoke to POLITICO said, lies with Kallas, whose task it is to liaise with capitals and formulate a common position — even if that’s often a slow and painstaking process. Von der Leyen risks creating confusion in relations with the rest of the world, they said. “The problem is the president going out with ideas and somehow committing the European Union without consulting countries beforehand,” said a senior EU diplomat involved in foreign policy discussions and who, like others in this article, was granted anonymity to speak frankly about sensitive internal matters. “She is saying things that are not in her mandate.” These tensions will be in the background as von der Leyen and Kallas preside over a conference of EU ambassadors in Brussels today, where both are due to give keynote speeches. The Commission rejected the accusations, saying von der Leyen was carrying out her work as she should. She is demonstrating “political leadership of the Commission’s external policies” in line with the EU’s treaties, a Commission spokesperson said. “Outreach to other leaders worldwide is part and parcel of President von der Leyen’s responsibilities, be it bilaterally, multilaterally or in EU-led initiatives, such as the Global Gateway event,” designed to boost investment around the world, the spokesperson said. The EU’s formal position on the Iran war was not set out by von der Leyen but defined by Kallas in a statement coordinated with Europe’s 27 countries a week ago, according to the spokesperson. “The statement reflects the EU’s position on the matter,” the spokesperson said. EUROPE’S PRESIDENT? Von der Leyen’s evolution into the EU’s most powerful figure with a stature on a par with presidents and prime ministers has been nearly seven years in the making. The former German defense minister has led the EU through one crisis after another, from the Covid pandemic to Russia’s full-scale invasion of Ukraine and trade disputes with U.S. President Trump. In many of those situations, EU leaders have expressed gratitude that she has stepped forward. “You rarely hear much criticism of von der Leyen when it comes to Ukraine,” said a diplomat. | Martin Bertrand/Hans Lucas/AFP via Getty Images “You rarely hear much criticism of von der Leyen when it comes to Ukraine,” said the diplomat from a mid-sized EU country. “That’s because most EU countries are aligned in their support of Ukraine and it’s almost seen as an internal matter.” Diplomats voiced support for the EU executive chief’s work as a crisis manager, praising her for coordinating support for Ukraine against Russia and managing tense commercial relations with the U.S. The difficulties have emerged on thorny Middle East politics or when the Commission’s position on EU expansion is felt as pressuring governments to agree before they’re ready. The diplomats who spoke to POLITICO argued that von der Leyen’s flurry of tweets and conversations with Gulf leaders did not formally represent EU foreign policy positions. Critics also voiced skepticism about what von der Leyen, who has no military means at her disposal and has no mandate to shape EU-wide foreign policy positions, could be offering Gulf states under missile and drone attack from Iran. “What exactly is she promising when she says we will support them?” asked Loiseau. “Who is ‘we’? For now, the support is the Charles de Gaulle [French aircraft carrier], Rafale jets in Abu Dhabi and defense agreements with some countries.” “What we’re seeing is role-play with nothing behind it,” said Loiseau, who belongs to French President Emmanuel Macron’s centrist party. Von der Leyen is a member of the center-right European People’s Party, along with German Chancellor Friedrich Merz. A statement in which von der Leyen appeared to embrace a change of leadership in Iran proved particularly irksome to EU countries that lean closer to Spanish Prime Minister Pedro Sánchez’s highly critical stance toward the U.S.-Israeli airstrikes. EU countries are split over how to respond to the conflict. Despite reaching a consensus on a statement about the war on March 1, ten countries had advocated a more prominent invocation of international law during an emergency gathering of EU foreign ministers, two diplomats said. Some countries argue that von der Leyen’s statements don’t reflect that delicate balance. “We [Europe] are meant to be the beacon of international law,” said a fourth diplomat. “But now she has trapped us on regime change. Whose position is this? Not ours.” Gulf countries had been “grateful” for von der Leyen’s “proactive” outreach in recent days, the Commission spokesperson said. ‘THIS IS NOT WHAT WE WANT’ In Paris, it’s von der Leyen’s decision to send her commissioner for the Mediterranean, Dubravka Šuica, to the inaugural session of the Board of Peace ― the Trump-led body aimed at promoting global stability ― that irked most, leading to public criticism from French Foreign Minister Jean-Noël Barrot. The ruffled feathers were “predictable,” a fifth diplomat said.  Von der Leyen decided to send Dubravka Šuica to the inaugural session of the Board of Peace. | Dursun Aydemir/Anadolu via Getty Images “As we knew, Trump made no distinction between observers and full members [of the Board of Peace],” the diplomat said. “He displayed the EU flag along with others, suggesting that Europe supports this initiative. This is not what we want.” As if to underscore the divisions in Brussels, Kallas had been working to coordinate a joint position on the Board of Peace by texting the bloc’s foreign ministers and inviting them not to participate, the diplomat said. “This is what we expect” on foreign policy, the diplomat added. Defending Šuica’s participation, the Commission distanced itself from fully supporting the Trump body.  “The participation of Commissioner Šuica cannot be interpreted as amounting to an implicit endorsement of the Board of Peace by the Commission, let alone by the [European] Union, nor an endorsement of the outcome of the meeting or of any resolutions that might be adopted by the board members,” the Commission spokesperson said. One diplomat from a mid-sized EU country backed up that view. “On the Board of Peace, realistically the large majority of member states were fine with how this went,” the diplomat said. READING THE ROOM The way the Commission has pushed to expand the EU to new members has annoyed some capitals.  Marta Kos, the commissioner in charge of the topic, has floated a range of creative solutions, including an attempt to bring Ukraine into the bloc as early as 2027.  The ideas — shared during informal briefings rather than in written proposals — have irked governments, prompting them last week to push back during a dinner with von der Leyen’s powerful chief of staff, Bjoern Seibert. “This dinner was overdue,” said a EU diplomat from a large EU country. “We all want Ukraine to be anchored in the EU, but enlargement needs to be acceptable to member states. There is a process — we are reminding them of that.” “The Commission did not read the room on this one,” said the diplomat from a mid-sized EU country. At the dinner, diplomats told the Commission they wanted to retain a merit-based approach to EU enlargement and were not in favor of a Commission idea to allow countries like Ukraine to join while they are still working to meet the joining criteria, according to officials in the meeting. An EU official aware of von der Leyen’s thinking pushed back on the idea that her Commission had overstepped on enlargement, pointing out that the EU executive has not put forward any formal proposals on changing the EU’s approach.  Discomfort with von der Leyen’s foreign policy activity has led to barely concealed tensions with Kaja Kallas. | Frederick Florin/AFP via Getty Images Even so, it was the institution’s job to reflect on how procedures may be updated in light of geopolitical changes. “The world has changed dramatically” since those rules were created, said the official. DECIDING IT CONSCIOUSLY Diplomats who spoke to POLITICO for this article voiced support for the EU executive chief’s work as a crisis manager, praising her for coordinating support to Ukraine against Russia and managing tense commercial relations with the U.S. But discomfort with von der Leyen’s foreign policy activity has led to barely concealed tensions with Kallas — creating a need for a reckoning about who does what in the EU, several diplomats and officials said. “We need to decide whether we want an institutional change — whether we want to give more foreign policy functions to the Commission,” said Nacho Sánchez Amor, a Spanish European lawmaker from the Socialists and Democrats group. “If so, we need to think about it, examine it, and decide it consciously.” The Iran crisis, the push to get Ukraine into the bloc and the wider challenges prompted by Trump’s second term in the White House add to the sense of unease in some capitals. “There is a conversation to have about the competences” of the EU in foreign policy, a diplomat from a large country said. “Between the HRVP [High Representative Kallas], the Commission and the Council presidency, there is a risk of cacophony. There will be a time to discuss this in depth.” Max Griera contributed to this report.

LUXEMBOURG — The European Commission didn’t want to reveal which staffers worked on Covid vaccine contract negotiations with pharma companies to avoid them being targeted by “conspiracy theorists,” its lawyers said Wednesday. A “lack of trust” about the contracts meant officials could have been subjected to “physical or psychological” harassment, said Antonios Bouchagiar, a Commission lawyer. “It’s a real risk in this case,” he added in a courtroom in Luxembourg.  The Commission is fighting a 2024 ruling from the EU’s General Court (the bloc’s lower court) that said it should have provided more details about the lucrative contracts — and the people negotiating them — when asked to do so by a group of Green MEPs and members of the public. The court ruled there was sufficient public interest in disclosing that information, saying: “It was only by having the names, surnames and details of the professional or institutional role of the members of the team in question that they could have ascertained whether or not the members of that team had a conflict of interests.” The Commission disagreed with that ruling and the case is now at the bloc’s highest court, the Court of Justice of the EU. The Commission signed six advance purchase agreements with pharma companies at the height of the Covid-19 pandemic in 2020 and 2021, promising to buy a certain amount of vaccines for European citizens as part of the EU’s bloc-wide approach to tackling the virus. The Green lawmakers said the public deserved to know more about how those contracts — worth millions of euros — came to be negotiated. When the MEPs made requests for access to documents, the Commission published redacted information. More than 3,000 members of the public, many of them skeptics of the EU’s approach and some hostile to mass vaccination policies, brought a separate legal action against the Commission. Lawyers for both the MEPs and the EU citizens were in court on Wednesday, arguing in front of a packed public gallery that the Commission should uphold the highest standards of transparency. “It is not some abstract aspiration,” said Raluca Gherghinaru, the lawyer for the MEPs, but a “constitutional value.” She added: “In crisis, we might expect leaders to be more accountable.” The Commission’s lawyers said the EU executive has already demonstrated a high level of accountability. Unredacted documents which prove that the negotiating team had no conflict of interest were studied by the European Court of Auditors, the lawyers said, adding that the anti-fraud agency (OLAF) and the European Public Prosecutor’s Office (EPPO) could look into the contracts if they felt that was necessary. Arnaud Durand, the lawyer for the members of the public who brought the case, argued that EPPO isn’t sufficiently independent because its budget is signed off by the Commission.  The Commission’s lawyers disputed that, saying independence is baked into EPPO and OLAF’s rules. The Commission also faced tough questioning from the president of the court, Koen Lenaerts, who asked: “Do you really mean that?” when Commission lawyers said that a request for access to information from a member of the public with a “lack of specific interest” should not automatically have to be complied with. Officials have “the right to work in serenity without having the finger pointed for some policy that they didn’t decide,” Bouchagiar said. But Lenaerts argued that the negotiations do not only take place at the highest political level but also at a technical level, and therefore any potential conflicts of interest of the civil servants involved deserve to be scrutinized. To laughter in the court, Lenaerts repeated the Commission’s argument that disclosing the names of staffers could lead to harassment, “particularly by conspiracy theorists.” Would disclosing those names “not be the best way of combating these conspiracy theorists?” he asked. The next step in the case will be a legal opinion on June 11 by Advocate-General Athanasios Rantos, which will guide the judges on their final ruling. No date has yet been given for that ruling. The EU’s Covid vaccine agreements have become a flashpoint for transparency campaigners, with Commission President Ursula von der Leyen coming under fire for her text messages with the CEO of Pfizer, which secured a multibillion-euro agreement with the Commission.  The Commission’s refusal to release von der Leyen’s messages came to be known as “Pfizergate.” The General Court ruled that the Commission was ultimately wrong not to reveal the messages.

Year two of Robert F. Kennedy Jr.’s tenure as health secretary is already yielding some wins — but not for him and his Make America Healthy Again movement. Instead, the agriculture and pharmaceutical industries he’s long targeted are breathing a sigh of relief as the White House signals it’s reining in Kennedy’s attacks on their products and tasking him with touting healthy eating and President Donald Trump’s efforts to cut drug price deals. The latest evidence came Wednesday when Trump issued an executive order promoting the production of glyphosate, the herbicide Kennedy and his MAHA followers believe is a carcinogen. For Washington’s lobbyists, the move was an early glimpse of how midterm realities are forcing the administration to shift away from Kennedy’s anti-vaccine, anti-chemical plans. “Picking on farmers. That’s the base of your party,” said Sam Geduldig, managing partner at CGCN, a Republican lobbying shop that has worked for food maker Kraft Heinz. “You don’t want to mess with that before an election.” Lately, Kennedy’s been on a road show promoting his new dietary guidelines. They differ from past government guidelines in their endorsement of eating meat and drinking whole milk, but are otherwise in line with conventional wisdom about the dangers of ultraprocessed food and the benefits of fruits and vegetables. Kennedy’s also been talking a lot about Trump’s efforts to pressure drug makers to make voluntary price cuts. A Trump administration official told POLITICO the White House wants Kennedy, an anti-vaccine activist before joining forces with Trump, to lay off the shots. Surveys from Trump’s pollster, Tony Fabrizio, have found Kennedy’s moves to downsize the childhood vaccine schedule are unpopular. The White House last week pressured the Food and Drug Administration to reconsider a flu vaccine from drugmaker Moderna that a Kennedy subordinate shot down days before. And on Thursday, Kennedy’s vaccine advisory panel — which has sought to lend scientific legitimacy to Kennedy’s push to reduce kids’ immunizations — postponed its February meeting indefinitely. Health and Human Services Department and White House officials explained a management shakeup at HHS last week was driven by a desire to refocus on drug pricing and other popular elements of the administration’s health agenda. Chris Klomp, who’s led the drug pricing effort, is now overseeing all HHS operations. The White House has rolled out its deals with pharma companies as evidence that it’s bringing prices down. But the deals are voluntary and industry has resisted efforts to make them law. The Supreme Court ruling against Trump’s tariffs Friday weakens a major lever in the president’s pressure campaign. Kennedy’s followers have noticed the shift. The order on glyphosate, for example, has sparked fierce backlash. “Bayer just got a license to kill from our gov’t. This [is] the mass poisoning of Americans and it continues,” Vani Hari, a MAHA influencer, wrote on X, referencing the German conglomerate that makes the world’s most popular herbicide. The victories for agriculture and pharma underscore the Trump administration’s delicate balancing act ahead of November’s midterm elections, which will shape the president’s influence for the remainder of his term. The president is juggling not only competing factions within the MAHA coalition, but also tensions between MAHA and his broader MAGA base. Vaccines remain a thorny issue even among MAHA supporters, for example, while efforts to rein in pesticides have upset farmers, a key Republican constituency. “They’re walking a tightrope,” said Jeremy Furchtgott, a director at Baron Public Affairs, a government affairs consultancy. “The administration is very creatively trying to triangulate to keep the coalition together, deliver some wins, and show that everybody can get some kind of win.” Emily Hilliard, an HHS spokesperson, maintained that the department was still focused on MAHA priorities. “HHS is doubling down on the MAHA strategy to improve the health of our nation’s children, improve nutrition, and make medicine more affordable and accessible. Americans voted for greater transparency and accountability in health care, and under President Trump’s leadership, HHS is delivering on those priorities,” she wrote in a statement. Some key MAHA leaders are keeping in line with Trump. Tony Lyons, president of the political group MAHA Action, who has positioned his PAC to back Trump-endorsed candidates, told POLITICO the recent executive order on glyphosate was “not a step backward” but a temporary action needed to boost national security. “This is a step to solve a short-term problem, which is that we can’t rely on China or anybody else to solve problems that farmers have,” he said. Sharon Mayl, a partner at DLA Piper, a Washington-based law and lobbying firm that represents many pharmaceutical clients, said it’s smart politics for Kennedy to focus on healthy eating. “Food is an issue that is relatable to everyone. It is easy to speak in sound bites that oversimplify and vilify particular ingredients without considering the complexity of the food system and the benefits,” she wrote in a statement. The administration’s pivot arrives as Republicans worry the health secretary’s earlier moves to weaken the country’s vaccine policies will hurt them in the midterms. An October poll conducted by health policy think tank KFF and the Washington Post found the majority of MAHA parents still expressed confidence in childhood vaccine safety, while the vast majority of MAHA and non-MAHA parents agreed ultraprocessed foods were harmful. Last week, HHS reshuffled its leadership team, dismissing Kennedy’s second-in-command, Jim O’Neill, and General Counsel Mike Stuart. The department, meanwhile, promoted Klomp from deputy administrator of the Centers for Medicare and Medicaid Services to chief counselor in charge of overseeing all HHS operations. Within the FDA, deputy commissioners Kyle Diamantas and Grace Graham were also promoted to senior counselors, while retaining their prior roles. The restructuring at the top followed a high-profile messaging blitz from Kennedy focused on food over vaccines, involving rallies in Harrisburg, Pennsylvania, and Nashville, Tennessee, and a Kennedy-endorsed Super Bowl ad paid for by the MAHA Center featuring boxer Mike Tyson and the slogan “Eat Real Food.” Earlier this week, Kennedy teamed up with the conservative musician Kid Rock to deliver a message about the importance of exercise in a video showing the two pumping iron shirtless. White House officials granted anonymity to discuss strategy attributed the changed focus to the importance health care will play in the midterms and the desire to focus on issues that have broad appeal. “I think we’re largely done with vaccines. I think the food stuff, we’re just beginning to kind of get into more,” the official said. “When you look at what’s keeping America unhealthy, it largely has to do with obesity and diabetes and heart disease and other very diet-driven and lifestyle-driven issues.” Kennedy has also devoted more time to touting Trump’s drug pricing deals as voters grow frustrated with the Republican party over the high cost of living. “We negotiated with 16 of the 17 pharmaceutical companies. We brought them all to the table, and now we have agreements with all of them. We are now going from paying the highest price in the world to paying the lowest,” Kennedy said at an event at the conservative Heritage Foundation think tank earlier this month. The White House has not disclosed details about the agreements, which were brokered in exchange for tariff relief. Health policy analysts doubt they will bring down prices for the vast majority of Americans, and drugmakers have made little mention of them in their investor calls. The turn away from pesticides and vaccines is a dramatic departure for the White House that, less than a year ago, called out the harms of pesticides and suggested vaccines may be linked to childhood chronic disease. Kennedy believes they have caused a big increase in autism rates, even as researchers have failed to find a connection. Kennedy defended Trump’s order to boost glyphosate production in the name of national security. “We must safeguard America’s national security first, because all of our priorities depend on it. When hostile actors control critical inputs, they weaken our security. By expanding domestic production, we close that gap and protect American families,” he said. For MAHA activists and industry observers, the shift underscores the continued strength of corporate lobbies even under a populist administration that has been critical of corporate influence. “We hate it,” said Paula Obeid, a MAHA organizer in Arizona, referring to Trump’s executive order on glyphosate. “There’s so much money on the agriculture side there.” Drugmakers and manufacturers of chemicals, including pesticides, are some of the biggest spenders in Washington, typically outpacing food makers. The Pharmaceutical Research and Manufacturers of America, which represents brand-name drugmakers, spent nearly $38 million on lobbying last year, its highest on record. The American Chemistry Council, meanwhile, spent almost $19 million last year. The Consumer Brands Association and the American Beverage Association, representing food conglomerates and soft drink producers, respectively, spent less than $11 million combined. “It’s easier to get a win in the food industry,” said Furchtgott. “The food industry spends a lot less on lobbying than the pharma industry.” “The companies that have taken D.C. seriously over many years have seen the benefits.” Cheyenne Haslett contributed to this report.

The German government rejected claims by U.S. Health Secretary Robert F. Kennedy Jr. that Berlin prosecuted doctors and patients for refusing Covid-19 vaccinations or mask mandates. “The statements made by the U.S. Secretary of Health are completely unfounded, factually incorrect, and must be rejected,” German Health Minister Nina Warken said in a statement late Saturday. “I can happily explain this to him personally,” she said. “At no time during the coronavirus pandemic was there any obligation for doctors to carry out vaccines against Covid-19,” Warken added. “Anyone who did not wish to offer vaccines for medical, ethical or personal reasons were not criminally liable and did not have to fear penalties,” she said. Warken added that “criminal prosecution took place only in cases of fraud and forgery of documents, such as the issuing of false vaccine certificates” or exemption certificates for masks.  “Doctors [in Germany] decide independently and autonomously on the treatment of patients,” the minister stressed, adding that “patients are also free to decide which treatment they wish to receive.” Kennedy said in a video post on Saturday that he had written to Warken after receiving reports that Germany was restricting “people’s abilities to act on their own convictions” in medical decisions. He claimed that “more than a thousand German physicians and thousands of their patients” faced prosecution for issuing exemptions from mask-wearing or Covid-19 vaccination requirements during the pandemic. Kennedy did not provide specific examples or identify the reports he cited, but he said Germany was “targeting physicians who put their patients first” and was “punishing citizens for making their own medical choices.” He accused Berlin of undermining the doctor–patient relationship and replacing it with “a dangerous system that makes physicians enforcers of state policies.” Former German Health Minister Karl Lauterbach also pushed back on the claims, telling Kennedy on X to “take care of health problems in his own country.”

President Donald Trump has told his health secretary, Robert F. Kennedy Jr., to consider aligning the U.S. vaccination schedule with those in Europe, where many countries recommend fewer vaccines. Kennedy has taken up the charge with gusto and is considering advising parents to follow Denmark’s childhood schedule rather than America’s. Many who specialize in vaccination and public health say that would be a mistake. While wealthy European countries do health care comparatively well, they say, there are lots of reasons Americans are recommended more shots than Europeans, ranging from different levels of access to health care to different levels of disease. “If [Kennedy] would like to get us universal health care, then maybe we can have a conversation about having the schedule adjusted,” Demetre Daskalakis, who led the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases before resigning in protest in August, told POLITICO. Children, especially those who live in poor and rural areas, would be at greater risk for severe disease and death if the U.S. were to drop shots from its schedule, Daskalakis said. Denmark, for instance, advises immunizing against only 10 of the 18 diseases American children were historically recommended immunizations against. It excludes shots for potentially serious infections, including hepatitis A and B, meningitis and respiratory syncytial virus. Under Kennedy, the government has already changed its hepatitis B vaccine recommendations for newborns this year, even as critics warned the new advice could lead to more chronic infections, liver problems and cancer. The health department points out that the new guidance on hepatitis B — that mothers who test negative for the virus may skip giving their newborn a shot in the hospital — now align more closely with most countries in Europe. Public health experts and others critical of the move say slimmer European vaccine schedules are a cost-saving measure and a privilege afforded to healthier societies, not a tactic to protect kids from vaccine injuries. Kennedy’s interest in modeling the U.S. vaccine schedule after Europe, they point out, is underpinned by his belief that some childhood vaccines are unsafe and that American kids get too many too young. Kennedy’s safety concerns don’t align with the rationale underpinning the approach in Europe, where the consensus is that childhood vaccines are safe. Wealthy European countries in many cases eschew vaccines based on a risk-benefit calculus that doesn’t hold in America. European kids often don’t get certain shots because it would prevent a very small number of cases — like hepatitis B — or because the disease is rarely serious for them, such as Covid-19 and chickenpox. But since the U.S. doesn’t have universal access to care, vaccinating provides more return on investment, experts say. “We just have a tradition to wait a little bit” before adding vaccines to government programs, said Johanna Rubin, a pediatrician and vaccine expert for Sweden’s health agency. Swedish children are advised to get vaccines for 11 diseases before they turn 18. Rubin cited the need to verify the shots’ efficacy and the high cost of new vaccines as reasons Sweden moves slowly to add to its schedule. “It has to go through the health economical model,” she said. VACCINE SAFETY’S NOT THE ISSUE Martin Kulldorff, a Swedish native and former Harvard Medical School professor who led Kennedy’s vaccine advisory panel until this month, pointed to that country’s approach to vaccination and public health in an interview with POLITICO earlier this year. Before the Centers for Disease Control and Prevention this month dropped its recommendation that children of mothers who test negative for hepatitis B receive a vaccine within a day of birth, Kulldorff cited Sweden’s policy. “In Sweden, the recommendation is that you only do that if the mother has the infection. That’s the case in most European countries,” he said. “You could have a discussion whether one or the other is more reasonable.” The U.S. policy, as of Dec. 16, more closely resembles Sweden’s, with hepatitis B-negative mothers no longer urged to vaccinate their newborns against the virus at birth. But Sweden’s public health agency recommends that all infants be vaccinated, and the country’s regional governments subsidize those doses, which are administered as combination shots targeting six diseases starting at 3 months. Public health experts warn that even children of hepatitis B-negative mothers could catch the virus from others via contact with caregivers who are positive or shared household items. The prevalence of chronic hepatitis B in the U.S. is 6.1 percent compared to 0.3 percent in Sweden, according to the Coalition for Global Hepatitis Elimination, a Georgia-based nonprofit which receives funding from pharmaceutical companies, the CDC and the National Institutes of Health, among others. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the U.S. has taken a more comprehensive approach to vaccination, in part because its population is sicker than that of some Western European countries, and the impact of contracting a disease could be more detrimental. Osterholm pointed to the Covid pandemic as an example. By May 2022, the U.S. had seen more than 1 million people die. Other high-income countries — though much smaller — had more success controlling mortality, he said. “People tried to attribute [the disparity] to social, political issues, but no, it was because [peer nations] had so many more people who were actually in low-risk categories for serious illness,” Osterholm said. Kennedy and his advisers also cited European views on Covid vaccination in the spring when the CDC dropped its universal recommendation, instead advising individuals to talk to their providers about whether to get the shot. Last month, the Food and Drug Administration’s top vaccine regulator, Vinay Prasad, linked the deaths of 10 children to Covid vaccination without providing more detailed information about the data behind his assertion. European countries years ago stopped recommending repeat Covid vaccination for children and other groups not considered at risk of becoming severely sick. Covid shots have been linked to rare heart conditions, primarily among young men. European vaccine experts say Covid boosters were not recommended routinely for healthy children in many countries — not because of safety concerns, but because it’s more cost-effective to give them to high-risk groups, such as elderly people or those with health conditions that Covid could make severely sick and put in the hospital. In the U.K., Covid-related hospitalizations and deaths declined significantly after the pandemic, and now are “mostly in the most frail in the population, which has led to more restricted use of the vaccines following the cost-effectiveness principles,” said Andrew Pollard, the director of the Oxford Vaccine Group in the United Kingdom, which works on developing vaccines and was behind AstraZeneca’s Covid-19 shot. Pollard led the Joint Committee on Vaccination and Immunization, which advises the U.K. government, for 12 years before stepping down in September. In the U.S., more moves to follow Europe are likely. At a meeting of Kennedy’s vaccine advisers earlier this month, Tracy Beth Høeg, now acting as the FDA’s top drug regulator, pointed to Denmark’s pediatric schedule, which vaccinates for 10 diseases, while questioning whether healthy American children should be subject to more vaccines than their Danish counterparts. Danish kids typically don’t get shots for chickenpox, the flu, hepatitis A and B, meningitis, respiratory syncytial virus and rotavirus, like American children do, though parents can privately pay for at least some of those vaccines. The country offers free Covid and flu vaccines to high-risk kids. After the vaccine advisory meeting wrapped, Trump said he was on board, directing Kennedy to “fast track” a review of the U.S. vaccine schedule and potentially align it with other developed nations. He cited Denmark, Germany and Japan as countries that recommend fewer shots. Last week, Kennedy came within hours of publicly promoting Denmark’s childhood vaccine schedule as an option for American parents. The announcement was canceled at the last minute after the HHS Office of the General Counsel said it would invite a lawsuit the administration could lose, a senior department official told POLITICO. The notion that the U.S. would drop its vaccine schedule in favor of a European one struck health experts there as odd. Each country’s schedule is based on “the local situation, so the local epidemiology, structure of health care services, available resources, and inevitably, there’s a little bit of political aspect to it as well,” said Erika Duffell, a principal expert on communicable disease prevention and control at the European Centre for Disease Prevention and Control, an EU agency that monitors vaccine schedules across 30 European countries. Vaccine safety isn’t the issue, she said. For example, even though most Europeans don’t get a hepatitis B shot within 24 hours of birth, the previous U.S. recommendation, “there is a consensus that the effectiveness and safety of the vaccine has been confirmed through decades of research” and continuous monitoring, she said. European nations like Denmark and the U.K. have kept new cases of hepatitis B low. Denmark recorded no cases of mother-to-child transmission in 2023, and Britain’s rate of such spread is less than 0.1 percent — though the latter does routinely recommend vaccinating low-risk infants beginning at 2 months of age. European experts point to high levels of testing of pregnant women for hepatitis B and most women having access to prenatal care as the reasons for success in keeping cases low while not vaccinating all newborns. The major differences between the U.S. and the U.K. in their approach to hepatitis B vaccination are lower infection rates and high screening uptake in Britain, plus “a national health system which is able to identify and deliver vaccines to almost all affected pregnancies selectively,” Pollard said. The CDC, when explaining the change in the universal birth dose recommendation, argued the U.S. has the ability to identify nearly all hepatitis B infections during pregnancy because of ”high reliability of prenatal hepatitis B screening,” which some European experts doubt. “If we change a program, we need to prepare the public, we need to prepare the parents and the health care providers, and say where the evidence comes from,” said Pierre Van Damme, the director of the Centre for the Evaluation of Vaccination at the University of Antwerp in Belgium. He suggested that, if there was convincing evidence, U.S. health authorities could have run a pilot study before changing the recommendation to evaluate screening and the availability of testing at birth in one U.S. state, for example. WHERE EUROPEANS HAVE MORE DISEASE In some cases, European vaccination policies have, despite universal health care, led to more disease. France, Germany and Italy moved from recommending to requiring measles vaccination over the last decade after outbreaks on the continent. The U.S., until recently, had all but eradicated measles through a universal recommendation and school requirements. That’s starting to change. The U.S. is at risk of losing its “measles-elimination” status due to around 2,000 cases this year that originated in a Texas religious community where vaccine uptake is low. The 30 countries in the European Union and the European Economic Area, which have a population of some 450 million people combined, reported more than 35,000 measles cases last year, concentrated in Romania, Austria, Belgium and Ireland. Europe’s comparatively high rate is linked to lower vaccination coverage than the level needed to prevent outbreaks: Only four of the 30 countries reached the 95-percent threshold for the second measles dose in 2024, according to the European Centre for Disease Prevention and Control. Kennedy touted the U.S.’s lower measles rate as a successful effort at containing the sometimes-deadly disease, but experts say the country could soon see a resurgence of infectious diseases due to the vaccine skepticism that grew during the pandemic and that they say Kennedy has fomented. Among kindergarteners, measles vaccine coverage is down 2.7 percentage points as of the 2024-2025 school year, from a peak of 95.2 percent prior to the pandemic, according to CDC data. That drop occurred before Kennedy became health secretary. Kennedy and his advisers blame it on distrust engendered by Covid vaccine mandates imposed by states and President Joe Biden. But Kennedy led an anti-vaccine movement for years before joining the Trump administration, linking shots to autism and other conditions despite scientific evidence to the contrary, and he has continued to question vaccine safety as secretary. In some EU nations, vaccines aren’t compulsory for school entry. Swedish law guarantees the right to education and promotes close consultation between providers and patients. Some governments fear mandates could push away vaccine-hesitant parents who want to talk the recommended shots over with their doctor before giving the vaccines to their children, Rubin explained. In the U.S., states, which have the authority to implement vaccine mandates for school entry, rely on the CDC’s guidance to decide which to require. Vaccine skeptics have pushed the agency to relax some of its recommendations with an eye toward making it easier for American parents to opt out of routine shots. Scandinavian nations maintain high vaccine uptake without mandates thanks to “high trust” in public health systems, Rubin said. In Sweden, she added, nurses typically vaccinate young children at local clinics and provide care for them until they reach school age, which helps build trust among parents. CHICKENPOX Another example of where the U.S. and Europe differ is the chickenpox vaccine. The U.S. was the first country to begin universal vaccination against the common childhood illness in 1995; meanwhile, 13 EU nations broadly recommend the shot. Denmark doesn’t officially track chickenpox — the vaccine isn’t included on its schedule — but estimates 60,000 cases annually in its population of 6 million. The vastly larger U.S. sees fewer than 150,000 cases per year, according to the CDC. Many European countries perceive chickenpox as a benign disease, Van Damme said. “If you have a limited budget for prevention, you will spend usually the money in other preventative interventions, other vaccines than varicella,” he said, referring to the scientific term for chickenpox. But there’s another risk if countries decide to recommend chickenpox vaccination, he explained. If the vaccination level is low, people remain susceptible to the disease, which poses serious risks to unborn babies. If it’s contracted in early pregnancy, chickenpox could trigger congenital varicella syndrome, a rare disorder that causes birth defects. If children aren’t vaccinated against chickenpox, almost all would get the disease by age 10, Van Damme explained. If countries opt for vaccination, they have to ensure robust uptake: vaccinate virtually all children by 10, or risk having big pockets of unvaccinated kids who could contract higher-risk infections later. Europe’s stance toward chickenpox could change soon. Several countries are calculating that widely offering chickenpox vaccines would provide both public health and economic benefits. Britain is adding the shot to its childhood schedule next month. Sweden is expected to green-light it as part of its national program in the coming months. While the public doesn’t see it as a serious disease, pediatricians who see serious cases of chickenpox are advocating for the vaccine, Rubin told POLITICO. “It is very contagious,” she said. “It fulfills all our criteria.” The U.K. change comes after its vaccine advisory committee reviewed new data on disease burden and cost-effectiveness — including a 2022 CDC study of the U.S. program’s first 25 years that also examined the vaccine’s impact on shingles, a painful rash that can occur when the chickenpox virus reactivates years later. Scientists had theorized for years that limiting the virus’ circulation among children could increase the incidence of shingles in older adults by eliminating the “booster” effect of natural exposure, but the U.S. study found that real-world evidence didn’t support that hypothesis.

Health Secretary Robert F. Kennedy Jr. came within hours of publicly promoting Denmark’s childhood vaccine schedule as an option for American parents — before legal and political concerns got in the way. A senior HHS official told POLITICO that a press conference set for Friday was canceled at the last minute after the HHS Office of the General Counsel said it would invite a lawsuit the administration could lose. A second senior official at the Department of Health and Human Services confirmed the press conference, which HHS had publicly announced, was to be about the Danish schedule. The second official said it was canceled because it was deemed politically risky. Billed as an “announcement regarding children’s health,” Kennedy was to appear alongside his top agency heads and Tracy Beth Høeg, the Food and Drug Administration’s top drug regulator. Høeg touted the Danish schedule at a vaccine advisory committee meeting earlier this month. HHS canceled the event Thursday evening, hours after announcing it. Andrew Nixon, an HHS spokesperson, called accounts of the cancellation that didn’t come directly from the department “pure speculation” in a statement. HHS officials skeptical of moving to the Danish schedule, which recommends immunization for only 10 of the 17 diseases on the U.S. list, were relieved it was never publicly recommended, the first official said. The internal confusion and disagreement follow similar management bungling within HHS’ Food and Drug Administration that has frustrated the White House. On Dec. 5, President Donald Trump signed a presidential memorandum titled “Aligning United States Core Childhood Vaccine Recommendations with Best Practices from Peer, Developed Countries.” The memorandum directed HHS and the Centers for Disease Control and Prevention, one of its subagencies that sets the vaccine schedule, to review peer-country best practices for vaccines recommended for all children and, if those practices were judged superior, to update the U.S. schedule while preserving access to vaccines already available. In the memorandum, Trump mentioned Denmark, Japan and Germany as examples of countries that recommend fewer shots than the U.S. According to the first official, Kennedy and his top aide, Stefanie Spear, helped sell the peer-country framing to West Wing officials as the clearest way to turn internal vaccine skepticism into a signed White House directive. Spear is Kennedy’s principal deputy chief of staff and senior counselor. Kennedy is a longtime vaccine skeptic who believes the U.S. schedule has grown too quickly, has not been tested in its entirety for adverse effects, and is a likely cause of rising autism rates. Numerous studies have not found a link between vaccines and the neurological disorder that now affects one in 31 U.S. children, up from one in 150 two decades ago. Experts in the condition, which affects the ability to communicate, say expanded diagnostic criteria and awareness are responsible for most of that rise. The condition’s cause is usually genetic, they believe, but researchers are studying possible environmental causes. HHS has made it a priority to learn more about what causes autism and why diagnoses are rising. The department’s research arm, the National Institutes of Health, announced an Autism Data Science Initiative on May 27 and has awarded around $50 million to fund 13 projects investigating potential causes. In April, Kennedy promised to reveal autism’s cause in September, but HHS later said it would reveal preliminary findings early next year. Autism researchers, who have studied the condition for years, have called that unrealistic. The first indication Kennedy might be considering the slimmer Danish schedule, which excludes vaccines for chickenpox, the flu, hepatitis A and B, meningitis, respiratory syncytial virus and rotavirus, came earlier this month during the CDC’s Advisory Committee on Immunization Practices meeting in Atlanta. Høeg presented a slide deck titled “U.S. vs. Danish Vaccine Schedule,” which the CDC posted among the meeting presentations. The department then circulated Høeg’s presentation to top officials at HHS, the first senior official said. In the ensuing debate, Høeg’s supporters proposed offering the Danish schedule as a government-recommended alternative to the U.S. one. The first senior official and two others inside HHS familiar with internal discussions, all of whom were granted anonymity to reveal deliberations they were not authorized to discuss publicly, said proponents of the Danish schedule felt that offering it would help restore trust in vaccines; many Americans were turned off by Covid-era vaccine mandates and claims that Covid shots would halt transmission that turned out to be incorrect, they argued. The three officials said the view of proponents inside the administration was that the Danish schedule could be pitched as a “reset” that might convince hesitant parents to vaccinate their kids. Critics inside the administration, the officials said, argued the plan to recommend the Danish schedule was not rigorous and science-based — and that promoting it publicly would invite criticism. Rather than restoring trust, they said it could undermine it by signaling doubt about the need for, and safety of, routine immunization. Going forward without laying the scientific groundwork or going through normal regulatory processes could also make the department vulnerable to lawsuits, the HHS general counsel’s office argued, according to the first senior official. Mike Stuart, who was a U.S. attorney in West Virginia in Trump’s first term, now is HHS general counsel. The American Academy of Pediatrics, which represents doctors who care for children, along with other physician and public health groups, has already sued HHS for changes it made earlier this year to Covid vaccine recommendations, saying the department violated rules governing how regulatory changes are made. That case is pending in federal district court in Boston. HHS has stopped recommending Covid boosters for previously vaccinated people under 65 who are not at high risk of the disease. Instead, the department says Americans should talk to their doctor and make a shared decision. Carmen Paun contributed to this story. Tim Röhn is senior editor of the Axel Springer Global Reporters Network.