Anna Kirkland, University of Michigan

For almost 40 years, people who suspect they’ve been harmed by a vaccine have been able to turn to a little-known system called the Vaccine Injury Compensation Program – often simply called the vaccine court.

Health and Human Services Secretary Robert F. Kennedy Jr. has long been a critic of the vaccine court, calling it “biased” against compensating people, slow and unfair. He has said that he wants to “revolutionize” or “fix” this system.

I’m a scholar of law, health and medicine. I investigated the history, politics and debates about the Vaccine Injury Compensation Program in my book “Vaccine Court: The Law and Politics of Injury.”

Although vaccines are extensively tested and monitored, and are both overwhelmingly safe for the vast majority of people and extremely cost-effective, some people will experience a harmful reaction to a vaccine. The vaccine court establishes a way to figure out who those people are and to provide justice to them.

Having studied the vaccine court for 15 years, I agree that it could use some fixing. But changing it dramatically will be difficult and potentially damaging to public health.

Deciphering vaccine injuries

The Vaccine Injury Compensation Program is essentially a process that enables doctors, lawyers, patients, parents and government officials to determine who deserves compensation for a legitimate vaccine injury.

It was established in 1986 by an act of Congress to solve a specific social problem: possible vaccine injuries to children from the whole-cell pertussis vaccine. That vaccine, which was discontinued in the U.S. in the 1990s, could cause alarming side effects like prolonged crying and convulsions. Parents sued vaccine manufacturers, and some stopped producing vaccines.

Congress was worried that lawsuits would collapse the country’s vaccine supply, allowing diseases to make a comeback. The National Childhood Vaccine Injury Act of 1986 created the vaccine court process and shielded vaccine manufacturers from these lawsuits.

Here’s how it works: A person who feels they have experienced a vaccine-related injury files a claim to be heard by a legal official called a special master in the U.S. Court of Federal Claims. The Health and Human Services secretary is named as the defendant and is represented by Department of Justice attorneys.

Doctors who work for HHS evaluate the medical records and make a recommendation about whether they think the vaccine caused the person’s medical problem. Some agreed-upon vaccine injuries are listed for automatic compensation, while other outcomes that are scientifically contested go through a hearing to determine if the vaccine caused the problem.

Awards come from a trust fund, built up through a 75-cent excise tax on each dose of covered vaccine sold. Petitioners’ attorneys who specialize in vaccine injury claims are paid by the trust fund, whether they win or lose.

Some updates are needed

Much has changed in the decades since Congress wrote the law, but Congress has not enacted updates to keep up.

For instance, the law supplies only eight special masters to hear all the cases, but the caseload has risen dramatically as more vaccines have been covered by the law. It set a damages cap of US$250,000 in 1986 but did not account for inflation. The statute of limitations for an injury is three years, but in my research, I found many people file too late and miss their chance.

When the law was written, it only covered vaccines recommended for children. In 2023, the program expanded to include vaccines for pregnant women. Vaccines just for adults, like shingles, are not covered. COVID-19 vaccine claims go to another system for emergency countermeasures vaccines that has been widely criticized. These vaccines could be added to the program, as lawyers who bring claims there have advocated.

These reform ideas are “friendly amendments” with bipartisan support. Kennedy has mentioned some of them, too.

A complex system is hard to revolutionize

Kennedy hasn’t publicly stated enough details about his plan for the vaccine court to reveal the changes he intends to make. The first and least disruptive course of action would be to ask Congress to pass the bipartisan reforms noted above.

But some of his comments suggest he may seek to dismantle it, not fix it. None of his options are straightforward, however, and consequences are hard to predict.

Straight up changing the vaccine court’s structure would probably be the most difficult path. It requires Congress to amend the 1986 law that set it up and President Donald Trump to sign the legislation. Passing the bill to dismantle it requires the same process. Either direction involves all the difficulties of getting a contentious bill through Congress. Even the “friendly amendments” are hard – a 2021 bill to fix the vaccine court was introduced but failed to advance.

However, there are several less direct possibilities.

Adding autism to the injuries list

Kennedy has long supported discredited claims about harms from vaccines, but the vaccine court has been a bulwark against claims that lack mainstream scientific support. For example, the vaccine court held a yearslong court process from 2002 to 2010 and found that autism was not a vaccine injury. The autism trials drew on 50 expert reports, 939 medical articles and 28 experts testifying on the record. The special masters deciding the cases found that none of the causation hypotheses put forward to connect autism and vaccines were reliable as medical or scientific theories.

Much of Kennedy’s ire is directed at the special masters, who he claims “prioritize the solvency” of the system “over their duty to compensate victims.” But the special masters do not work for him. Rather, they are appointed by a majority of the judges in the Court of Federal Claims for four-year terms – and those judges themselves have 15-year terms. Kennedy cannot legally remove any of them in the middle of their service to install new judges who share his views.

Given that, he may seek to put conditions like autism on the list of presumed vaccine injuries, in effect overturning the special masters’ decisions. Revising the list of recognized injuries to add ones without medical evidence is within Kennedy’s powers, but it would still be difficult. It requires a long administrative process with feedback from an advisory committee and the public. Such revisions have historically been controversial, and are usually linked to major scientific reviews of their validity.

Public health and medical groups are already mobilized against Kennedy’s vaccine policy moves. If he failed to follow legally required procedures while adding new injuries to the list, he could be sued to stop the changes.

Targeting vaccine manufacturers

Kennedy could also lean on his newly reconstituted Advisory Committee on Immunization Practices to withdraw recommendations for certain vaccines, which would also remove them from eligibility in the vaccine compensation court. Lawsuits against manufacturers could then go straight to regular courts. On Aug. 14, 2025, the Department of Health and Human Services may have taken a step in this direction by announcing the revival of a childhood vaccine safety task force in response to a lawsuit by anti-vaccine activists.

Kennedy has also supported legislation that would allow claims currently heard in vaccine court to go to regular courts. These drastic reforms could essentially dismantle the vaccine court.

People claiming vaccine injuries could hope to win damages through personal injury lawsuits in the civil justice system instead of vaccine court, perhaps by convincing a jury or getting a settlement. These types of settlements were what prompted the creation of the vaccine court in the first place. But these lawsuits could be hard to win. There is a higher bar for scientific evidence in regular courts than in vaccine court, and plaintiffs would have to sue large corporations rather than file a government claim.

Raising the idea of reforming the vaccine court has provoked strong reactions across the many groups with a stake in the program. It is a complex system with multiple constituents, and Kennedy’s approaches so far pull in different directions. The push to revolutionize it will test the strength of its complex design, but the vaccine court may yet hold up.

Anna Kirkland, Professor of Women’s and Gender Studies, University of Michigan

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Christine Picard, Indiana University and Hector Rosche-Flores, Indiana University

Insects are becoming increasingly popular to grow on farms as feed for other animals, pet food and potentially as food for people. The process of bringing a wild animal into an artificial environment, known as domestication, comes with unique challenges. Luckily, there are important lessons to be learned from all the other animals people have domesticated over millennia.

As researchers who study how domesticating animals changes their genes, we believe that recognizing the vulnerabilities that come with domestication is important. Today’s powerful biotechnology tools can help researchers anticipate and head off issues early on.

Domestication is nothing new

From grain domestication starting as far back as 12,000 years ago to today’s high-tech, genome-based breeding strategies, humans have long bent nature to suit their purposes. By selectively breeding individual plants or animals that have desirable traits – be it appearance, size or behavior – humans have domesticated a whole host of species.

The same principle underlies all domestication attempts, from dogs to crops. A breeder identifies an individual with a desired trait – whether that’s a dog’s talent for tracking or a plant’s ability to withstand pests. Then they breed it to confirm that the desired trait can be passed down to offspring. If it works, the breeder can grow lots of descendants in a lineage with the genomic advantage.

People have made crops resilient to disease and environmental challenges, docile cows that yield more milk or meat, large-breasted poultry and cute dogs.

A long history of insects working for people

Insect domestication is also far from new. People have reared silkworms (Bombyx mori) to produce silk for over 5,000 years. But selective breeding and isolation from wild relatives have led to their inability to fly, dependence on one food source and need for assistance to reproduce. As a result, silkworms are wholly reliant on humans for survival, and the original species doesn’t exist anymore.

Similarly, people have maintained colonies of the western honeybee (Apis mellifera) for pollination and honey production for centuries. But bees are at risk due to colony collapse disorder, a phenomenon where worker bees disappear from seemingly healthy hives. The causes of colony collapse disorder are unknown; researchers are investigating disease and pesticides as possible factors.

Now the insect agriculture industry has set its sights on domesticating some other insects as a source of sustainably farmed protein for other animals or people.

Insects such as the black soldier fly (Hermetia illucens) and the mealworm (Tenebrio molitor) can grow on existing organic waste streams. Rearing them on organic farm and food waste circularizes the agricultural system and reduces the environmental footprint of growing proteins.

But these insects will need to be grown at scale. Modern agriculture relies on monocultures of species that allow for uniformity in size and synchronized growth and harvest. Domesticating wild insects will be necessary to turn them into farmed animals.

Domestication has an immunity downside

Chickens today grow faster and bigger than ever. But factory-farmed animals are genetically very homogeneous. Moreover, people take care of everything for these domesticated animals. They have easy access to food and are given antibiotics and vaccines for their health and safety.

Consequently, industrially-farmed chickens have lost a lot of their immune abilities. Building these strong disease-fighting proteins requires a lot of energy. Since their spotless, controlled environments protect them, those immune genes are just not needed. The energy their bodies would typically use to protect themselves can instead be used to grow bigger.

In the wild, individuals with faulty immune genes would likely be killed by pathogens, quickly wiping these bad genes out from the population. But in a domesticated environment, such individuals can survive and pass on potentially terrible genes.

The H5N1 bird flu provides a recent example of what can go wrong when a homogeneous population of domesticated animals encounters a dangerous pathogen. When disease broke out, the poor immune systems of domesticated chickens cracked under the pressure. The disease can spread quickly through large facilities, and eventually all chickens there must be euthanized.

Domestication and the risks of monoculture

Weak immune systems aren’t the only reason the bird flu spread like it did.

Domestication often involves growing large numbers of a single species in small concentrated areas, referred to as a monoculture. All the individuals in a monoculture are roughly the same, both physically and in their genes, so they all have the same susceptibilities.

Banana cultivars are one example. Banana plants grown in the early 1900s were all descendants of a single clone, named Gros Michel. But when the deadly Panama disease fungus swept through, the plants had no defenses and the cultivar was decimated.

Banana growers turned to the Cavendish variety, grown in the largest banana farms today. The banana industry remains vulnerable to the same kind of risk that took down Gros Michel. A new fungal strain is on the rise, and scientists are rushing to head off a global Cavendish banana collapse.

Lessons about weaknesses that come with domestication are important to the relatively new industry advancing insects as the future of sustainable protein production and organic waste recycling.

How genomics can help correct course

Modern genomics can give insect agriculture a new approach to quality control. Technological tools can help researchers learn how an organism’s genes relate to its physical traits. With this knowledge, scientists can help organisms undergoing domestication bypass potential downsides of the process.

For instance, scientists combined data from hundreds of different domesticated tomato genomes, as well as their wild counterparts. They discovered something you’ve probably experienced – while selecting for longer shelf life, tomato flavor genes were unintentionally bred out.

A similar approach of screening genomes has allowed scientists to discover the combination of genes that enhances milk production in dairy cows. Farmers can intentionally breed individuals with the right combinations of milk-producing genes while keeping an eye on what other genes the animals have or lack. This process ensures that breeders don’t lose valuable traits, such as robust immune systems or high fertility rates, while selecting for economically valuable traits during domestication.

Insect breeders can take advantage of these genetic tools from the outset. Tracking an animal population’s genetic markers is like monitoring patients’ vital signs in the hospital. Insect breeders can look at genes to assess colony health and the need for interventions. With regular genetic monitoring of the farmed population, if they begin to see individuals with markers for some “bad” genes, they can intervene right away, instead of waiting for a disaster.

Mechanisms to remedy an emerging disaster include bringing in a new brood from the wild or another colony whose genes can refresh the domesticated population’s inbred and homogeneous genome. Additionally, researchers could use gene-editing techniques such as CRISPR-Cas9 to replicate healthy and productive combinations of genes in a whole new generation of domesticated insects.

Genomics-assisted breeding is a supplement to standard practices and not a replacement. It can help breeders see which traits are at risk, which ones are evolving, and where natural reservoirs of genetic diversity might be found. It allows breeders to make more informed decisions, identify genetic problems and be proactive rather than reactive.

By harnessing the power of genomics, the insect agriculture industry can avoid setting itself up for an accidental future collapse while continuing to make inroads on sustainable protein production and circularizing the agricultural ecosystem.

Christine Picard, Professor of Biology, Indiana University and Hector Rosche-Flores, Ph.D. Student in Biology, Indiana University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

David Higgins, University of Colorado Anschutz Medical Campus

It’s August, and parents and caregivers are frantically preparing their kids for a new school year by buying supplies, filling out forms and meeting teachers. This year, many parents also face a question that’s more complicated than usual: Should my child get an updated COVID-19 vaccine, and will I even have that choice? For some, that decision may have already been made by chaotic federal policy, just as COVID-19 cases are rising nationwide.

As a pediatrician and researcher who studies vaccine delivery and health policy, I am hearing uncertainty from both parents and health care providers. If that describes you, you are not alone. A poll published Aug. 1, 2025, by the health policy organization KFF found half of parents are unsure whether federal health agencies are recommending COVID-19 vaccines for healthy children this fall.

The process that normally provides clear, consistent recommendations and ensures availability for vaccines before respiratory virus season has been upended, and this year’s COVID-19 vaccine guidance for children is a prime example.

How the process typically works

For over two decades, there was a predictable, well-coordinated process to ensure recommended seasonal vaccines, such as the flu shot, were available for anyone who wanted them by early fall. In recent years, COVID-19 vaccines have been incorporated into this same annual cycle.

Beginning in February, the Food and Drug Administration, including its independent committee of experts, reviewed data and approved the optimal formulation. After FDA approval, the Advisory Committee on Immunization Practices, or ACIP, an independent panel of experts that advises the Centers for Disease Control and Prevention, reviewed the evidence in public meetings and issued clear recommendations.

Manufacturers then scaled up production; insurers confirmed coverage, which is tied to the advisory committee’s recommendations; and doses were distributed nationwide so vaccines would be available in clinics and pharmacies before the leaves started turning. This usual series of steps ensured that guidance incorporated input from scientists, epidemiologists, public health experts, clinicians, manufacturers, insurers and consumers. It also fostered trust among health care providers and, in turn, provided parents with clarity and confidence when making decisions.

What’s different this year

Since Robert F. Kennedy Jr. took over as secretary of Health and Human Services in February 2025, that usual, tightly choreographed dance has become a chaotic scramble marked by uncertainty and a lack of transparency. Decisions about vaccine guidance have been made through internal channels without the same level of public discussion, review of the evidence or broad stakeholder input.

In May 2025, Kennedy and FDA leadership bypassed the agency’s independent review committee and announced that some COVID-19 vaccines would be approved only for children with high-risk conditions. One formulation has yet to be FDA-approved for children at all. The secretary first announced updated recommendations for children on X, stating COVID-19 vaccines would no longer be recommended for healthy children. Shortly after, the CDC posted guidelines that differed from that announcement and said healthy children “may” receive them. Meanwhile, the Advisory Committee on Immunization Practices was disbanded by Kennedy and replaced with a smaller, hand-picked panel that operates with less transparency and has yet to weigh in on COVID-19 vaccines for children.

Public messaging has added to the confusion. Statements from newly appointed federal health leaders have questioned the safety of COVID-19 vaccines and the long-standing processes for ensuring their safety. Funding for mRNA technology, which supports several COVID-19 vaccines and is being explored for use against other diseases and even some cancers, has been cut. And many of the claims used to justify these actions have been challenged by experts as inaccurate or misleading.

What this means for parents

For parents, the result is uncertainty about whether their children should be vaccinated, when and where the vaccines will be available, whether insurance will cover them, or whether their choice has effectively been made for them by newly appointed health leaders operating outside the guardrails of the normal vetting process. This uncertainty comes at a time when the uptake of COVID-19 vaccines in children is already lower than that of other routine vaccines.

Currently, CDC guidelines say healthy children six months and older “may” receive a COVID-19 vaccine based on shared decision-making with their health care provider. The CDC recommends that children who are moderately or severely immunocompromised receive it. These guidelines differ from FDA approvals and Kennedy’s guidelines announced on X, and they have not been reviewed or voted on in an advisory committee on immunization practices meeting.

Parents can start by talking with their child’s pediatrician about benefits and potential risks, confirming eligibility and checking on insurance coverage. Pediatricians welcome parents’ questions and work tirelessly to provide answers grounded in the best available evidence so families can make truly informed decisions about their child’s health.

In some cases, unfortunately, even if parents want the vaccine and their pediatrician agrees, they may not be able to get it due to any number of factors, including local supply shortages, lack of insurance coverage, policies that prevent administration by pharmacists and other health providers without clear federal guidance, or an unwillingness of providers to give it “off-label,” meaning in a way that differs from the FDA’s official approval. For those parents, their decision has been made for them.

Reducing risks in other ways

Whether or not a child receives an updated COVID-19 vaccine, parents can still take steps to reduce illness, including keeping children home when sick, teaching them cough-and-sneeze hygiene and encouraging frequent hand-washing. The CDC provides national and state data on seasonal respiratory illnesses, including COVID-19, while local public health websites often offer community-level information.

Parents should also remember that the COVID-19 vaccine is not the only thing to consider before school starts. Routine immunizations such as those for measles, mumps and rubella, known as the MMR vaccine; diphtheria, tetanus and pertussis, called DTaP; and influenza are essential for keeping kids healthy and in school. These are widely available for now. This is particularly important, as this year the United States has experienced the highest number of measles cases in decades.

Uncertainty surrounding COVID-19 vaccine recommendations, and potentially other vaccines, may worsen in the coming weeks and months. It is possible parents will continue to see shifting guidance, conflicting statements from federal agencies and reduced access to vaccines in their communities.

In this chaotic environment, parents can look to trusted sources such as their pediatrician or organizations such as the American Academy of Pediatrics, which will continue to provide independent, evidence-based vaccine guidance.

David Higgins, Assistant Professor of Pediatrics, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.