The fight over vaccines and autism has thrust the Centers for Disease Control and Prevention (CDC) back into the headlines. But the agency’s recent decision to hedge on whether vaccines cause autism is not an isolated mistake. It is the latest symptom of a deeper illness: a public-health agency whose scientific voice is increasingly vulnerable to political pressure.
I trained at a time when the CDC was rightly seen as a beacon of scientific integrity. This was the agency that helped bring polio under control, contributed to the eradication of smallpox, and cracked the mysteries of Legionnaires’ disease and toxic shock syndrome. Its reputation rested on one core principle: Let the data lead, even when they anger powerful people.
That culture did not erode overnight, and it did not begin with Covid or vaccines. To see how far we have drifted, it helps to look back.
The swine flu lesson—learned the wrong way
The 1976 swine flu episode is often cited as a turning point. When a novel influenza strain appeared at Fort Dix, CDC director David Sencer recommended a nationwide vaccination campaign, fearing a repeat of the 1918 pandemic. President Ford agreed, and about 45 million Americans were vaccinated. The feared pandemic never materialized, and a small number of vaccine recipients developed serious adverse events, including Guillain–Barré syndrome.
Congressional inquiries and a widely read report, The Swine Flu Affair: Decision-Making on a Slippery Disease, concluded that Sencer had driven an aggressive campaign on limited evidence, and he ultimately lost his job. For many inside government, the lesson wasn’t “be prepared for pandemics”; it was “don’t stick your neck out.” As scholars of that episode have noted, the fallout taught public-health leaders that they could be punished for overreacting to a threat that did not fully materialize.
Over time, the CDC directorship became a more overtly political position, with leaders serving at the pleasure of the administration and expected to align with its priorities. The result has been a slow but steady shift away from scientific independence to political vulnerability. Each new controversy—AIDS, abortion, gun violence, opioids, Covid-19, etc.—has revealed the same pattern: When scientific conclusions collide with ideological agendas, science too often loses.
Today’s vaccine–autism page is simply the latest, and perhaps most glaring, example.
From Lyme and opioids to Covid: when politics overrules evidence
I have watched this pattern play out across several domains I know well: Lyme disease, pain medicine, and Covid-19.
In Lyme disease, official messaging has long leaned toward minimizing the problem. For years, leading guidelines emphasized that Lyme was “hard to catch and easy to cure,” while patients with persistent pain, fatigue, and cognitive problems after treatment found their suffering dismissed as “controversial” or psychosomatic. The reluctance of federal agencies to even acknowledge what many patients and clinicians describe as chronic Lyme has less to do with careful weighing of evidence than with a decision that only certain diseases merit sympathy, research dollars, and political attention.
In pain medicine, the CDC’s Guideline for Prescribing Opioids for Chronic Pain—released in 2016 with the stated goal of improving safety—was quickly converted from “voluntary guidance” into something resembling law. Insurers, state legislatures, and prosecutors treated its dosage thresholds as rigid caps. Patients with intractable pain who had been stable for years on higher doses were forcibly tapered. Some turned to illicit markets, others to suicide.
By 2019, CDC’s own leadership felt compelled to publish a clarification in the New England Journal of Medicine and issue a public statement warning against misapplication of the guideline, including abrupt tapers and applying it to people with cancer or sickle-cell disease—practices that were harming patients and were never recommended. The underlying concern about opioid risks was scientifically legitimate. The way the guideline was developed and weaponized, however, reflected a politically irresistible story—that overprescribing doctors and “pill mills” were the primary drivers of the crisis—while the surge in illicit fentanyl did most of the killing.
Covid-19 exposed this politicization to the entire world. In August 2020, the CDC’s website was quietly edited to say that people who had been in close contact with someone infected with Covid-19 “do not necessarily need a test” if they lacked symptoms, abruptly reversing earlier guidance that all close contacts should be tested, because asymptomatic people can spread the virus.
Later reporting showed that this change had been pushed by officials in the first Trump administration over the objections of CDC scientists. The guidance was eventually reversed, and the original testing recommendations restored. That episode, like the early confusion over masks, damaged public trust—not because recommendations evolved with new data, but because they were seen to shift with political winds.
Now the vaccine–autism page reproduces the same dynamic in an even more dangerous context. It takes a settled scientific question and reopens it for political reasons, under the banner of being “evidence-based.”
Who pays the price when science is rewritten?
The immediate victims of the new autism page are families and clinicians.
For families with autistic children, the suggestion that “we can’t rule out vaccines” revives a painful narrative—that someone did this to their child by giving them a shot. Autism advocates have long argued that framing autism primarily as an injury inflicted by vaccines stigmatizes autistic people and diverts attention away from where help is actually needed: support, accommodation, and inclusion. The new CDC language hands fresh ammunition to anti-vaccine activists who profit, politically and financially, from sowing fear and suspicion.
For clinicians, the CDC has created a contradictory mess. The headline declares that vaccines do not cause autism. The key points then insist that claim is “not evidence-based,” accuse health authorities of ignoring supportive studies, and imply that decades of research showing otherwise are inconclusive. It is hard to imagine a more confusing message to give the public—or a more effective way to undermine confidence in all vaccine recommendations, not just those for children.
More broadly, every time the CDC allows its scientific messaging to be shaped by political demands, it reinforces a corrosive belief I hear increasingly from patients: that our public-health agencies cannot be trusted to tell the truth. In a 2020 blog post titled “Something Awful Seems to Have Happened to the CDC,” I wrote that I could no longer accept CDC guidance at face value unless it was corroborated by independent, non-partisan scientific bodies. Sadly, the events of 2025 have only deepened that concern.
How to rebuild trust: change the structure, not just the webpage
We cannot fact-check our way out of a structural problem. The CDC’s credibility will not be restored by yet another round of edits, press statements, or carefully crafted talking points. It requires changing how the agency is governed.
Two reforms are essential, and both must be structural. First, leadership of the CDC should be made meaningfully independent. Agencies that must make technically complex, sometimes unpopular decisions—like the Federal Reserve—are insulated from day-to-day political pressure by longer, fixed terms and norms against firing leaders for partisan reasons. The CDC needs similar protection. Its director, or perhaps a small governing board, should be appointed primarily for scientific and public health expertise, serve a fixed, non-renewable term, and not be easily removed simply for saying something that powerful people dislike.
Second, we need explicit firewalls between scientific assessments and political messaging. Elected officials are entitled to set policy goals, budgets, and laws. They are not entitled to redefine what counts as “evidence-based” to match their prior beliefs. For major conclusions—such as assessments of vaccine safety—Congress should require transparent processes led by career scientists and external experts, with any edits from political leadership documented and disclosed. That would not eliminate conflict, but it would make interference visible and contestable rather than hidden behind a CDC logo.
Clinicians also have a responsibility here. We should say clearly what the CDC is now hedging. It should be acknowledging that, based on decades of rigorous research, vaccines do not cause autism. That does not mean vaccines are risk-free; no effective medical intervention is. It means autism is not one of those risks, and pretending otherwise, to satisfy a political appointee, is dishonest and dangerous.
CDC was once the world’s most respected public-health agency. It can be again—but only if we stop treating it as a political prize and restore it as an independent guardian of evidence. Until we do, we will keep reliving the same story: contested conditions dismissed as “controversial,” pain patients harmed by misapplied guidelines, Covid guidance rewritten in the West Wing, and now a vaccine–autism page that sacrifices science to ideology.
If we want the public to trust the CDC in the next crisis, we must give them a CDC that deserves to be trusted. That means changing more than a webpage. It means changing the structure that allowed it to be rewritten in the first place.
Lynn R. Webster, MD, is a pain and addiction medicine specialist and serves as Executive Vice President of Scientific Affairs at Dr. Vince Clinical Research, where he consults with pharmaceutical companies. He is also Senior Fellow, Center for U.S. Policy
Dr. Webster is the author of the forthcoming book, Deconstructing Toxic Narratives—Data, Disparities, and a New Path Forward in the Opioid Crisis, to be published by Springer Nature. He is not a member of any political or religious organization
Lynn Webster, MD
Lynn R. Webster, MD, is a pain and addiction medicine specialist and serves as Executive Vice President of Scientific Affairs at Dr. Vince Clinical Research, where he consults with pharmaceutical companies.
