March 6, 2025 • 22 mins
This week, President Trump made his joint address to Congress, where he outlined his priorities. Following his lead, in this episode, Drs. Alicia and Stephanie Rolin outline their top five health concerns for 2025.
This is not intended to be medical advice, and the content is solely the responsibility of the authors and does not necessarily represent the official views of their employers or funders
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Episode Transcript
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(00:00):
Here we go. We ready?
(00:01):
Let's do it.
Rolin' Forward, Doctors Sister Science Facts.
Welcome to the Rolin Forward podcast.
I'm Dr. Alicia Rolin.
I'm Dr. Stephanie Rolin.
We're both NIH-funded researchers, and I'm a pediatrician.
And I'm a psychiatrist.
We both spend part of our weeks seeing and treating patients,
(00:22):
mostly in the emergency department,
and then we spend part of our weeks doing grant-funded research.
Where we're trying to design new treatments and improve access to care.
On this podcast, we help break down health news and science
to make it more easily understandable.
Because there's just so much news happening.
Our wish here as physicians is to help weigh through some of this mess
(00:44):
and see what we can take out in terms of clear recommendations
and science-based solutions.
Maybe they're sisters, maybe they're friends, honey, they're doctors. Rollin' forward, Dr. Sister Science Facts.
In honor of the joint address to Congress that's happening this week,
(01:05):
which is a fancy term for the first State of the Union in a presidency,
we've pulled together our own mini State of the Union about health policies here in the US.
The five topics that we're going to talk about today.
Proposed cuts to the budget, which may affect Medicaid.
We're going to talk about what's happening with measles and what we might expect next.
We're going to talk about the flu.
(01:27):
We're going to talk about some mental health medications that are being targeted by this administration.
And then we're going to talk about access to transgender health care, especially for youth.
So let's get started.
Jinks.
So let's start at the top.
We've talked a lot about health and human services in the past.
(01:48):
Including their role in providing health care to many American families through their programs of Medicare,
which provides insurance to disabled Americans, and Medicaid,
which provides insurance to many American families who may earn below a certain income level
or who may have disabilities or other conditions that make them eligible for Medicaid.
(02:11):
Medicaid provides insurance for approximately 20% of the American people.
And the reason that we're going to talk about that today is because the House has passed a budget resolution
that is calling for $880 billion in cuts.
And now this budget resolution, it's just the framework.
It's saying cuts are going to come from here or from there,
(02:32):
but it hasn't really been clarified how these cuts will be enacted.
What we do know though is $880 billion is so much money.
In order to make this math work, money is going to need to come from Medicaid.
The Republican budget will set in motion the largest cut to Medicaid in American history.
(03:01):
Children will be hurt, families will be hurt, seniors will be hurt, everyday Americans with disabilities will be hurt,
hospitals will be hurt, and nursing homes will be hurt all across America.
Republicans are specifically saying that they have no plans to cut Medicaid
(03:24):
and that they're going to target, quote, waste, fraud, and abuse.
But in the recent past, it seems like the Republicans and I have a little bit of a different definition
of what constitutes as waste, fraud, and abuse.
And we cover that in our episode called Whiplash.
And you know, the math is going to need to work.
The money needs to come from somewhere.
(03:46):
And it seems like it's going to need to come from Medicaid.
Democrats are worried that these cuts are going to affect nursing homes and other families.
And it's really unclear, since this is just a framework, where the money is actually going to come from.
But it's going to need to come from somewhere.
And who knows if the Republicans aren't just going to label a program they don't like, waste, fraud, and abuse,
(04:08):
cut it and then say, we eliminated a program because it was waste, fraud, and abuse.
Which has happened.
It has happened.
In 2025, what we have our eyes on are how this budget resolution moves forward.
It's been approved in the House, but not in the Senate.
And then it needs to move forward in that process.
And then they also need to clarify where these $800 billion come from.
(04:28):
Where exactly? You can't just say a number and act like that's going to happen without targeting specific policies.
Next on the list, measles.
Measles.
We went into more detail in our episode called Measles 101.
Yeah, in that episode, we talked in some detail about what the symptoms of measles were,
(04:52):
how you can prevent measles using the MMR vaccine, and then what was currently happening in an outbreak in West Texas.
Since that episode, cases of measles have exploded across the United States.
We've seen rapid rise in number of cases, and we've seen rapid spread from Texas to other parts of the U.S.,
(05:13):
including nearby us here in Philadelphia.
And tragically, the first child also died of measles.
Measles kills over 100,000 people globally each year.
But measles was eradicated in the United States in the year 2000.
So it's been more than a decade since we've had a death in America of measles.
(05:35):
And it's just very sad to be at this place.
Following the first death, RFK Jr., the new Secretary of Health and Human Services, said,
quote, it's not unusual. We have measles outbreaks every year, which is incredibly alarming
because it is incredibly unusual. This is the first death in over 10 years.
(05:57):
Measles is very contagious and spreads rapidly.
People tend to spread measles for a few days before they realize that they're ill with measles,
which means that we just see these very rapid increase in the number of people with measles.
And we're seeing that now where this is spread so far beyond West Texas.
We have cases in Philadelphia, in Seattle, in Canada, in Kentucky.
(06:20):
And in the past, measles outbreaks have been contained with a very clear public health
messaging, including vaccine mandates.
In 2019, there was a large outbreak in parts of New York.
And in order to end the outbreak, over 60,000 vaccines were administered.
At this point, the response seems to have been slow with RFK Jr. initially really downplaying
(06:46):
this outbreak. But we've seen cases increase quite rapidly.
And I think we're going to continue to see cases increase because of the way that measles spreads.
Earlier this week, RFK Jr. flip-flopped a little bit on his position with regards to vaccines.
He wrote an opinion piece that was published on Fox News and said that the measles outbreak
(07:08):
is a, quote, call to action for people to reaffirm their commitment to public health.
He went on to say that vaccines were important and that, quote, all parents should consult
with their health care provider to understand their options to get the MMR vaccine.
But then said the decision to vaccinate is a personal one.
And really left some of this doubt open, which is something that he's done in the past in
(07:31):
his career is sowing doubt about established science.
So our concern for 2025 is that this measles outbreak is going to get worse before it gets
better. And we've tragically had one death from measles.
And we fear that more children may needlessly die from this vaccine preventable illness.
(07:53):
I also think we're going to see the spread of more vaccine preventable illnesses across
the United States. And we're starting to see this.
There was a case of rubella, which is also known as German measles, that was reported
in Texas. We're seeing an outbreak of chickenpox right now at Penn State.
We're seeing increase in whooping cough across the United States.
So I think over 2025, we're just going to see an increase in vaccine preventable illnesses.
(08:15):
And Alicia, that leads us nicely into our third point, which is about influenza or the
flu.
Twenty one thousand lives lost, including 98 children.
This year's flu season is one of the worst in more than a decade.
And although the season appears to have peaked, flu activity is expected to last several more
weeks.
(08:36):
We're currently in the middle of our annual flu season.
This happens every year between the fall and the spring.
And this has been the worst flu season of the past 15 years.
According to the CDC, there's been about half a million to a million hospitalizations for
the flu in the U.S. alone.
And it's hard to know exactly, but they estimate between 20,000 and 100,000 deaths this season
(09:00):
from the flu.
This is the highest since the 2009 swine flu pandemic.
And we have seen 98 deaths in children.
We were just talking about a lot of serious illnesses that are vaccine preventable, and
yet children are dying of them, which is something that makes me very sad as a physician and
(09:21):
as a parent, especially because we have a vaccine for the flu as well.
According to the CDC, the flu vaccine was somewhere between 60 to 80 percent effective
at preventing hospitalization from the flu for children and adolescents and about 50
percent effective for adults.
(09:42):
And the rates of vaccinations for influenza, like the annual flu shot, is lower than we've
seen in previous years.
So per the CDC, less than 50 percent of kids received a flu vaccine this year, which is
about five percent less than the year before.
And we're probably going to see those rates go down in 2025 because the HHS has made three
(10:06):
major changes to public health efforts around the flu.
The first change came at the end of February, and they canceled the Advisory Committee on
Immunization Practice Meeting.
This committee is the group that helps decide how to implement vaccines, what the vaccine
schedule should be, what is safe, how many doses, at what age.
(10:29):
And they meet every year to talk about newly approved vaccines by the FDA, and they provide
recommendations to the CDC.
So that meeting has been canceled, and TBD, what happens there?
A second major change to flu vaccination efforts is that the CDC has been running an adorable
flu shot vaccine campaign called Wild to Mild.
(10:51):
It's the cutest.
The flu shot doesn't prevent you from getting the flu.
It makes your symptoms significantly less severe, and it makes people less likely to
need to be hospitalized or to have severe injuries such as death.
And so the Wild to Mild campaign has been helping families understand that by showing
(11:13):
wild animals and their domestic animal counterparts saying that with the flu shot, the flu goes
from a lion to a cat or from a polar bear to a teddy bear.
It's so cute.
(11:33):
And unfortunately, this flu shot vaccine campaign has been paused for the moment.
This seems to be related to R.F.K.
Jr.'s doubts about vaccine efficacy, claiming that it doesn't prevent or lessen deaths
in hospitalization despite the evidence that it does.
And his false claims that a flu shot means that you're spreading flu around.
(11:58):
Highly concerning, especially considering all the data that is published.
And then the third major change to flu vaccines are that the annual flu vaccine meeting at
the FDA was canceled.
So the FDA, the Food and Drug Administration, typically convenes a meeting every spring
to get recommendations on what strains should be included in next year's flu vaccines.
(12:22):
This is really important because the flu virus changes every year and therefore the strains
that are included in the vaccine has to change year to year to provide the best protection.
And it needs to be done in the spring so that there's time to produce the vaccines before
the fall.
So we're at a place where hospitalizations, especially among children for the flu, are
(12:42):
increasing, yet vaccination rates for the flu are decreasing.
And then the HHS has made these three major changes to how the flu vaccine is offered.
And for 2025, I think it's going to be really important to keep an eye on what's happening
with flu rates.
We're coming to the end of this flu season, but we're going to turn right around.
(13:04):
And before you know it, it's going to be the fall with new vaccine strains circulating.
And so that's going to be something that's really important to keep an eye on, how flu
is spreading in communities and what's happening with hospitalizations and death rates.
Another thing to keep an eye on is the availability of vaccines.
Are they going to be produced next year?
Is it going to be the same vaccine, a different vaccine?
(13:24):
Will it be updated?
Will they be ready in time for the first cases of flu in the fall?
It is so true.
And then the fourth thing that we really want to keep our eyes on is availability of medications
that treat psychiatric conditions.
RFK Jr. has been really focused on mental health and medications that target mental
(13:46):
health illnesses.
This came up multiple times during his confirmation hearings.
We have an episode called Recap.
You can go back and listen to numerous exchanges that he had about mental health drugs and
other things.
But essentially, he was falsely claiming things about the dangerousness of common mental health
(14:09):
medications like antidepressants, also known as SSRIs.
And ADHD medications.
And after RFK Jr. was confirmed, President Trump issued an executive order establishing
the priorities of Make America Healthy Again.
And there was one that really raised my eyebrows and similarly caused a lot of concern among
(14:33):
psychiatrists who take care of many people who may be on mental health medications for
a variety of reasons.
The priority is to, quote, assess the prevalence of and the threat posed by the prescription
of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants,
(14:54):
and weight loss drugs.
Just even the way that that was phrased, as opposed to assessing the risks and benefits,
the only thing that they want to assess is the prevalence and the threat.
There's nothing in this language about assessing how these medications are helping people.
RFK Jr. has consistently said that these drugs are dangerous and overprescribed.
He has made a lot of false statements, including saying that SSRIs are linked to school shootings.
(15:20):
He has said that these medications are addictive.
I know people, including members of my family, who've had a much worse time getting off of
SSRIs than they did, than people have getting off heroin.
And all of this contributes to increased stigma of mental health treatment.
It is hard enough to ask for mental health care when you need it because of our societal
(15:44):
stigma against people who need support for mental health conditions.
And the decision to receive treatment for a mental health diagnosis, and that treatment
can include therapy, medications, whatever it is that's right for your condition, that's
a private conversation and decision that should be made between a person and their doctor,
(16:05):
not something that should be politicized or spread with falsehoods like this.
He's been advocating for these, quote, government wellness farms.
Have you heard about this?
I have, and they're so concerning.
He feels like there should be a rehab, a wellness farm to help people, quote, detox from their
prescribed medications.
(16:25):
So that instead of providing evidence-based treatment, people would voluntarily go to
these government wellness farms where they would work through their illness.
It's really hard not to see the parallels between this program and other types of government-run
(16:46):
work camps, detention camps, and other places where people have provided forced labor for
the government.
I don't even know what to say after that.
So in 2025, let's keep our eyes out on how the conversations around mental health treatment
are going and how access to these medications are changing.
(17:08):
And these medications are all FDA approved.
They're prescribed by a doctor.
Right now, with RFK Jr. leading HHS, he has an ability to influence what the FDA does.
And so it's going to be important to listen to the conversations about these mental health
medications, the SSRIs, the antipsychotics, the mood stabilizers, the stimulants.
(17:28):
The fact that he joined them together is really interesting.
But he has particularly targeted the use of these medications in the pediatric population.
And so it'll be interesting to see how that changes this upcoming year.
There has been a mental health crisis in adolescents and children and adolescents, particularly
since the COVID-19 pandemic in 2020.
We've been seeing an increased use of different types of mental health medications for kids.
(17:51):
We've seen an increase in use of stimulants for ADHD, attention deficit hyperactivity
disorder.
And some kids rely on these medications.
Yeah.
So it's hard to make a blanket statement like these medications are good for everyone.
But when appropriately prescribed, these medications help improve symptoms.
They improve functioning.
They reduce suffering and they reduce mortality.
(18:15):
And so these are private conversations that somebody should be having with their doctor
about what's right for them, not public discourse where we're assessing threats that are posed
by these medications without evidence.
And so in 2025, that's something that we are going to be keeping our eyes on to see what
happens.
And so the last big thing that we have our eye on right now, and we will continue to
(18:40):
have our eye on this year, is about access to care for individuals that identify as transgender.
We have a previous episode called Trump on sex and gender, where we go through the executive
order that Trump put out, some of the repercussions and the evidence around that.
(19:00):
There have been a whole range of executive orders that have targeted gender affirming
care that have targeted LGBTQIA issues, some of which have been blocked, some have not.
And overall, things have been in limbo.
Gender affirming care is evidence-based.
It's supported by multiple academic societies, including the American Academy of Pediatrics
(19:25):
and the American Endocrine Society, stating that this type of health care is safe, effective.
And yet, we've seen these executive orders already start to restrict the care that is
available to people who need it.
One specific executive order has threatened to remove funding from hospitals that offer
(19:47):
gender affirming care to individuals under the age of 19.
That's right, Alicia.
And when this executive order says that it's going to remove funding, it's not talking
about funding for gender affirming care.
It's talking about federal funding to the entire hospital for all of the programs that
they offer.
And that kind of loss would be financially devastating to a hospital.
(20:11):
It's hard to imagine that given the way that health care is set up in America, any hospital
could really survive with no federal funding, especially a pediatric hospital.
This is essentially a way to ban gender affirming care for minors in the United States.
There are lawsuits that have been filed and a judge has blocked implementation of this,
but it's something we're going to be watching closely in 2025.
(20:34):
And that is our state of medicine.
Those are our five points.
We're going to be keeping our eyes in 2025.
We're going to be keeping them on what's happening with the budget resolution and cuts to insurance
like Medicaid and Medicare.
We're going to be following the measles outbreak, which unfortunately is going to get worse
before it gets better.
(20:55):
What's happening with flu both this season and what could potentially happen next flu
season?
We're worried about access to mental health medications and access to gender affirming
care.
And so those are topics that we'll be talking about in future podcast episodes.
And we'll just have to wait and see how everything unfolds.
(21:19):
If there's anything that you're noticing, please send us an email, send us a message.
We're at Rolin Forward Show, R-O-L-I-N Forward Show at gmail.com.
We're also on social media.
We have Blue Sky, TikTok, Instagram.
And we'd love to hear from you what you're seeing in your community and what you're noticing.
(21:42):
And that's it for today.
I'm Dr. Alicia Rolin.
I'm Dr. Stephanie Rolin.
Thank you for tuning in.
See you next time.
We don't actually see them.
No, we don't.
We don't actually see anybody.
Here we go. We ready?
(00:01):
Let's do it.
Rolin' Forward, Doctors Sister Science Facts.
Welcome to the Rolin Forward podcast.
I'm Dr. Alicia Rolin.
I'm Dr. Stephanie Rolin.
We're both NIH-funded researchers, and I'm a pediatrician.
And I'm a psychiatrist.
We both spend part of our weeks seeing and treating patients,
(00:22):
mostly in the emergency department,
and then we spend part of our weeks doing grant-funded research.
Where we're trying to design new treatments and improve access to care.
On this podcast, we help break down health news and science
to make it more easily understandable.
Because there's just so much news happening.
Our wish here as physicians is to help weigh through some of this mess
(00:44):
and see what we can take out in terms of clear recommendations
and science-based solutions.
Maybe they're sisters, maybe they're friends, honey, they're doctors. Rollin' forward, Dr. Sister Science Facts.
In honor of the joint address to Congress that's happening this week,
(01:05):
which is a fancy term for the first State of the Union in a presidency,
we've pulled together our own mini State of the Union about health policies here in the US.
The five topics that we're going to talk about today.
Proposed cuts to the budget, which may affect Medicaid.
We're going to talk about what's happening with measles and what we might expect next.
We're going to talk about the flu.
(01:27):
We're going to talk about some mental health medications that are being targeted by this administration.
And then we're going to talk about access to transgender health care, especially for youth.
So let's get started.
Jinks.
So let's start at the top.
We've talked a lot about health and human services in the past.
(01:48):
Including their role in providing health care to many American families through their programs of Medicare,
which provides insurance to disabled Americans, and Medicaid,
which provides insurance to many American families who may earn below a certain income level
or who may have disabilities or other conditions that make them eligible for Medicaid.
(02:11):
Medicaid provides insurance for approximately 20% of the American people.
And the reason that we're going to talk about that today is because the House has passed a budget resolution
that is calling for $880 billion in cuts.
And now this budget resolution, it's just the framework.
It's saying cuts are going to come from here or from there,
(02:32):
but it hasn't really been clarified how these cuts will be enacted.
What we do know though is $880 billion is so much money.
In order to make this math work, money is going to need to come from Medicaid.
The Republican budget will set in motion the largest cut to Medicaid in American history.
(03:01):
Children will be hurt, families will be hurt, seniors will be hurt, everyday Americans with disabilities will be hurt,
hospitals will be hurt, and nursing homes will be hurt all across America.
Republicans are specifically saying that they have no plans to cut Medicaid
(03:24):
and that they're going to target, quote, waste, fraud, and abuse.
But in the recent past, it seems like the Republicans and I have a little bit of a different definition
of what constitutes as waste, fraud, and abuse.
And we cover that in our episode called Whiplash.
And you know, the math is going to need to work.
The money needs to come from somewhere.
(03:46):
And it seems like it's going to need to come from Medicaid.
Democrats are worried that these cuts are going to affect nursing homes and other families.
And it's really unclear, since this is just a framework, where the money is actually going to come from.
But it's going to need to come from somewhere.
And who knows if the Republicans aren't just going to label a program they don't like, waste, fraud, and abuse,
(04:08):
cut it and then say, we eliminated a program because it was waste, fraud, and abuse.
Which has happened.
It has happened.
In 2025, what we have our eyes on are how this budget resolution moves forward.
It's been approved in the House, but not in the Senate.
And then it needs to move forward in that process.
And then they also need to clarify where these $800 billion come from.
(04:28):
Where exactly? You can't just say a number and act like that's going to happen without targeting specific policies.
Next on the list, measles.
Measles.
We went into more detail in our episode called Measles 101.
Yeah, in that episode, we talked in some detail about what the symptoms of measles were,
(04:52):
how you can prevent measles using the MMR vaccine, and then what was currently happening in an outbreak in West Texas.
Since that episode, cases of measles have exploded across the United States.
We've seen rapid rise in number of cases, and we've seen rapid spread from Texas to other parts of the U.S.,
(05:13):
including nearby us here in Philadelphia.
And tragically, the first child also died of measles.
Measles kills over 100,000 people globally each year.
But measles was eradicated in the United States in the year 2000.
So it's been more than a decade since we've had a death in America of measles.
(05:35):
And it's just very sad to be at this place.
Following the first death, RFK Jr., the new Secretary of Health and Human Services, said,
quote, it's not unusual. We have measles outbreaks every year, which is incredibly alarming
because it is incredibly unusual. This is the first death in over 10 years.
(05:57):
Measles is very contagious and spreads rapidly.
People tend to spread measles for a few days before they realize that they're ill with measles,
which means that we just see these very rapid increase in the number of people with measles.
And we're seeing that now where this is spread so far beyond West Texas.
We have cases in Philadelphia, in Seattle, in Canada, in Kentucky.
(06:20):
And in the past, measles outbreaks have been contained with a very clear public health
messaging, including vaccine mandates.
In 2019, there was a large outbreak in parts of New York.
And in order to end the outbreak, over 60,000 vaccines were administered.
At this point, the response seems to have been slow with RFK Jr. initially really downplaying
(06:46):
this outbreak. But we've seen cases increase quite rapidly.
And I think we're going to continue to see cases increase because of the way that measles spreads.
Earlier this week, RFK Jr. flip-flopped a little bit on his position with regards to vaccines.
He wrote an opinion piece that was published on Fox News and said that the measles outbreak
(07:08):
is a, quote, call to action for people to reaffirm their commitment to public health.
He went on to say that vaccines were important and that, quote, all parents should consult
with their health care provider to understand their options to get the MMR vaccine.
But then said the decision to vaccinate is a personal one.
And really left some of this doubt open, which is something that he's done in the past in
(07:31):
his career is sowing doubt about established science.
So our concern for 2025 is that this measles outbreak is going to get worse before it gets
better. And we've tragically had one death from measles.
And we fear that more children may needlessly die from this vaccine preventable illness.
(07:53):
I also think we're going to see the spread of more vaccine preventable illnesses across
the United States. And we're starting to see this.
There was a case of rubella, which is also known as German measles, that was reported
in Texas. We're seeing an outbreak of chickenpox right now at Penn State.
We're seeing increase in whooping cough across the United States.
So I think over 2025, we're just going to see an increase in vaccine preventable illnesses.
(08:15):
And Alicia, that leads us nicely into our third point, which is about influenza or the
flu.
Twenty one thousand lives lost, including 98 children.
This year's flu season is one of the worst in more than a decade.
And although the season appears to have peaked, flu activity is expected to last several more
weeks.
(08:36):
We're currently in the middle of our annual flu season.
This happens every year between the fall and the spring.
And this has been the worst flu season of the past 15 years.
According to the CDC, there's been about half a million to a million hospitalizations for
the flu in the U.S. alone.
And it's hard to know exactly, but they estimate between 20,000 and 100,000 deaths this season
(09:00):
from the flu.
This is the highest since the 2009 swine flu pandemic.
And we have seen 98 deaths in children.
We were just talking about a lot of serious illnesses that are vaccine preventable, and
yet children are dying of them, which is something that makes me very sad as a physician and
(09:21):
as a parent, especially because we have a vaccine for the flu as well.
According to the CDC, the flu vaccine was somewhere between 60 to 80 percent effective
at preventing hospitalization from the flu for children and adolescents and about 50
percent effective for adults.
(09:42):
And the rates of vaccinations for influenza, like the annual flu shot, is lower than we've
seen in previous years.
So per the CDC, less than 50 percent of kids received a flu vaccine this year, which is
about five percent less than the year before.
And we're probably going to see those rates go down in 2025 because the HHS has made three
(10:06):
major changes to public health efforts around the flu.
The first change came at the end of February, and they canceled the Advisory Committee on
Immunization Practice Meeting.
This committee is the group that helps decide how to implement vaccines, what the vaccine
schedule should be, what is safe, how many doses, at what age.
(10:29):
And they meet every year to talk about newly approved vaccines by the FDA, and they provide
recommendations to the CDC.
So that meeting has been canceled, and TBD, what happens there?
A second major change to flu vaccination efforts is that the CDC has been running an adorable
flu shot vaccine campaign called Wild to Mild.
(10:51):
It's the cutest.
The flu shot doesn't prevent you from getting the flu.
It makes your symptoms significantly less severe, and it makes people less likely to
need to be hospitalized or to have severe injuries such as death.
And so the Wild to Mild campaign has been helping families understand that by showing
(11:13):
wild animals and their domestic animal counterparts saying that with the flu shot, the flu goes
from a lion to a cat or from a polar bear to a teddy bear.
It's so cute.
(11:33):
And unfortunately, this flu shot vaccine campaign has been paused for the moment.
This seems to be related to R.F.K.
Jr.'s doubts about vaccine efficacy, claiming that it doesn't prevent or lessen deaths
in hospitalization despite the evidence that it does.
And his false claims that a flu shot means that you're spreading flu around.
(11:58):
Highly concerning, especially considering all the data that is published.
And then the third major change to flu vaccines are that the annual flu vaccine meeting at
the FDA was canceled.
So the FDA, the Food and Drug Administration, typically convenes a meeting every spring
to get recommendations on what strains should be included in next year's flu vaccines.
(12:22):
This is really important because the flu virus changes every year and therefore the strains
that are included in the vaccine has to change year to year to provide the best protection.
And it needs to be done in the spring so that there's time to produce the vaccines before
the fall.
So we're at a place where hospitalizations, especially among children for the flu, are
(12:42):
increasing, yet vaccination rates for the flu are decreasing.
And then the HHS has made these three major changes to how the flu vaccine is offered.
And for 2025, I think it's going to be really important to keep an eye on what's happening
with flu rates.
We're coming to the end of this flu season, but we're going to turn right around.
(13:04):
And before you know it, it's going to be the fall with new vaccine strains circulating.
And so that's going to be something that's really important to keep an eye on, how flu
is spreading in communities and what's happening with hospitalizations and death rates.
Another thing to keep an eye on is the availability of vaccines.
Are they going to be produced next year?
Is it going to be the same vaccine, a different vaccine?
(13:24):
Will it be updated?
Will they be ready in time for the first cases of flu in the fall?
It is so true.
And then the fourth thing that we really want to keep our eyes on is availability of medications
that treat psychiatric conditions.
RFK Jr. has been really focused on mental health and medications that target mental
(13:46):
health illnesses.
This came up multiple times during his confirmation hearings.
We have an episode called Recap.
You can go back and listen to numerous exchanges that he had about mental health drugs and
other things.
But essentially, he was falsely claiming things about the dangerousness of common mental health
(14:09):
medications like antidepressants, also known as SSRIs.
And ADHD medications.
And after RFK Jr. was confirmed, President Trump issued an executive order establishing
the priorities of Make America Healthy Again.
And there was one that really raised my eyebrows and similarly caused a lot of concern among
(14:33):
psychiatrists who take care of many people who may be on mental health medications for
a variety of reasons.
The priority is to, quote, assess the prevalence of and the threat posed by the prescription
of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants,
(14:54):
and weight loss drugs.
Just even the way that that was phrased, as opposed to assessing the risks and benefits,
the only thing that they want to assess is the prevalence and the threat.
There's nothing in this language about assessing how these medications are helping people.
RFK Jr. has consistently said that these drugs are dangerous and overprescribed.
He has made a lot of false statements, including saying that SSRIs are linked to school shootings.
(15:20):
He has said that these medications are addictive.
I know people, including members of my family, who've had a much worse time getting off of
SSRIs than they did, than people have getting off heroin.
And all of this contributes to increased stigma of mental health treatment.
It is hard enough to ask for mental health care when you need it because of our societal
(15:44):
stigma against people who need support for mental health conditions.
And the decision to receive treatment for a mental health diagnosis, and that treatment
can include therapy, medications, whatever it is that's right for your condition, that's
a private conversation and decision that should be made between a person and their doctor,
(16:05):
not something that should be politicized or spread with falsehoods like this.
He's been advocating for these, quote, government wellness farms.
Have you heard about this?
I have, and they're so concerning.
He feels like there should be a rehab, a wellness farm to help people, quote, detox from their
prescribed medications.
(16:25):
So that instead of providing evidence-based treatment, people would voluntarily go to
these government wellness farms where they would work through their illness.
It's really hard not to see the parallels between this program and other types of government-run
(16:46):
work camps, detention camps, and other places where people have provided forced labor for
the government.
I don't even know what to say after that.
So in 2025, let's keep our eyes out on how the conversations around mental health treatment
are going and how access to these medications are changing.
(17:08):
And these medications are all FDA approved.
They're prescribed by a doctor.
Right now, with RFK Jr. leading HHS, he has an ability to influence what the FDA does.
And so it's going to be important to listen to the conversations about these mental health
medications, the SSRIs, the antipsychotics, the mood stabilizers, the stimulants.
(17:28):
The fact that he joined them together is really interesting.
But he has particularly targeted the use of these medications in the pediatric population.
And so it'll be interesting to see how that changes this upcoming year.
There has been a mental health crisis in adolescents and children and adolescents, particularly
since the COVID-19 pandemic in 2020.
We've been seeing an increased use of different types of mental health medications for kids.
(17:51):
We've seen an increase in use of stimulants for ADHD, attention deficit hyperactivity
disorder.
And some kids rely on these medications.
Yeah.
So it's hard to make a blanket statement like these medications are good for everyone.
But when appropriately prescribed, these medications help improve symptoms.
They improve functioning.
They reduce suffering and they reduce mortality.
(18:15):
And so these are private conversations that somebody should be having with their doctor
about what's right for them, not public discourse where we're assessing threats that are posed
by these medications without evidence.
And so in 2025, that's something that we are going to be keeping our eyes on to see what
happens.
And so the last big thing that we have our eye on right now, and we will continue to
(18:40):
have our eye on this year, is about access to care for individuals that identify as transgender.
We have a previous episode called Trump on sex and gender, where we go through the executive
order that Trump put out, some of the repercussions and the evidence around that.
(19:00):
There have been a whole range of executive orders that have targeted gender affirming
care that have targeted LGBTQIA issues, some of which have been blocked, some have not.
And overall, things have been in limbo.
Gender affirming care is evidence-based.
It's supported by multiple academic societies, including the American Academy of Pediatrics
(19:25):
and the American Endocrine Society, stating that this type of health care is safe, effective.
And yet, we've seen these executive orders already start to restrict the care that is
available to people who need it.
One specific executive order has threatened to remove funding from hospitals that offer
(19:47):
gender affirming care to individuals under the age of 19.
That's right, Alicia.
And when this executive order says that it's going to remove funding, it's not talking
about funding for gender affirming care.
It's talking about federal funding to the entire hospital for all of the programs that
they offer.
And that kind of loss would be financially devastating to a hospital.
(20:11):
It's hard to imagine that given the way that health care is set up in America, any hospital
could really survive with no federal funding, especially a pediatric hospital.
This is essentially a way to ban gender affirming care for minors in the United States.
There are lawsuits that have been filed and a judge has blocked implementation of this,
but it's something we're going to be watching closely in 2025.
(20:34):
And that is our state of medicine.
Those are our five points.
We're going to be keeping our eyes in 2025.
We're going to be keeping them on what's happening with the budget resolution and cuts to insurance
like Medicaid and Medicare.
We're going to be following the measles outbreak, which unfortunately is going to get worse
before it gets better.
(20:55):
What's happening with flu both this season and what could potentially happen next flu
season?
We're worried about access to mental health medications and access to gender affirming
care.
And so those are topics that we'll be talking about in future podcast episodes.
And we'll just have to wait and see how everything unfolds.
(21:19):
If there's anything that you're noticing, please send us an email, send us a message.
We're at Rolin Forward Show, R-O-L-I-N Forward Show at gmail.com.
We're also on social media.
We have Blue Sky, TikTok, Instagram.
And we'd love to hear from you what you're seeing in your community and what you're noticing.
(21:42):
And that's it for today.
I'm Dr. Alicia Rolin.
I'm Dr. Stephanie Rolin.
Thank you for tuning in.
See you next time.
We don't actually see them.
No, we don't.
We don't actually see anybody.
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