BATON ROUGE, La. \u2014 The ambitious liver doctor would go just about anywhere in his home state to give people the hepatitis B vaccine.<\/p>\n
Bill Cassidy offered jabs to thousands of inmates at Louisiana\u2019s maximum-security prison in the early 2000s. A decade before that, he set up vaccine clinics in middle schools, a model hailed nationally<\/a> as a success.<\/p>\n \u201cHe got that whole generation immunized in East Baton Rouge,\u201d said Holley Galland, a retired doctor who worked with Cassidy vaccinating schoolchildren.<\/p>\n About the same time, a lawyer and environmental activist with a famous last name was starting to build the loyal anti-vaccine coalition that, two decades later, would move President Donald Trump to nominate him as the nation\u2019s top health official.\u00a0<\/p>\n Today, a year after now-Sen. Cassidy warily cast the vote that ensured Robert F. Kennedy Jr.\u2019s ascension to that role, the Louisiana Republican\u2019s life\u2019s work \u2014 in medicine and in politics \u2014 is unraveling.\u00a0<\/p>\n Newborn hepatitis B vaccination rates in the U.S. had plunged to 73% as of August, down 10 percentage points since a February 2023 high, according to research<\/a> published in JAMA last month. In December, the Centers for Disease Control and Prevention\u2019s Advisory Committee for Immunization Practices \u2014 remade by Kennedy \u2014 voted to revoke a two-decade-old recommendation that all newborns get the shot.<\/p>\n The next month, Trump endorsed U.S. Rep. Julia Letlow, a Cassidy challenger in what\u2019s shaping up to be a competitive Republican Senate primary. Letlow\u2019s foray into politics began in 2021 when she took the seat won by her husband, left vacant after he died from covid.<\/p>\n KFF Health News made multiple requests for comment from Cassidy over three months. His staff declined to make him available for an interview or provide comment. Letlow\u2019s campaign did not respond to requests for comment.<\/p>\n Rise of the Skeptics<\/strong><\/p>\n As the May primary nears, some Louisiana doctors are worried they\u2019ve begun a long trek down a dark road when it comes to vaccine-preventable diseases.<\/p>\n Last year, on the day Kennedy was sworn in a thousand miles away in Washington, Louisiana\u2019s health department stopped promoting vaccines, halting its clinics and advertising. Its communications about an ongoing whooping cough outbreak in the state have nearly ceased. It took months for the state to announce last year that two infants had died<\/a> from the illness. A Louisiana child\u2019s death from the flu was confirmed this January, and a couple of cases of measles were reported last year.<\/p>\n Spokespeople for the Louisiana Department of Health did not respond to questions.<\/p>\n \u201cIt\u2019s so hard to see children get sick from illnesses that they should have never gotten in the first place,\u201d said Mikki Bouquet, a pediatrician in Baton Rouge. \u201cYou want to just scream into the void of this community over how they failed this child.\u201d<\/p>\n As anti-vaccine forces have taken hold of the state and federal health departments, Cassidy has lamented the consequences.<\/p>\n \u201cFamilies are getting sick and people are dying from vaccine-preventable deaths, and that tragedy needs to stop,\u201d he wrote on social media<\/a> last fall.<\/p>\n But while it is Cassidy\u2019s duty as chairman of the Senate\u2019s Health, Education, Labor, and Pensions Committee to conduct oversight of the health department, Kennedy has appeared before the committee just once since he was confirmed.<\/p>\n The secretary speaks at a \u201cregular clip\u201d with Cassidy, said Department of Health and Human Services spokesperson Andrew Nixon.<\/p>\n Kennedy\u2019s department has elevated Louisiana vaccine skeptics. The state surgeon general who terminated Louisiana\u2019s vaccine campaign, Ralph Abraham, was named deputy director of the CDC. (He left the role in February.) And Kennedy handpicked Evelyn Griffin, a Baton Rouge OB-GYN who later replaced Abraham as the state surgeon general, for an appointment to ACIP. Griffin has suggested<\/a> the covid vaccine had dangerous side effects for young patients.<\/p>\n Research has shown that serious side effects from the vaccinations are rare and that the shots saved millions of lives during the pandemic.<\/p>\n Cassidy \u201chas really not had an outspoken chorus of policy supporters\u201d when it comes to inoculating people, said Michael Henderson, a professor of political communication at Louisiana State University. \u201cThere\u2019s not a lot of political stakes in doing that in Louisiana if you\u2019re a Republican.\u201d<\/p>\n Louisiana Gov. Jeff Landry reprimanded Cassidy after the senator called for the state\u2019s health department to ease access to covid shots.<\/p>\n \u201cWhy don\u2019t you just leave a prescription for the dangerous Covid shot at your district office and anyone can swing by and get one!\u201d the Republican quipped on X<\/a> in September.<\/p>\n On \u2018Eggshells\u2019 in the Exam Room<\/strong><\/p>\n On a sunny February afternoon, as Carnival floats were readied to parade the streets of New Orleans, pediatrician Katie Brown approached a basement apartment on a well-child visit. Cowboy boot pendants dangled from her ears, and a pack of diapers were clutched tightly in her arms.<\/p>\n The patient, a toddler who waved at the sight of visitors, was up to date on her immunizations. But when Brown suggested a covid vaccine, the girl\u2019s mother quickly declined, noting she had never gotten the shot either.<\/p>\n Many of Brown\u2019s young patients \u2014 seen through Nest Health, which offers in-home visits covered by Louisiana\u2019s Medicaid program \u2014 are current with their vaccines. Brown said home visits make parents more comfortable immunizing their children, but she\u2019s still spending more time these days explaining what they\u2019re getting in those shots.<\/p>\n \u201cAfter covid vaccines, that\u2019s when some people just decided, \u2018I don\u2019t know if I trust vaccines, period,\u2019\u201d she said.<\/p>\n Across the state, vaccination rates have declined since the pandemic, falling short of the levels scientists say are required to achieve herd immunity for some deadly diseases, including measles. About 92% of Louisiana\u2019s kindergartners<\/a> have had the recommended two doses of the measles, mumps, and rubella vaccine.<\/p>\n The New Orleans Health Department has tried to step up with a $100,000 immunization campaign of its own, with clinics and billboards, during this year\u2019s flu season, said Jennifer Avegno, the department\u2019s director.<\/p>\n But the state\u2019s absence is felt. Other parishes across Louisiana have not taken similar action, leaving doctors largely on their own to promote immunizations.<\/p>\n \u201cI\u2019ll say that with certainty,\u201d Avegno said. \u201cIt\u2019s been a blow to not have a statewide coordination.\u201d<\/p>\n A day after Brown\u2019s home visit, a mother in Baton Rouge shook her head when Bouquet offered a flu shot for her 10-year-old daughter in an exam room.<\/p>\n In the waiting room, parents could thumb through a handmade book that offers scientific facts to counter fears about vaccines. A laminated guide placed in each exam room explained the benefits of each recommended immunization.<\/p>\n Bouquet said she\u2019s experimenting with ways to educate parents about vaccines without seeming overbearing. She still hasn\u2019t figured out a surefire formula. Some parents now shut down any vaccine talk, and she worries others skip scheduling appointments to avoid the topic entirely.<\/p>\n \u201cWe\u2019re having to walk on eggshells a bit to determine how to get that trust back,\u201d Bouquet said. \u201cAnd maybe these discussions can come up in future visits.\u201d<\/p>\n Pro-Vax, Pro-Anti-Vaxxer<\/strong><\/p>\n Children\u2019s Health Defense, the nonprofit that Kennedy helmed, worked to erode vaccine trust during the pandemic \u2014 falsely claiming, for instance, that covid shots cause organ damage and that polio vaccines were at fault for a rise in the disease. The organization also sued the federal government over the mRNA-based covid shots, hoping to get their emergency authorizations from the Food and Drug Administration revoked.<\/p>\n When Kennedy came before Cassidy\u2019s committee in January 2025 as Trump\u2019s nominee for health secretary, the senator-doctor saw risks if the prominent anti-vaccine lawyer was confirmed.<\/p>\n Cassidy described a time years ago when he loaded an 18-year-old onto a helicopter to get an emergency liver transplant. The young woman had acute hepatitis B, an incurable disease that is spread primarily through blood or bodily fluids and can lead to liver failure.<\/p>\n It was \u201cthe worst day of my medical career,\u201d he said, addressing Kennedy at the witness table in front of him. \u201cBecause I thought, $50 of vaccines could have prevented this all.\u201d<\/p>\n Cassidy started in politics in 2006 as a state senator, winning election to the U.S. House two years later. When he first ran for the U.S. Senate, in 2014, he charmed Louisiana voters with campaign ads showing him dressed in scrubs and a white lab coat<\/a>, talking about his work with Hurricane Katrina evacuees and patients at Baton Rouge\u2019s public hospital.<\/p>\n But some Republicans soured on Cassidy after he voted to convict Trump on an article of impeachment charging him with inciting the Jan. 6, 2021, insurrection at the U.S. Capitol.<\/p>\n The impeachment vote has hampered Cassidy\u2019s reelection bid this year in a state where Trump captured 60% of the vote in 2024.<\/p>\n \u201cCassidy has things that are associated with his name: the impeachment vote in 2021,\u201d Henderson said.<\/p>\n Cassidy\u2019s loyalty to Trump was tested again with Kennedy\u2019s nomination. Cassidy said he endorsed Kennedy after extracting pledges that he wouldn\u2019t tinker with the nation\u2019s vaccination program.<\/p>\n But since taking office, Kennedy has largely ignored<\/a> those promises, and Cassidy hasn\u2019t publicly rebuked him.<\/p>\n Former Texas congressman Michael Burgess served for years with Cassidy in the House, where they were founding members of the GOP Doctors Caucus, started in 2009. He said Cassidy\u2019s discomfort with some of Kennedy\u2019s actions is palpable.<\/p>\n \u201cYou could hear some of the pain in Sen. Cassidy\u2019s voice when he was addressing that the secretary wanted to drop the birth dose of hepatitis B,\u201d Burgess said. \u201cYou got cases to nearly zero on hepatitis B. It was painful to him to think about taking this away from the population.\u201d<\/p>\n Retired Baton Rouge nurse practitioner Elizabeth Britton has switched her party affiliation so she can vote in the closed Republican primary for Cassidy, with whom she vaccinated inmates decades ago.<\/p>\n She doesn\u2019t quite understand the \u201cmess\u201d in Washington that resulted in the senator voting to confirm a vaccine critic.<\/p>\n Watching Kennedy and others promulgate doubts about shots she once administered has made her \u201cprofoundly sad\u201d and \u201cangry,\u201d she said, but most of all worried.<\/p>\n \u201cIt puts a pit in my stomach, because I know the consequences of people not getting the vaccine,\u201d she said.<\/p>\n\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. 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