Department of Health and Human Services | Food and Drug Administration
Important Safety Information
DEAR
HEALTHCARE
PROVIDER
Subject
Ongoing adverse policy events originating from the Department of Health and Human Services that may affect your ability to provide standard-of-care treatment, follow federal clinical guidance, and access population-level surveillance data.
Why You Are Receiving This Letter
Dear Healthcare Provider,
We are writing to inform you of significant changes to federal health infrastructure that may directly affect your clinical practice. These changes have been implemented by the Department of Health and Human Services under Secretary Robert F. Kennedy Jr. and are ongoing as of March 2026.
This letter addresses three categories of concern: (1) changes to clinical guidance that may contradict your current practice, (2) reductions to the agencies that generate the evidence your practice depends on, and (3) the emergence of a federal policy environment in which your professional judgment may conflict with official government positions.
We recognize this is not the type of safety communication you are accustomed to receiving. The product in question is not a pharmaceutical. It is a policy. We are writing to you anyway because its effects on patient care are indistinguishable from a drug safety event.
Clinical Details
I. Changes to Federal Clinical Guidance
Vaccine Schedule Modifications
The recommended childhood vaccine schedule has been reduced from 17 to 11 vaccines by the reconstituted ACIP panel.
A federal judge ruled these changes were “probably illegal” and that the reconstituted panel violated the Federal Advisory Committee Act (FACA).
All previous ACIP votes under the new panel have been voided by the court, including changes to hepatitis B and COVID-19 vaccine recommendations for newborns.
26 states now reject CDC vaccine guidance. Your state may provide different recommendations than the federal government.
Measles Outbreak Status
1,300+ measles cases reported in 2025 (on top of 2,200+ in 2024). This is the highest level in three decades.
93% of 2025 cases were in unvaccinated individuals.
DTaP vaccination coverage has declined from 95% (2019-2020) to 92.1% (2024-2025), falling below the herd immunity threshold.
Acting CDC Director Bhattacharya publicly endorsed the measles vaccine, breaking with the Secretary. This was the first unequivocal endorsement of childhood vaccination from a senior Trump administration health official.
Clinical implication: You may need to independently verify which federal vaccine recommendations remain in effect, which have been voided by court order, and which your state has chosen to reject. We recognize this is not a normal part of clinical practice.
Clinical Details
II. Reductions to Research and Regulatory Capacity
NIH Clinical Trials
160 clinical trials have been ended. 38% were HIV-related.
3,200+ research grants terminated. Approximately $3 billion in approved funding has been cut.
The proposed 2026 NIH budget represents a 40% reduction from current levels.
$500 million+ in mRNA vaccine development contracts have been terminated.
If your patients are enrolled in NIH-funded trials, their participation may be affected. Contact your institution's research office for current status.
FDA and CDC Workforce Reductions
HHS total workforce reduced from 82,000 to 62,000 (25% cut).
CDC: 2,400 employees fired. Disease surveillance and outbreak response capacity degraded.
FDA: 3,500 workers let go. Food safety inspections delayed or canceled. Labs monitoring the food supply have lost staff.
NIH: 1,200 staff cut.
Clinical implication: The evidence pipeline your practice depends on -- CDC surveillance data, FDA drug approvals, NIH research findings -- has been materially impaired. New evidence may take longer to reach you. Outbreak data may be less complete.
Clinical Details
III. Professional Guidance Conflicts
The Secretary's Public Statements
“FDA's war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can't be patented by Pharma.”
Kennedy, X.com, October 2024
The Secretary has publicly described the FDA -- the agency that approves the medications you prescribe -- as waging a “war on public health.” He has advocated replacing pharmaceutical treatments with supplements, raw milk, sunshine, and exercise.
The Personal Responsibility Framework
“If you're smoking three packs of cigarettes a day, should you expect society to pay when you get sick? ... It is an American's choice to eat donuts all day.”
Kennedy, CBS News, April 2025
The Secretary has framed chronic disease as a failure of individual behavior rather than a systems-level problem. This directly conflicts with the evidence base for population-level interventions. As a provider, you may encounter patients who cite the Secretary's statements as justification for refusing preventive care.
Recommendations for Healthcare Providers
Continue to follow evidence-based clinical guidelines. Where federal guidance conflicts with the current evidence base, defer to the evidence. This has always been good practice; it is now essential.
Independently verify the status of federal vaccine recommendations. Some have been voided by court order. Some have been rejected by individual states. The CDC website may not reflect the current legal reality.
Monitor your patients enrolled in NIH-funded clinical trials. Contact your institution's research office for the current status of affected grants and studies.
Be prepared for patient questions about food dyes, seed oils, raw milk, and supplements. The Secretary's public statements on these topics are widely circulated but do not reflect the medical consensus.
Document any instances where federal policy changes have materially affected your ability to provide standard-of-care treatment. This documentation may be relevant to ongoing litigation.
Consult your state medical association for guidance. The AMA, AAP, and specialty societies continue to provide evidence-based recommendations independent of the current federal administration.
Reporting Adverse Events
How to Report
Adverse events related to pharmaceutical products should be reported through FDA MedWatch (Form 3500). Note: the FDA has lost 3,500 employees and response times may be extended.
Adverse events related to federal health policy should be reported to your elected representatives. Note: this is not a standard pharmacovigilance pathway, but no standard pathway exists for this type of event.
The Lancet has characterized the situation as damage that “might take generations to repair.” If you are experiencing professional distress related to these changes, you are not alone.
We appreciate your continued commitment to evidence-based patient care under circumstances that no medical school curriculum anticipated.
Sincerely,
Director, Center for Drug Evaluation and Research
U.S. Food and Drug Administration
This letter is being distributed to physicians, pharmacists, nurse practitioners, physician assistants, and other healthcare providers who may be wondering what happened to the federal agencies they used to rely on.
The FDA sends Dear Healthcare Provider letters when a drug is dangerous. There is no form for when the danger comes from the department itself.
This page is satire formatted as a pharmaceutical document. It is not medical advice. The pharmacology, however, is real.