In today's newsletter:

▪ RFK Jr. defends public health outlook

▪ National Guard to patrol D.C. until December

▪ Trump faces roadblocks from the courts

▪ Western allies pledge security for Ukraine

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Health and Human Services Secretary Robert F. Kennedy Jr.’s fiery appearance on Thursday in the Capitol exposed the country’s still simmering discord about vaccines, COVID-19 and the future of public health during President Trump’s watch.

Kennedy clashed with members of the Senate Finance Committee over newly restricted COVID vaccine access for healthy children and younger adults, as federal guidance is still taking shape under a new immunization advisory board. The board has been criticized for including skeptics and individuals whom some Democratic senators disparage as conspiracy theorists. That group, handpicked by the secretary, will meet virtually later this month.

After three hours of barbed exchanges, senators sounded increasingly worried about the confusion they are hearing from constituents about inoculations, access to COVID-19 shots this fall and assertions that supporting scientific data are still needed for public health interventions that are well-established in the U.S. and globally.

▪ The Hill: Five takeaways from the Kennedy hearing.

▪ The Hill: GOP senators signal to Trump that Kennedy is on thin ice.

The administration’s evolving guidance and questioning of scientific and pharmaceutical company clinical trials have sparked adaptations by states to try to clear the tangles. Colorado won’t require COVID-19 prescriptions, hoping to open available vaccine supplies to more residents who want the shots, Gov. Jared Polis (D) announced. Hawaii on Thursday joined California, Oregon and Washington in a new West Coast Health Alliance, which says it is providing unified recommendations on immunizations to residents based on science.

The health chief defended his recent firing of Susan Monarez, who briefly directed the Centers for Disease Control and Prevention (CDC), while attacking her trustworthiness. Her departure prompted resignations among top infectious disease experts at the CDC.

Ahead of the hearing, 11 of the 12 Democrats on the committee demanded Kennedy’s resignation, arguing the nation’s top health official “endangers the lives of all Americans.”

Monarez, who penned a Thursday op-ed for The Wall Street Journal, says she’s willing to share her views with lawmakers. Sen. Bernie Sanders (I-Vt.), a member of the Finance and Health committees, said he wants to hear from Monarez, who was terminated 29 days after taking the CDC's reins.

“What we’re going to do is reorganize CDC,” Kennedy told senators. “We are the sickest country in the world. That’s why we have to fire people at CDC. They did not do their job. This was their job to keep us healthy.”

Monarez criticizes what she calls the Trump administration’s “deliberate effort to weaken America’s public-health system and vaccine protections.”

Finance Committee member Sen. Thom Tillis (R-N.C.), who is not seeking reelection next year, joined two physicians, Sens. Bill Cassidy (R-La.), who faces voters in 2026, and Wyoming’s John Barrasso, the second-ranking Senate Republican, in challenging Kennedy, who once called the COVID-19 shot the “deadliest vaccine ever made.”

Tillis asked why Kennedy’s praise for Monarez during her confirmation hearing turned into bitter accusations within a month.

“Effectively, we’re denying people vaccines,” Cassidy told the secretary, suggesting that pharmacies may no longer offer COVID vaccines because the administration narrowed the population it recommends for shots, leaving out healthy children and adults under 65.

“You’re wrong,” Kennedy replied.

▪ The Hill: CVS is withholding COVID-19 vaccines in 15 states and Washington, D.C., citing the “regulatory........

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