BATON ROUGE, La. — The formidable liver physician would go nearly wherever in his house state to provide folks the hepatitis B vaccine.
Bill Cassidy provided jabs to 1000’s of inmates at Louisiana’s maximum-security jail within the early 2000s. A decade earlier than that, he arrange vaccine clinics in center colleges, a mannequin hailed nationally as a hit.
“He got that whole generation immunized in East Baton Rouge,” stated Holley Galland, a retired physician who labored with Cassidy vaccinating schoolchildren.
About the identical time, a lawyer and environmental activist with a well-known final identify was beginning to construct the loyal anti-vaccine coalition that, 20 years later, would transfer President Donald Trump to appoint him because the nation’s prime well being official.
Today, a yr after now-Sen. Cassidy warily forged the vote that ensured Robert F. Kennedy Jr.’s ascension to that position, the Louisiana Republican’s life’s work — in medication and in politics — is unraveling.
Newborn hepatitis B vaccination charges within the U.S. had plunged to 73% as of August, down 10 share factors since a February 2023 excessive, according to research revealed in JAMA final month. In December, the Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices — remade by Kennedy — voted to revoke a two-decade-old suggestion that each one newborns get the shot.
The subsequent month, Trump endorsed U.S. Rep. Julia Letlow, a Cassidy challenger in what’s shaping as much as be a aggressive Republican Senate main. Letlow’s foray into politics started in 2021 when she took the seat gained by her husband, left vacant after he died from covid.
KFF Health News made a number of requests for remark from Cassidy over three months. His employees declined to make him obtainable for an interview or present remark. Letlow’s marketing campaign didn’t reply to requests for remark.
Rise of the Skeptics
As the May main nears, some Louisiana medical doctors are frightened they’ve begun a protracted trek down a darkish street in the case of vaccine-preventable ailments.
Last yr, on the day Kennedy was sworn in a thousand miles away in Washington, Louisiana’s well being division stopped selling vaccines, halting its clinics and promoting. Its communications about an ongoing whooping cough outbreak within the state have almost ceased. It took months for the state to announce final yr that two infants had died from the sickness. A Louisiana little one’s dying from the flu was confirmed this January, and a few instances of measles had been reported final yr.
Spokespeople for the Louisiana Department of Health didn’t reply to questions.
“It’s so hard to see children get sick from illnesses that they should have never gotten in the first place,” stated Mikki Bouquet, a pediatrician in Baton Rouge. “You want to just scream into the void of this community over how they failed this child.”
As anti-vaccine forces have taken maintain of the state and federal well being departments, Cassidy has lamented the results.
“Families are getting sick and people are dying from vaccine-preventable deaths, and that tragedy needs to stop,” he wrote on social media final fall.
But whereas it’s Cassidy’s responsibility as chairman of the Senate’s Health, Education, Labor, and Pensions Committee to conduct oversight of the well being division, Kennedy has appeared earlier than the committee simply as soon as since he was confirmed.
The secretary speaks at a “regular clip” with Cassidy, stated Department of Health and Human Services spokesperson Andrew Nixon.
Kennedy’s division has elevated Louisiana vaccine skeptics. The state surgeon basic who terminated Louisiana’s vaccine marketing campaign, Ralph Abraham, was named deputy director of the CDC. (He left the position in February.) And Kennedy handpicked Evelyn Griffin, a Baton Rouge OB-GYN who later changed Abraham because the state surgeon basic, for an appointment to ACIP. Griffin has suggested the covid vaccine had harmful negative effects for younger sufferers.
Research has proven that critical negative effects from the vaccinations are uncommon and that the photographs saved hundreds of thousands of lives through the pandemic.
Cassidy “has really not had an outspoken chorus of policy supporters” in the case of inoculating folks, stated Michael Henderson, a professor of political communication at Louisiana State University. “There’s not a lot of political stakes in doing that in Louisiana if you’re a Republican.”
Louisiana Gov. Jeff Landry reprimanded Cassidy after the senator referred to as for the state’s well being division to ease entry to covid photographs.
“Why don’t you just leave a prescription for the dangerous Covid shot at your district office and anyone can swing by and get one!” the Republican quipped on X in September.
On ‘Eggshells’ within the Exam Room
On a sunny February afternoon, as Carnival floats had been readied to parade the streets of New Orleans, pediatrician Katie Brown approached a basement condominium on a well-child go to. Cowboy boot pendants dangled from her ears, and a pack of diapers had been clutched tightly in her arms.
The affected person, a toddler who waved on the sight of holiday makers, was updated on her immunizations. But when Brown recommended a covid vaccine, the woman’s mom shortly declined, noting she had by no means gotten the shot both.
Many of Brown’s younger sufferers — seen by Nest Health, which presents in-home visits lined by Louisiana’s Medicaid program — are present with their vaccines. Brown stated house visits make dad and mom extra comfy immunizing their kids, however she’s nonetheless spending extra time as of late explaining what they’re getting in these photographs.
“After covid vaccines, that’s when some people just decided, ‘I don’t know if I trust vaccines, period,’” she stated.
Across the state, vaccination charges have declined because the pandemic, falling wanting the degrees scientists say are required to realize herd immunity for some lethal ailments, together with measles. About 92% of Louisiana’s kindergartners have had the really useful two doses of the measles, mumps, and rubella vaccine.
The New Orleans Health Department has tried to step up with a $100,000 immunization marketing campaign of its personal, with clinics and billboards, throughout this yr’s flu season, stated Jennifer Avegno, the division’s director.
But the state’s absence is felt. Other parishes throughout Louisiana haven’t taken related motion, leaving medical doctors largely on their very own to advertise immunizations.
“I’ll say that with certainty,” Avegno stated. “It’s been a blow to not have a statewide coordination.”
A day after Brown’s house go to, a mom in Baton Rouge shook her head when Bouquet provided a flu shot for her 10-year-old daughter in an examination room.
In the ready room, dad and mom may thumb by a hand-crafted ebook that provides scientific information to counter fears about vaccines. A laminated information positioned in every examination room defined the advantages of every really useful immunization.
Bouquet stated she’s experimenting with methods to teach dad and mom about vaccines with out seeming overbearing. She nonetheless hasn’t found out a surefire method. Some dad and mom now shut down any vaccine speak, and she or he worries others skip scheduling appointments to keep away from the subject totally.
“We’re having to walk on eggshells a bit to determine how to get that trust back,” Bouquet stated. “And maybe these discussions can come up in future visits.”
Pro-Vax, Pro-Anti-Vaxxer
Children’s Health Defense, the nonprofit that Kennedy helmed, labored to erode vaccine belief through the pandemic — falsely claiming, as an illustration, that covid photographs trigger organ injury and that polio vaccines had been at fault for an increase within the illness. The group additionally sued the federal authorities over the mRNA-based covid photographs, hoping to get their emergency authorizations from the Food and Drug Administration revoked.
When Kennedy got here earlier than Cassidy’s committee in January 2025 as Trump’s nominee for well being secretary, the senator-doctor noticed dangers if the outstanding anti-vaccine lawyer was confirmed.
Cassidy described a time years in the past when he loaded an 18-year-old onto a helicopter to get an emergency liver transplant. The younger lady had acute hepatitis B, an incurable illness that’s unfold primarily by blood or bodily fluids and may result in liver failure.
It was “the worst day of my medical career,” he stated, addressing Kennedy on the witness desk in entrance of him. “Because I thought, $50 of vaccines could have prevented this all.”
Cassidy began in politics in 2006 as a state senator, successful 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 marketing campaign adverts displaying him dressed in scrubs and a white lab coat, speaking about his work with Hurricane Katrina evacuees and sufferers at Baton Rouge’s public hospital.
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, rebel on the U.S. Capitol.
The impeachment vote has hampered Cassidy’s reelection bid this yr in a state the place Trump captured 60% of the vote in 2024.
“Cassidy has things that are associated with his name: the impeachment vote in 2021,” Henderson stated.
Cassidy’s loyalty to Trump was examined once more with Kennedy’s nomination. Cassidy stated he endorsed Kennedy after extracting pledges that he wouldn’t tinker with the nation’s vaccination program.
But since taking workplace, Kennedy has largely ignored these guarantees, and Cassidy hasn’t publicly rebuked him.
Former Texas congressman Michael Burgess served for years with Cassidy within the House, the place they had been founding members of the GOP Doctors Caucus, began in 2009. He stated Cassidy’s discomfort with a few of Kennedy’s actions is palpable.
“You could hear some of the pain in Sen. Cassidy’s voice when he was addressing that the secretary wanted to drop the birth dose of hepatitis B,” Burgess stated. “You got cases to nearly zero on hepatitis B. It was painful to him to think about taking this away from the population.”
Retired Baton Rouge nurse practitioner Elizabeth Britton has switched her social gathering affiliation so she will be able to vote within the closed Republican main for Cassidy, with whom she vaccinated inmates many years in the past.
She doesn’t fairly perceive the “mess” in Washington that resulted within the senator voting to substantiate a vaccine critic.
Watching Kennedy and others promulgate doubts about photographs she as soon as administered has made her “profoundly sad” and “angry,” she stated, however most of all frightened.
“It puts a pit in my stomach, because I know the consequences of people not getting the vaccine,” she stated.
