The Trump administration's 2026 health care agenda is shaping up to look pretty different from last year's — and that's not going over very well with some of the "Make America Healthy Again" faithful.

Why it matters: Vaccine politics is becoming a trip wire in administration efforts to overhaul America's public health system before the midterm elections.

• But there's still plenty of unfinished business in the eyes of vaccine critics, many of whom have close ties to the administration.
• And some are pushing back on the narrative that their agenda is unpopular.

State of play: Reputable polling — including from President Trump's own campaign pollster — has repeatedly found that vaccines are popular, and for all of the power vaccine critics have amassed within the federal government, accommodating them is politically risky.

• It doesn't take much reading between the lines of recent events to gather that such vaccine skepticism is falling out of fashion as we get further into the election cycle.

Driving the news: HHS has undergone a series of personnel changes over the past several weeks, including the departure of Ralph Abraham — who has called COVID vaccines "dangerous" — from the CDC.

• Other personnel changes included the elevation of Chris Klomp, the administration's lead negotiator in its pricing deals with drug manufacturers, to a more powerful role at HHS.
• This week, neither vaccines nor any other MAHA priorities merited a mention in Trump's State of the Union address. Instead, his health care comments focused on costs and prescription drug prices.
• HHS Secretary Robert F. Kennedy Jr. has hit the campaign trail, highlighting the administration's efforts to eliminate certain food dyes and other additives and overhaul dietary guidelines — with no mention of its shrinking of the childhood vaccination schedule or its overhaul of a key vaccine advisory committee.
• And the FDA did a high-profile about-face after initially declining to review Moderna's application for a new mRNA flu vaccine, reportedly following White House pressure.

A separate issue has really roiled the MAHA movement of late, testing its loyalty to the Trump administration.

• Trump's new executive order boosting the herbicide glyphosate caused such an uproar that Kennedy issued a long defense of the decision on X, arguing that "reform at this scale will test entrenched interests, and it will not move in a straight line."

Yes, but: Despite the personnel shakeup of recent weeks, the health department and its advisory committees still include a lot of people with tightly held concerns about vaccines — and who are passionate about some of the very same policy changes that have apparently fallen out of fashion.

• There's also surgeon general nominee Casey Means, a Kennedy ally who could have a powerful platform if she's confirmed.
• Means said during her confirmation hearing Wednesday that she believes vaccines save lives but stopped short of unequivocally urging people to get vaccinated, calling for a "a culture shift towards making sure that we're respecting parent questions."
• And though Kennedy may have moderated some of his public comments of late, it's hard to forget his years in the spotlight as one of America's top vaccine critics.

What we're watching: An influential vaccine advisory committee, newly staffed with handpicked Kennedy allies, rescheduled a meeting for next month after this month's meeting was canceled.

• The agenda will include discussions on COVID vaccine injuries and long COVID, per the announcement in the Federal Register.
• Members of that committee have heavily criticized the COVID vaccines, and vice chair Robert Malone has publicly accused FDA commissioner Marty Makary of blocking efforts to remove COVID vaccines from the market.

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Some of the MAHA movement's most passionate supporters are already signaling that they don't appreciate the sidelining, and are pointing fingers directly at certain White House staffers.

• "A majority of Americans support @SecKennedy and the goals of the Make America Healthy Again movement. (Someone should tell the America First Policy Institute knuckleheads in the White House so that they stop purging the MAHA reformers from the public health agencies.)," read an X post from Toby Rogers, a fellow at the Brownstone Institute — a think tank that often promotes widely discredited vaccine theories.
• Rogers — an outspoken vaccine critic — was appointed by Kennedy last month to a federal advisory committee that advises HHS on issues related to autism.
• He also blamed White House staffers who previously worked at the America First Policy Institute for Abraham's departure, which he called "a huge blow to our movement."

Others are pushing back hard on the idea that the MAHA agenda — outside of its focus on food and healthy living — is unpopular.

• Jeffrey Tucker, president of the Brownstone Institute, recently wrote a blog post taking issue with the December findings of Trump pollster Tony Fabrizio, which Tucker said were "being tossed around White House circles" late last year.
• "Someone commissioned this December Fabrizio poll to produce exactly the results it did, and give fodder to whomever wants Kennedy to be quiet on the explosion of the vaccine schedule, the mandates for shots, and the indemnification of the entire industry," Tucker wrote.

Between the lines: The Kennedy-aligned political advocacy group MAHA Action released separate polling by Fabrizio earlier this month that framed vaccine policy as something to be handled carefully but not totally avoided.

• A vaccine policy solution it said candidates should be comfortable promoting is removing vaccine manufacturers' federal liability shield — a move it believes would promote vaccine safety.

Yes, but: Tinkering with manufacturers' liability protections — which would require an act of Congress to remove completely — would likely have unintended consequences.

• The reason those protections were erected decades ago in the first place was because ongoing litigation was threatening to cause vaccine shortages in the U.S.
• And a threat of vaccine shortages would be exactly the kind of problem that the White House probably wants to avoid heading into election season.

White House spokesman Kush Desai said in a statement: "The Trump administration will never back away from restoring the Gold Standard of Science in health care policymaking, including on vaccines.

• "HHS scrapping COVID vaccine mandates and realigning America's childhood vaccine schedule to global standards are proof."

The bottom line: The rest of 2026 may be determined by the answer to a single question: Is it riskier politically to anger a subset of the MAHA movement, or the persuadable voters who aren't buying the vaccine skepticism?

• So far, those who think the latter seem to be winning out.