It is much more than a battle over vaccines in the United States.

It has become a proxy war about trust, freedom, and the role of government in public health.

The debate about childhood immunisations, once a matter of bipartisan consensus, is now a defining clash between federal government, state leadership and the medical community.

At the centre of it is the federal government’s sharp policy shift under US health secretary Robert F Kennedy Jr.

He has rolled back vaccine recommendations and reshaped advisory committees with sceptics.

States have responded along ideological lines – Florida planning to abolish all vaccine mandates; California, Oregon, and Washington forming a “Health Alliance” to safeguard them.

The western states felt they had to act when the head of the agency tasked with disease prevention was sacked.

‘You’re putting Americans’ health at risk’

Susan Monarez had only been in the job for a month when Donald Trump told her she was no longer required.

“She didn’t bend the knee, so you fired her,” Democratic Senator Elizabeth Warren told Mr Kennedy during a heated committee hearing on Capitol Hill.

“You’re putting American babies’ health at risk, American seniors’ health at risk, all Americans’ health at risk, and you should resign,” she added.

Democratic Senator Raphael Warnock described the health secretary as “a hazard to the health of the American people.”

“For the first time, we’re seeing deaths of children from measles. We haven’t seen that in two decades. We’re seeing that under your watch,” he said.

Mr Kennedy told the hearing America had done “worse than any country in the world” in terms of COVID deaths.

“…the people at CDC who oversaw the process, who put masks on our children, who closed our schools, are the people who will be leaving,” he said.

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Jab mandates compared to ‘slavery’

Several senior figures at the Centers for Disease Control and Prevention have resigned since Susan Monarez was removed.

The turmoil in public health has led to a fragmented system where Americans’ access to vaccines and the rules governing them, largely depend on where they live.

Likening vaccine mandates to “slavery”, Florida’s surgeon general Joseph Ladapo said the government had no right to dictate them.

“Your body is a gift from God. What you put into your body is because of your relationship with your body and your God,” he said.

It is a tug of war between collective responsibility or individual choice and one that will redefine public health in this nation.

Donald Trump is to rebrand the US Department of Defense as the “Department of War”, according to the White House.

The president will today sign an executive order allowing it to be used as a secondary title for the US government’s biggest organisation.

It also means defence secretary Pete Hegseth will be able to refer to himself as the “secretary of war” in official communications and ceremonies.

Mr Hegseth posted the words “DEPARTMENT OF WAR” on X on Thursday night.

Permanently renaming the department would need congressional approval, but the White House said the executive order will instruct Mr Hegseth to begin the process.

The Department of Defense – often referred to colloquially as the Pentagon due to the shape of its Washington HQ – was called the War Department until 1949.

Historians say the name was changed to show the US was focussed on preventing conflict following the Second World War and the dawning of the nuclear age.

Mr Trump raised the possibility of a change in June, when he suggested it was originally renamed to be “politically correct”.

His reversion to the more combative title could cost tens of millions, with letterheads and building signs in the US and at military bases around the world potentially needing a refresh.

Joe Biden’s effort to rename nine army bases honouring the Confederacy and Confederate leaders, set to cost $39m (£29m), was reversed by Mr Hegseth earlier this year.

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Opponents have already criticised Mr Trump’s move.

“Why not put this money toward supporting military families or toward employing diplomats that help prevent conflicts from starting in the first place?” said Democratic senator Tammy Duckworth, a member of the armed services committee.

Mr Trump’s other federal renaming orders include controversially labelling the Gulf of Mexico the “Gulf Of America” and reverting North America’s tallest mountain, Denali in Alaska, to its former name of Mount McKinley.

The Mexican government and Alaska’s Republican senators both rejected the changes.

For so long, the Epstein story has cast them in a cameo role.

Everyday coverage of the scandal churns through the politics and process of it all, reducing their suffering to a passing reference.

Not anymore.

Not on a morning when they gathered on Capitol Hill, survivors of Epstein‘s abuse, strengthened by shared experience and a resolve to address it.

In a news conference that lasted over an hour, they brought an authenticity that only they could.

There was vivid recollection of the abuse they endured and a certainty in the justice they seek.

They had the safety of each other – adults now, with the horrors of youth at a distance, though never far away.

It was an emotional gathering on Capitol Hill, attended by survivors, politicians and several hundred members of the public who turned up in support.

Banners read “Release the files”, “Listen to the victims” and “Even your MAGA base demands Epstein files”.

A startling spectacle

That last statement isn’t lost on Donald Trump. As if for emphasis, one of the speakers was the ultra-loyal House representative Marjorie Taylor Greene – they don’t make them more MAGA.

In a spectacle, startling to politics-watchers in this town, she stood side by side with Democrat congressmen to demand the Epstein files be released.

It reflects a discontent spread through Donald Trump’s support base.

He is the man who once counted Jeffrey Epstein as a friend and who has said he’d release the files, only to reverse course.

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Trump’s vulnerability

The Epstein files is the slow-burner that won’t go out, a story that exposes Trump’s vulnerability.

Just how vulnerable can be measured on Congress, where politicians need only a couple of Republicans to back legislation demanding full publication.

It bears the shape of a loyalty test to the president and the dynamics of that have changed with the survivors stepping forward.

One by one, they presented a thunderous reminder of the people and the moral imperative at the heart of the Jeffrey Epstein saga.

It’s political, sure, but it’s about much more – that, we saw on Capitol Hill.