What the letters demand

At least one Texas pediatrician has received letters from the attorney general's consumer protection division concerning her vaccination records. The letters cite "potential misleading or deceptive acts regarding incentives associated with the administration of childhood vaccines".

The scope of the document requests is broad. Investigators are seeking details on every "reward, financial benefit, bonus, discount, return, rebate or other consideration" from vaccine makers. The pediatrician under investigation has already spent thousands of dollars in legal fees responding, according to the New York Times.

The money claim, tested

Paxton's case rests on the idea that doctors profit handsomely from vaccinating children. The pediatricians under investigation describe a very different balance sheet.

Marjan Linnell, a pediatrician and president-elect of the Texas Pediatric Society, said pediatricians are one of the lowest-paid medical specialties and "barely break even" on vaccines. Katherine Wells, director of Lubbock Public Health, put numbers on it: "I get reimbursed as little as $6 for giving a vaccine" - about $13 even with free state vaccines.

Wells said that reimbursement does not cover a nurse's time, and that her health department loses money on every vaccine it administers. "I'm taking a loss every time I give a vaccine, but it's the right thing to do," she said. Linnell described a five-day freeze a couple of years ago during which every vaccine in her clinic's freezer had to be thrown out and replaced. "All of those vaccines, our clinic had to pay out of pocket to replace," she said.

Health stakes and the political context

The investigations land in a state where childhood vaccination rates are already slipping:

• Only 93.3% of Texas kindergarteners are now fully vaccinated against measles, as MMR vaccination falls in the state.
• A new Texas law makes it easier for parents to request school vaccine exemptions.
• Linnell warned that making it harder for children to get vaccinated increases the risk of vaccine-preventable diseases such as measles and Haemophilus influenzae type b (Hib) - a disease she had never seen before but now watches spreading.
• She also said Texas already has a shortage of primary care, and that threatened lawsuits could deter people from entering the field: "Texas already has a shortage of primary care," Linnell said.
• In her view, vaccines are "one of the best studied, safest things that we can do to keep kids in their communities," playing and going to school.

Kennedy has his own financial history with vaccine litigation. He has made at least $2.5m in referrals of vaccine side-effect lawsuits to the law firm Wisner Baum, and held a 10% contingency stake in a Gardasil vaccine lawsuit that reportedly settled for about $50m in June. At his confirmation hearing, Elizabeth Warren pressed him on these conflicts of interest; Kennedy initially said he would stop profiting from vaccine lawsuits, then filed an amended ethics disclosure saying he would give the money to one of his sons.

In an August 2025 video on X, Kennedy decried doctors making decisions based on "financial bonus" and claimed: "Doctors are being paid to vaccinate, not evaluate".

The organizations around him have acted in parallel. Children's Health Defense, which Kennedy previously led, claimed it reported Lubbock doctors to the Texas medical board for treating measles patients, and it sued the AAP for racketeering on the same day Paxton announced his pediatrician investigation.

Public trust, meanwhile, still runs toward the doctors rather than the investigators. Primary care doctors and the AAP both rank as more trustworthy than federal health agencies, according to a February survey.

Paul Offit, a vaccines expert at Children's Hospital of Philadelphia, sees the politics clearly - and thinks it may not pay off. "Pediatricians are beloved," he said, describing them as nice people trying to do the right thing. "I just think this war on pediatricians is not a winner. Ken Paxton, I think, is desperate," Offit said, suggesting Paxton may lose to Talarico.

The story remains open: Paxton's Senate run, backed by Trump, continues while the pediatrician investigations proceed - and at least one Texas pediatrician keeps accruing legal fees answering document requests.