Texas Attorney General Investigates AAP’s Financial Ties to Childhood Vaccine Recommendations

When Texas Attorney General Ken Paxton launched a wide-sweeping investigation into financial incentives tied to childhood vaccinations in January, his office issued more than twenty civil investigative demands to pediatric providers, insurance companies, and vaccine manufacturers across the country. Seven months later, that investigation has expanded. Paxton’s office has now issued a civil investigative demand to the American Academy of Pediatrics (AAP), the largest professional medical trade association representing pediatricians in the United States.¹

Since the 1930’s, AAP officials have issued childhood vaccine use recommendations for pediatricians administering vaccines to infants and children. Starting in 1995, the medical trade association collaborated with and formally aligned its childhood vaccine use recommendations with those of the federal government issued by the U.S. Centers for Disease Control and Prevention (CDC), with both CDC and the AAP consistently promoting an identical childhood vaccine schedule to providers and families ever since.²

The AAP’s publishes a list of corporate funders, which includes vaccine manufacturers Pfizer, Merck, Moderna, and Sanofi among its top-tier donors, with each drug corporation contributing $50,000 or more annually. Those companies are invited to a private Corporate Summit held each year at AAP headquarters in Illinois.³

The civil investigative demand by Paxton calls on the AAP to hand over records detailing how it arrived at its vaccine recommendations and to disclose any financial ties between the organization and the companies whose products those recommendations promote.⁴

Federal payment records show that members of the AAP “Red Book” committee responsible for issuing the association’s childhood vaccine recommendations had received payments and research funding from vaccine manufacturers, in some cases without those relationships being transparently revealed in the AAP’s published vaccine recommendations.⁵ As Paxton’s office conducted the original January investigation, it became clear that the extent of the AAP’s outsized influence across the childhood vaccine industry could no longer be ignored.⁶

AAP Sets Own Vaccine Schedule

After Secretary of Health and Human Services Robert F. Kennedy Jr. restructured the Advisory Committee on Immunization Practices (ACIP) in 2025 and the committee began revising the CDC’s childhood vaccine schedule to include fewer routinely recommended vaccines, the AAP filed suit against HHS in July 2025, arguing that Kennedy had acted without scientific basis and exceeded his legal authority. On Aug. 19, 2025, the AAP released its own childhood vaccine schedule that ignored the CDC’s new childhood vaccine recommendations and called on insurers to reimburse every shot on its list.⁷

Ever since 1995, the AAP had not disputed the CDC’s childhood vaccine recommendations. Formally rejecting the CDC’s new childhood vaccine schedule gave the appearance at least that the pediatric trade association was protecting the childhood vaccine market for its largest pharmaceutical donors, which were facing lost revenue from a reduced federal childhood vaccine schedule. Paxton’s office suggests that this timing is not a coincidence.⁸

January 2026 Investigation

Paxton’s office sent more than twenty civil investigative demands in January 2026 to major medical providers, health insurers, and pharmaceutical companies, including UnitedHealthcare and Pfizer, examining whether those entities had hidden financial arrangements built around how many vaccines they promoted to parents of children being seen in “well child” visits. Health insurers had offered physician bonuses reaching $400 per child for meeting vaccine uptake targets for CDC and AAP recommended vaccines.⁹

UnitedHealthcare published documentation listing bonus eligibility for physicians who made sure their patients were vaccinated against tetanus, diphtheria, pertussis, and HPV. However, that document was removed after the investigation became public.¹⁰

Pediatric practices across the state had been conditioning care on vaccination status. Physician pay, including base wages, bonuses, and continued employment, was structured around shot counts, a framework his office found had pushed Texas families toward agreeing to upward of 70 doses of 17 vaccines (many doses bundled into combination shots) between the day of birth and age 18.¹¹

Paxton vowed:

I will ensure that Big Pharma and Big Insurance don’t bribe medical providers to pressure parents to jab their kids with vaccines they feel aren’t safe or necessary.¹²

Paxton continued…

Parents deserve vaccine recommendations that are driven by science and the best interests of their children, not by financial gains or bribes from Big Pharma. If the American Academy of Pediatrics is giving medical guidance that is fueled by financial incentives, we will expose and put an end to this unlawful behavior. My office will fight to protect kids’ health and uphold transparency in the medical industry alongside President Trump and Secretary Kennedy.¹³

Pending AAP Lawsuit

Children’s Health Defense (CHD) filed suit against the AAP in federal court in January 2026, the same week Paxton issued his first civil investigative demands, alleging violations of federal law in how the organization had characterized the childhood vaccine schedule and citing the same insurer bonus programs his office had already begun examining.¹⁴

The complaint pointed to an AAP-published report stating:

under value-based care models, pediatricians may receive a significant part of their payments based on performance metrics, one of which is completion of childhood and adolescent immunizations.¹⁵

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