‘Undermining trust': Kennedy's promises on vaccines put to the test

Politico

a day ago

In convincing wary senators to confirm him as the nation's top health official, Robert F. Kennedy Jr. promised he would not discourage people from getting vaccines or make the shots 'difficult' to access.
Now that the longtime anti-vaccine activist has the job, he's putting his promise to the test.
In the four months since GOP senators signed off on Kennedy's appointment as secretary of Health and Human Services, Kennedy has moved deliberately to upend the people and processes that have guided decision-making about vaccines.
This week, he purged a government panel of outside vaccine experts and appointed eight replacements, some of whom share his view that the government has covered up vaccine side effects. He skipped the advisory process in changing who the government says should get Covid vaccines and stoked confusion when he issued updated guidance that gave parents room to decide for themselves. He's hired an anti-vaccine activist to scour government records on vaccine safety and launched a search for autism's cause. Kennedy has long believed vaccines are one cause of the neurological disorder.
'If we have a system that has been dismantled — one that allowed for open, evidence-based decision-making and that supported transparent and clear dialogue about vaccines — and then we replace it with a process that's driven largely by one person's beliefs, that creates a system that cannot be trusted,' said Dr. Helen Chu, a University of Washington School of Medicine professor who was dismissed from the vaccine panel this week.
In the absence of independent, unbiased advice, she added, 'we can't trust that safe and effective vaccines will be available for use in the United States.'
Kennedy's sweeping moves in his first few months on the job underscore the broad mandate President Donald Trump gave him to remake the federal health department.
'Secretary Kennedy is restoring trust by demanding radical transparency and ending the complacency that defined past public health failures,' HHS spokesperson Andrew Nixon told POLITICO in a statement Thursday, noting that Kennedy's commitment to putting 'accountability and radical transparency first' will 'restore trust in our public health system.'
Kennedy has said his mission is to reestablish trust by rooting out corruption in the health agencies — stemming, he believes, from the symbiotic relationship between regulators and industry.
But leaders in the public health establishment say his actions are more likely to do the opposite, arguing he distorts scientific data to suit his message.
'What he's doing is undermining trust,' said Tom Frieden, who led the Centers for Disease Control and Prevention during Barack Obama's presidency.
Frieden worries that Kennedy's hyper-skepticism about vaccine safety, which could be amplified now by like-minded members of his vaccine advisory panel, will mislead more people into believing the shots are unsafe, causing immunization rates to dip and infectious diseases to spread.
Kennedy's belief that vaccines often carry serious side effects already has led to policy change, with HHS dropping guidance that pregnant women get vaccinated for Covid. HHS cited evidence that the shot was linked to miscarriages — though one of the researchers footnoted in an HHS document disputed the agency's characterization. Thirty-two medical groups protested the decision earlier this week.
Among the new members of the vaccine advisory panel are Dr. Robert Malone and Retsef Levi, who share Kennedy's view that Covid vaccine side effects are more serious than the government has disclosed.
The changes Kennedy has made, public health experts warn, are upending the nation's health agencies and risk paralyzing decision-making about what advice to give the public.
But to Kennedy's supporters, he's just doing what Trump asked him to do.
'Frankly, the experts really got an awful lot wrong about Covid in particular, so I think in general the American population right now is pretty darn skeptical of the so-called experts,' said Mary Holland, president and general counsel at Children's Health Defense, the anti-vaccine nonprofit Kennedy founded.
The vaccine panel Kennedy has upended, the CDC's Advisory Committee on Immunization Practices, is one of four external panels housed at HHS that advise agencies on vaccine policy, but it's regarded as the most influential.
The panel helps set the CDC's childhood and adult immunization schedules, and several state and federal laws reference ACIP recommendations — including the Affordable Care Act, which requires health plans to cover vaccines the committee recommends for routine use without cost-sharing. ACIP also votes on whether vaccines should be offered through the Vaccines for Children program that ensures low-income and under- and uninsured kids can access shots for free.
'If the secretary puts in place an advisory committee that shares his views around vaccination … I can envision the committee not making recommendations for vaccine use in children, or revisiting the existing schedule and changing some of those recommendations,' Dr. Richard Besser, a former CDC acting director who's now president and CEO of the Robert Wood Johnson Foundation, told POLITICO Tuesday. 'We would be in a situation where your ability to get a vaccine depends on how much money is in your pocket.'
The demise of an independent ACIP, Chu said, would lead to 'a patchwork of different policies by different states' — a development that could see some states stop mandating certain vaccines for school entry and likely increasing the risk of infectious disease.
Historically, the CDC director decides whether to accept, reject or amend the group's recommendations, but it's unclear whether anyone is filling that role.
Dr. Susan Monarez, a former Advanced Research Projects Agency for Health official, was tapped to lead the CDC, compelling her to step down as acting director. Kennedy told lawmakers in May that agency chief of staff Matthew Buzzelli — a lawyer with no public health background — was in charge.
Even Holland called the absence of a confirmed CDC director 'troubling' and questioned whether the Senate is prioritizing the position.
If approved, Monarez would be the first confirmed CDC director since Congress changed the law in 2023 to require the Senate to vote on the position. The Office of Government Ethics posted her financial disclosure forms on Saturday, which clears the way for the Senate health panel to schedule a confirmation hearing.
ACIP voting members usually serve four-year terms — and STAT has reported that the Biden administration intentionally stacked the committee's membership, selecting replacements for members whose terms were set to expire in June.
Even so, Kennedy's decision to fire all of the panel's members and replace them is unprecedented. The HHS secretary wields broad authority to manage the panel as he sees fit under federal law.
And the slate he announced late Wednesday includes several people known for questioning the safety of either messenger RNA vaccines specifically or, more broadly, the childhood schedule.
Dr. Jeffrey Klausner, a former public health official in California, has informally advised Kennedy since the November election, including compiling a list of names for new ACIP members who he thought would balance public health imperatives with vaccine safety concerns. None of his suggestions made the cut so far, he told POLITICO.
'Most people don't understand there are very different ethics in the practice of public health. In medicine, it's all about 'do no harm,' and it's about advocating as much as one can for the benefit of that individual patient,' Klausner said. 'In public health, you're trying to do the most good for the most people.'
Kennedy said the new members will 'review safety and efficacy data for the current schedule,' raising questions about how the new panel may seek to change recommendations relied upon by pediatricians nationwide.
'I'm very disappointed. Not so much for me, but for public health,' said Mysheika W. Roberts, health commissioner for Columbus, Ohio, who was slated to join ACIP in July, replacing one of the members whose terms was set to expire. 'How are we going to make sure we have individuals at the table who can make decisions that impact everyone in our country, and really make those decisions based on proper data and proper science?'
The firing of the vaccine advisers is only Kennedy's most recent effort to remake HHS' administrative structure in his image.
It follows his decision to launch a search for autism's cause — he's putting $50 million into it and promising answers within months — and his cancellation of a nearly $600 million contract with Covid shotmaker Moderna to use its mRNA platform to develop a bird flu vaccine. Kennedy has called the mRNA Covid shots from Moderna and Pfizer the 'deadliest vaccine ever made.'
At the same time, Kennedy and the vaccine-wary wing of his Make America Healthy Again movement have elevated the once-fringe view that vaccination should be an individual choice and not a public obligation.
Kennedy has made the point repeatedly in congressional testimony and in his response to an ongoing measles outbreak. He has said he believes reassuring Americans that vaccination is up to them, and not required, is essential to restoring trust in public health after vaccine mandates drew backlash during the pandemic.
But Kennedy's perception of 'evidence-based decision-making with objectivity and common sense' — the approach he said the vaccine advisory panel's new roster would take — runs contrary to that of most scientists. They see vaccination as one of the most important public health interventions to limit and prevent disease spread, along with clean water, and believe it essential that people feel an obligation, if not a requirement, to get vaccinated.
'It's the rise of individualism going against collective good, and public health DNA is public good — it's protecting the population to protect the most vulnerable,' said Katelyn Jetelina, an epidemiologist who's consulted for the CDC. 'That's just a very different framework in theory than the medical freedom movement, and how you reconcile those two things in this moment is the big question.'
While Klausner said he's disappointed with Kennedy's ACIP choices, he'll continue to offer the secretary advice because he's in the position of authority.
'I'm trying to work with him to keep things on the rails,' he said.