a day ago
How one meeting in 2020 and a GOP senator helped create RFK Jr.'s vaccine wreck
In more than 20 years of covering policy, I have witnessed some crazy stuff. But one episode towers above the rest in sheer lunacy: the November 2020 meeting of the CDC's Advisory Committee on Immunization Practices. Sounds boring? Usually, maybe.
But that meeting was when the committee's eminent experts, having considered a range of vaccine rollout strategies, selected the plan that was projected to kill the most people and had the least public support.
In a survey conducted in August 2020, most Americans said that as soon as health-care workers were inoculated with the coronavirus vaccine, we should have started vaccinating the highest-risk groups in order of their vulnerability: seniors first, then immunocompromised people, then other essential workers. Instead of adopting this sensible plan, the Centers for Disease Control and Prevention advisory committee decided to inoculate essential workers ahead of seniors, even though its own modeling suggested this would increase deaths by up to 7 percent.
Why did they do this? Social justice. The word 'equity' came up over and over in the discussion — essential workers, you see, were more likely than seniors to come from 'marginalized communities.' Only after a backlash did sanity prevail.
I've thought a lot about that meeting as I've watched the havoc Robert F. Kennedy Jr. is wreaking as secretary of the Department of Health and Human Services — including, most recently, firing all the members of the ACIP panel and replacing them with advisers more to his liking.
That 2020 committee meeting was one of many widely publicized mistakes that turned conservatives against public health authorities. It wasn't the worst such mistake — that honor belongs to the time public health experts issued a special lockdown exemption for George Floyd protesters. And of course, President Donald Trump deserves a 'worst supporting actor' award for turning on his own public health experts. But if you were a conservative convinced that 'public health' was a conspiracy of elites who cared more about progressive ideology than saving lives — well, there was our crack team of vaccine experts, proudly proclaiming that they cared more about progressive ideology than saving lives.
This is one of the reasons we now have a health and human services secretary who has devoted much of his life to pushing quack anti-vaccine theories.
That's not to say that public health experts deserve all of the blame. They don't even deserve most of the blame, which properly belongs to Trump, who appointed Kennedy to curry favor with Kennedy's supporters, and to the Republican senators who confirmed Kennedy to curry favor with Trump.
When Kennedy was being considered for the nomination, I interviewed Yuval Levin of the American Enterprise Institute about what that might mean for HHS. Levin, a former George W. Bush staffer who worked on health-care policy, said that as secretary, Kennedy would have significant power to shape our vaccination policy, thanks to his control over advisory boards such as ACIP.
'In practice, the secretary can more or less remove and add individuals to these advisory boards at his discretion,' Levin told me. I concluded that column by begging senators not to confirm him.
For a moment it looked as if they might actually put principle over party. On Feb. 3, our Editorial Board praised Sen. Bill Cassidy (R-Louisiana) for the probing questions he asked during Kennedy's confirmation hearing, pressing him to admit that there's no good evidence vaccines cause autism. The next day, Cassidy, who is a medical doctor, made one of the clearest and most forthright defenses of vaccination in a speech on the Senate floor: 'Vaccines save lives. They are safe. They do not cause autism. There are multiple studies that show this. They are a crucial part of our nation's public health response.'
Alas, he said those things while explaining why he was voting to confirm Kennedy. His excuse was that Kennedy had promised that he was committed to vaccination … including to maintain ACIP 'without changes.'
Now Levin's warning has proven prophetic. Kennedy's ACIP moves were entirely predictable to anyone who has read his book 'Vax-Unvax.' If Cassidy believed Kennedy's assurances, he was a fool, and if he didn't, he's a disgrace to his office.
Not all the ACIP appointments are terrible, and one could argue that the board is now better positioned to reestablish credibility with vaccine-skeptical conservatives, something Cassidy talked about in his floor speech. But I'm afraid I can't make that argument very convincingly. Two of his appointments, Vicky Pebsworth and Robert Malone, are known for their hostility to vaccines. Most of the rest seem to be experts in fields other than vaccination. Vaccination specialists, of course, tend to have a long paper trail of public disagreement with Kennedy's theories.
I'm no believer in blind deference to experts. Science isn't an answer; it's a process, and sometimes that process spits out answers that have to be revised. But I agree with Cassidy that vaccines are one of the greatest public health achievements in humanity's history. The evidence is clear that they protect millions of Americans from diseases that can kill or cripple.
So if it's a choice whether to trust my health to experts who might recommend a somewhat suboptimal vaccination schedule to score political points, or to experts selected by a guy who has casually suggested that the polio vaccine has killed more people than polio, well, that's not a hard decision. And it shouldn't have been hard for Republicans to spare us that decision, either. Instead they made the same mistake as that ACIP committee, only more so: They let politics get in the way of the job they'd been given by the American public.
Before writing this column, I re-listened to a recording of that 2020 committee meeting. Almost five years on, it remains equal parts enraging and mystifying.
During the brief discussion period — the committee had allocated a full 10 minutes for deciding who would live or die — the panel's members didn't seem to have much to say, other than 'equity good.' But each of them said it anyway, commending one another on their high ethical standards before voting to condemn thousands of innocent people to death. The speeches were wholly unnecessary, except as a signal to fellow experts, who were then caught up in the moral fervor of America's racial reckoning.
Listening, I wondered whether any of them harbored private qualms at the time, even as they publicly declared their fealty to the politics of the moment. I wonder, too, whether any of them now wake up at night, blushing in shame and humiliation, as they remember what they did, and the pompous, self-congratulatory little speech they gave about it.
And that's also the question I'd really like to ask Cassidy.
