A recent poll found that 44% of U.S. voters approve of Trump’s nomination of Robert F. Kennedy Jr. to Secretary of Health and Human Services. Yet public opinion polls show Americans continue to overwhelmingly support childhood vaccination, including 88% who agree that the benefits of the measles-mumps-rubella (MMR) vaccine outweigh its risks — the same vaccine that Kennedy discouraged Samoans from using during their deadly 2019 measles outbreak.
The discrepancy between those numbers suggests that millions of Americans remain unaware of Kennedy’s opposition to all approved vaccines, or at least of just how much influence the HHS Secretary has on vaccine policy. It’s therefore important that journalists ensure their readers, listeners and viewers understand how vaccines are approved and recommended so they understand the HHS Secretary’s power over vaccine policy and availability in the U.S.
Related: What to know about Robert F. Kennedy Jr.’s anti-vaccine advocacy
It’s also important that journalists avoid “sane-washing” Kennedy, downplaying the seriousness of his advocacy against the scientific consensus of evidence on issues ranging from vaccines and COVID-19 to fluoride and raw milk. If Americans don’t realize how dangerous Kennedy’s beliefs are to public health or the power he would have over public health policy as HHS Secretary, they aren’t equipped to share their opinions about his nomination with their senators, who will decide whether to confirm his nomination.
What can Kennedy actually do?
At the FDA, all new products, including vaccines, are submitted for approval with evidence of their safety and effectiveness. The volunteer Vaccines and Related Biological Products Advisory Committee (VRBPAC) reviews the evidence and makes a recommendation to the FDA. The FDA is not bound to follow those recommendations, but they carry a great deal of weight. The HHS Secretary can appoint and dismiss VRBPAC members at will, so Kennedy could fill that committee with anyone he wants, including those who share his beliefs about vaccines.
What Kennedy cannot do is easily remove a product from the shelves or undo its approval. Doing so requires a high level of scientific evidence, and attempting it without adequate evidence would prompt lawsuits from drug companies that the companies would likely win, or at least keep the case in court for a while, explained Dorit Reiss, a law professor at UC Law San Francisco who specializes in vaccine policy.
Kennedy’s influence at the CDC could be more significant. A similar voluntary committee initially makes vaccine recommendations, the Advisory Committee on Immunization Practices (ACIP). Kennedy can, at any time, appoint and dismiss ACIP members — and members of the ACIP work groups who focus on specific vaccines.
ACIP’s recommendations then go to the CDC director to officially issue or alter them. The CDC director rarely changes recommendations from ACIP, though it has happened. If Dave Weldon is confirmed as CDC director — which has anti-vaccine advocates cheering — it would not be difficult for Kennedy to effectively revoke any or all of the current vaccine recommendations.
And this is all just the tip of the iceberg. Check out this outstanding slide from ASU law professor James Hodge on nearly two dozen things Kennedy could do on vaccine policy alone as HHS Secretary.
Key takeaway
If confirmed as HHS Secretary, Kennedy has the will and the ability to upend a half-century of U.S. vaccine policy.
What could happen if current vaccine recommendations are eliminated
If currently recommended vaccines are no longer recommended, they would still be approved and legally available, and states’ vaccination requirements for school attendance would not immediately change. But three possible downstream effects could affect vaccine access and/or uptake:
- Insurance companies could opt to no longer cover vaccines. This is unlikely since they are cost-effective — 500 measles vaccines (a cost of approximately $47,500) is the same cost as a single measles hospitalization. (Some vaccines’ cost-effectiveness takes longer to reap, such as the HPV vaccine, since HPV-caused cancers take years to develop.) Insurance companies also have value-based care targets related to immunization coverage that are set at the start of each year and would be expensive and time-consuming to change, especially if Kennedy, if confirmed, does not remain at HHS, given that most past Trump appointees didn’t last long.
- Confusion about the CDC changing its recommendations would have a substantial impact on vaccine confidence, especially for those who don’t follow vaccine policy and would not understand why the agency has reversed course. Vaccine hesitancy would likely dramatically increase, Reiss and Offit both told me, and vaccine uptake could dramatically decrease. All 50 states currently require at least some vaccination for school attendance (though legislatures could change that), but most states also offer exemptions, and exemption rates would likely continue climbing as they have in recent years.
- Low uptake of vaccines could impact demand in the market if either of the above scenarios occurs, leading manufacturers to reduce the supply of vaccines or even stop making them, as happened in the 1980s due to litigation. And Kennedy could attempt to revise the Vaccine Injury Table used to determine compensation for specific, bona fide vaccine injuries in the National Vaccine Injury Compensation Program. Doing so requires a potentially months-long process that undergoes judicial review, Reiss said. If Kennedy succeeded, it could open up the kind of liability litigation against pharmaceutical companies that led vaccine makers to stop making vaccines and necessitated the program’s formation in the first place.
For more on Kennedy’s power over vaccine policy, check out this Washington Post piece, this STAT piece, Matthew Herper’s STAT analysis on HHS more broadly, or Herper’s STAT analysis specifically on the CDC and FDA.
Key takeaway
As HHS Secretary, Kennedy can potentially dramatically reduce vaccine uptake, thereby causing the return of multiple severe infectious disease outbreaks.
Point out Kennedy’s influence with CDC and FDA picks
To further understand the risks Kennedy poses to public health, audiences should be aware of the beliefs and actions of those tapped to lead two other health agencies. Trump nominated Florida physician and former congressman Dave Weldon to lead the CDC, a move praised by anti-vaccine activists. Weldon has previously questioned vaccine safety that studies have already definitively addressed, including advocating for the disproven claim of a link between vaccines and autism, and experts fear he will support an anti-vaccine agenda.
Trump’s pick for the FDA, Marty Makary, has also espoused vaccine claims not supported by the evidence, such as inaccurately claiming that myocarditis from COVID-19 vaccines is more dangerous than what a Covid infection can cause. Makary is among the “Covid contrarians” so named by many in the scientific establishment because he made statements that were contradicted by the evidence.
Key takeaway
Kennedy would have support from other Trump appointees, if confirmed, in implementing any new vaccine policy.
Avoid false balance and “sane-washing”
For years, reporters covered discussions about a link between vaccines and autism as though the jury were still out. Curtis Brainard brilliantly cataloged the damage of that false balance coverage more than a decade ago, but the lessons are more relevant than ever. The “this side/that side” model of journalism does not apply when there is clear scientific evidence on one side and misinformation on the other side. Journalists have a responsibility to make that clear to their audiences.
Media critic Parker Malloy wrote in September about the news media’s “sane-washing” of Donald Trump, calling it not “just poor journalism” but “a form of misinformation that poses a threat to democracy.” Others have since written more about the media’s apparent struggle — and failure — to cover Trump appropriately. Too many articles try to find sensible meaning in Trump’s rambling speeches or erratic behavior. Reporters cannot make the same mistake with Kennedy, as Benjamin Mazer wrote at The Atlantic.
But, as Mazer points out, some pieces have already begun doing this, seeking “common ground” instead of clearly reporting Kennedy’s history and the evidence about his beliefs on vaccines, raw milk, fluoride and other issues. If a potential public official has repeatedly lied and shared misinformation about life-saving interventions, it’s not journalistically unethical to say so plainly.
There’s no need to look for the one or two times the broken clock might be right. And it’s journalistically unethical to invite commentary from people who falsely deny Kennedy is anti-vaccine. It’s telling that Trump’s own previous FDA commissioner, Scott Gottlieb, has warned that Kennedy leading HHS will “cost lives.” If the facts show that to be the case, journalists have an obligation to convey that, as the Washington Post did here.
Key takeaway
Report on Kennedy’s misinformation without feeling a need to “balance” it with something he said that may be true.
Additional resources
- 10 RFK Jr. conspiracy theories and false claims, in his own words, Washington Post
- Potential Vaccine Law & Policy Impacts of the 2nd Trump Administration, James Hodge, ASU
- What Trump and Robert F. Kennedy Jr. might do to undermine vaccines — and what they likely can’t, STAT News
- What could Trump mean for the business of health? Scenarios for an RFK Jr. HHS, STAT News
- Prognosis: Under Trump, the CDC is in big trouble, but the FDA might be OK, STAT News
- How much influence could RFK Jr. have over vaccines in Trump’s government?, Washington Post
- Global health experts sound alarm over RFK Jr., citing Samoa outbreak, Washington Post
- With RFK Jr.’s HHS nomination, autism advocates fear a return to ‘a dark age’, STAT News
- Kennedy’s Coalition of Quacks Wants to Feed America a Diet of Lies, McGill University Office for Science and Society
- I’ll Never Forget What Kennedy Did During Samoa’s Measles Outbreak, New York Times
