As Robert F. Kennedy Jr. meets with Senate Republicans on the Hill this week in an effort to secure his confirmation as secretary of health and human services, his biggest hurdle may be convincing them that he doesn’t hold extreme views on vaccines.
That could prove difficult, however, as Kennedy has spent decades publicly opposing vaccines, including making repeated false claims about vaccines being linked to autism and his involvement with Children’s Health Defense, a leading anti-vaccine group.
In recent days, concerns over how Kennedy might wield his influence as health secretary have grown. Last week, The New York Times reported that a lawyer for Kennedy who is reviewing candidates for jobs at HHS filed a petition to the Food and Drug Administration in 2022 to revoke approval of the polio vaccine. The petition, the Times said, was on behalf of the Informed Consent Action Network, an anti-vaccine group with ties to Kennedy.
On Monday, President-elect Donald Trump added to the controversy, saying during a news conference that he believes there are “problems” with vaccines and suggesting they may be linked to rising autism rates. Trump said, however, that he’s a “big believer” in the polio vaccine.
Senate Minority Leader Mitch McConnell, R-Ky., a polio survivor and a potential key figure in Kennedy’s confirmation, fired a warning shot at Kennedy in a statement Friday.
“Efforts to undermine public confidence in proven cures are not just uninformed — they’re dangerous,” McConnell said. The polio vaccine was approved in the U.S. in 1955, and it has prevented an estimated 20 million cases of paralysis in children, according to the Centers for Disease Control and Prevention.
Experts say Kennedy’s long history of anti-vaccine activism could translate into significant changes to childhood immunization policies in the U.S. and could undermine decades of progress in preventing diseases like measles, polio and whooping cough.
A Kennedy spokesperson did not respond to a new request for comment. In an earlier statement to NBC News, Kennedy spokeswoman Katie Miller said, “The Polio Vaccine should be available to the public and thoroughly and properly studied.”
Kennedy’s previous comments conflict with that statement, however. On the “Lex Fridman Podcast” last year, Kennedy said there’s “no vaccine that’s safe and effective” and linked the polio vaccine to cancer.
Advisory committees
Childhood vaccination policies in the U.S. are complex, with states holding much of the authority.
Still, experts say that Kennedy could wield enormous influence over childhood vaccinations.
If confirmed as health secretary, Kennedy would oversee a suite of health agencies that includes the CDC, the FDA, the National Institutes of Health and the Centers for Medicare and Medicaid Services, among others.
His greatest influence on vaccines, experts say, could come through the CDC’s Advisory Committee on Immunization Practices, or ACIP, an independent group of health experts that helps the agency make recommendations for states and insurers on what vaccines to cover, including childhood vaccinations.
The committee reports to the CDC director. The CDC director then informs the HHS secretary of the immunization recommendations. Last month, Trump tapped Dr. Dave Weldon, a former congressman from Florida and a physician who has made false claims about vaccines, to lead the CDC.
According to KFF, a nonprofit group that researches health policy issues, the HHS secretary has the authority to appoint new members to the committee, and advisory committee members can be replaced at the discretion of the secretary.
There are currently 15 voting members of ACIP, but the committee can have up to 19. Committee members generally serve four-year terms, and several members’ terms are set to end in 2025, according to a committee roster. However, many will remain in place until 2028, unless Kennedy directs them to resign.
Dorit Reiss, a vaccine policy researcher at the University of California Law San Francisco, said she sees two potential scenarios: Kennedy could replace members of ACIP with anti-vaccine advocates who make recommendations that the CDC approves, or he could influence Weldon, as the CDC director, to reject ACIP recommendations. The CDC director is not required to sign off on the committee’s recommendations, but usually does.
Dr. Sean O’Leary, chair of the American Academy of Pediatrics Committee on Infectious Diseases and a nonvoting member of ACIP, said that even if there’s a shake-up at ACIP — and the CDC makes new recommendations against certain vaccines — parents may still choose to vaccinate their children. States are not required to follow the recommendations, but most do.
“Although this stuff can and will have an impact, most parents, I think, are still going to listen to the recommendation of their child’s pediatrician,” O’Leary said. “When we’re talking about childhood vaccines, parents want to do what’s best for their kids, and politics aside, that matters a lot more.”
Reiss noted, however, that ACIP’s recommendations have direct implications for insurance and which vaccines are covered.
Under the Affordable Care Act, insurance companies are required to cover vaccines that ACIP recommends.
“For example, if the committee requests against giving children DTaP, or recommends against giving them at the ages they are now, those won’t be covered by insurance,” she said, referring to the vaccine for diphtheria, tetanus and pertussis (whooping cough). Insurers could decide to cover them anyway, she added, but that’ll be up to them.
Federal funds
Experts also expressed concerns about Kenndy’s influence over the allocation of federal funds.
The Section 317 program, for example, is a grant managed by the CDC that provides funding to states and local health agencies to deliver vaccines. Public health departments apply for grants through the CDC.
“He could make vaccines more difficult to get paid for,” said Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia. “He could make them less available.”
Offit and other experts also said they’re concerned about Kennedy’s influence over new vaccine approvals and whether he could slow the approval process down.
He could also direct new research into existing vaccines, such as the polio shot, creating the appearance of potential issues with the vaccines and fostering public distrust, experts say.
Trump picked Dr. Marty Makary, a pancreatic surgeon at Johns Hopkins University, to lead the FDA. It’s unclear how Makary would operate in the position, but he has recently made comments defending Kennedy. A Trump transition spokesperson did not immediately respond to a request for comment.
Offit, also a member of the FDA’s vaccine advisory committee, said he’s concerned that Kennedy could continue to spread misinformation about vaccines, which could cause parents to rethink vaccinating their children.
“If you look at polls now, there’s clearly been an erosion in trust in vaccines and vaccine safety,” he said. “Now he’ll have a bigger platform. He’s the head of the most important public health agency,” he said, referring to Kennedy.
This article was published by NBC News on 2024-12-18 18:45:00
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