Now that we know President-elect Trump has nominated Robert F Kennedy Jr as the Secretary of Health and Human Services, we must understand how he might harm vaccines in the USA. And it is not pretty.

Vaccines are one of the greatest success stories in medicine, saving thousands of lives of children every year. But Robert F Kennedy Jr hates vaccines by pushing misinformation about the safety and effectiveness of all vaccines. He has nothing (and I mean nothing) supporting his claims, but that doesn’t stop him.

In case you think that RFK Jr won’t have the power to affect vaccine policy in the USA, this post will show you how he might cause grave harm to vaccines. If he does what we think he’s going to do, it could lead to thousands of lives being lost to diseases that were once unknown in the USA. We will go back to a time when vast swaths of children died because of diseases that RFK Jr dismissed with a wave of his hand.

How Robert F Kennedy Jr will destroy vaccines

I am going to focus on how RFK Jr. can profoundly impact vaccines. There may be other areas where he could damage our vaccination system; please mention them in the comment section.

RFK Jr will have a new platform for vaccine misinformation

Before I get to the specific ways that Robert F Kennedy Jr can damage vaccine development and policy, there is one important way that he will influence vaccinations — he will have the bully pulpit of being a cabinet secretary under Trump. He will have access to news programs and other media outlets where he can speak out with his misinformation about vaccines and people will listen.

Before he started his run to be President, he really did not have a wide audience. Those of us who fight the good fight for vaccines realized he was wrong about everything regarding vaccines, but his audience seemed to be nothing more than rabid anti-vaxxers. Now, as a cabinet secretary, he can push his lies about vaccines with the authority of a government official in charge of healthcare in the USA.

Most people don’t pay attention to the vaccine discussions, though it increased greatly during the COVID pandemic. Now, people will hear him on Fox News or some other media outlet, and they will refuse vaccines because Robert F Kennedy Jr said they are dangerous. This is what concerns me most, because his bully pulpit may have more of an effect than actual policy changes.

Advisory Committee on Immunization Practices (ACIP)

ACIP is an independent committee of the CDC that examines vaccine safety and effectiveness data and then recommends which vaccines should be given to children and adults. The committee consists of up to 19 voting members who are independent vaccine experts in vaccinology, immunology, pediatrics, internal medicine, nursing, family medicine, virology, public health, infectious diseases, and/or preventive medicine. It also usually includes a “consumer representative,” an individual who can represent the community and social aspects of vaccine policy. There are also ex-officio members from other governmental agencies and there are non-voting members from groups that have an interest in vaccines like medical societies.

ACIP recommendations are evidence-based, that is, they rely upon data from clinical trials and post-marketing studies that are generally published in peer-reviewed journals. Their recommendations are not based on opinions but on scientific data. None of the voting members are employees of a pharmaceutical company, so there is no bias in their votes.

ACIP recommendations are forwarded to the CDC’s Director and once adopted become official CDC policy. 

There are several ways RFK Jr can cause damage:

1. He can change the makeup of ACIP, putting vaccine deniers on the committee. The HHS Secretary has the final say over who sits on ACIP, so he may replace every scientist with anti-vaccine crackpots. Can you imagine if Andrew Wakefield was put on the committee?
2. Since the CDC director is appointed by the President, RFK Jr may get someone who is in sync with his beliefs and will reject the ACIP recommendations.
3. He could change the system where ACIP no longer has an advisory role for vaccine recommendations.

RFK Jr probably could not ban vaccines or anything like that, but with his influence over ACIP, he could cause a great deal of harm along with distrust of vaccines. We will talk more about that later.

Vaccine adverse effects

One thing that RFK Jr keeps doing is highlighting the adverse effects of vaccines, even if they are minor and rare. Moreover, he completely ignores the fact that the benefits of vaccines far outweigh these effects.

Robert F Kennedy Jr could force the FDA and CDC to highlight side effects, even if they are rare. So when you get a vaccine information sheet from your physician, all of these side effects (some of which have never been shown to be caused by vaccines) would be in big bold print, scaring people from getting the vaccines for themselves or their children.

He could force more research on vaccine safety, which isn’t a bad thing, but only if it is scientifically rigorous. If he just wants to focus on vaccine side effects, it will cause a further drop in vaccine uptake in this country.

Vaccine development

The FDA is a part of the Health and Human Services bureaucracy, so RFK Jr will have control over the FDA. He has threatened to “purge” the FDA of people who don’t tow the Robert F Kennedy line on pharmaceuticals, including vaccines.

Now, he probably could not revoke authorizations for current vaccines, because he would run into the Big Pharma behemoth. They would sue him and the FDA, and he would probably lose. I am not a fan of Big Pharma, but on this one issue, we are aligned — fight RFK Jr on every aspect of vaccines.

He could delay or stop approvals of new vaccines, many of which are necessary for the fight against Lyme disease, norovirus, and other diseases. He could also stop new indications and labeling for current vaccines. The flu vaccine, which gets annual updates, could end up being a disaster if RFK Jr has control over the FDA.

He could also stop or slow vaccine development research conducted at or funded by the National Institutes of Health, the federal government’s top medical research agency, which would also fall under his jurisdiction.

Without all of this, we would also be at risk of a new pandemic where our response would fall short of what would be necessary to save American lives. I guess we would have to travel to Canada to get that vaccine for a new pandemic flu because RFK Jr stopped research and development on new vaccines.

Weaken the National Vaccine Injury Compensation Program

In 1986 Congress passed the National Childhood Vaccine Injury Act, which among other things created the National Vaccine Injury Compensation Program (NVICP). While the main impetus for the passage of the act was protecting manufacturers from liability – manufacturers were leaving the market because of lawsuits, many of them unjustified, and Congress was concerned about the vaccine supply – it was not the only goal and not the only value reflected in the act.

In addition to protecting the vaccine supply, the program also addressed the shortcomings of the tort system in this area with a no-fault program designed to resolve vaccine injury claims “quickly, easily, with certainty and generosity.”

People who experience serious side effects after receiving certain routine vaccinations are limited in their ability to sue drug companies. But they can use NVICP to easily, and relatively quickly, sue for damages.

Despite the claim of anti-vaxxers, pharmaceutical companies can be sued for damages that vaccines cause, but that takes a long time with no guarantee of success. NVICP works.

RFK Jr probably could not end the NVICP, but he could remove vaccines from the program. That could reduce the availability of those vaccines while greatly increasing their prices. Consequently, it will also make it much more difficult for plaintiffs to win lawsuits and potential compensation.

Vaccines for Children Program

The Vaccines for Children Program (VFC) is a program administered by the CDC and is fully funded by the Federal Government. The CDC purchases the vaccines at a significant discount directly from the vaccine manufacturers and then distributes them to state health departments along with certain local and territorial public health agencies. These health departments and agencies may vaccinate eligible children directly, or they may, in turn, redistribute the vaccines at no cost to private physicians and public health clinics that are registered as Vaccines for Children Program providers.

Children, 18 years or younger, are eligible for free vaccines if they meet one or more of the following criteria:

• American Indian or Alaska Native
• Medicaid-eligible, although children covered by Medicaid can receive vaccines through that program
• Uninsured

The Patient Protection and Affordable Care Act (ACA), better known as Obamacare, mandates providing ACIP-recommended vaccines at no cost for children and adults up to the age of 26 years.

Since the program is administered by the CDC, RFK Jr could reduce its scope or remove vaccines that are covered by the program. Since the program is funded by the Federal government it is also possible that Congress or one of Trump’s minions could defund it.

I have written previously that the VFC Program has saved hundreds of thousands of children’s lives since the Program became effective on 1 October 1994 after Congress passed the Omnibus Budget Reconciliation Act of 1993 and subsequently signed into law by President Bill Clinton.

Summary

After Robert F Kennedy Jr was appointed to become Secretary of Health and Human Services, my level of anxiety about vaccines, and the noise from anti-vaxxers, increased dramatically. Before this election, I thought the discussion about vaccines was about a few people who were persuadable, what many of us call vaccine fence-sitters.

Now, there is an existential threat to vaccines in the form of Kennedy. If his vaccine goals are met, children and adults will die. It really is that simple.

I cannot believe that we have to work harder to protect vaccinations in the USA. I’m going to do it because the safety and effectiveness of vaccines are supported by evidence not the wild claims of a victim of a brain-eating worm.

And just a reminder of how much vaccines have Made America Healthy Again: