Last week, the day before the election, I described Robert F. Kennedy, Jr., who in return for abandoning his quixotic and bizarre campaign for the Presidency as an independent to bend the knee and swear everlasting fealty to former President Donald Trump had been promised control over the entire federal health policy apparatus, as an “extinction-level threat to federal public health programs and science-based health policy” as I pointed out what RFK Jr. had been saying and promising all these years. Unfortunately, for federal science policy and public health, last Tuesday Donald Trump won not only well over the 270 votes in the Electoral College needed to become President but a clear majority of the popular vote (and all seven swing states) to defeat Kamala Harris and become President-Elect again. As a result, on January 20, 2025 he will be sworn in as the 47th President of the United States, which means that that extinction-level threat to public health is now less than two and a half months away. It thus behooves me to follow up last week’s post by taking a look at what form—many forms, actually—that threat might take.
So, even as I deal with a hectic weekend (my father is in the hospital), let me try to lay out some of my thoughts and speculation. In many cases, I hope that I’m wrong, but fear that I’m actually not alarmed enough. I’ll start with vaccines. Why? Because antivax is what RFK Jr. is known for, and, despite his denials that he’s antivax, antivaxxer Del Bigtree is closely associated with him, Bigtree and now chief executive of MAHA Action, a new organization named after Kennedy’s “Make America Healthy Again” slogan that is also proposing appointees to RFK Jr.
No confirmation has come from Trump’s presidential team on which position Kennedy will fill. He may only become an adviser, according to the Kennedy campaign’s former director of communications, Del Bigtree.
“President Trump is giving him two years to show success,” Bigtree said. “President Trump is keenly interested in the selections that Bobby Kennedy thinks would get the job done.”
He also said that Kennedy would recommend doctors who have no “conflicts of interest” with Big Pharma companies involved in vaccine and drug production.
That will be interesting, as any doctor who believes as RFK Jr. and Del Bigtree believe about vaccines pretty much all have conflicts of interest. They’re all selling or promoting quackery to treat either COVID-19 or “vaccine injury.” Bigtree himself has a massive conflict of interest, given that he has a podcast that makes money promoting antivax disinformation and conspiracy theories and runs ICAN, which he is paid to run and which exists to sue governments and pharmaceutical companies over vaccines and vaccine policy.
Worse:
Bigtree is involved in proposing appointees to Kennedy, having become the chief executive of the Make America Healthy Again Action organization, which seeks to follow on Kennedy’s healthcare campaign pledges.
Meanwhile, Reuters is reporting that RFK Jr. is reviewing resumes for top Trump health jobs.
Will Trump let antivax activist RFK Jr. “go wild” on vaccines (and health), as promised?
To someone who has been writing about RFK Jr. for nearly two decades (as I have) since he first outed himself as an antivaxxer on the national stage with his publication of a conspiracy-mongering “investigation” co-published by Salon.com and Rolling Stone. In the article, Deadly Immunity, RFK Jr. falsely implicated the mercury-containing preservative thimerosal that had been used in a number of childhood vaccines until around 2002 as the cause of an “epidemic” of autism, the first question that comes to mind is: What role will RFK Jr. have in the second Trump administration? You might recall that at his Madison Square Garden rally two weeks ago, Donald Trump promised, mentioning Elon Musk:
And we also have somebody that is great. And look, we’re not going to let him go too crazy, Elon, with the oil and gas stuff. Because Robert F. Kennedy cares more about human beings and health and the environment than anybody. And he’s going to be absolute. Having him is such a great honor. I’ve been friends of his for a long time. And I’m going to let him go wild on health. I’m going to let him go wild on the food. I’m going to let him go wild on medicine. The only thing I don’t think I’m going to let him even get near is the liquid gold that we have under our feet. I don’t know, Elon. He might not like liquid gold. It’s oil and gas. Sometimes referred to as oil and gas. J. D. , I think we’re going to have to keep him away from the oil and gas. What do you think, Howard? Yes?
As I noted last week, it is very telling that Trump promised to let RFK Jr. “Make America Healthy Again” (an obvious nod to Donald Trump’s “Make America Great Again,” or MAGA), but only if he doesn’t go too far and actually do something about one of the most serious threats to public health, environmental pollution, particularly if that pollution is a result of the fossil fuel industry. By “telling,” I mean telling about both men: Trump for being willing to embrace antivax “wellness” grift but not anything that would harm the business interests that support him, and RFK Jr. for being willing to forget about his pre-antivax crusade as an environmentalist in the service of achieving power and declaring MAHA “war” on the FDA while trying (and failing) to hide his true antivax nature.
Of course, RFK Jr. does share one trait with Donald Trump. He is a malignant narcissist, and two malignant narcissists generally don’t mix very well together. Generally, whoever is the more powerful narcissist will get rid of or punish the less powerful one. This is why I was amused to see stories like this last week:
Let’s just say that, at least for the moment, I don’t think that we can count on Trump getting so fed up with RFK Jr.’s showboating that he reneges on his promise to appoint him to a high-ranking position on health in his administration. I have little doubt that, at some point, Trump and RFK Jr. will butt heads, even have a falling out, but I doubt that it will happen soon enough to prevent massive damage to the federal health policy infrastructure, and, even if it does, anyone waiting in the wings to replace RFK Jr.’s influence would be just as bad—or even worse.
In any event, according to the story above:
Donald Trump’s team appeared to be quietly distancing itself from Robert F Kennedy Jr in the immediate aftermath of the election amid speculation that the former presidential candidate could be handed control of US public health agencies.
Advisers to the president-elect questioned whether Mr Kennedy, a vaccine sceptic who has also been the subject of a series of bizarre stories involving animals, would make it through a security check for a cabinet position.
It raises questions about what role, if any, Mr Kennedy would be given in the Trump administration, as the Republican’s transition team sets about filling thousands of federal posts for his return to the White House.
Mr Kennedy had previously said that Mr Trump had “promised” him control of the Department of Health and Human Services and public health agencies like the Food and Drug Administration (FDA).
However, there is disquiet in the Trump team about media attention on the former independent candidate after he was pressed in a post-election interview with NBC about his vaccine scepticism.
Dammit, reporters. RFK Jr. is not a “vaccine skeptic.” He is antivax. If you can’t call him antivax, at least don’t misuse the word “skeptic.” Call him instead a vaccine misinformation spreader and/or conspiracy theorist, or something like that. I’ll stop now, but that’s long been one of my pet peeves about reporting on the antivaccine movement, and I couldn’t resist mentioning it.
But what, exactly, did RFK Jr. say in his NBC News interview, given the day after the election? I suspect that it was an attempt to reassure people after an interview before the election with the co-chair of Trump’s reelection campaign, Howard Lutnick, who stated that RFK Jr. wanted “access to federal health data so he can show vaccines are unsafe and lead to them being pulled from the market in a second Trump administration.” Now that Trump has won, RFK Jr. is trying to sound more “moderate” in an interview with NBC News reporter Vaughn Hillyard:
Here’s the key part. I will quote at length, so that you don’t have to watch the video above if you don’t want to and to discuss things that were left out of the news reports on this interview, which included only brief quotes and left out RFK Jr.’s whole mendacious antivax schtick, in which he tries to claim he’s “never been antivaccine” (even though he most definitely is and has been rabidly antivax for nearly two decades, with a long history of antivax conspiracy mongering and misinformation) and that he won’t endanger anyone (he most definitely will). As an aside, I will mention my frustration at how news organizations never seem to produce a full transcript of interviews like this (if there is one, I couldn’t find it), leaving me to use YouTube’s AI transcript generator (which puts time stamps in the transcript that need to be deleted and makes a lot of mistakes) and my painstakingly watching the video to produce this:
HILLYARD: You have been a crusader on questioning vaccines. Are there specific vaccines that you would seek to take off the market?
RFK JR: Oh, I’m not going to I’m not going to take away anybody’s vaccines. I’ve never been antivaccine I’ve just…
HILLYARD (interjects): You will not…you will not take any vaccine that is currently on the market?
RFK JR: I’m not. If somebody, if vaccines are working for somebody, I’m not going to take them away. People ought to have choice and that choice ought to be informed by the best information. So I’m going to make sure scientific safety studies and efficacies are out there and people can make individual assessments about whether that product is going to be good for them.
HILLYARD: Would that include covid vaccines that are currently on the market?
RFK JR: I, I want the best science for every vaccine.
HILLYARD: It is part of that, in, during the pandemic, the height of the pandemic, you were questioning the FDA and calling them out for approving the emergency authorization of the COVID vaccines if you had been in charge of the FDA at that time would you have blocked the authorization of the COVID vaccines like you were suggesting publicly?
RFK JR: What I was saying at that time is the vaccines are not going to prevent transmission, which they were telling the public that they would. They were saying you need to take this vaccine in order to protect Grandma. I knew in May of 2020 that the vaccines were not going to protect against transmission, because I was actually reading the monkey studies…
HILLYARD (interjecting): But you would not have told the FDA to block the authorization of the vaccine…
RFK JR: I would have been honest with the American people and…
HILLYARD (interjecting): So you wouldn’t, you wouldn’t have blocked it?
RFK JR: I wouldn’t have directly blocked it I would have made sure that we had the best science and there was no effort to do that at that time.
Translation: RFK Jr. most definitely would have blocked the mRNA COVID-19 vaccines if he had been in charge in 2020. As for his having “read the monkey studies,” my response is that it doesn’t take much looking to find articles about how COVID-19 vaccines might not block transmission but that many vaccines don’t. What we want from a vaccine is, first and foremost, to prevent severe disease and death, which COVID-19 vaccines most definitely accomplished. If a vaccine blocks transmission, so much the better; that’s icing on the cake. That’s why my response to drivel like this is: So what? RFK Jr. does not have significant scientific expertise in medicine, immunology, molecular biology, virology, epidemiology, public health, or any relevant specialty to assess the safety and efficacy of COVID-19 vaccines in a science- and evidence-based way. What he does possess is expertise in conspiracy mongering, data dredging, cherry picking and misrepresenting studies, and, in general, being a disinformation agent, expertise that he’s honed over the last two decades since Deadly Immunity.
In the interview above he’s also spreading the usual antivax tropes about “choice” and “consent.” Remember, as I’ve long said, when an antivaxxer like RFK Jr. invokes informed consent, what he really means is misinformed refusal (a term that applies not just to vaccines but to all rejection of evidence-based treatments) based on a totally warped risk-benefit assessment in which potential risks are exaggerated far beyond what the evidence supports, while the benefits are downplayed to the point where there are none. I’ve frequently said that, if I actually believed the assessments of someone like RFK Jr. regarding the risk-benefit ratios of vaccines I’d be antivaccine too. That’s why I’ve always found RFK Jr.’s claim that he’s “not antivax” or that he is even “fiercely pro-vaccine” to be transparently disingenuous and risible as hell. After all, RFK Jr. has a nearly 20-year history of comparing vaccines to the Holocaust, twisting science (with examples too numerous to mention here), and conspiracy mongering. The bottom line is that RFK Jr. is either lying to you or lying to himself when he claims he’s “not antivaccine.”
All of this is just my usual prolonged introduction to a spoiler alert: If he becomes Trump’s “health czar” or Secretary of Health and Human Services (HHS), RFK Jr. will most definitely start targeting vaccines currently approved, if he can, to try to prove them “unsafe,” no matter how much he and his minions have to distort science and lie to accomplish this, all as a pretext for eventually taking them off the market, all the bromides about “choice” notwithstanding, likely starting with the mRNA COVID-19 vaccines and then proceeding to vaccines like the MMR vaccine and the hated (by antivaxxers) HPV vaccines. If there’s one thing I’ve learned about antivaxxers (and, indeed, the “health freedom movement”) over the last quarter century, it’s that, when they invoke “health freedom,” what they really mean is freedom for them and people who believe what they believe and make the same decisions that they want to make. Those of us who try to champion science-based medicine and health policy don’t count, nor do people who try to take care of their health following science- and evidence-based medical recommendations. Be afraid. Be very afraid.
Hillyard, to his credit, followed up with a very pertinent question:
HILLYARD: And if there was another pandemic that were to strike, why should the American public have confidence that you would allow a vaccine to be made available through the market even it’s…
RFK JR: Well, I mean, let me point this out. They should not have confidence and the people who are managing our pandemic we had the worst record of any country in the world so we had 16% of the covid deaths in the United States of America we only have 4.2% of the globe’s population so whatever we were doing in this country was the worst of every country in the world…
First off, as bad as the US did as a nation handling COVID-19, for COVID-19 mortality on a per-capita basis it was not the worst. Peru was. Unfortunately, that’s cold comfort, as the US still did very poorly in terms of deaths per 100,000 people due to COVID-19 and fell in the middle of the pack in terms of case fatality ratio.
Be that as it may, one can’t help but point out who was in charge for most of the first year of the pandemic. (Hint: It was not Joe Biden, who didn’t assume office until January 20, 2021. By the time Biden took office, the disordered response to COVID-19 led by Trump had become so baked in that his administration had to spend his first year trying to fix the mess that he’d been left at federal public health agencies) Yes, the man to whom he has bent the knee, Donald Trump, was President when the pandemic first hit. He’s the President who downplayed and mostly ignored the warnings in December 2019 and January 2020 that the mysterious new viral respiratory disease due to a novel coronavirus then spreading in Wuhan, China could well result in a major pandemic. He’s the one who constantly interfered with the CDC and FDA response to the pandemic, promoted ineffective repurposed drugs like hydroxychloroquine (which was granted emergency use authorization by Trump’s FDA based on far, far less data than what were used to grant COVID-19 vaccines their EUAs).
And what’s RFK Jr.’s answer to the problem of pandemic response? He follows the above exchange by saying that he’d get rid of “corruption” at the FDA and CDC, bragging about how he has a PhD in corporate corruption, and then going on a bizarre tangent about Fruit Loops supposedly having only three ingredients in Canada while having 19 ingredients in the US—”Why do we have Fruit Loops in this country that have 18 or 19 ingredients and you go to Canada and it’s got two or three?”—in order to justify getting rid of the FDA nutrition department.
That’s not all, though. RFK Jr. doubled down on his bad idea to recommend—”on day one”—that states stop fluoridating their water, citing the usual cherry-picked studies and ranting about “corruption” at the EPA under the Obama administration. This is, of course, a very bad idea, as Steve Novella just wrote last week, given that fluoride is safe and effective and water fluoridation programs represent one of the greatest public health achievements of the 20th century. While it is true that states, not the federal government, make policy decisions on water fluoridation, it’s not difficult to imagine some Republican-led states using such a recommendation as a reason to stop their water fluoridation programs.
What would RFK Jr. actually do?
One thing that’s puzzled me ever since RFK Jr. bent the knee to Donald Trump in return for a role in his administration is the question of what, exactly, he would do, Bigtree’s pronouncements quoted earlier in this post (which don’t clarify things at all) notwithstanding. What would RFK Jr.’s role be? Nothing that I’ve read so far has really clarified that. I’ve heard speculation that he might be named HHS Secretary, but I’ve had discussions in which people have said that, even in a Republican Senate (which we will have in January), he is “unconfirmable,” based his past and the likely difficulty he would have gaining a security clearance from his previous behavior, which includes photos documented in this news article, such as the famous interview this year when he admitted to having dumped a bear carcass in Central Park ten years ago:
These photos don’t even include when RFK Jr. beheaded a beached whale and transported the head home on top of his car.
Even with these photos and RFK Jr.’s history I’m not so sure that he’s “unconfirmable” anymore, given what’s become of the GOP, but I do know that RFK Jr. doesn’t have any experience running a bureaucracy as huge as HHS. I also suspect that he would chafe under many of the mundane details that come with running a bureaucracy as huge as HHS, particularly given his lack of experience. So I rather suspect that he’ll likely take on an advisor or “czar” role that is relatively undefined and work behind the scenes to pick who runs HHS, the FDA, the CDC, and NIH, while letting the picks know just what he wants them to do.
One of the names that I keep seeing popping up to be FDA Commissioner is Dr. Martin Makary, although sometimes I see his name popping up to lead the CDC. Makary is a well-published surgical oncologist at Johns Hopkins, which is why I frequently joke (as a fellow surgical oncologist) about needing to put a paper bag over my head when I see some of his pronouncements. You probably recall that we at SBM don’t think much of Makary, who first came to my attention as one of the foremost promoters of the myth that medical errors constitute the third leading cause of death in the US, all based on a risibly incompetent study that used unjustifiable extrapolation from small numbers to conclude that 250,000 deaths occur each year in hospitals due to medical error. As I pointed out at the time, whenever you see an estimate of how many deaths are “deaths by medicine,” it’s very helpful to compare that estimate with what we know to assess its plausibility. According to the CDC in 2016, of the 2.6 million deaths that were occurring every year in the U.S., 715,000 occurred in hospitals, which meant that, if Makary’s estimates were correct, 35% of all hospital deaths were due to medical errors. But the plausibility of Makary’s estimate was worse than that. Remember that the upper estimate used by Makary and Daniels was 400,000 inpatient deaths due to medical error. That was 56%—yes, 56%—of all inpatient deaths. It was never anywhere near plausible that one-third to over one-half of all inpatient deaths in the US were (or are) due to medical error.
Since then, Marty Makary started out semi-reasonable on COVID-19 but was, as our very own Jonathan Howard has long documented, quick to be captured by his audience and fully embrace the “let ‘er rip” approach to the pandemic in a futile effort to achieve “natural herd immunity,” which, he promised, was always no more than six months away, after which he rapidly pivoted to fear mongering about COVID-19 vaccines. I can’t decide whether he would be more of a disaster heading up the FDA or the CDC, given his ideology and lack of qualifications for either.
Another name I keep seeing popping up as possible CDC Director is Dr. Joseph Ladapo. However unsure I am about just how bad Dr. Makary would be at CDC, I know that Dr. Ladapo would be an unmitigated disaster, given his track record in Florida, where he as Surgeon General has been in charge of the Florida Department of Health since 2021. This, of course, was never unexpected given that Dr. Ladapo was a founding member of America’s Frontline Doctors, which made a name for itself in that horrible first summer of the pandemic by touting hydroxychloroquine as a miracle cure for COVID-19 and later turned to telehealth grift selling prescriptions for ivermectin to cure COVID-19, and a signatory of the Great Barrington Declaration, the document published by contrarian scientists brought together by a right-wing think tank to advocate a social Darwinist “let ‘er rip” approach to the pandemic with poorly defined “focused protection” for those most at risk for severe disease and death from the pandemic. Last year, he was busted for altering a Florida Department of Health study for lying with statistics to make it look as though the vaccine was more dangerous than COVID-19 for men under 40. Earlier this year, consistent with its inclusion in this “guidance,” Dr. Ladapo was parroting bad science that massively exaggerated the problem of DNA contamination of the vaccine. I discussed not too long ago just how bad he would be as a potential pick at the federal level, namely plenty bad, man. He’d be an utter disaster, no matter what agency he was placed in charge of CDC, FDA, or whatever.
And then I remembered a Washington Post article that I had seen before the election but forgotten, reporting that Ladapo is on the shortlist to become HHS Secretary, although he might end up being Surgeon General, given that HHS Secretary is a position that requires Senate confirmation and Surgeon General is not. We can only hope it’s not HHS Secretary, as, unlike the case of being Surgeon General in Florida, which has considerable power, the post of Surgeon General of the US is more a bully pulpit, with little actual political power.
Then there’s Dr. Vinay Prasad, who before the election and even more so since the election seems to be furiously angling for a position in the Trump administration by kissing up to RFK Jr. and appears to be angling for a high ranking job at NIH. (He’s clearly too junior to be NIH Director, but I have little confidence that that would stop Trump from appointing him.) For example:
The NIH is a failure. It has never tested how to give grant money. We have no idea if the current system is better than modified lottery or other proposal. It has no interest in data transparency, publishing in timely fashion, and reproducibility. The agency also needs a hair cut, and a leader who understands these concerns.
While the NIH has problems, some of which I have even written about, in these areas, I’ve seen nothing in Dr. Prasad’s Substack and public utterances to suggest that he has clue one what to do to address these problems through modifications in policy and operation. Some of the other things that he mentions are problems that RFK Jr. notes that are actually problems, such as too many conflicts of interest in certain agencies and a revolving door between government and industry, but I have zero confidence that RFK Jr. or Prasad has any workable ideas on how to correct these problems, particularly given how gullible Prasad was in agreeing that RFK Jr. had a point when he claimed that the childhood vaccine schedule is unsafe because not all vaccines have been tested against saline placebo, a distortion that I’ve discussed a number of times. Basically, Prasad has been good at weaponizing the evidence-based medicine paradigm against public health. One also wonders what he thinks of RFK Jr.’s MAHA plan to devote half the NIH budget to studying “integrative” health and chronic disease.
Meanwhile, RFK Jr. wants to gut the NIH by firing 600 people on “day one” and replacing them with compliant lackeys.
Finally, there’s Dr. Jay Bhattacharya, co-author in 2020 of the Great Barrington Declaration, which advocated a “let ‘er rip” approach to the pandemic, with “focused protection” of those at highest risk for severe disease and death, in order to achieve “natural herd immunity,” while not spelling out what, exactly, was meant by “focused protection.” It’s an approach that never would have worked and whose advocates devastated (and continue to devastate) public health. What position is his name popping up for? CDC Director, of course.
A number of pundits and apologists have been trying to reassure the public that it isn’t that bad, that what RFK Jr. can actually do is fairly limited given that much of the current construction of HHS and the agencies that make it up is defined by statute and would require an act of Congress to change too dramatically. True enough, but that doesn’t mean that RFK Jr., through the appointment of his buddies, couldn’t do enormous damage anyway. Let’s look at one example, the Advisory Committee on Immunization Practices (ACIP). This is the committee that advises the CDC on vaccination policy and which vaccines to include on the childhood and adult schedules, which is why it has long been a target of ire for antivaxxers. In August, Dr. Paul Offit wrote about what sort of mischief that could be done to ACIP by antivaxxers in a Trump administration, although he focused on The Heritage Foundation’s Project 2025 and the desire to basically eliminate the CDC as a recommending body for vaccines. I don’t think that even RFK Jr. would do that.
First, Dr. Offit describes ACIP and its history:
During the 1940s and 1950s, the United States Public Health Service (USPHS) relied on committees that met intermittently to address various vaccine issues. For example, in 1955, the USPHS convened experts to determine who should get Jonas Salk’s polio vaccine. By the early 1960s, with the licensure of new vaccines, it became evident that these committees needed to meet regularly. In March 1964, the Surgeon General created the Advisory Committee on Immunization Practices (ACIP), which was composed of experts in virology, immunology, microbiology, pediatrics, epidemiology, public health, and preventive medicine. The charge to the ACIP was clear: “The Committee shall concern itself with immunization schedules, dosages and routes of administration and indications and contraindications for the use of these agents. The Committee shall also provide advice [to the CDC] regarding the relative merits and methods for conducting mass immunization programs.”
Since 1964, ACIP experts have recommended many safe and effective vaccines. Prior to these recommendations, every year in the United States polio caused 20,000 cases of paralysis and 1,500 deaths; measles caused 48,000 hospitalizations and 500 deaths; mumps was the most common cause of acquired deafness; rubella (German measles) caused 20,000 cases of congenital birth defects; rotavirus caused 70,000 hospitalizations from severe dehydration; and bacteria such as pneumococcus and Haemophilus influenzae type b (Hib) caused tens of thousands of cases of pneumonia, sepsis, and meningitis and hundreds of deaths. Thanks to vaccines, and the clear, strong recommendations by the ACIP and CDC, these diseases have been dramatically reduced or eliminated. Indeed, in a recent report published on August 8, 2024, researchers found that among 117 million children born between 1994 and 2023, CDC-recommended vaccines prevented about 500 million illnesses, 32 million hospitalizations, and 1.13 million deaths.
All of this is true, which is why I don’t think RFK Jr. would eliminate ACIP, even though he could. (The ACIP charter expires if it isn’t renewed every two years.) Rather, more likely he would subvert ACIP. The Secretary of HHS picks the members of ACIP, after a nomination and selection process. These members serve staggered terms, and the current roster has four members, including the chair Dr. Helen Keipp Talbot, whose term expires June 30, 2025, four whose terms expire in 2027, with the rest expiring in 2028. (The reason for this is that, for whatever reason, the Biden administration left a number of ACIP committee positions vacant after the members’ terms had expired and then appointed several new members in February.) By the end of a Trump administration, all members of ACIP could be replaced. Now imagine putting, say, RFK Jr. or his designee in charge of vetting potential new ACIP Members, a process that could be used to place four antivax and/or contrarian “scientists” and physicians on the committee next June, qualifications that prospective members be “acknowledged experts with an outstanding record of achievement in their own field and an understanding of the immunization issues covered by ACIP” be damned. Then in 2027, he could add four more, followed in 2028 by replacing the eight remaining voting members appointed this year.
Regular readers can only imagine the disaster that would be. Likely no new vaccines would be added to the CDC-recommended schedule, while some might even be removed, as committee members harass CDC and FDA scientists to torture the safety and efficacy data to make it “confess” that vaccines are unsafe and ineffective. I shudder at the thought. Of course, one thing that I do know about ACIP is that its conflict of interest reporting requirements are quite rigorous. That might keep the worst grifters off the committee, but I can’t guarantee that.
Can RFK Jr. succeed in destroying federal public health policy and programs?
There are many contradictions inherent in the MAHA movement that RFK Jr. has forged with Donald Trump. For example, RFK Jr. rails against the FDA as being too beholden to drug companies and quick to approve products without adequate evidence of efficacy and safety, while also wanting to lower the bar for the approval of the various quack treatments that he espouses, such as ivermectin for COVID-19 and cancer. He wants to make the FDA more strict and accountable, which, even if one could trust him to do this right, would run headlong into the interests of big business supporters of Trump in big pharma. One might easily see Trump being swayed to rein in or get rid of RFK Jr. because billionaires running pharmaceutical and medical device companies don’t like him interfering with their business. Given Trump’s history, who do you think Trump will listen to, his billionaire supporters or RFK Jr., whom he only took on as his health advisor (whatever position he ends up occupying) as an expedience, to get rid of a potential threat to his election?
Even so, and even considering that it will take years to accomplish what RFK claims to want to accomplish, be afraid. Be very afraid. Even if RFK Jr. accomplishes only a fraction what he promises, the damage to public health, the vaccination program, the FDA drug and device approval process, and federal science-based health policy in general, especially public health, will be incalculable. Previously controlled or even conquered vaccine-preventable infectious diseases are likely to return, although it might take a few years, by which time Trump will be out of office and his successor will be blamed. As for the rest, RFK Jr. will not “make America healthy again.” Far from it. He will jeopardize the health of Americans by making them vulnerable to infectious disease, keeping the FDA from approving safe and effective medications while encouraging it approve quackery of which he approves, and subjecting them to foodborne illness in the pursuit of the “natural,” like raw milk. And I haven’t even gotten into how he could change the rules at CMS to force it to pay for quackery under Medicare and Medicaid.
The next four years will be a disaster for science-based health policy and programs. The only question is: How bad? Again, my thought is: Plenty bad, man.