After learning that, in return for his having suspended his independent Presidential campaign to bend the knee to Donald Trump, Trump had said that he’d appoint longtime antivax activist Robert F. Kennedy Jr. to an important health-related position in his administration and “let him go wild on health,” “go wild on the food,” and ‘go wild on medicine,” I wrote a post with an intentionally rather inflammatory title, RFK Jr. is now an extinction-level threat to federal public health programs and science-based health policy. Some, of course, considered me alarmist. Some of the usual suspects who had been attacking public health and vaccines during COVID-19 even suggested that doctors should “stop worrying and learn to love MAHA,” MAHA standing for RFK Jr.’s slogan, “Make America Healthy Again,” which was a clear nod to Donald Trump’s longstanding slogan, “Make America Great Again” (MAGA). As we all know, Donald Trump won the 2024 election and has since appointed RFK Jr. as Secretary of Health and Human Services, in addition to appointing a wretched collection of grifters, antivaxxers, and quacks (most of whom have long been discussed on this blog) to important positions in HHS.
I hadn’t wanted to write about RFK Jr. again. Really, I hadn’t. Believe it or not, I get tired of his antics, grift, and conspiracy theories, having written about them on a regular—or semi-regular—basis for nearly 20 years now. Unfortunately, he’s doing so much damage to US health and science policy in such a short period of time that it’s difficult for me to ignore. Also, there was an impetus by fellow SBM blogger Dr. Jonathan Howard:
Damn, I thought. Maybe I should revisit that post, now that we’re nearly three months into the Trump Administration, and see how well it aged. Fortunately for me—and unfortunately for us as a nation—I find that it has aged pretty well. In fact, rereading it and reflecting on what has happened during the last five months since I posted that, I realize that, if anything, I arguably underestimated the damage that would be done in such a short period of time. I note that a month and a half ago I also discussed how RFK Jr. would likely undermine and destroy vaccine policy in the US and over the last two weeks noted how MAHA is the new Lysenkoism, not to mention at least “soft” eugenics, based on RFK Jr.’s response thus far to the large and growing measles outbreaks in this country.
The article cited above by Dr. Howard shows RFK Jr. spewing a number of common antivax tropes, including these two:
There is malnutrition in West Texas, in Gaines County, and in the Mennonite community. The doctors that I’m talking to on the ground, the leaders in the community are reporting that the people who are getting sick are people who are umm and the little girl who died, where malnutrition may have been an issue in her death. There’s a lot of poverty in that area and the food is kind of a food desert. The best thing that Americans can do is to keep themselves healthy. It’s very very difficult for measles to kill a healthy person.
And:
If you are healthy, it’s almost impossible for you to be killed by an infectious disease in modern times because we have nutrition, because we have access to medicines. It’s very, very difficult for any infectious disease to kill a healthy human being.
Of course, these are the sorts of things that RFK Jr. has been saying all along. First, his idea that measles is a harmless disease if you are healthy is just plain wrong. Don’t get me wrong, I’m not arguing against good nutrition, but good nutrition is not going to make it less likely that an unvaccinated child will catch measles and is not a silver bullet to prevent death. The second part is so wrong that RFK Jr. is not even wrong. It is, however, a common MAHA talking point that frames health as an issue of private virtue with respect to health-related behaviors and implies, if not outright states, that if you live the “correct” lifestyle, consume the “correct” diet, and do the “correct” amount of exercise, infectious diseases can’t harm you.
It’s the same mindset that Bill Maher exhibited in 2009 when he claimed that he lives a lifestyle that basically made him immune to influenza, leading his guest Bob Costas to retort sarcastically, “Oh, come on, Superman!” One need only point to the historical fact that one of the earliest outbreaks of influenza during the 1918 pandemic occurred in an Army barracks in Kansas, where the recruits were, presumably, young, healthy men. There are, of course, many other examples from history. The whole point of vaccination is that an immunologically naive population can’t fight off a pathogenic bacterial or viral infection because they’ve never been exposed to it before. A healthy immune system needs priming, not nutrition. If that priming is by infection, there will be suffering and death as the price to pay for immunity, rather than a sore arm and maybe some fever, aches, and/or chills.
Let’s take a look at some of the things that RFK Jr. and his minions have done since taking office as HHS Secretary. I’ll go by critical agencies and provide an overview of what’s happening, because this post is already too long and going into detail would make it still longer. Again, let’s just say that, if anything, I understated the danger when I called RFK Jr. an extinction-level threat to US federal science-based programs in health, public health, and biomedical research.
RFK Jr. at the FDA: Beware the “deep state”!
Last week, Politico and others reported on a visit to the Food and Drug Administration by RFK Jr. and the new FDA Commissioner, Dr. Marty Makary, where an “all hands” meeting was held. Dr. Makary, you might recall, rose to infamy by popularizing the myth that one-third of all deaths in the US are due to medical errors each year. It’s a myth that has become so pervasive that it’s a common sound bite on stories about the subject, despite the absolutely awful “science” by Dr. Makary on which it was based. (Suffice to say that the true absolute number of deaths attributable to medical error is at least 10- to 20-fold smaller than the inflated figure that Makary estimated.) Later, of course, Dr. Makary became a “COVID-19 contrarian” and, as frequently documented by Dr. Howard, did his damnedest to minimize the severity of the disease, rail against public health interventions, and making failed prediction after failed prediction about herd immunity. Still, I almost felt sorry for Dr. Makary—almost!—as I read about what went down at that “all hands” meeting, as Dr. Makary tried to claim, against all reality, after the massive staffing cuts instituted at FDA:
The cuts came during FDA Commissioner Marty Makary’s first full week in charge of the agency. Makary acknowledged the staff cuts as he introduced Kennedy and pledged that scientists, reviewers, inspectors and administrative staff would have the resources they needed to do their jobs.
“There have been some changes as all of you are extremely aware of,” Makary, a Johns Hopkins surgeon and former Fox News contributor, said. “Thank you for your patience in those changes.”
Seriously, even if you believe that Dr. Makary is sincere in his stated desire to tighten up the FDA’s regulatory standards for approving drugs and devices (a need for which I’ve had sympathy and some agreement in the past), it’s going to be mighty difficult to accomplish that now that the agency’s staff have been decimated. It’s also going to be difficult to communicate clearly, write product safety sheets, or in general explain things to the public given that nearly all the FDA communications staff have been fired. One wonders if Dr. Makary realizes that he’ll be the fall guy when needed drugs fail to be approved and unsafe drugs get approved or when there are outbreaks of food-borne illness that could have been prevented with more staff.
For someone who keeps claiming that he’s “not antivaccine” (although he’s definitely anti-COVID-19 vaccine), I wonder if Dr. Makary realizes that, most likely, no new vaccines will be approved as long as RFK Jr. is HHS Secretary. Perhaps he doesn’t care. After all, he brought in Dr. Tracy Beth Høeg, who as a special assistant to him will serve as dual purpose, apparently. First, in her previous life, she was a sports medicine quack who offered unproven stem cell therapies in her practice., a perfect fit, given RFK Jr.’s desire to deregulate stem cell quackery. Since COVID-19, she’s basically aligned with Dr. Makary’s contrarian views (the two are friends now), opposing nonpharmaceutical interventions (NPIs) such as “lockdowns,” business closures, school closures, and masking while also opposing vaccinating children against COVID-19. While not as antivax as RFK Jr. clearly is, she has echoed common antivax talking points, such as “questioning” the need for certain childhood vaccines, such as immunizations against flu, rotavirus and varicella, for children not known to be at high-risk for severe illness.
To get an idea why Dr. Høeg’s appointment is worrisome, just consider this story, which shows direct political interference in a licensing decision:
The US Food and Drug Administration was slated to transition Novavax’s COVID-19 vaccine from emergency use authorization to full licensure on April 1, when Principal Deputy Commissioner Sara Brenner intervened, asking to take a look at the application, per multiple sources familiar with the matter.
Brenner enlisted Tracy Beth Høeg, who recently joined the FDA as a special assistant to the commissioner, to help look at the application again, a source said. Brenner announced Høeg’s arrival at the agency on 2 April at Commissioner Martin Makary’s introductory all-staff meeting.
Høeg has promoted incorrect information about COVID-19 vaccines, including misinterpreted data, multiple people with vaccine expertise said.
“Having senior political staff stepping on and potentially overrule decisions made by FDA experts raises a big red flag,” said Aaron Kesselheim, director of the Program on Regulation, Therapeutics and Law at Harvard Medical School. “It is perhaps worse that none of this is being done transparently.”
Although it’s not unheard of for the FDA Commissioner’s office to intervene in the decision whether or not to approve individual products, it is rare and nearly always problematic. What I see here is a signaling that Dr. Makary will indeed bow to the MAHA antivax agenda, as Dr. Scott Gottlieb, former FDA Commissioner, notes:
Scott Gottlieb, FDA commissioner during Trump’s first term, said 2 April at Politico’s 2025 Health Care Summit that he expects some very early tests “of how much [Makary] is going to establish independence in decision making, not just on policy, but on product-specific things related to vaccines or how much he’s going to be pressured by the secretary to do certain things that are clearly evidence of political decision-making in the scientific and review process.”
Gottlieb said it is typical for commissioners to guard against outside political pressure.
“We all got it, although I was fortunate,” Gottlieb said. “I mean Alex Azar in many ways was exceptional. He understood that it was important to maintain the independence of FDA and he guarded that.”
Remember, Trump 2.0 is not the same as Trump 1.0. This time around, there are no guardrails. My expectation is that Dr. Makary will either bend the knee and serve as RFK Jr.’s vassal, a political hack, or he won’t last long, nor will he succeed in his stated aim of making the FDA approval process more rigorous. After all, while RFK Jr. might want “more rigor” for vaccines and pharmaceuticals, he clearly wants to loosen standards for stem cells and many other unproven treatments that MAHA likes.
Basically, I didn’t say a lot about the FDA in my original post from November, but speculated that the FDA could pull approval from already approved vaccines and/or issue black box warnings for potential side effects that don’t exist. Nothing I see thus far tells me that these are not possibilities. Moreover, the first test of whether Dr. Makary will try to exercise some independence from HHS and RFK Jr. will likely be, as Dr. Howard predicted, the first time that RFK Jr. tells FDA to revoke the approval for a long-approved vaccine, which I predict that he will do this year or, at the latest, next year. Dr. Howard predicted that Dr. Makary will capitulate, rather than risk being fired or forced to resign. There’s nothing in his history to suggest that he will do otherwise. I agree with Dr. Howard that, if this happens, Dr. Makary will live in infamy as the doctor who most enabled vaccine-preventable diseases to return and ravage our children. Meanwhile, we’re treated to headlines like FDA’s New Commissioner Marty Makary Signed Off on Peter Marks Ouster, FDA Commissioner Marty Makary Gets Off To A Bruising Start As Agency Is Wracked By Layoffs, and The FDA Is ‘Finished’ as Firings Sweep Health Agencies. Drug Stocks Are Falling.
Of course, it’s very likely that nearly everyone with any scientific integrity left will leave the FDA, especially after RFK Jr.’s rambling speech last week in the aforementioned “all hands” meeting about how the “deep state” is real, the FDA has been hopelessly captured by industry to the point of being a “sock puppet,” and referenced referenced the CIA’s Project MKUltra — a notorious human experimentation program from the 1960s — and the Milgram experiment, a well-known study meant to test people’s willingness to obey authority even if it meant inflicting pain on others, and also:
But in his first visit to the FDA, he offered little in the way of a vision for how the agency would come away from the layoffs stronger — instead devoting much of his speech to railing against the agency’s past failings and repeating his assertions that the U.S. was far healthier during his childhood than it is now.
“This whole generation is damaged,” Kennedy said, according to the transcript, claiming that rising rates of chronic disease, allergies and other illnesses are the result of some “environmental toxin.”
“The information is out there,” he said. “But those studies aren’t done because they may offend the financial interests of powerful entities.”
RFK Jr.’s concern about environmental toxins must be why the CDC told the Milwaukee health department that it couldn’t help them investigate elevated lead levels in the city’s public schools because the CDC personnel who would normally offer such help had all been fired. RFK Jr.’s response to being asked about this?
It was basically, “Oopsie!”:
Two days later, asked about the cutting of the CDC’s lead poisoning prevention and surveillance branch, US Department of Health and Human Services Secretary Robert F. Kennedy Jr. suggested that the program might be reinstated.
“There are some programs that were cut that are being reinstated, and I think that’s one of them,” he said April 3, noting that “there were a number of instances where … personnel that should not have been cut were cut.”
Truly, I had underestimated the malignant incompetence of this administration and RFK Jr. This is far from the only example of mass firings that had to be undone. Moreover, it’s clear that the message in the chaos will be that you must toe the line or be fired. Dr. Peter Marks, the FDA’s Director of the Center for Biologics Evaluation and Research (CBER) and therefore in charge of vaccine approval, was recently forced to resign and left with a banger of a resignation letter, in which he noted that he had tried to work with RFK Jr. but that it had “become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.”
The NIH is already in dire straits
I didn’t make much in the way of specific predictions about the NIH, but let me just say right now that what’s going on at the NIH is far worse than my worse nightmares last year. What I rather expected is that the NIH would stop funding grants that went against RFK Jr.’s MAHA and antivax views or the views of the administration. One thing that I did not expect was that Elon Musk and his “Department of Government Efficiency” (DOGE) would try to slash indirect costs on grants to 15%, thus kneecapping universities with the most NIH grants. What I did not expect was that there would be an ideologically targeted and vengeance-motivated mass cancellation of NIH research grants, which began before the new NIH Director Dr. Jay Bhattacharya was even confirmed. RFK Jr. made sure that the NIH started unilaterally canceling grants that had passed peer review through NIH study sections as scientifically worthy of funding and then been funded—and canceling them without warning, thus utterly disrupting research.
They started with grants to study vaccine hesitancy, then moved on to grants to study and develop the mRNA technology used in the Pfizer and Moderna COVID-19 grants for use in other ways, such as vaccines against other pathogens and as cancer treatments. Then, “reasoning” that the “pandemic is over,” they moved to cancel grants to study COVID-19 itself, followed by instituting their disbelief in climate science to cancel grants studying the health effects of climate change. No, seriously, HHS literally said:
The NIH did not respond to Nature’s queries about the grant terminations or scientists’ concerns about them. Its parent organization, the US Department of Health and Human Services (HHS), told Nature that “the COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago”.
The updated documents that Nature obtained (see Supplementary Information below) were sent on 25 March to ‘grants-management specialists’ — NIH staff members who oversee the business side of awarding funding. This document includes COVID-19 on a list of “research activities that NIH no longer supports”, in addition to research on China, DEI, “transgender issues” and vaccine hesitancy. The latest guidance also says that grants related to South Africa and climate change should be terminated.
The document also outlines a new category of research that should be terminated: any project on a list sent by the NIH director or the HHS, which is currently helmed by long-time anti-vaccine advocate Robert F. Kennedy Jr.
In other words, if RFK Jr. doesn’t think your science matters, you won’t get funded. As Nature notes, the scope of the cancellations is totally unprecedented:
Such large-scale grant terminations are unprecedented; the agency typically cancels only a few dozen projects each year in response to serious concerns about research misconduct or fraud — and does so only as a last resort, after taking other actions such as suspension.
Grants-management specialists will be tasked with identifying and terminating projects, because the NIH’s current leadership considers its scientific staff members too biased to make these determinations, says an NIH official who requested anonymity because they weren’t authorized to speak to the press.
Lysenkoism 2.0 indeed, as I feared. Only research approved by Dear Leader HHS Secretary RFK Jr. is real science! After all, remember how both Dr. Steve Novella and I recently wrote about how the NIH has hired longtime antivax hack “scientist” David Geier to oversee a study of vaccine safety to determine if vaccines cause autism. (Spoiler alert: He’ll use crappy science to conclude that they do.) As we both noted—and Dr. Howard, too!—you don’t hire someone like Mr. Geier unless you want a predetermined result and know that rigorous science won’t support it.
Speaking of predetermined outcomes, apparently the NIH will lead an autism initiative announced last week by RFK Jr.:
Robert F. Kennedy Jr., the nation’s health secretary, pledged on Thursday to seek out experts globally to discover the reasons for the increasing rates of autism in the United States.
“We’ve launched a massive testing and research effort that’s going to involve hundreds of scientists from around the world,” Mr. Kennedy announced at a cabinet meeting held by President Trump. “By September, we will know what has caused the autism epidemic and we’ll be able to eliminate those exposures.”
“There will be no bigger news conference than that,” Mr. Trump replied.
And:
He said the Centers for Disease Control and Prevention would soon release data showing that the autism diagnoses had now increased to one of every 31 children. Many scientists and doctors attributed the rise in autism rates over the last several decades in part to growing awareness of the disorder and to expanded diagnoses along a spectrum.
“We are launching requests to scientists from all over the country and all over the world,” Mr. Kennedy said in an interview on Fox News. “Everything is on the table: our food system, our water, our air, different ways of parenting, all the kind of changes that may have triggered this epidemic.”
As I’ve been saying on social media about this story, spoiler alert: The study will conclude that it was the vaccines. There, I saved five months and tens of millions of dollars! Don’t believe me? Oh, come now:
In the interview, Mr. Kennedy also said an important part of the effort would be to compare autism rates in vaccinated and unvaccinated children. It’s an angle that many scientists dismiss, saying that parents who vaccinate their children are also more likely to get a diagnosis, given higher rates of interaction with health providers.
Of course, I shouldn’t need to repeat again that vaccines don’t cause autism; we have copious evidence from many large epidemiological studies dating back a quarter century or more supporting that conclusion. What does RFK Jr. have? David Geier, the hack nonscientist who’s spent the last 25 years doing bad research to “prove” that mercury in vaccines. But what about the rest? “Different ways of parenting”? WTF does he mean by that? Is he resurrecting the long-discredited “refrigerator mother” hypothesis? How does one even study “different ways of parenting” as a risk factor for autism, anyway?
Moving on, let’s just take a look at the scope of the carnage being inflicted on NIH grants. It is truly unprecedented. I’ve been applying to the NIH for various grants, training to young investigator, to bigger grants, since the late 1990s, and I’ve never seen anything like it. Neither have researchers more senior than I am whom I’ve asked. As of April 7, according to Nature, 770 research grants have been canceled, mainly these topics:
And:
You might ask how the NIH can do this. Although most NIH grants are longer than a year, with the “gold standard” NIH R01 grant typically being for five years, they are funded one year at a time. After each year, the investigator must submit a progress report, and, based on that, the next year’s funding is granted. In the past, the progress report would have to be really bad for the NIH to consider cutting off the next year’s funding, but now the NIH is basically just stopping grants cold because they are, from the administration’s point of view, outside of goodthink or are even doubleplusungood, either. The overall effect is to utterly change how scientists view the NIH, which has for eight decades been very trustworthy as a funder:
In the past, the termination of grants has been exceedingly rare, reserved only for gross misconduct, poor performance or fraud, says a former senior employee at the NIH, who requested anonymity out of fear of retribution. Even in those cases, institutions are often given the opportunity to remedy the situation, the former worker says.
“Up until now, grant recipients have been able to assume that, as long as they do good work and don’t do anything stupid, they’ll have five years of funding,” they add. “Now, that’s gone.”
This uncertainty, combined with the hostility toward institutions of higher education, is already having a deep chilling effect: more than 75% of respondents to an informal Nature poll of readers who are scientists said that they were considering leaving the United States.
And that’s not even when the administration is canceling grants in order to punish specific institutions, like Columbia, and make them obey:
Last month, White House began to pressure Columbia over its handling of anti-Israel protests and other allegations of antisemitism at the university, saying it was killing $400 million in federal grants to the school, including the NIH money. NIH terminated approximately 400 grants to Columbia on 12 March and ordered their researchers to stop work on them.
They’ve also threatened NIH funding for major universities if they did not eliminate DEI (Diversity, Equity, and Inclusion) programs. Embarrassingly, my alma mater, both undergraduate and medical, the University of Michigan, caved under such threats. As Gregg Gonsalves accurately described it, this is all a purge of a generation of knowledge and expertise:
What we are seeing is a purge—of the administrative state, of the universities, of expertise—that is consistent with events like the Cultural Revolution in China in the 1960s and ’70s, or the dismantling of the tsarist civil service after the Bolshevik Revolution in 1917. Just because this moment isn’t associated with the intense political bloodshed of those eras doesn’t make the comparison any less apt. In one way or another, the goal is to get rid of an entire set of people and institutions in the service of a radical ideology.
And what is rising in its place is also recognizable from history. From the Covid contrarians running the National Institutes of Health and the Food and Drug Administration to the anti-vaxxers down at HHS headquarters, we have our 21st-century Lysenkos propped up not by the strength of their ideas but by their political patrons in the White House.
While the short-term effects of the administration’s policies have been well-articulated, the long-term ones are just as chilling. In less than 100 days, President Trump has created a lasting legacy: We have lost a generation of expertise, of systems built up to care for our nation and provide for our collective future in terms of scientific advances.
And I haven’t even gotten to the CDC yet.
Like the case for Dr. Makary, I wonder if Dr. Jay Bhattacharya knows that he’s being set up to be the fall guy for when these initiatives all go wrong. Either that, or he will, along with Dr. Marty Makary, be remembered as the physician face of the effort to destroy biomedicine and public health in the US. As Alt-NIH put it, Trump and RFK Jr. are attacking the NIH and universities because they want them to knuckle under and obey:
American universities are a shining star of America’s economic power, a magnet for talent that attracts people from all over the world. So why do movement conservatives want to destroy universities? It’s an important question right now, one that many scientists are just waking up to. The answer is that conservatives hate universities because they are bastions of free thought, which leads them to self-organize into liberal places. Smart people, whether they are center-right, center-left, or left, generally support core liberal values of intellectual freedom, fairness, and the rule of law. That leads people in academia, including scientists, to oppose today’ authoritarian conservatism — today’s autocratic and oligarchic US Republican party.
Universities also occupy a privileged place in public debate. Scholars at universities get quoted in the press; scientists at universities weigh in on the truth and validity of oil CEOs’ climate claims, and on COVID deniers’ public health claims. In other words, universities are independent arbiters of truth in a free society. They are institutions that can push back on autocrats. That’s a major reason Rufo and Vance hate universities so much: universities limit the power of autocrats. So Trump and Republican elites are now seeking to politicize, damage, and corrupt NIH — they want to take over the science grantmaking system to destroy US universities.
So does Dr. Bhattacharya, apparently. Funny how much he complained about supposedly being “canceled,” which in his case consisted of being sharply criticized and having his feelings hurt because in 2020 former NIH Director Francis Collins referred to him in a private email as a “fringe epidemiologist” while now enthusiastically embracing canceling whole areas of scientific investigation and knowledge. I would also add that I only half-agree with Dr. Collins. Dr. Bhattacharya is indeed quite fringe, but he is not an epidemiologist. He is a health economist, and it showed. The Great Barrington Declaration, which he co-authored, advocated for a “let ‘er rip” approach to the pandemic among the “healthy” in order to achieve “natural herd immunity” faster, while weakly suggesting “focused protection” of high risk populations without any actual concrete strategies to do so. The document was truly about economics and opening the economy back up, the human toll be damned.
The CDC is being destroyed
I noted in my original post that RFK Jr. would have huge influence over the CDC, particularly given that the HHS Secretary appoints the members of the Advisory Commission on Immunization Practices (ACIP), the committee that formally recommends the childhood and adult vaccine schedule. While it is true that states determine which vaccines are included in school vaccine mandates, generally they take the CDC’s lead, following its recommendations, which are made and periodically updated by ACIP. One can imagine an HHS Secretary under Trump appointing antivaxxers to ACIP, which would wreak havoc with our vaccination program. To my knowledge, RFK Jr. has not as yet appointed antivaxxers to ACIP, but the February meeting was delayed until next week.
There is a conspiracy theory that I’ve dubbed the “central conspiracy theory of the antivaccine movement” (at least the US antivaccine movement), which posits that vaccines cause autism and all sorts of horrible health outcomes and that the CDC “knew” but covered up the data. That conspiracy theory was at the heart of RFK Jr.’s “coming out” party when he published his antivax conspiratorial screed Deadly Immunity back in 2005, and nothing in his world view has changed. It was also at the heart of Del Bigtree and Andrew Wakefield’s antivax propaganda film disguised as a documentary, VAXXED and has continued to be the main driving antivax conspiracy theory through the COVID-19 pandemic. RFK Jr. fully believes in these conspiracy theories, and, as a result, the CDC is suffering a similar destruction of its mission and corruption of its values and science.
Examples abound, the most recent of which occurred last week when RFK Jr. told the CDC to stop recommending that states fluoridate their drinking water. Of course, before that, RFK Jr. had stopped advertising that promotes vaccination, wanting instead to emphasize “choice” and “informed consent,” while temporarily and abruptly shutting down the CDC’s weekly scientific publication, the Morbidity and Mortality Weekly Report (MMWR), which CDC’s primary way of publishing and communicating important data for public health. Then, of course, Trump appointed Dr. Dave Weldon, an antivax blast from the past, to be CDC Director, although Weldon’s nomination was abruptly yanked at the last minute when it became clear that he wasn’t going to win confirmation. Not that it mattered. When it came to the deadly measles outbreaks, the largest of which is in west Texas, RFK Jr. only grudgingly recommended vaccination with MMR, burying the recommendation in nonsense about using vitamin A and steroids to treat measles, even after two children have died of measles. Despite the so-far disastrous response of CDC and HHS to the measles outbreak under RFK Jr.’s leadership, he’s crowing that the CDC has done an “amazing job” getting the measles outbreak under control, even though the measles outbreak is definitely not under control yet and, as Dr. Paul Offit wrote, RFK Jr. should apologize:
When RFK Jr. attends the funeral of yet another child who has died from measles unnecessarily, he should apologize to the family. Apologize for his inaction. Apologize for his continual spread of misinformation about the disease and the vaccine. Apologize for his failure to strongly support the importance of vaccinating children during an epidemic. And apologize for cutting funds for immunization clinics in areas with low vaccination rates. The frankly dismissive mantra of “thoughts and prayers” doesn’t cut it here.
Meanwhile, the CDC has slashed funding to community health departments and to programs designed to encourage childhood vaccination, leading, predictably, to outcomes like:
In Dallas County, Texas, the health director said the cuts compelled the cancellation of 50 community vaccination events — including many in schools with low measles vaccination rates amid a rising outbreak.
In Minnesota, the Health Department announced it would lay off 170 employees after losing more than $220 million in federal funds. Among the casualties is the state’s immunization registry, which will no longer be upgraded — leaving Minnesota with one of the most outdated tracking systems in the country.
In California, the Health Department said in a federal filing that it would be unable to provide childhood vaccines, including for measles, to millions of children, roughly half of the state’s youth.
And in Washington state, the Health Department announced that in response to $20 million in grant cuts targeting immunization programs, it would furlough or lay off 46 workers and suspend its mobile clinic operation, known as the Care-a-Van. The 104 canceled clinics were expected to administer 2,000 vaccines to vulnerable kids, including those in rural areas and homeless populations.
And:
The National Association of County and City Health Officials survey captured further impacts: A department in Ohio said it plans to halt training on vaccine hesitancy. One in Indiana will lose two nurses who travel to schools to vaccinate children, so parents don’t have to miss work. A Texas agency will not be able to replace old equipment as planned.
The cuts also threaten a less visible but critical part of the vaccine infrastructure: the data systems that public health departments use to record and share immunizations. Vaccines for Children relies on these systems to order doses, approve and track distribution, and monitor safety.
It’s almost as though the HHS is now intentionally trying to destroy federal vaccination programs. Scratch the word “almost.” That’s exactly what it is doing. I could continue to go on, but Dr. Howard has collected a whole bunch of links to news stories documenting the carnage.
US public health, medicine, and science are in deep trouble
Looking above at what I’ve written, I just realized that I haven’t even mentioned that America’s Quack, Dr. Mehmet Oz, now runs the Centers for Medicare & Medicaid Services (CMS), which is in charge of our largest health programs, including Medicare, Medicaid, and Affordable Care Act insurance plans. Maybe another time. Now I’m too tired.
I’ll conclude by riffing on Gregg Gonsalves, who notes the consequences of this rapid destruction of generations of institutional and scientific knowledge:
These resources won’t just spring back if Trump is gone. Senior figures outside the government are seeking other opportunities. Students and trainees are missing the chance right now to take up their chosen profession; they’re not all going to wait around indefinitely for the political winds to change. The rest of the human, administrative, and physical infrastructure for science, public health, and healthcare is starting to wither away as well. In government, in addition to the mass dismissals, we have people like Peter Marks—central to drug development and regulation for years—walking away from the FDA in disgust and protest. If you needed more evidence of the central punitive nature of these purges, some agency officials are getting told they can go work in remote rural locations in Alaska or Montana and remain in federal service. At least they are not getting a bullet to the head as they are marched out to the countryside. But they are indeed facing a kind of exile.
This is basically Nuremberg 2.0, the fantasy that many antivaxxers and COVID-19 contrarians held that one day they could punish those whom they viewed as responsible for all the “horrors” in policy instituted to control COVID-19. The problem is, this time it’s no fantasy. Indeed, Jeffrey Tucker, who played a major role in bringing together the three “dissident” scientists to write the GBD and later founded the right wing antivax and anti-public health think tank, the Brownstone Institute, has even stated as much recently at the Independent Medical Alliance (IMA; Previously FLCCC) Annual Conference:
But my highlight of the weekend was Tucker’s plenary talk, in which he summarized his worldviews – anti-lockdown, pharma controls the world, etc – and then revealed the reason for HHS cuts in the form of a theatrical skit. “And this is why there is upheaval going on in Washington,” he said. “Nobody says it, but this is why.” “How come you just fired twenty thousand people from the HHS?” “Oh, cost cutting…” – he looks down, pretending to be a coy government spokesperson, then pauses to give the audience time to come to their own conclusion. “It’s not cost cutting. It’s JUSTICE. It’s JUSTICE.” (I later asked Tucker and Mansdoerfer whether this is the view of the White House as well – they said No).
See for yourself:
Arguably, before Trump and RFK Jr., Mr. Tucker did more to destroy public health by first enabling and then promoting the GBD. As an aside, if you believe their account, the FLCCC/IMA had a lot to do with getting RFK Jr. confirmed, as their speakers bragged about how they had “carpet-bombed” Sen. Bill Cassidy’s district in Louisiana, calling thousands of constituents and transferring them directly to Cassidy’s phone lines, thus ensuring his tie-breaking committee vote. An opening video apparently also showed Senator Ron Johnson holding a stack of “65 thousand letters” in support of Kennedy during the hearings – also, if you believe them, the work of IMA Action.
Depressingly, I’m with Gregg Gonsalves:
We’re in deep trouble. The midterms, the 2028 elections, should they change the balance of power in Congress or who is in the White House, all come too late. The patient is bleeding out in the waiting room. American science, public health, and healthcare will be damaged for a generation or more.
I’m at least as pessimistic. The damage has already been done, and it will only get worse the longer Trump and RFK Jr. remain, in effect, unopposed in this sphere. Lysenkoism 2.0 is upon us. How much damage will be done? Will it take us decades to recover, as it did the Soviet Union? I don’t know, but I’m afraid to learn the answers as the months roll by. Five months ago, I called RFK Jr. an “extinction-level” threat to US biomedical science and public health. That extinction is well under way. If my old post hasn’t aged well, it’s because I was not pessimistic enough and exhibited a failure of imagination regarding just how far President Trump and RFK Jr. would go and how fast.