On February 13, 2025, longtime antivaccine activist and promoter of quackery under the guise of “make America healthy again” (MAHA), Robert F. Kennedy, Jr., assumed the office of Secretary of Health and Human Services (HHS), the largest cabinet-level department in the United States federal government. By any standard, HHS is a behemoth of a department, with a budget of $1.8 trillion—yes, trillion—in 2025. In fact, by budget it is the largest department in the federal government, larger than even the Department of Defense. As HHS Secretary, RFK Jr. was placed in charge of nearly all non-military US federal programs in medicine, public health, and biomedical research. To give you an idea of the scope of the department that RFK Jr. has headed for the last year, think about this: Upon assuming office, he took charge of a number of critical government agencies related to medicine and public health, including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH), not to mention the Centers for Medicare & Medicaid Services (CMS), the government agency responsible for administering and regulating Medicare, Medicaid, and the implementation of the Affordable Care Act (ACA, sometimes colloquially called Obamacare). Even now, over a year later, it boggles my mind that such an addled conspiracy-mongering antivax crank would ever be granted so much power in the US, even by a President as irresponsible as Donald Trump.
You think I exaggerate? (I know that regular readers know that I’m not exaggerating, but someone who just found their way here through a search or by accident might.) Let’s just put it this way. Here are two recent videos posted by RFK Jr.
I mean, seriously. The video above looks as though it’s mocking RFK Jr. I know it’s intended ironically, in the way that so much “make America great again” (MAGA) content is, but this use of a 1990s-style toy ad aesthetic to promote this message seems so mocking that maybe it will backfire? Then there’s this:
Yes indeed, this is just what I’d want to watch to “inspire” me to exercise: A shirtless RFK Jr. with a shirtless Kid Rock. Seriously, I thought RFK Jr. was opposed to gender-affirming care, but, with a physique like that at age 72, he sure looks as though he’s on more testosterone than the average trans male. And what’s with wearing jeans in the sauna and the cold plunge after?
But I digress.
These are just two recent examples among many others of the bonkers messaging coming out of HHS these days, even as RFK Jr. works to systematically remove access to as many vaccines as he can, undermine public health, turn the NIH into just another grift as the “research arm of MAHA,” and realign the FDA to approve quackery while making it more difficult to approve new vaccines, all while aligning HHS policies with what can only be referred to as soft eugenics, thus turning health solely into a matter of personal responsibility in which good health is viewed as being due to virtuous living and bad health due to individual failure, with nary a mention (other than lip service) to the social determinants of health and genetic predispositions to disease to be heard. In this Brave New World, if your child dies of measles, it’s because the child was unfit, and if you have a chronic disease, it is your fault, which means that nature should be allowed to take its course and cull you from the herd.
Of course, I was warning about the extinction-level threat to public health represented by RFK Jr. even before the 2024 election, after then-candidate Donald Trump promised to let RFK Jr. “go wild” on healthcare if elected and then reiterated my warning after RFK Jr. had assumed his current position as HHS Secretary. That’s why I’m torn whether to be gratified or annoyed that The Lancet published an editorial late last week entitled Robert F Kennedy Jr: 1 year of failure. It’s a short editorial, only around 725 words (which is basically barely enough for me to get started, at least here), but it does sum things up fairly well while, of necessity, not being able cover a lot of the carnage inflicted on US public health, medicine, and biomedical science in the year since RFK Jr. took office. Amusingly, at least one antivaxxer didn’t like it and said so, while a staunch pro-vaccine pro-science advocate, while appreciating the message, noted the flawed messenger.
One year of failure after nearly 20 years of antivax messaging
As is the case with my fellow SBM blogger Dr. Jonathan Howard, one thing that has irritated the crap out of me ever since it became apparent that Donald Trump might win and then actually appoint RFK Jr. to a high ranking health-related position in his administration, which everyone (correctly) assumed to be HHS Secretary, so many “respectable” physicians, journalists, and pundits have bent over backwards to give him the benefit of the doubt, to “both sides” it. This would generally take the form of positive (or at least noncommittal but hopeful) takes on RFK Jr.’s MAHA emphasis on healthy food and exercise, coupled with downplaying or almost downright ignoring his preceding two decades of bonkers antivax conspiracy mongering (not to mention HIV/AIDS denial and any number of conspiracy theories, relegating the bonkers to a throwaway comment about his “controversial” views on vaccines or his vaccine “skepticism.” As I and others have repeated many times, RFK Jr. is not and has not been a “vaccine skeptic” for a long time. He is hardcore antivax and has been so since at least 2005.
So naturally, he was lying when, as The Lancet recounts, he promised to be good:
In his first speech as Secretary of the US Department of Health and Human Services (HHS), Robert F Kennedy Jr laid out a plan to restore trust. The COVID-19 pandemic saw public faith in Federal health and science plummet—between April, 2020, and September, 2023, the percentage of polling respondents who trusted coronavirus and vaccine information from the Centers for Disease Control and Prevention (CDC) “a great deal” or “a fair amount”, fell from 83% to 63%—and the HHS employees to whom he was speaking were facing devastating mass lay-offs and funding cuts. Although Kennedy did not mince words about the likely fate of staff resistant to his ambitions, he promised open and honest engagement with everyone willing to work towards making the USA healthy again. To the Senate committee who confirmed his nomination, Kennedy promised a receptive and collaborative relationship, and to the public from whom he claims his mandate, he promised a new era of unbiased science without hidden conflicts of interest, secrecy, or profiteering. Radical transparency, gold-standard science, ethics, compassion, competency, and pride would restore to HHS the unimpeachable authority that the USA needs and deserves.
Those of us who had been paying attention for nearly two decades before that confirmation hearing and speech knew RFK Jr. was lying, but apparently too many people were like Charlie Brown in this famous series of comics, with RFK Jr. playing the role of Lucy:
As The Lancet drily notes:
Politicians are known to break promises, but Kennedy’s record, 1 year in, has been a failure by most measures, especially his own.
That’s only if you assume that RFK Jr. was telling the truth about what he was about and how he would measure success and that the metrics for success that he laid out were real. Unfortunately, by RFK Jr.’s likely real measures, RFK Jr. has been depressingly successful; that is, if you support science-based public health. He has reshaped the leadership of HHS, placing sycophants, toadies, and lackeys in key leadership positions, such as “Podcast Jay” Bhattacharya as NIH Director, Marty “third leading cause of death” Makary as FDA Commissioner, and, recently, “Podcast Jay Bhattacharya” as acting director of the CDC, as if NIH Director and CDC Director weren’t both very demanding full-time jobs that even a highly competent and experienced manager and leader would likely struggle to do well simultaneously. (Podcast Jay is neither experienced nor competent.) Meanwhile, RFK Jr. appointed America’s Quack, Dr. Mehmet Oz, as CMS Administrator, placing him in charge of all Medicare, Medicaid, and ACA programs.
Podcast Jay, as you might recall, made a name for himself as co-author of the Great Barrington Declaration, that public health-denying call for a “natural herd immunity” solution to the pandemic published two months before the first COVID-19 vaccines started trickling out first to healthcare professionals, in which Podcast Jay promised “natural herd immunity” in 3-6 months if only nations would “let COVID rip” (with, as an afterthought, “focused protection” of the vulnerable). It was a profoundly eugenicist or social Darwinist strategy (take your pick) that never could have worked, given that “natural herd immunity” requires lifelong (or at least long-lasting) immunity and SARS-CoV-2, the coronavirus that causes COVID-19, easily mutates to avoid pre-existing immunity, and that wrecked public health. Meanwhile, Marty Makary first made his name in crankdom for doing a very bad “study” that was basically a ridiculous extrapolation that claimed that medical errors are the third leading cause of death, claiming 250,000 Americans a year. During the pandemic, he “graduated” into pandemic minimization and antivax misinformation. Unsurprisingly, taking their marching orders from President Trump and his OMB Director Russell Vought and combining theme with RFK Jr.’s preexisting anti-public health proclivities, RFK Jr. and his minions have ushered in a new Lysenkoism—I like to call it Lysenkoism 2.0—into all the scientific and public health establishments, all while decimating workforces, withholding grant funding, and, well, I’ll let The Lancet summarize:
10 days after his speech about trust and openness, HHS rescinded a 54-year-old policy of soliciting public comments for new rules and regulations, silencing the voices of many of the stakeholders he pledged to serve. Kennedy has summarily dismissed advisers and experts, communicated policy changes on pay-walled media, fired a whistleblower, and overseen the revisions of guidelines and recommendations, contradicting decades of established science, often to the benefit of industries he formerly condemned. Under Kennedy’s leadership, the National Institutes of Health (NIH) shuttered programmes studying the health effects of air pollution, HHS withheld a report linking alcohol consumption to cancer, and the Food and Drug Administration (FDA) withdrew warnings of potential harm from consuming products (such as raw milk and chlorine dioxide) falsely marketed as treatments for autism. His changes at CDC have driven 26 states to reject official guidance on vaccine policy, and in December the CDC awarded an unsolicited $1·6 million grant to conduct a vaccine study in Guinea-Bissau that raised so many ethical concerns—the design would have risked exposing thousands of unvaccinated children to hepatitis B—that it has been compared to the infamous Untreated Syphilis Study at Tuskegee.
HHS under Kennedy has made a habit of throwing good money after bad science. Amid the Trump administration’s cuts to research funding and personnel there has been a harmful shift in priorities. Cutting-edge discoveries and clinical investigations—on subjects ranging from mRNA vaccines to diabetes and dementia—are denied crucial resources while junk science and fringe beliefs are elevated without justifiable explanation. Under Kennedy’s leadership, politicisation at the NIH, FDA, and CDC is imperilling the future of US science and innovation and throttling the public health enterprise that keeps the country safe today.
As I said, Lysenkoism 2.0. As I like to say, RFK Jr. is definitely coming for your vaccines, his goal being to eliminate all vaccines by the end of his term if he can or, failing that, to eliminate as many as he can however he can. He is also all about promoting his favored forms of quackery. For example, although I’ve discussed on multiple occasions how RFK Jr. purged all members of the CDC Advisory Committee on Immunization Practices (ACIP), to replace them with a wretched collection of antivax cranks, quacks, and grifters that RFK Jr., I haven’t really written about the Interagency Autism Coordinating Committee (IACC), a Federal advisory committee that coordinates Federal efforts and provides advice to the Secretary of Health and Human Services on issues related to autism spectrum disorder (ASD). Consistent with his longstanding belief that vaccines cause autism, RFK Jr. transformed this committee, too, adding a collection of autism cranks, quacks, and grifters, most antivax. Just look at the membership roster! It now includes Daniel Rossignol, Ginger Taylor, Toby Rogers, Lisa Ackerman, Elizabeth Mumper, and Walter Zahorodny, among others. (I never thought I’d see someone like Ginger Taylor, a particularly annoying old “friend” from the antivax website Age of Autism, in such a position, for example.)
The Lancet also notes that measles and other infectious diseases are on the upswing and that the US is in danger of losing its measles elimination status that it’s had for over a quarter of a century, while RFK Jr. does little or nothing about it, noting:
The destruction that Kennedy has wrought in 1 year might take generations to repair, and there is little hope for US health and science while he remains at the helm.
Correct, but, really, what did anyone expect when someone like RFK Jr. was appointed to such a powerful position? Given his extreme antivax views, what has been happening was largely predictable, and I was predicting a lot of what RFK Jr. would do before he did it. Kudos to The Lancet for calling out RFK Jr., albeit belatedly, complete with an article noting that the new dietary guidelines that RFK Jr. pushed through are a recipe for poorer health.
Unfortunately, The Lancet‘s history intrudes.
The Lancet: Surgisphere or Andrew Wakefield?
When I first saw The Lancet‘s editorial, I wondered how RFK Jr.’s defenders would respond. To that end, I headed over to the website of the antivax org founded by RFK Jr, Children’s Health Defense. To my surprise, there was nothing there defending RFK Jr. I’m sure they’ll get around to that eventually. In the meantime, the task of defending RFK Jr. from the depredations of science as wielded by the editors of The Lancet was left to a second- or third-tier antivaxxer, Jessica Rose, who took to her Substack to write The Lancet (Surgisphere) smears the Secretary of Health and Human Services (HHS) RFK Jr. Her attack begins:
If you don’t know about the Surgisphere scandal, read about it here. In brief:The Surgisphere study, which claimed patients who received chloroquine or HCQ had 35% higher death rates, was retracted 13 days after publication, as its data was determined to be fabricated.The Lancet journal was the apex predator in this scandal.Here, they smear RFK Jr.
I can’t help but laugh a bit. I will admit that I wrote about the Surgisphere study at my not-so-super-secret other blog when it was first published and was, admittedly, a bit too credulous about it. Let’s just say that I was very embarrassed afterwards for not having picked up on some of what should have been fairly obvious red flags and wrote a long postmortem about how I screwed up and vowed to do my utmost not to let it happen again. Suffice to say that I should have noted that what Surgisphere claimed to do seemed pretty implausible, particularly given that the study was only published in late May 2020, only two and a half months after the World Health Organization had declared COVID-19 a pandemic. Also note that The Lancet retracted the paper only 13 days after publication, which in the world of publishing is lightning fast.
None of that stops our intrepid antivaxxer from ranting:
1 year of failure? Really Lancet? Really? If you define failure by standing up to corporate bullies and pit vipers lurking in caves pining for your demise then yeah, sure, he’s a failure at NOT succumbing to evil. This article is a hit piece, plain and simple.
Funny, but Rose can’t name a single fact in the editorial that is incorrect or provide evidence to show that it is incorrect. Instead, her entire rebuttal is an ad hominem against The Lancet‘s editors. Admittedly, they didn’t exactly cover themselves in glory by publishing the Surgisphere study, but they did retract it pretty darned fast when its fraud was made plain. Still, let’s just say that RFK Jr.’s “admirer” doesn’t cover herself in glory either, posting nonsense regressions:
One is tempted to invoke the graph showing that the lack of pirates cause global warming. She might as well have just posted that. Amusingly, she concludes by saying, “And don’t get me started on glysophate,” to which I reply: Why not?
Seriously, though, there is a much more egregious offense for which The Lancet richly deserves criticism. I thought of it immediately and then saw that Vince Iannelli had beat me to writing about it in a post entitled A Reminder That The Lancet is Partly to Blame for the Destruction That Kennedy Has Wrought. Yes, The Lancet arguably turbocharged the latest iteration of the antivaccine movement when in 1998 it published Andrew Wakefield’s fraudulent paper relating the MMR vaccine with an increased risk inflammatory bowel disease and autism, leading Dr. Iannelli to produce this awesome parody of the cover of the issue of The Lancet in which the editorial was published. I hope he doesn’t mind if I “borrow” it:
Dr. Iannelli notes:
No, I’m not saying that The Lancet is solely responsible for creating the modern anti-vaccine movement…But Andy Wakefield’s 1998 ‘study’ that was published in The Lancet, and the media frenzy that went with it, was certainly a big trigger.“I cannot ask one who supports the controversial paper to read this posting and change your mind and unring the bell that the Lancet article clanged in 1998. It would be naive of me to claim that no vaccine has ever been correctly associated with causing a particular disease. However, in this case, what Wakefield and Lancet did in 1998 is akin to screaming fire in a crowded theater. Without proper medical and scientific research to support his findings, he and Lancet acted irresponsibly by releasing such information without proper “fact-checking” as we call it these days.”
Making Sense Of Dr. Andrew Wakefield Now
Without a doubt. Andrew Wakefield is a foundational figure of the 21st century antivax movement. So is RFK Jr., who first “came out” as an antivaxxer in 2005 with his conspiracyfest of an article Deadly Immunity. The two men formed two pillars of the modern antivax movement, Andrew Wakefield popularizing the fear mongering pseudoscience falsely claiming that the MMR vaccine causes autism and RFK Jr. popularizing the fear mongering pseudoscience blaming autism on the mercury-containing preservative thimerosal that was, until around 2001, in many childhood vaccines. In the case of RFK Jr., Salon.com and Rolling Stone enabled his conspiracy mongering by co-publishing his article. In the case of Andrew Wakefield, The Lancet enabled his conspiracy mongering by publishing his fraudulent case series. Which is worse? It’s bad when popular entertainment and news magazines publish pseudoscientific conspiracy theories, but it’s orders of magnitude worse when an academic journal enables pseudoscientific conspiracy theories. Eventually, of course, as antivaxxers tend to do, RFK Jr. embraced Wakefield’s pseudoscientific claims that MMR causes autism, and, of course, Wakefield embraced RFK Jr.’s fear mongering about thimerosal in vaccines causing autism. I like to call this crank convergence, although Mark and Chris Hoofnagle called it “crank magnetism.” Worse, these two men have arguably been the most influential leaders of the 21st century antivax movement.
As Dr. Iannelli points out, too, The Lancet knew that Wakefield’s paper had a lot of problems:
But weren’t they fooled into publishing it too?Although Wakefield’s fraud wasn’t uncovered until later, we saw immediate criticism of the study!“By publishing Andrew Wakefield and colleagues’ work purporting to show a link between MMR vaccination and inflammatory bowel disease and autism and related problems you give increased credence to their report. The Lancet is a prestigious, peer reviewed journal with high public profile. The profession, journalists, the public, and especially distressed parents of ill children suppose that a publication in your journal will be true. In this example you print a commentary, which if it had been a peer reviewer’s report, should have led to the rejection of the paper.”
Correspondence Autism, inflammatory bowel disease, and MMR vaccine
AJ Beale
And:
The Lancet actually knew about all the problems with Wakefield’s study, and they published it anyway! Problems that were spelled out in a commentary, Vaccine adverse events: causal or coincidental?, that was published in the same issue. Not only that, but they doubled down on their decision to publish Wakefield’s study!But this was nearly 30 years ago…“First, the decision to publish. There was no question in my mind that, subject to external peer review and editorial debate, we should publish this work.”
Autism, inflammatory bowel disease, and MMR vaccine
Editor’s Reply“Finally, what has been the outcome? In particular, has harm been done?”Shouldn’t we just let it go by now?Autism, inflammatory bowel disease, and MMR vaccine
Editor’s Reply
As Dr. Iannelli said, “Not on your life!” Yes, it’s been 28 years, but the damage persists.
One also notes that The Lancet didn’t formally retract Andrew Wakefield’s study until February 2010, a full twelve years after its publication, that despite many criticisms and only after the UK General Medical Council ruled that Wakefield had “acted ‘dishonestly and irresponsibly,’ and showed ‘callous disregard’ for the suffering of children involved in his controversial research.”
You might wonder: Why am I ragging on The Lancet 28 years after it published Wakefield’s fraudulent paper and 16 years after it was finally dragged into doing the right thing and retracting that paper? After all, it’s on the right side of science now, isn’t it? In this case, yes it is. However, its editors have never acknowledged their role in turbocharging what before Wakefield had been a fringier than fringe movement by giving it the oxygen of seeming scientific support and then taking years to rectify their mistake. The editors of The Lancet are definitely correct in their characterization of RFK Jr. and the damage that he’s done to US public health and biomedical research in just one year, and for that I commend them. However, I do wish there had been some acknowledgment that medicine itself, and also The Lancet itself, had enabled this destruction.
Jessica Rose might attempt to discredit The Lancet‘s harsh evaluation of RFK Jr.’s tenure as HHS Secretary thus far, but she chose the wrong failure by its editors, and that leads me laugh at her. What I can’t laugh at is the Wakefield affair, a seminal event that helped shape the modern antivaccine movement and provide it with the tools to be where it is today, with RFK Jr. in a position to make vaccines increasingly scarce in the US based on bad science, pseudoscience, and conspiracy theories.