WASHINGTON — Last month, before he called it quits on a presidential run, Robert F. Kennedy Jr., ran social media ads asking, “Is America sicker than it’s ever been?” The link led to a four-question quiz about major health issues including diabetes, autism, drug overdoses, and obesity.
The quiz highlights what has become a central focus of Kennedy’s political life: chronic disease, particularly among children. In joining the Trump transition team, the former hardcore environmentalist is also pitching himself as a public health guy — and trying to distance himself from the anti-vaccine rhetoric that’s made him famous.
Here’s how Kennedy might influence Trump’s health policy should the former president win a second term, and what health experts have to say about Kennedy’s theories on the roots of pediatric chronic illness.
RFK’s history of anti-vax messaging
The potent combination of Kennedy’s longtime vaccine theories and former president Trump’s openness to them could spell a new era for immunization policy.
For decades, Kennedy has pushed the unfounded theory that vaccines cause autism. He founded a nonprofit, Children’s Health Defense, to promote the same message and equip generations of American mothers with the tools to reject inoculation for their children. Study after study has failed to find evidence of a link between vaccines and autism. So his group’s message broadened to link vaccines to other conditions, including autoimmune disease, allergies, and ADHD.
“Studies link vaccines and toxic vaccine ingredients to a wide range of adverse health outcomes, including seizures, neurodevelopmental disorders and infant death. As the medical, public health, and government circles remain silent on the social and economic fallout from these toxic exposures, American children have never been so sick,” reads the “Science” section of the Children’s Health Defense website.
But his nonprofit, at which his current title is chairman-on-leave, connects many of his talking points to misleading articles and studies claiming vaccines are the cause. Kennedy frequently mentions autism, asthma, food allergies, and ADHD when discussing increases in childhood diseases — the same conditions he has for years argued, without evidence, may be triggered by vaccines. He has also claimed Covid vaccines were not effective and put people at higher risk of severe disease and death. Data show the opposite, and go even further: suggesting vaccination may lower people’s risk of developing autoimmune diseases and long Covid.
Kennedy has a sympathetic ear in Trump. The two discussed vaccines in a leaked video from earlier this year, which shows Kennedy listening to Trump as he criticizes vaccine policies and refers to earlier talks between them.
“I agree with you, man. Something’s wrong with that whole system, and it’s the doctors you find,” Trump says on speakerphone. “When you feed a baby, Bobby, a vaccination that is like 38 different vaccines, and it looks like it’s meant for a horse, not a, you know, 10-pound or 20-pound baby.”
This isn’t the first rendezvous between Kennedy and the former president. In 2017, he claimed Trump would “soon appoint him to head a commission on vaccine safety and scientific integrity.” That group never materialized. This time around, Kennedy seems to be having more luck pitching himself. His former running mate, Nicole Shanahan, has also said Kennedy would make a good secretary of Health and Human Services.
Like Kennedy, Trump has suggested drugmakers have undue influence — and incentive — to skip over the “tough questions” of what is causing rising health issues.
“We’ve seen a stunning rise in autism, auto-immune disorders, obesity, infertility, serious allergies, and respiratory challenge,” he says on his campaign website. “It is time to ask: What is going on? Is it the food that they eat? The environment that we live in? The over-prescription of certain medications? Is it the toxins and chemicals that are present in our homes?”
In a second administration, Trump would establish a presidential commission “charged with investigating what is causing the decades-long increase in chronic illnesses,” the website states.
The commissions will include “independent minds who are not bought and paid for by Big Pharma,” he said in a corresponding video. Trump also nodded to chronic health in his campaign platform, known as Agenda 47. “Republicans will support increased focus on chronic disease prevention and management,” according to the 16-page document.
Should Kennedy play a role in a new Trump administration, it could shake Americans’ already-eroding confidence in shots, particularly the Covid-19 vaccines. Many Americans still believe that the safety and benefits of measles, mumps, and rubella (MMR) vaccines — the target of autism and chronic health conspiracies in the 1990s — outweigh the risks. But their confidence falls off notably for coronavirus shots: Just 62% of Americans believe their benefits outweigh risks, according to Pew Research polling last year. Kennedy said in an interview this month that he would not give his children the MMR vaccine if presented with the opportunity again.
“Having lived through Covid, and seeing the importance of vaccines, my hope would be that some of this could be behind us,” said Ian Lipkin, an epidemiologist at the Columbia Mailman School of Public Health who has sought to dismantle anti-vaccine arguments. “But it continues to rear its head” with Kennedy joining the Trump team.
Relaunching Kennedy’s health agenda
Kennedy has presented himself in recent months as a champion for children’s health, and someone who can figure out how to slash the national debt by improving Americans’ well-being. He vows to exorcise corporate greed from regulatory agencies, and clean up the water, air and food supply.
He’s argued that federal agencies, such as the Food and Drug Administration, the National Institutes of Health, and the Centers for Disease Control and Prevention are puppets controlled by big industries. “The most profitable thing today in America is a sick child,” Kennedy said this month on FOX News. The Children’s Health Defense has started a project to “root out corruption” in the development of pharmaceuticals, an issue Kennedy often mentions in interviews and speeches. The project has among its goals the banning of pharmaceutical advertising and reinstating full vaccine manufacturer liability for injury claims.
He has also argued that the FDA is unduly influenced by pharmaceutical companies because drugmakers pay fees to the agency. These “user fees” supplement the budget allotted by Congress to the FDA each year.
“There is no direct connection between a fee paid to submit an application and the review outcome for that application,” the agency states on its website. “Rather, the user fees…are authorized by Congress to help the FDA fund payroll and related costs to deliver on program goals.”
Overhauling the user fee structure could throw billions of dollars of the FDA’s budget into jeopardy. The industry payments account for more than $3 billion of the agency’s budget this fiscal year, or 45% of the total.
If Trump pulls from Kennedy’s playbook, the FDA would also be on the hook for requiring part of more extensive safety studies for vaccines. Kennedy has argued repeatedly, in press interviews and his 2023 book, “Vax-Unvax,” that federal drug regulators do not require follow-up on “acute and long-term adverse effects” of childhood immunizations.
This is nothing new: Kennedy has repeatedly asserted that vaccines aren’t required to undergo as rigorous of testing as other pharmaceutical products. In a 2017 interview with STAT, he claimed vaccine safety tests only last a few days or weeks, and that vaccines aren’t studied against placebo.
Implementing the RFK game plan
In other remarks and campaign materials, Kennedy has stated a desire to change the NIH’s research focus away from infectious disease and toward chronic disease prevention, with an emphasis on “toxic chemicals (PFAS, glyphosate, neonics, etc.), air and water pollution, microplastics, electromagnetic pollution, ultra-processed foods, and pharmaceutical products.” Neonics are a kind of insecticide, and electromagnetic pollution refers to the currents emitted by devices, such as computers, televisions and cellphones.
Kennedy has also brought up the idea of taking legal action against scientific journals for “publishing fake science to promote the mercantile ambitions” of various industries, including food and pharma. Forcing journals to publish more studies on the unconventional “root causes” of chronic disease would give people the evidence they need to go after industry, he said. “You can’t sue a company for making your children fat, for poisoning them so that their microbiome doesn’t work anymore,” Kennedy said in a video on his campaign website. As a lawyer, Kennedy took part in the Monsanto lawsuit that alleged glyphosate in the weed-killer RoundUp was causing cancer and other diseases.
What children eat appears to be a major focus for Kennedy, and an interest he and Trump share, Kennedy said on FOX News. Reforming the food supply is something “Trump wanted to work on,” according to a long phone call and two meetings the two candidates had in recent weeks, Kennedy said. “One way or the other, I’m going to be fighting to get this stuff out of our food.” It may appear an unlikely coupling, considering Trump is famously fast-food-loving, and his campaign reportedly spent $4,700 at McDonald’s in the month of May.
Fact-checking claims on the roots of childhood chronic disease
Experts in pediatric disease told STAT that it’s true that diagnoses of chronic health conditions have increased in the past several decades. More children are being diagnosed with diabetes, developmental disabilities, asthma, mental health issues, food allergies, and other illnesses. The global prevalence of obesity has tripled since a sharp uptick beginning in the 1980s. But the numbers don’t reflect one of Kennedy’s favorite figures: That 60% of children in the U.S. are disabled by chronic disease.
Some estimates of pediatric chronic disease prevalence go as high as 20%. Many diseases and disorders don’t rise to the level of a severe disability. If mild chronic conditions are added in, the number may rise to about 40% of children. Less than 2% of children in the 1970s had severe conditions that interfered with daily life, according to national survey data. Those are dramatic increases in just a few decades, but not to the level Kennedy claims, said James Perrin, a Distinguished Chair in Pediatrics at MassGeneral Hospital for Children.
It’s difficult to know what share of those increases are a result of better, more consistent screening, clearer diagnostic criteria, or simply more awareness among patients and clinicians. For example, rates of autism that were calculated for the first time in the 1960s sharply increased in subsequent decades, once diagnostic criteria were expanded and there were more studies of prevalence around the world.
Genetics are thought to play a role in disease risk. Many parents are having children later in life, increasing the risk of birth complications and genetic disorders, said Lipkin. Environmental factors like air pollution and diet also contribute, researchers say, but there are others Kennedy hasn’t mentioned that may be driving a larger share of cases. Studies have found that the more negative early-life experiences a child has, the more likely they are to have a chronic condition.
Adverse childhood experiences, such as abuse, neglect, discrimination, poverty, the incarceration of a relative and living in unsafe neighborhoods, are important predictors of health problems — and they can be addressed, said Christina Bethell, founding director of the Child and Adolescent Health Measurement Initiative at the Johns Hopkins University Bloomberg School of Public Health. “We have the opportunity to promote health and prevent [disease] but our programs are not well-supported, and evidence is not making it into practice due to lack of investment,” she said.
Medicaid and the Children’s Health Insurance Program, which insure about half of all kids in the U.S., are under-financed, Perrin said. Pouring money into those programs would be supportive of children’s health.
Other research suggests improving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) could help prevent obesity, which is a risk factor for numerous other illnesses. Data show children with chronic conditions tend to have more than one disease.
Better housing would also go a long way, experts told STAT. And, finally, expanding the child tax credit that slashed child poverty rates to a historic low of 5% during the pandemic would also improve children’s health. (Senators killed a bipartisan attempt to do just that.)
With so many factors shaping the health of American children, it is impossible to pin trends in chronic health on broad childhood vaccination that even skeptics acknowledge will prevent serious infections such as measles and pertussis. Yet the anti-vaccination movement continues to come up with new claims.
“It’s like whack-a-mole. They come up on one side and you take care of that, and then they pop up someplace else,” said Lipkin. “They just keep moving the goalposts.”