If he can make it past the Senate, Robert F. Kennedy Jr. will be the next secretary of Health and Human Services. Since the position was created, each secretary has had significant experience in public health, health care administration, or related government work. None has listed “spreading vaccine misinformation” as their primary health care experience.
While in this position there will be some limits to Kennedy’s power — some actions require congressional approval, or are statutorily tied to the peer review process. Nevertheless, as a scientist who has studied and written about the anti-vaccine movement, I am deeply concerned, particularly because some have already started to whitewash his positions on vaccination.
Kennedy has said he would like to eliminate entire departments, such as the nutrition department at the FDA. He believes that health problems are caused by “seed oils, and pesticides,” and wishes to use the mechanisms of government to eliminate these from the American diet. In a post on the X, once known as Twitter, he wrote that he wants to end the FDA’s “war” on raw milk, chelating compounds, anti-parasite drug ivermectin, and sunshine — although it is not clear why he believes that the FDA has been at war against sunshine. He has long been concerned about heavy metal exposure, publishing a 2014 book warning of dangers from mercury in vaccines (although the mercury compound he was referencing had been removed from almost all childhood vaccines 15 years prior).
Perhaps most concerningly, in 2005, Kennedy wrote an article initially published in Rolling Stone and Salon, and subsequently retracted, about a 2000 CDC meeting to discuss weak evidence of risks associated with thimerosal (a vaccine adjuvant used at the time), where scientists expressed concerns that lawyers would exploit that to bring lawsuits. Kennedy mischaracterized the meeting as secret and described it as a coverup intended to keep the truth about thimerosal from the public — indications that he may use his position as secretary to fire, investigate or persecute civil servants and public officials through bad faith misinterpretations of documents he will have access to.
Kennedy likes to say that he isn’t anti-vaccine and just wants them to be safe. Anti-vaxxers seldom self-identify as such, but his words and action make the truth clear: Kennedy is an anti-vaxxer who has been extremely prolific in promoting anti-vaccine views. His speech and writing have consistently undermined public confidence in immunization. His lawsuits have fought to share misinformation and expand vaccine exemptions. If someone consistently opposes vaccination, promotes vaccine misinformation, and works to dismantle vaccine programs, then the label “anti-vaxxer” fits, regardless of how they describe themselves.
In the early 2000s, when anti-vaccine sentiment entered a boom cycle (such sentiment has waxed and waned since the discovery of the first vaccine), some anti-vaxxers began to self-describe as “vaccine skeptics,” appropriating the term for those who require evidence before adopting beliefs. However, wholesale rejection of a variety of technologies that enhance immunity against a variety of disease states is the opposite of being willing to update one’s beliefs to fit the available evidence. Some news sources have adopted the term “vaccine skeptic” from anti-vaxxers, perhaps because it sounds more neutral. But the truth is undeniable: Kennedy is an anti-vaxxer.
Not just an anti-vaxxer, Kennedy’s Twitter account is one of the most prolific spreaders of anti-vaccine misinformation. His anti-vaccine group, “Children’s Health Defense” (formerly “World Mercury Project”), has a history of targeting minority communities to exploit existing social tensions to spread fear of vaccination. It was also one of two organizations funding the majority of anti-vaccine advertisements on Facebook. Kennedy has spread false claims linking vaccines to autism, promoting spurious health claims, casting doubt on HIV being the cause of AIDS, claiming that Covid-19 was ethnically targeted to spare Ashkenazi Jews and Chinese people, and other bizarre, false, baseless and unevidenced claims. Indeed, nearly every instance of a health claim I can find made by Kennedy falls somewhere between false and misleading. Kennedy is one the world’s most prolific anti-vaxxers.
Why would someone with an ideological ax to grind against vaccination, and no other history with medicine or public health, seek to become the Secretary of Health and Human Services? We can reasonably speculate that it is because that position is the biggest grindstone around. His new appointment will give Kennedy both a larger platform from which to pursue his crusade, and a position of power from which Kennedy can reshape federal public health programs. What power will he have to directly influence federal vaccination programs?
The Public Health Service Act gives the secretary of health and human services direct authority to periodically establish and disseminate vaccination guidelines. The secretary also has responsibilities to appoint program leadership. The Social Security Act gives the secretary control over the Vaccines for Children program, and sets purchasing and distribution policies to state programs. The secretary can appoint the director of the National Vaccine Program Office, which develops the national vaccine plan and monitors vaccine safety, among other duties. Overseeing the FDA, the HHS secretary can appoint leadership, direct enforcement, and declare (or not declare) public health emergencies. The secretary can also influence the National Vaccine Injury Compensation Program (VICP) through changes to the vaccine injury table, or changing compensation parameters. The HHS secretary also influences the research priorities of the NIH through strategic appointments, although funding decisions will still occur through the peer review process.
Beyond these direct powers, the secretary sets a tone for the agencies under his authority, which will have potential impacts on morale and retention, international cooperation, and most importantly, public trust.
In 1964 the historian Richard Hofstadter won the Pulitzer Prize for his book “Anti-Intellectualism in American Life,” which identified the American populist tradition of opposition to intellectuals “blinded by abstractions and dead to common sense,” hostility toward expertise being framed as democratic resistance to authority, and religious tone and simplicity as the antipode to complexity and nuance, allowing anti-intellectuals to masquerade as alternative experts. The apotheosis of Kennedy is the apotheosis of anti-intellectualism in American medicine, where the fierce outsider fighting the medical establishment has ascended the hierarchy, where he can work to destroy what others have built.
Jonathan Berman is author of “Anti-vaxxers: How to Challenge a Misinformed Movement” (MIT Press 2020) and was a national co-chair of the March for Science in 2017.