Robert F. Kennedy Jr. can use significant authority to directly affect how and what Americans get vaccine national, current and former Federal health officials said, if confirmed next year for the head Department of Health and Human Services under President-elect Donald Trump.
The position will give Kennedy authorization for efforts like the Vaccines for Children program, which is estimated to save 1.1 million lives by immunizing children against diseases like polio and measles which is now rare thanks to the shots.
Many public health experts reject the option, saying Kennedy’s claims about vaccines are disqualifying.
“A serious candidate for this position will follow decades of real evidence that shows that vaccines are safe and prevent 5 million deaths every year,” said Dr. Georges Benjamin, executive director of the American Public Health Association, on Monday. in the statement.
Is RFK Jr. anti-vaccine?
Kennedy insists he is not “anti-vaccine” and has promised not to try to ban the shots under the Trump administration — but he has a long record. misleading claims about vaccines and skepticism about proven benefits and safety.
He wrote a now-retracted article in 2005 wrongly claiming autism was linked to discontinued vaccine ingredients, and went on to say he thought vaccines were the cause of autism, which decades of scientific research has discredited.
On social media, Kennedy called the COVID shot a “crime against humanity” and said children don’t need the COVID vaccine. (Research estimates that the COVID vaccine could prevent 3.2 million deaths in the U.S. through 2022.)
The group he leads, Children’s Health Defense, has been criticized by experts for being among them most productive spreading false information about vaccines.
In recent months, Kennedy has said his goal is to “provide the American people with transparency and access to all the data so they can make informed choices.” He also wants to clean house at the federal health agency, ousting “corrupt” officials he claims have destroyed “a rich tradition of science based on the gold standard.”
At the head of the FDA’s vaccine program said he hoped Kennedy would “open his mind” to what science showed him.
“Perhaps participating in the dialogue, especially if it is in a public place, may help. It may help to bring some other countries because sometimes people are convinced, maybe some other countries will be there. , “Dr. Peter Marks, head of the FDA’s Center for Biologics Evaluation and Research, said earlier this month.
CDC recommendations and cover charges
One of the biggest roles the CDC plays in vaccination is deciding whether vaccines should be covered by health insurance. Nearly all plans are required by law to cover routine shots recommended by the Advisory Committee on Immunization Practices.
Updating the recommended vaccine “schedule” is usually a months-long process for the committee, which includes medical experts who work to analyze and vote publicly on the benefits and risks of various shots.
The meeting happens at least three times a year, because the committee debates the newly approved vaccine, the annual update for routine shots like influenza or COVID 19 and reevaluate data on older immunizations.
“They combine epidemiology. Which groups are most affected? Are there certain subgroups that are most effective? Are there some groups that do not benefit greatly from certain vaccines,” said Dr. Carolyn Bridges, former CDC associate director for adult immunization.
Bridges, who is now a consultant on adult vaccination, praised the “public discussion and frequent debate” among the experts selected to serve on the committee.
Civil servants career CDC which is traditionally able to provide input to which experts are selected for the panel, and federal law says the members of the committee must be “sufficiently balanced in terms of point of view.”
However, it will be Kennedy’s decision to decide who will be on the committee. Kennedy’s choice to head the CDC would also have the authority to override the panel’s vote, as it has done in 2021 to roll out some COVID-19 booster shots.
The panel’s recommendations have far-reaching implications beyond insurance coverage, Bridges said, affecting the way doctors and local health departments talk about and prescribe the shot.
Kennedy and his choice to lead the CDC may also affect the agency’s immunization work in other ways.
For example, the agency is responsible for the Vaccines for Children program that provides shots to pediatricians nationwide to ensure access at no cost to uninsured children. It is also a routine action to address confusion among providers regarding vaccine recommendations.
The CDC also runs a major national data source that tracks immunization rates, vaccine effectiveness for some common shots and monitors ongoing vaccine safety.
“It’s really the integration of all that. There’s a lot that goes into this – policy, monitoring, coordination, communication,” said Bridges.
FDA approvals and regulations
Kennedy and whoever is chosen to lead the FDA will also have a large role in the approval of the vaccine and regulating it once it is on the market.
Decisions about approving or rejecting applications from vaccine manufacturers are usually left up to them career scientist work at the Center for Biological Evaluation and Research. That is usually guaranteed only by norms, not laws.
“It is totally in the law for the president or the secretary of HHS to overrule the entire FDA. And so, that can happen. Does it happen to me? No. But I also want to say, I think there is a clear line. between politics and science, we got speak truthfully about this,” FDA Commissioner Dr. Robert Califf said November 11, speaking at an event hosted by Friends of Cancer Research.
Califf said that “99.95% of FDA decisions on individual products” are made by civil servants with scientific expertise in the field. But commissioners are sometimes forced to get involved, happy to resolve internal disputes or appeals from outside the agency.
Kennedy and the FDA commissioner can also influence vaccines in other ways, such as through the agency’s guidance of issues to manufacturers seeking approval.
Policy changes recommended by agency staff may stopped or rejected by political leaders. Major changes to FDA regulations are also channeled through the White House, which has the ability to block them.
“There are many other aspects of this that are combined in various ways with politics. And there is no way we can do that,” Califf said.
Communicate risks and benefits
Beyond Kennedy’s direct authority over vaccines, another major way he was chosen and elected to lead the CDC and FDA was to influence public opinion by talking to Americans about the risks and benefits of vaccines.
The department is funding several efforts to examine public confidence in vaccines and study ways to improve them. They also run several campaigns to promote recommended shots, such as annual advertising COVID-19 and flu vaccines or help the health department respond retreat the level of immunization in schools.
“We don’t have to look back to see what happens because of vaccination rates, when there are no requirements and people don’t have access,” said Bridges, expressing a cases of polio which appeared in New York in 2022.
Polio outbreak it once killed thousands of Americans and left many survivors paralyzed, until the disease was nearly eradicated in the US with a vaccine first introduced in the 1950s.
At back from polio It led to an investigation by health authorities and a new push for vaccinations, although officials admitted they were struggling to “raise” immunization coverage.
“It’s just mind-boggling that we can have a resurgence of polio, in a country with all our resources. It doesn’t take all that much for the disease to still circulate in other places holding back,” said Bridges.
Another method of the communication role is to navigate how to explain the potential risks identified by the federal vaccine safety system to doctors and the public.
An example was last year after FDA and CDC officials worked to create a bulletin that announced early concerns that the COVID-19 shot could increase the risk of stroke for the elderly, while also explaining why early “safety signals” did not warrant stopping the use of the shot.
A review of the issue by U.S. and foreign health authorities ultimately found “no evidence of safety concerns,” although health authorities continue to study the issue.
The vaccine’s benefits continue to outweigh these theoretical risks, CDC advisors concluded, especially among older adults who are at risk of severe illness or death from COVID.
“Current evidence does not support the existence of safety concerns. FDA and CDC will continue to evaluate the available data and update the public as necessary,” said the FDA.
