robert f kennedy jr Could gain significant power to directly influence how and what Americans receive vaccines Nationwide, current and former federal health officials say, if he is confirmed next year Grow The Department of Health and Human Services under President-elect Donald Trump.
will provide position Kennedy authority on efforts such as the vaccine program for children, which is estimated Vaccinating children against diseases like has saved 1.1 million lives polio And measles This has become rare now because of the shots.
Many public health experts have condemned this selection, Kennedy says. past claims Are unqualified about vaccines.
“A serious candidate for this position will follow decades of real-world evidence that shows vaccines are safe and prevent more than 5 million deaths each year,” Dr. Georges Benjamin, executive director of the American Public Health Association, said Monday. Are.” one in statement,
Is RFK Jr. anti vaccine?
Kennedy has insisted 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 to make misleading Statements about vaccines and promoting skepticism about their proven benefits and safety.
he wrote now-withdrawn Article Falsely claimed in 2005 that autism was linked to a discontinued ingredient in vaccines, and continued to say he believed vaccines were a cause of autism for decades scientific research is completely Infamous,
On social media, Kennedy called COVID shots a “crime against humanity” and claimed that children do not need COVID vaccines. (Research Estimate That COVID vaccines could prevent 3.2 million deaths in the US by 2022.)
The group he chaired is Child Health Protection Condemned it To be among the experts most prolific Those spreading misinformation about vaccines.
In recent months, Kennedy Said Their goal is to “provide Americans with transparency and access to all data so they can make informed choices.” He also wants to clean up his standing at federal health agencies and oust “corrupt” officials he claims have tarnished “their rich tradition of gold-standard, evidence-based science.”
The head of the FDA's vaccine program says He hopes Kennedy will “keep an open mind” about what the science shows.
“Maybe engaging in that dialogue, especially if it's in a public space, can help. It can help bring some of the rest of the country together because sometimes when someone is convinced “So maybe, just maybe, some of the rest of the country will join in,” Dr. Peter Marks, head of the FDA's Center for Biologics Evaluation and Research, said earlier this month.
CDC Recommendations and Covering Costs
One of the CDC's biggest roles in vaccination is to decide which vaccines health insurers are required to cover. Almost all planning is required down by law To cover routine shots recommended by the agency's advisory committee on vaccination practices.
updating it “Schedule” The list of routinely recommended vaccines is typically a months-long process for the committee, made up of medical experts tasked with analyzing and voting publicly on the benefits and risks of different shots.
They meeting This happens at least three times each year, as the committee debates annual updates such as newly approved vaccines, routine shots influenza Or COVID-19 and reevaluating data on older vaccinations.
“They involve the epidemiology,” said Dr. Carolyn Bridges, former associate director of the CDC. “Which groups are most affected? Are there certain subgroups for which it is most effective? Are there certain groups that need a certain vaccine?” There may not be much benefit from it.” Adult vaccination.
Bridges, who now works as an advisor on adult vaccination, praised the “very public discussion and often very rigorous debate” among the experts selected to serve on the committee.
CDC's career civil servants have traditionally been able to provide input Which experts have been selected? To the panel and federal law They say Membership of the committee should be “fairly balanced in terms of viewpoint”.
But Kennedy alone would decide who would sit on the committee. Kennedy's selection to head the CDC would also have the power to override the panel's votes, as was done in 2021 To roll out some COVID-19 booster shots.
The panel's recommendations have broad implications beyond insurance coverage, Bridges said. Influences How doctors and local health departments talk and offer vaccines.
Kennedy and his selection to head the CDC could also affect the agency's broader vaccination work in other ways.
For example, the agency responsible for vaccines for children Program Which supplies shots to pediatricians across the country to ensure free access for uninsured children. It also takes regular steps to clear up any confusion among providers on vaccine recommendations.
CDC also runs tracking key national data sources vaccination rates, Vaccine effectiveness For some general shots and ongoing monitoring vaccine safety,
“It's really an integration of all those things. There's a lot involved — policy, monitoring, coordination, communication,” Bridges said.
FDA approval and regulations
Kennedy and whoever he picks to lead the FDA will also play a bigger role in approving vaccines and regulating them once they hit the market.
The decision to approve or reject vaccine manufacturers' applications is traditionally left to them career scientist Working in the agency's Center for Biologics Evaluation and Research. This is mostly ensured by norms, not by law.
“It's completely within the law for the President or the HHS Secretary to overrule the entire FDA. And so, that can happen. Did that happen to me? No. But I also want to say, I think the idea There's a sharp line between the political and the scientific, we have to be truthful about this,” said FDA Commissioner Dr. Robert Califf. Said November 11, speaking at an event organized by the Friends of Cancer Research.
Califf said that “99.95% of the FDA's decisions about individual products” are made by civil servants with scientific expertise in the field. But the Commissioner is sometimes forced to intervene, such as to resolve internal disagreements or appeals from outside the agency.
Kennedy and his FDA commissioners could also influence vaccines in other ways, such as when the agency issues guidance to manufacturers seeking approval.
Agency staff can make recommended policy changes to stop or rejected by political leaders. Major changes to FDA regulations also go through the White House, which has the ability to block them.
Califf said, “There are many other aspects of this that are integrated with politics in different ways. And there's no way around it.”
Communicating risks and benefits
In addition to Kennedy's direct authority over vaccines, another major way he and the people he chose to lead the CDC and FDA are influencing opinion is how they talk to Americans about the risks and benefits of vaccines. We do.
The department funds several efforts to survey public confidence in vaccines and studies ways to improve itThey also run several campaigns to promote the recommended shots, such as advertising about the annual COVID-19 and flu vaccines or helping health departments respond apostasy vaccination rates in schools,
“We don't have to remember very far back to see what happens to vaccination rates when the requirements aren't in place and people don't have access,” Bridges said, citing a quote. polio case which appeared in New York in 2022,
polio outbreak It once killed thousands of Americans and paralyzed many survivors, until vaccines first introduced in the 1950s nearly eliminated the disease in the US.
return of polio Investigation prompted by health authorities and fresh investigation to push As for vaccination, however, officials admitted they are struggling to “meaningfully increase” vaccination coverage.
Bridges said, “It's amazing that polio could reemerge in a country with all our resources. It doesn't take that long for diseases spreading elsewhere to reemerge.”
Another way communications plays a role is how to explain to doctors and the public about potential risks identified by federal vaccine safety systems.
An example came last year when FDA and CDC officials worked to develop a plan bulletin Disclosing early concerns that COVID-19 shots could increase the risk of stroke for seniors, while also explaining why the initial “safety signal” did not warrant stopping the use of the shots.
Ultimately the issue was thoroughly investigated by health officials in the US and abroad found “There is no evidence of safety concern,” although health officials are keeping a close eye on it study the issue,
CDC advisers say the vaccine's benefits outweigh this theoretical risk concludedEspecially among senior citizens who are at higher risk of serious illness or death from COVID.
“The current evidence does not support the existence of a safety issue. FDA and CDC will continue to evaluate data as they become available and will update the public as needed,” FDA Said,