Secretary Kennedy's fever dreams are coming true. Will President Trump let him destroy his major first term achievement?

Getty Images / David Espejo.

Health Secretary Robert F. Kennedy Jr.’s idea for improving American health goes something like this: Distract you with “victories” on nutrition. Undermine vaccines.

Spoiler: This is not going to make America healthy again. Vaccines have saved millions of lives. Banning additives that Kennedy’s movement is obsessed with won’t. We simply aren’t going to fry our way to better health outcomes using beef tallow instead of seed oils every time someone has a hankering for a churro cheesecake or a “Bloomin’ Onion.”

As metabolism researcher and registered dietitian Dr. Kevin Klatt said in a group chat the other day (with more detail on X/Twitter), “I love that we are splitting nutritional hairs over which oils to fry our foods in. Like, hmmm, maybe 800-calorie fries with a day’s worth of sodium aren't great for you regardless of the oil choice.”

Preach!

So, two currents caught my attention this week. First, the “anticipated” MAHA report has been delayed. (The 180-day deadline that President Trump announced back on February 13 was just missed this week.) According to The New York Times, this is partly due to infighting over what to include in the plan. Apparently, real life is more complicated than Kennedy imagined. For example, it turns out you can’t just ban pesticides.

Second, anti-vaccine sentiments were spewing out of the Trump administration on multiple fronts this week. The remainder of today’s Inside Medicine explores what was a banner week for anti-vaxxers at the hands of Secretary Kennedy, but enabled by his more-qualified deputies.

Exhibit A: Silence on the CDC shooting.

Still nothing from the White House on the 500-bullet shooting at the CDC that was stoked by anti-vaccine sentiments. Don’t forget that this attack killed a police officer, David Rose. Now, you’d think that violence against law enforcement would be the kind of thing that President Trump would care about. But you’d be wrong.

I can tell you that the HHS employees I have spoken with are incensed. Many of them see last Friday’s shooting as (to paraphrase a journalist I was chatting with yesterday) “January 6^th for public health.” (I thought this was apropos, as law enforcement was again lethally attacked, and the Trump administration’s response was not only astonishingly slow, but weak.)

In the absence of any kind of strong response from the Trump administration, former officials have spoken out. Dr. Jerome Adams, the former Surgeon General during President Trump’s first term, called out Secretary Kennedy’s slow, milquetoast response in STAT News.

Over on LinkedIn, CDC Director Dr. Mandy Cohen had this to say:

Finally, Dr. Paul Friedrichs, who ran the White House Office of Pandemic Preparedness and Response (which, by the way, is basically nonexistent now that Dr. Gerald Parker resigned once he realized he was captain of a ship with no crew) skewered the lack of leadership from the Trump administration overall.

Exhibit B: Attacking mRNA vaccines, but blaming others for said attack.

Earlier this month, it was announced that the US government would begin a “coordinated wind-down of its mRNA vaccine development activities.” Not to put too fine a point on it, but this is a terrible idea.

Now, rather than saying nothing—which was an option!—NIH Director Dr. Jay Bhattacharya again chose to serve as a feckless consigliere for Secretary Kennedy’s worst instincts. Jay also could have stood up for vaccines, perish the thought. Instead, in an unusually poorly reasoned Washington Post opinion, Bhattacharya argued that mRNA vaccines should not be studied because there is not sufficient public trust in them. This is intellectually destitute. Science is not subject to popular opinion, but to data. It seems like Jay might have argued that it would have been better to stick with the idea that the Earth is the center of the solar system back when heliocentrism hadn’t quite caught on yet. “No matter how elegant the science, a platform that lacks credibility among the people it seeks to protect cannot fulfill its public health mission,” he wrote.

Really principled stuff, lol. But even that wasn’t enough. He then blamed the Biden administration for damaging public trust in the vaccine. This is rich, given that his circle of friends amplified rare (but real) adverse events from mRNA vaccines in some populations, while barely acknowledging their historic achievements. Even in this shoddy Washington Post piece, he quibbled about how many millions of lives the vaccines saved. A recent study by one of his buddies suggests that “only” 2.5 million lives, rather than 14 million that some other models suggest. Even if the lower number were closer to the truth, it would remain an astounding contribution.

“I am not here to litigate the past. I am here to chart a better path forward,” Bhattacharya wrote. Memo to the Post editorial staff: He just did. This is sloppy rhetorical gaslighting that is beneath your historical standards.

“That is why the NIH, under the leadership of HHS Secretary Robert F. Kennedy Jr., is investing in new vaccine technologies—based on whole-virus inactivated vaccines…” he continued.

Cool. But if we really want to do science well, we have to explore all the options, not just the ones that current HHS leadership hasn’t gotten around to demonizing yet. As they say…

“We will move forward with scientific rigor, transparency and humility. At the NIH, we will fund promising research based not on hype, but on evidence.” Humility is more than just saying the word humility. Humility is recognizing that we do not know which of many good ideas will turn out to work. That’s why we try lots of things. That’s how science works. So, I ask again, “¿Por qué no los dos?”

Bhattacharya finished by saying that disagreements are welcome. More sloppy reasoning. It’s an empty statement because he’s already let his boss decide which vaccine platforms we should study. So yes, I disagree. But the only way to determine which vaccines are best is not to disqualify one based on politics. The way forward is to fund all of this—including the vaccines that current HHS leaders relentlessly undermined in order to ascend to power.

Exhibit C: RFK Jr. expands his hunt for vaccine problems.

Yesterday, HHS announced that it would revive its Task Force on Safer Childhood Vaccines. Obviously we want all medical interventions to be safe. But under Secretary Kennedy, we know what this type of action means: more attacks on vaccines. As the New York Times story on this reminded us, Kennedy founded a group called the “Children’s Health Defense,” an influential anti-vaccine organization.

Exhibit D: Pfizer’s pediatric Covid-19 vaccines may get yanked.

It has been reported that the FDA may revoke its emergency use authorization (EUA) for Pfizer’s pediatric Covid-19 vaccine. This could make it much harder for healthy children to receive the vaccines—including the primary series. Recall that when Moderna received its “full” FDA approval for its pediatric Covid-19 vaccine, the action actually meant that the FDA’s approval applied to fewer children (i.e., only children with certain health conditions) than had been covered by the previous EUA (i.e., all children)—an irony, to say the least. But Pfizer’s pediatric Covid-19 vaccine has not yet received “full” FDA approval, and therefore remains available under EUA. Technically, that means the FDA’s full approval for Moderna’s pediatric Covid-19 vaccine encompasses a small number of children, while its EUA for Pfizer’s vaccine still covers all kids. Fun times!

So, barring changes, until Pfizer gets “full” FDA approval for its pediatric Covid-19 vaccine, the shots would continue to be available to all kids under the broader EUA. That’s why the news that the FDA may revoke the EUA for Pfizer’s shots is important—it would remove the FDA’s go-ahead on Covid-19 vaccines for most children, including infants who have hospitalization rates that exceed most non-geriatric adult age groups.

Now that Dr. Vinay Prasad has returned to the FDA, his previous rationale for the limited approval of Moderna’s pediatric vaccine is again worth exploring, as it may well be applied to Pfizer next. So, I’ll tidy up that analysis and get it to you soon.

Overall, this was a marquee week in the Trump administration’s surrender to Secretary Kennedy’s anti-vaccine fever dreams come true. I’m still hoping that President Trump will eventually realize that Kennedy is undermining the main achievement from his first administration: our great leap forward with mRNA vaccines.

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If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.