How have RFK Jr.'s vaccine policies impacted America's public health?

0:00It was clear even before he got the job that Robert F. Kennedy Jr.'s tenure as Secretary of Health and Human Services would be defined by one question. Here's how Republican Senator Bill Cassidy laid it out during Kennedy's confirmation hearing. Does a 70-year-old man, 71-year-old man who spent decades criticizing vaccines and who's financially vested in finding fault with vaccines, Can he change his attitudes and approach now that he'll have the most important position influencing vaccine policy in the United States? Before he entered politics, Kennedy made a career out of stoking doubt about vaccines.

0:40He promoted theories contradicted by mountains of scientific evidence, like the idea that vaccines cause autism. And he suggested that many common vaccines, which have been studied for decades and administered to hundreds of millions of people, that they haven't been adequately tested, as he argued on Piers Morgan Uncensored on Talk TV. Therefore, we do not know what the risk profile for any of these products are. And we do not know. In the Senate, Cassidy ultimately concluded that Kennedy could change his attitudes and approach. He voted in favor of Kennedy's nomination. He said Kennedy promised to work within the current vaccine approval system and preserve information on the CDC website pointing out that vaccines do not cause autism.

1:29We need a leader at HHS who will guide President Trump's agenda to make America healthy again. Based on Mr. Kennedy's assurances on vaccines and his platform to positively influence Americans' health, It is my consideration that he will get this done. Democrats took a different view. Here's Senator Patty Murray of Washington State. Republicans are choosing to pretend it like it is in any way believable that RFK Jr. won't use his new power to do exactly the thing he's been trying to do for decades, undermine our vaccines. Well, six months into the Trump administration, RFK Jr. now has a track record we can dig into.

2:18Consider this. RFK Jr. promised he would not take away Americans' vaccines. Many medical experts say his changes are already chipping away at access.

2:33From NPR, I'm Mary Louise Kelly.

2:45It's Consider This from NPR. Robert F. Kennedy Jr. has already made big changes to vaccine policy. He's shaken up the process for vaccine recommendations and scaled back eligibility for COVID vaccines for a start. NPR health correspondents Rob Stein and Ping Huang are here to talk through what this will mean for Americans' access to vaccines. Hi, you two. Hey, Mary Louise. I want to start by just digging in on the COVID vaccines because they have been so much in the headlines these last several years. Rob, you kick us off. What is happening with the COVID vaccine? Yeah, so that's the huge first change that the Trump administration made under Kennedy.

3:27The COVID vaccines were becoming like the flu shot. You know, everyone gets an updated jab at least once a year. But Kennedy and his team are now saying only people most likely to get really sick should routinely get vaccinated. Only people age 65 and older or who have some health issue. That means a lot of people, a healthy 14-year-old, a 40-year-old, even a 64-year-old are no longer on the list. And Mary Louise, that's not all. The CDC dropped the recommendation that pregnant women get vaccinated and is now telling parents, wait, talk to your pediatrician first about whether you should vaccinate your healthy kids or not.

4:07Kennedy announced all this in the video on X. I couldn't be more pleased to announce that as of today, the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule. And that was a real bombshell. Hold on and stay on that word for a second. Bombshell. Why is it a bombshell? Is it bad policy? Ping? Well, this policy change really goes against what a lot of medical experts were thinking, especially the part about pregnant women who can get really sick from COVID. And also vaccinating pregnant women can protect their babies as well.

4:44And we know that COVID can be as dangerous to the youngest kids as it is to older people. Now, on the other hand, the Centers for Disease Control and Prevention had already been considering changing COVID vaccine policy to only recommend shots for people at higher risk of severe COVID. And you know, Mary Louise, the administration argues that so many people have so much immunity now that it makes sense to stop and rethink this, and that this will help rebuild trust in vaccines by the government requiring new evidence before telling most healthy people they still really need to keep getting shot after shot.

5:17And this would bring the U.S. in line with how lots of other countries do it. And the administration estimates that as many as 200 million Americans would still be eligible because they have, say, you know, a weak immune system, obesity, heart disease, even just sedentary lifestyles. So what kind of reaction are y 'all hearing, Ping? Yeah, well, in the public health community, some people are super alarmed about it, mostly because of the way it was done. So in the case of the COVID vaccines, it was RFK Jr. deciding who should and shouldn't be getting them and announcing it to the world, which bypasses this sort of, you know, multi-step expert vetting process that's been going on for decades in terms of how this gets done.

6:01So that was sort of the first thing. And then that was followed shortly by another move last month when RFK Jr. fired all 17 members of the CDC's Vaccine Advisory Committee. Now, you've probably heard of this. This is a group of outside experts. They usually have backgrounds in vaccines, immunology, pediatrics. And he's replaced them so far with seven new members that he picked. And many of them don't have the traditional medical or research background that these members typically have. But, you know, Mary Louise, in a rare interview with us just yesterday, the new chair of the committee, Martin Koldorf, defended the new members of that committee.

6:36There's been a lot of false news media about the members of the committee that we are somehow anti-vaxxers or so. But I think that's just kind of nonsense. There is misconceptions that we're not science-based, and I think that's complete nonsense. And he says the administration is focused on restoring trust in vaccines. Well, I think what has eroded trust in vaccines has been the way that the COVID vaccine was handled. Well, then they start questioning not just the COVID vaccine, but other vaccines as well. It's interesting that emphasis on trust and eroded trust, as we know, trust is so hard to build and so hard to regain once it's lost.

7:15Is it possible that these moves could restore trust in vaccines, Peng? Well, some critics like Dr. Yvonne Maldonado, she's a pediatrician at Stanford, one of the members of this committee that Kennedy fired. She says the administration's actions are actually having the opposite effect. We're dismissing science and facts, and we're accepting things on the basis of either no data or poor data or outright false data. And so that's what's confusing. Maldonado said that the tone of the new administration is to question the safety and efficacy of vaccines, even when that's been demonstrated over and over again.

7:55And she thinks that that actually undermines public trust, which was already declining, and it also undermines people's willingness to get vaccines. So just step back, Rob Stein, and setting aside the issues of undermining or building public trust, what are the actual real-world implications of these shifts? Yeah, so even though most people don't bother getting vaccinated against COVID anymore, many people still do want the shots. And RFK Jr.'s changes would mean that insurance wouldn't be required to pay for vaccinating some people, you know, like pregnant women, healthy, younger adults, and even possibly kids.

8:32Now, insurers might decide they want to anyway, but it would be a big change and adds to the uncertainty. I talked about this with Jennifer Nudzo, who runs Brown University's Pandemic Center. All of this is just unacceptable. It shouldn't be the case that people have to actively wonder whether they are eligible for a vaccine and whether they'll be able to get it. You know, people could still get vaccinated by paying for the shots themselves. But COVID shots are expensive, about$200 for each jab. Doctors' offices may stop stocking the vaccines. Pharmacists may be unable or unwilling to give you a shot because federal authorities aren't recommending it for you anymore.

9:12And then what about beyond the COVID vaccine? What about other vaccines? What changes are you tracking, Ping? Yeah, so currently, you know, in addition to the changes that we've been talking about with the COVID vaccines, HHS has also banned seasonal flu vaccines that contain thimerosal. That's a mercury-based preservative. And honestly, it really wasn't used that much. And so it's not a very big practical change, but it's being seen as a victory among people who have long questioned the safety of vaccines and have been pushing for many years this disproven theory that thimerosal causes autism.

9:48And there's also more on the horizon. Martin Kulldorff, who we heard from earlier, that's the Vaccine Advisory Committee chair, he made it clear that they're looking into the whole way we vaccinate kids, you know, with an eye towards reducing or spreading out the number of vaccines that kids get. And he also questioned specifically the need for the hepatitis B vaccine, which is currently recommended for all infants at birth. Well, so I guess this leaves me wondering, where does this leave us? Where do things go from here? Ping? Well, we are at a crossroads. The government is changing how they're making vaccine policy.

10:20And professional medical groups are saying, we like the way things were made before. We want that to continue. So they're actually banding together to create separate guidelines, which means that the public is going to be hearing some mixed messages going forward. And states may actually start having very different policies from each other. And PR health correspondents Peng Huang and Rob Stein, thanks to you both. You're welcome. You bet. This episode was produced by Connor Donovan. It was edited by Scott Hensley and Jeanette Woods. Our executive producer is Sammy Yenigan. And before we go, a quick thank you to our Consider This Plus listeners who make the journalism you hear on this show possible.

11:03Supporters also hear every episode without messages from sponsors. You can learn more at plus.npr.org. It's Consider This from NPR. I'm Mary Louise Kelly.