In Brief:
- Kennedy is the nation’s most prominent vaccine skeptic. If he’s confirmed as HHS secretary, his views will become more mainstream.
- Public health communications are meant to be consistent, but now there will be more debate about what is true and what actions individuals should take.
- Vaccinations are already viewed with increased doubt post-pandemic, particularly among Republicans.
According to the World Health Organization, up to 5 million deaths are prevented globally each year thanks to vaccinations against diseases such as measles, diphtheria, pertussis and influenza.
According to Robert F. Kennedy Jr., President-elect Donald Trump’s pick to serve as secretary of Health and Human Services, “there’s no vaccine that is, you know, safe and effective.”
Who should you believe? People who work in public health recognize that their work is cut out for them if Kennedy, as health secretary, continues to promote messages casting doubt on the safety and efficacy of vaccines. “It really increases the workload for people like me,” says Georges Benjamin, executive director of the American Public Health Association. “We’re going to be spending a lot of time correcting the record and pushing back on things that we know are not true.”
Kennedy has sought to soften his message, saying after the election that he “won’t take away anybody’s vaccines.” It’s not yet clear whether he will seek to take some vaccines off the list that the federal government recommends, or whether he will attempt to convince Congress to defund subsidies for childhood immunizations, or strip vaccine manufacturers of their legal liability protections.
But even if Kennedy makes no substantive policy changes, there’s now the prospect that, thanks to his official role, any remarks he makes spreading doubt about vaccines will greatly muddy the waters. And Trump’s picks to head the Centers for Disease Control and Prevention and the Food and Drug Administration have also cast doubt in the past about vaccines.
Public health experts routinely emphasize the importance of having clear and consistent messaging to the public. That could be a greater challenge in the years ahead. “When the same people who tell you to evacuate because the hurricane is coming are spreading false information about health, which of those is true and which of them is false?” says Brian Castrucci, president of the de Beaumont Foundation, which promotes public health. “And now we’re creating a world where the American people need to discern what from their government is true and what is false.”
Uptake of traditional childhood vaccines has already declined since the pandemic. Unfounded fears about COVID-19 vaccines — as well as loud complaints about lockdowns and masking during the pandemic — have increased distrust.
"We have been in a challenging environment for vaccine uptake for some time now, but our members don’t waver from their charge to follow the data and the science to protect their communities’ health and wellness," says Elizabeth Green, communications director for the Big Cities Health Coalition, which represents the largest local health departments. "We are keeping focused on the same goals as always."
Kennedy’s rhetoric is already having an effect. Last week, Florida Surgeon General Joseph Ladapo echoed another Kennedy concern, advising communities to stop adding fluoride to their water supplies, which he called “public health malpractice.” Arkansas legislators introduced a bill that would overturn the state’s law requiring fluoridation, leaving the decision up to local residents.
“When the secretary speaks, they have a big bullhorn, a big voice,” Benjamin says. “People make the assumption that it’s been vetted, it’s the correct information, it’s coming from a credible source and people act on it.”
Conflicting Sources of Information
Kennedy, of course, is the scion of one of the nation’s most prominent Democratic families. His father served as attorney general and in the U.S. Senate, while his uncle was the president. His embrace of Trump in some ways mirrors the broader partisan shift on the vaccine issue, suggests Jennifer Reich, a sociologist at the University of Colorado Denver who wrote a book about why parents reject vaccines.
“Vaccine hesitancy prior to COVID was not particularly partisan,” she says. “I heard very similar responses from both the left and the right about distrust of pharmaceutical companies, about regulation and monitoring, about individual preferences to decide risk and benefit.”
But disagreement has become more partisan, a division in part fostered by misinformation from Russian social media accounts, which began before the pandemic but then helped spread doubts about side effects and Biden administration policies about COVID-19 vaccines. Reich notes that, in a highly fragmented media and social media environment, Americans are getting wildly varying sets of information. “Where are the access points to any sort of factual or neutral information about government, about policy?” she asks.
Traditional news sources will be obliged to report on Kennedy’s positions. Even if they have occasion to point out he’s stating things that are verifiably false, distrust of the media will undermine the credibility of such attempted fact-checking with some audiences.
At the same time, groups that mainstream media outlets have generally ignored are likely to find their platforms enhanced, for instance by being granted prominent speaking roles at government-sponsored events. “It’s really galvanizing groups that have historically been somewhat fringe,” Reich says. “The Health Freedom Summit or the National Vaccine Information Center or other organizations may now have legitimacy that comes through the federal government, including potentially access to grants and other funds.”
Kennedy's Not Operating in a Vacuum
Reich says it’s understandable that Kennedy’s message has resonance. People are skeptical about a health system that is often frustrating and expensive to deal with and doesn’t always lead to great outcomes. Some of Kennedy’s complaints about pharmaceutical companies and the agriculture and food industries are widely echoed by others, including prominent elected Democrats.
Castrucci, from the de Beaumont Foundation, concedes that the public health field has not done a good job over the years of convincing people of the value of preventive measures. It certainly has not won the post-COVID-19 message war about whether the clear costs of shutdowns and lockdowns were outweighed by saving lives and preventing illness.
Castrucci says that Kennedy’s nomination is an “opportunity” for people in public health to talk about the diseases eradicated by vaccines and the benefits of other measures such as fluoridated water. “Healthy people are productive people,” he says. “You can’t make America healthy again by taking away health care.”
But the share of Americans who believe that childhood vaccines are important has dropped by a third since the start of the century, according to Gallup polling. Democrats and Republicans once shared similar views on the topic but now there’s a huge partisan gap. Kennedy’s pick makes it hard to imagine that a second Trump administration will push something like Operation Warp Speed, the highly successful investment in rapid COVID-19 vaccine development during Trump’s first term.
There are currently multiple outbreaks of measles around the country, while six times as many cases of pertussis have been reported compared to this point last year. If there are widespread outbreaks of these diseases or any others, Kennedy as the HHS secretary would either play a prominent role in that messaging or coordinate it, Benjamin points out.
“It’s tough to coordinate something you don’t believe in,” he says.
