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Health and Human Services Secretary Robert F. Kennedy Jr.’s campaign to change how US children are vaccinated against serious diseases faces multiple major tests this week.
The Centers for Disease Control and Prevention director he ousted last month, Dr. Susan Monarez, will testify on Capitol Hill about her abrupt firing and her allegation that he is undercutting vaccine standards.
Separately, a key CDC advisory panel Kennedy reconstituted with his own picks —some of whom have made unproven claims about vaccines — will hold a meeting that could lead to drastic changes in vaccine recommendations.
For all the questions raised about Kennedy’s stance on vaccines, he maintains some broad bipartisan support for his Make America Healthy Again efforts to change the way Americans eat.
I spoke with CNN health policy and politics reporter Sarah Owermohle about the dichotomy of Kennedy and what to expect from this week.
Our conversation, conducted by telephone and edited for length, is below.
What is MAHA?
WOLF: Kennedy’s agenda is MAHA – Make America Healthy Again. What does that mean in practice?
OWERMOHLE: While the MAHA agenda is this huge tent of different people coming in with different priorities, I would put it into three buckets: food, pharmaceuticals and the environment.
On the food part, Kennedy has spearheaded calls to phase out artificial dyes, crack down on ultraprocessed foods, improve school lunches and improve SNAP, our food stamp program. That’s the most popular and approachable part of this.
Then there’s the pharmaceuticals and vaccine side. I think a lot of people associate Kennedy most with the anti-vaccine rhetoric. He’s been very active on questioning whether certain vaccines are safe and whether children especially should be required to have them.
And then there’s the environmental side, which is another one that is divisive. He was an environmental lawyer for a long time before pivoting to MAHA, this broader idea that all of these factors are causing the rise in chronic disease.
I don’t know how many people know that, but before this, he was a lawyer. He was part of the legal team that won a huge case against Monsanto for a man who had terminal cancer.
That third leg is this idea that there’s all these things we’re exposed to in the environment —from farming chemicals to forever plastics — that he wants to take a harder look at.
The issue with that third part is that’s not under his purview as HHS secretary.
Kennedy’s moves on vaccines
WOLF: What are the specific things he’s done with regard to vaccines that have public health experts so worried?
OWERMOHLE: Dismissing an advisory panel, CDC’s Advisory Committee on Immunization Practices, this June. These are experts who advise CDC on who should get vaccines and when they should get them, and CDC generally takes up what that panel recommends — he dismissed all those people, and pretty soon after replaced them with his handpicked appointees, many of whom have made critical remarks in the past, questioning the safety of Covid-19 vaccines, MMR vaccines, hepatitis B vaccines.
That new panel is set to convene this week to talk about those three vaccines.
What recommendations they make there, especially since now Kennedy has ousted the CDC director and has installed his deputy there, could have real ramifications for access to those vaccines.
One of the most significant things that has happened so far under his tenure has been the changes around Covid-19 vaccines. The FDA and CDC made changes that essentially mean that you and me, as healthy people, cannot go into a pharmacy to get them. Even though the eligibility is now 65 and up, our parents might still have to go to the doctor’s office.
We’re finding out from reporting that some of our colleagues have done that a lot of doctors are not stocking these vaccines. There’s ton of confusion about, if I did want to get a Covid-19 booster shot, could I get it? And how could I get it?
In terms of his future plans, Kennedy has talked about reassessing how many people have been injured by vaccines and whether they should be compensated for those injuries. He talks about making the childhood vaccine schedule the most ideal it can be for children, which a lot of people interpret to mean reducing the amount of vaccines that children get in first six months to few years of their life.
I think the end goal here, he really laid out in the second MAHA report that came out last week. In the part under vaccines, they wrote that this is about ensuring medical freedom. I think that’s the overall ethos here. What he would tell you, if he was in front of you right now, is, “I’m not trying to take away your vaccines. I’m just trying to give people a choice about vaccines.”
Kennedy wants to reexamine legal immunity for vaccine producers
WOLF: A lot of people probably don’t know there already is a federal system – the Vaccine Injury Compensation Program —to compensate the very small minority of people who suffer serious side effects from vaccines. Does he want to expand that or change it, or has he even talked about, has he gotten that specific?
OWERMOHLE: He has gotten pretty specific about that, the Vaccine Injury Compensation Program. He believes it is too narrow a system that ignores a lot of the claims that people make, or reviews them in a biased way.
One of his big targets is the idea that vaccine manufacturers are shielded from liabilities in a lot of circumstances.
This is a parallel to the pesticides issue. MAHA people have also railed against the idea that pesticide manufacturers could possibly get these same sort of liability shields in legislation that’s in Congress right now, and he hasn’t weighed in on that, but the very same thing liability shields that they rail against with vaccine manufacturers could happen for pesticide manufacturers.
There’s already a system to detect issues with vaccines. Kennedy is changing it.
WOLF: What does the evidence actually say about the number of people injured by vaccines?
OWERMOHLE: There are two different ways that we track that. The FDA has the Vaccine Adverse Events Reporting System, which is a self-reporting system. So if I went in and I fainted, or something more serious happened, myocarditis or something like that, I could report myself into the system.
Then there’s a Vaccine Safety Datalink, which is this huge repository of different health systems and patient records. That’s not a self-reporting system. That’s an overview of everybody in the system. If certain unusual things start to pop up, like myocarditis — is this linked to a vaccine or to something else?
We already have these two reporting systems, and what we know from those is that serious injuries, serious side effects, are exceedingly low from vaccines. What Kennedy has argued is that the people who are reviewing that data are not giving us the full extent of it, essentially, and that there are flaws in the way that these are being reported and analyzed.
Kennedy made assurances to get confirmed. Has he kept his word?
WOLF: Kennedy made some pretty clear promises to Sen. Bill Cassidy, the Louisiana Republican, who is a medical doctor and chair of the Senate Health, Education, Labor, and Pensions Committee. Has Kennedy done anything specifically to violate those assurances that he made?
OWERMOHLE: It would depend on who you ask. Sen. Cassidy had a pretty lengthy list of things that he said he got assurances on.
One was that they would closely collaborate and talk all the time. I do think that they talk fairly often. From what I have heard, even from Sen. Cassidy, when certain things have happened, he has said, you know, “I spoke to the secretary about this.” Cassidy has said Kennedy would ask for his input into hiring decisions, that he would work within the vaccine approval process and not create like his own parallel processes.
Importantly, the two things that everyone that everyone’s watching, though, are:
WOLF: Hep B, specifically?
OVERMOHLE: That was just an example, but I think as we go into that committee’s meeting, if they recommend things that change the recommendations for longtime, widely used vaccines, that that could be the red line that actually breaks the promise to Cassidy.
Will Cassidy turn on Kennedy?
WOLF: I suppose if you keep the system but fire everybody on the advisory panel, you have not changed the system, but you’ve changed how it is going to operate.
OVERMOHLE: Exactly. That’s why it’s up to interpretation whether Kennedy has broken a promise to Cassidy. I think Cassidy is in quite a bind now, because he’s the chair of the HELP Committee, and they are going to have a hearing with Dr. Susan Monarez, which will be interesting to see how Cassidy navigates it. But he has the authority to bring Kennedy in front of him again and ask, “Are you breaking your promises?” He hasn’t done that yet, and he’s avoided questions about whether he’s going to.
WOLF: He has not turned on Kennedy.
OWERMOHLE: Notably, no, he hasn’t. MAHA voters have expressed long-term frustration with Cassidy. He’s up for reelection next year. I think he’s in a politically tenuous position, and he’s trying to navigate how to keep people happy but also not go back on what he said he would do.
What about food dyes?
WOLF: Part of what he wants to do, like getting dyes out of foods, when you hear him talk, it sounds very much like he would mandate these things. But nothing that he’s done so far would be any sort of requirement for food companies. He’s not taking a more collaborative approach. How is he influencing food companies?
OWERMOHLE: One of the funny things to me is he put out this plan, or the FDA did under his leadership, to phase out certain artificial food dyes by 2026. There were two that they wanted out of all food by 2026, and others had a longer runway. And that starts this wave of companies being like, “Well, we’re going to do this. We already have a plan.” They had this event in front of USDA where they celebrated with ice cream companies. And the whole big announcement was that the ice cream companies were going to phase these out by 2028. OK, so they bought themselves two years by holding an event. Is that a win? I don’t know, but it’s mostly been voluntelling people to “do this, and then we won’t crack down on you.”
The Kennedy conundrum
WOLF: The conundrum of Kennedy is that he’s pushing for these popular things. I think everybody would love to see dyes out of these ultraprocessed foods. At the same time, he’s doing things that are genuinely scary to public health professionals. How do you separate those two tracks of his agenda? Or should we separate them?
OWERMOHLE: That’s the most interesting part of this whole MAHA phase. There’s such a wide coalition of people. It brings in all these different people who are motivated by maybe one thing to start, and then they get into the others or they resent the others for taking more attention from the priority that they have.
The food and nutrition work is definitely some of the most bipartisan and broadly popular that you’ll see. Some people that I’ve talked to from that corner of the movement have expressed frustration about the vaccine rhetoric and worry that it’s distracting from or discrediting the food and nutrition motivations, or leading people not to take Kennedy so seriously.
The focus on vaccines might surprise anyone who saw his confirmation hearing
WOLF: He has focused on vaccines to a degree that his confirmation hearing suggested that he would not. Is that right?
OWERMOHLE: Absolutely. He is focused most strongly in terms of actions at HHS on vaccines. We were just talking about the food aspect, where they’re asking companies to be proactive in this arena. But they have changed vaccine policies. They have changed Covid-19 vaccine labels. There’s real action there, and there hasn’t been real action so much in food.
Democrats especially are struggling with that question of, “do we separate these tracks or take MAHA as a whole?” Because the food aspect, there’s a lot of bipartisan support for that. And then there’s the whole environmental thing, going back to pesticides and forever plastics. That has traditionally been a Democratic priority, and that’s been an area where they probably could work with MAHA people if they could stomach the rest of this.
What does Kennedy mean by “interventions” and autism?
WOLF: When Kennedy says “interventions” will be shown to be the cause of autism, what does he mean by that? Is that a phrase that has been commonly used, or did it catch people off-guard?
OWERMOHLE: The use of the word “intervention” caught me a little bit by surprise, because medically, the word intervention means a treatment or therapy. The first thing I would think of if I heard the word “intervention” would have been a pharmaceutical drug, maybe even more a drug than a vaccine He could have been using it more broadly. He could have been referring to environmental toxins, but that’s not quite a medical intervention.
These last few weeks, there has been some swirling about Tylenol during pregnancy. Tylenol would be something that a doctor would tell you is an intervention. It’s a pain intervention. So is that what he was referring to?
SSRIs (antidepressants) have been a really big focal point for him, and the potential risks that he sees there. Those are interventions. With that comment, he expanded it beyond vaccines.
Is this like Michelle Obama’s “Let’s Move”?
WOLF: Back to food. The last person who launched a public effort to get people to eat healthier was then-first lady Michelle Obama. But she ran into a lot of opposition on the right, particularly with school lunches. What’s the difference between her plan 15 years ago and Kennedy’s plan today?
OWERMOHLE: There really are not that many differences. Her plan maybe wasn’t quite as ambitious in the things it was going to tackle. But they are remarkably similar, down to how they started. Michelle Obama started by working with brands to say, “Can you improve your food labels, and can you reduce fat and sugar in school foods?” Brands were proactively doing that just the way that things are happening with Kennedy and these brands right now. Exact same thing.
Hers started to get that Republican backlash once regulatory action started. There was this 2010 law that imposed new federal standards for milk and whole grains and sodium in school lunches. And that’s really when the rhetoric around her “Let’s Move” initiative kicked into overdrive.
There have been lots of subsequent Republican efforts to soften those standards, even as recently as 2018. In the first Trump administration, Sonny Perdue, the USDA secretary, tried to roll back that standard, even though it was it was thrown out in court. It speaks to how this has changed politically, but I also think it speaks to the appeal that Kennedy has had to bring all these different people into the fold with him and make this now a Republican priority. It’s also a reminder that Kennedy was a Democrat.
WOLF: He’s also a celebrity. Have we ever had a celebrity HHS secretary before? (No offense to Kathleen Sebelius, Tom Price, Alex Azar or Xavier Becerra.)
This is a part of the government that has such great importance, but having Kennedy there has actually upped its profile.