Robert F. Kennedy, Jr. is definitely coming for your vaccines

In other words, as everyone suspected, Dr. Monarez wouldn’t go along with RFK Jr.’s attempts to promote unscientific and pseudoscientific policies at the CDC or to fire the people he wanted her to fire. A little explanation is in order here. The CDC Director currently is not hired by the HHS Secretary. Rather, the President appoints the CDC Director, and, according to what I’ve read, that means that only the President, not RFK Jr., can fire Dr. Monarez. When the White House issued a statement that Dr. Monarez had indeed been fired, her lawyer resisted further:

But Monarez’s lawyers again pushed back, arguing that because Monarez was appointed by President Donald Trump to the post — the first CDC director to go through a Senate confirmation process — Trump had to personally dismiss her.

“For this reason, we reject the notification Dr. Monarez has received as legally deficient and she remains as CDC Director. We have notified the White House Counsel of our position,” Zaid and Lowell said in a statement.

Kennedy, at an event in Texas on Thursday, would not comment on Monarez except to say she was “let go” — which her lawyers refute. He argued that the priorities at the CDC need to be re-examined.

“There’s a lot of trouble at CDC, and it can require getting rid of some people over the long term in order for us to change the institutional culture and bring back pride and self esteem and make that agency the stellar agency that it’s always been,” Kennedy said.

I’m not qualified to argue over the legalities of this kerfuffle. The effective bottom line is that Dr. Monarez is no longer CDC Director, but she did a great service by forcing Trump and the White House to fire her, rather than just going meekly after RFK Jr. posted his announcement to X. Then came the rest of the Wednesday night massacre, as four major CDC officials resigned, apparently in solidarity:

Deb Houry, Chief Medical Officer and Deputy Director for Program and Science at CDC, Dan Jernigan, Director of the National Center for Emerging and Zoonotic Infectious Diseases, and Demetre Daskalakis, Director of the National Center for Immunization and Respiratory Diseases, sent emails to colleagues on Wednesday night informing them that they’d submitted their resignations, each mentioning changing policies at CDC.

Jennifer Layden, Director for the Office of Public Health Data, Surveillance, and Technology, resigned as well.

Demetre Daskalakis, in particular, published a resignation letter for the ages, which he posted to—where else?—X, the hellsite formerly known as Twitter:

I am going to quote a large excerpt from the letter, because, sadly, it confirms pretty much everything that I and others who have been following RFK Jr. for years have been warning about in increasingly apocalyptic tones since RFK Jr. was nominated for HHS:

I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.  The recent change in the adult and children’s immunization schedule threaten the lives of the youngest Americans and pregnant people. The data analyses that supported this decision have never been shared with CDC despite my respectful requests to HHS and other leadership. This lack of meaningful engagement was further compounded by a “frequently asked questions” document written to support the Secretary’s directive that was circulated by HHS without input from CDC subject matter experts and that cited studies that did not support the conclusions that were attributed to these authors.  Having worked in local and national public health for years, I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people.

It is untenable to serve in an organization that is not afforded the opportunity to discuss decisions of scientific and public health importance released under the moniker of CDC.  The lack of communication by HHS and other CDC political leadership that culminates in social media posts announcing major policy changes without prior notice demonstrate a disregard of normal communication channels and common sense.  Having to retrofit analyses and policy actions to match inadequately thought-out announcements in poorly scripted videos or page long X posts should not be how organizations responsible for the health of people should function.  Some examples include the announcement of the change in the COVID-19 recommendations for children and pregnant people, the firing of scientists from ACIP by X post and an op-ed rather than direct communication with these valuable experts, the announcement of new ACIP members by X before onboarding and vetting have completed, and the release of term of reference for an ACIP workgroup that ignored all feedback from career staff at CDC.

The recent term of reference for the COVID vaccine work group created by this ACIP puts people of dubious intent and more dubious scientific rigor in charge of recommending vaccine policy to a director hamstrung and sidelined by an authoritarian leader.  Their desire to please a political base will result in death and disability of vulnerable children and adults.  Their base should be the people they serve not a political voting bloc.

I have always been first to challenge scientific and public health dogma in my career and was excited by the opportunity to do so again. I was optimistic that there would be an opportunity to brief the Secretary about key topics such as measles, avian influenza, and the highly coordinated approach to the respiratory virus season.  Such briefings would allow exchange of ideas and a shared path to support the vision of “Making America Healthy Again.”  We are seven months into the new administration, and no CDC subject matter expert from my Center has ever briefed the Secretary.  I am not sure who the Secretary is listening to, but it is quite certainly not to us.  Unvetted and conflicted outside organizations seem to be the sources HHS use over the gold standard science of CDC and other reputable sources.  At a hearing, Secretary Kennedy said that Americans should not take medical advice from him.  To the contrary, an appropriately briefed and inquisitive Secretary should be a source of health information for the people he serves. As it stands now, I must agree with him, that he should not be considered a source of accurate information.

The intentional eroding of trust in low-risk vaccines favoring natural infection and unproven remedies will bring us to a pre-vaccine era where only the strong will survive and many if not all will suffer.  I believe in nutrition and exercise. I believe in making our food supply healthier, and I also believe in using vaccines to prevent death and disability. Eugenics plays prominently in the rhetoric being generated and is derivative of a legacy that good medicine and science should continue to shun. The recent shooting at CDC is not why I am resigning.  My grandfather, who I am named after, stood up to fascist forces in Greece and lost his life doing so.  I am resigning to make him and his legacy proud.   I am resigning because of the cowardice of a leader that cannot admit that HIS and his minions’ words over decades created an environment where violence like this can occur.  I reject his and his colleagues’ thoughts and prayers, and advise they direct those to people that they have not actively harmed.

I give kudos to Dr. Demetre, because he said what I’ve been saying, pointing out the eugenicist nature of MAHA, confirming that RFK Jr. is listening not to subject matter experts but rather to antivax cranks, pointing out how the CDC and other HHS agencies are citing nonsense science and even studies that don’t exist, as well as railing against the lack of transparency that the man who had promised the “most transparent” policy making in history was engaging in. Again, if any of this is a surprise to you, you clearly weren’t paying attention. Indeed, in June, RFK Jr. expressed his contempt for experts and expertise in an interview with Tucker Carlson:

“We need to stop trusting the experts, right?” Kennedy told Carlson. “We were told at the beginning of COVID, don’t look at any data yourself, don’t do any investigation yourself, just trust the experts. And trusting the experts is not a feature of science, it’s not a feature of democracy, it’s a feature of religion, and it’s a feature of totalitarianism.”

Of course, no one says that one should just mindlessly trust experts and do what they say. I do say, however, that, one should understand that there are people who have spent their entire adult lives training and researching certain questions in certain scientific and academic disciplines and that maybe—just maybe—they know a lot more than you do about their areas of expertise and that maybe—just maybe—their conclusions and opinions in these areas of expertise should carry more weight than the conclusions and opinions of people like RFK Jr., who lack the training and expertise. In medicine, when I have a patient with a condition outside my area of expertise, I call in a consult. Heck, when I have a patient with a problem or condition within my area of expertise that I’m not sure of, I’ll call my partner or a colleague for advice.

People like RFK Jr., however, use their own ignorance and appeals to the ignorance of their audience to present themselves as having greater authority than the expert. As A.R. Moxon put it, calling people like him “philosophers of ignorance”:

So this man who is committed to demolishing public health and scientific research on behalf of a totalitarian regime that is committed to demolishing democracy is doing so in the name of public health and science and democracy, and he’s positioning himself against expertise and the accumulation of our inherited human knowledge in the name of open-mindedness and curiosity and knowledge. He’s positioning whatever he personally is willing to accept about a topic in which he is not trained as superior to the sum total of human knowledge from those who have studied the matter deeply enough to actually expand the limits of human understanding on the topic.

He’s able to do this because he appeals to the authority of his own ignorance, and millions of people who have access to answers to all their questions nevertheless prefer ignorance.

Precisely. Cranks and science deniers often position themselves as The True Seekers of Knowledge, because they are, apparently, unbound by all that accumulated weight of human knowledge, which makes their crank beliefs somehow superior.

Unfortunately, by Thursday evening, President Trump had appointed Jim O’Neill as Acting Director of the CDC. Longtime readers might remember that O’Neill was under serious consideration to be FDA Commissioner under the first Trump administration, as I wrote about in 2017. He’s one of those radical libertarian tech bros, an acolyte of Peter Theil, and, relevant to health, he had before his consideration advocated that the FDA should only require safety data before approving drugs, leaving efficacy data until afterwards:

We should reform FDA so there is approving drugs after their sponsors have demonstrated safety — and let people start using them, at their own risk, but not much risk of safety. Let’s prove efficacy after they’ve been legalized.

The above quote comes from a speech which is still available on YouTube.

And I haven’t even mentioned the August 8 shooting, in which a gunman who thought that COVID-19 vaccines had damaged his health shot up the CDC central campus, killing a police officer, a shocking incident the reaction to which by RFK Jr. was decidedly lacking.

Things are bad at the CDC, real bad. And this is by design. Remember, OMB Director Russell Vought, architect of Project 2025, said this about federal workers in scientific agencies like the Environmental Protection Agency (and no doubt meant it about the CDC, FDA, and other HHS agencies):

“We want the bureaucrats to be traumatically affected,” he said. “When they wake up in the morning, we want them to not want to go to work because they are increasingly viewed as the villains. We want their funding to be shut down so that the EPA can’t do all of the rules against our energy industry because they have no bandwidth financially to do so.

“We want to put them in trauma.”

Things are now so bad that even Sen. Bill Cassidy, whose cowardice allowed RFK Jr. to be confirmed as HHS Secretary based on a pinky swearing that he wouldn’t mess with ACIP or the vaccine schedule and would do things according to longstanding HHS policies and regulations, now wants “oversight” over HHS. My comment to him is below:

And:

On Thursday, Sen. Cassidy also called for an indefinite postponement of September’s ACIP meeting, citing serious allegations “about the meeting agenda, membership, and lack of scientific process being followed for the now announced September ACIP meeting.” It’s too little, too late. Meanwhile, Sen. Bernie Sanders published an op-ed in the New York Times calling for RFK Jr.’s resignation, and, to his credit, he realizes what I’ve been saying all along:

Covid is just the beginning. Mr. Kennedy’s next target may be the childhood immunization schedule, the list of recommended vaccines that children receive to protect them from diseases like measles, chickenpox and polio. The danger here is that diseases that have been virtually wiped out because of safe and effective vaccines will resurface and cause enormous harm.

There’s no “may be” about it, Senator. RFK Jr.’s next target will almost certainly be the childhood immunization schedule. Moreover. this message applies to all the Republicans who voted to confirm RFK Jr.:

Where does this all fit in with respect to RFK Jr.’s desire to take away Americans’ vaccines? In other words, how far along is RFK Jr. on his quest to eliminate vaccines? The stories coming out from CDC as a result of this story suggest that he’s farther along than I had feared.

RFK Jr. is coming for your vaccines sooner than you think

In a time that seems long, long ago, I described the strategies that RFK Jr. would use to undermine federal vaccination programs. It’s worth listing them again, and discussing where he is on each one and where he’s likely to go next. Here is what he will do (and is doing):

1. Co-opt the CDC to change its evidence-based policy-making apparatus to policy-based evidence-making designed to fuel antivax messaging.
2. Co-opt the NIH to direct research funds away from vaccines and towards studying “vaccine injury” and other antivax narratives (to support the policy-based evidence-making). 
3. Remake ACIP as an antivax committee, in order to remove recommended vaccines from the CDC recommended immunization schedule and refuse to approve new vaccines.
4. Influence the Vaccine Court and the NVICP to compensate “vaccine injuries” that antivaxxers believe in but that are not supported by science.
5. Take control of the vaccine safety monitoring systems, the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safetylink Database (VSD), to cherry-pick evidence designed to portray vaccines as dangerous.
6. Co-opt the FDA to make approval of new vaccines more difficult and issue black-box warnings based on antivax fear mongering for existing vaccines.

It is clear from the events of last week, that #1 is the strategy what needs the most updating, as the most has happened. In particular, the allegations and stories that came out last week as a result of the Wednesday night bloodbath are very telling; so let’s start there. Also note that firing of Dr. Monarez and the resignations of the four top officials have allowed RFK Jr. to consolidate his power over the agency enormously.

1. Co-opt the CDC to change its evidence-based policy-making apparatus to policy-based evidence-making designed to fuel antivax messaging

It was clear from the very earliest days of RFK Jr.’s tenure at HHS was turning from doing its best to be science- and evidence-based to reversing the order of things to try to generate seemingly scientific evidence to support its agenda, beginning with the claim that vaccines cause autism, cribbing from a longstanding antivax playbook designed to generate “science” that supposedly “proves” that vaccines cause autism, a playbook helpfully described in a recent NYT feature article. It started with RFK Jr. announcing in April the commissioning of a study that would examine the causes of autism whose preliminary results would be released this month, even promising, By September, we will know what has caused the autism epidemic and we’ll be able to eliminate those exposures” (Spoiler alert: The main “exposure” that will be implicated as the cause of autism will be vaccines. I guarantee it.) He even hired David Geier, who with his father Dr. Mark Geier had done ideological and bad science over decades in order to “prove” that mercury in the thimerosal preservative that was used in some childhood vaccines until around 2001-2 caused autism, to lead a “reanalysis” of vaccine safety data. (His father Mark Geier had recently died at the time of David’s hiring in March, which is no doubt why RFK Jr. didn’t hire them both.)

The Geiers were known for the truly bizarre idea—I certainly won’t dignify it by calling it a “theory” or even a hypothesis—that testosterone binds mercury from vaccines in the brain, making it more difficult to remove using chelation therapy. This led them to propose that lowering testosterone levels would somehow increase the efficacy of the chelation therapy. Why? To reiterate, the Geiers proposed a scientifically unsupported—to put it kindly—idea that somehow testosterone binds the mercury from vaccines and makes it more difficult to chelate. I kid you not. The Geiers called this nonexistent phenomenon “testosterone sheets.” Never mind that there has never been any convincing scientific evidence that chelation therapy does anything to help the behavioral symptoms of autism or that mercury in vaccines causes autism, and never mind that there is no physiological evidence that testosterone in any way binds mercury in the body, much less makes it inaccessible to chelation therapy. Unbelievably, the Geiers based their concept of “testosterone sheets” on a paper from 1968 looking at the crystal structure of testosterone and mercuric chloride derived from crystals made by boiling equimolar amounts of testosterone and mercuric chloride in hot benzene.

Let’s just put it this way. Such conditions are far from physiologic. Pulling nonsensical ideals out of their nether regions, the Geiers just speculated that testosterone binds mercury and that lowering testosterone would free up the mercury for chelation, even though, once again, there was no evidence for this concept. Neither the extreme scientific implausibility of their idea nor the lack of scientific evidence for it deterred them in the least from franchising their protocol as clinics and trying to patent it. Their treatment became widely known in antivax circles as the Lupron protocol. Such is the man in charge of reanalyzing the CDC’s vaccine safety data. Through it all the Geiers grifted as “expert witnesses” for Vaccine Court cases and as proprietors of a mail order pharmacy.

What came out from the fallout over Dr. Monarez’s firing is that this project is going about as well as you might think when an utter crank like David Geier is put in charge of a project and then real scientists encounter him:

Jernigan said the last straw for him was being forced to work with David Geier, a proponent of the false claim that vaccines cause autism. He was hired by HHS to review old vaccine safety data and study a possible link between the two. In recent weeks, an HHS official asked for Geier to be given access to additional up-to-date vaccine safety data, which Jernigan said raised patient privacy and ethical concerns.

And:

“The current administration has made it very difficult for me to stay,” Jernigan said. “We have been asked to revise and to review and change studies that have been settled in the past, scientific findings that were there to help guide vaccine decisions.”

Jernigan, you might recall, was the Director of the National Center for Emerging and Zoonotic Infectious Diseases and one of the four CDC leaders who resigned last Wednesday. One can only assume that David Geier and any other crank “scientists” that RFK Jr. might have brought in to find a link between vaccines and autism now have unfettered access to all CDC data, the only possible exception being the Vaccine Safety Datalink, if only because the VSD data is held not by the CDC but by the private healthcare organizations and companies that contribute data to it.

But what about that autism study? RFK Jr.’s old antivax org Children’s Health Defense exulted over statements that RFK Jr. made at a Cabinet meeting a week ago. First, though, note that, as predicted, RFK Jr. has thoroughly taken over and subverted federal science in this cause. For example, in April, NIH Director Dr. Jay Bhattacharya announced the agency would use health records of Americans from multiple federal and commercial databases to study the causes of autism, and:

Between 10 and 20 outside groups of researchers will be given grant funding and access to the records to produce Kennedy’s autism studies. Bhattacharya did not give details on how they would be chosen, but said their selection would be “run through normal NIH processes.”

Bhattacharya said the research they will back using the data will be “the highest quality proposals” that will range “from basic science to epidemiological approaches, to other more applied approaches” to treat and manage autism. He also acknowledged autism’s wide variation in how it affects people.

Color me…skeptical, especially given what RFK Jr. said last week:

U.S. Health Secretary Robert F. Kennedy Jr. said today during a Trump administration Cabinet meeting that his agency is on track to announce the findings of an ongoing study on the causes of autism next month.

“We’re finding interventions, certain interventions now that are clearly almost certainly causing autism, and we’re going to be able to address those in September,” Kennedy said.

“Certain interventions”? One wonders, given RFK Jr.’s history, what those might be, one does. Actually, one does not. It’ll be vaccines, possibly with food dyes, wifi, and pesticides, but, above all, it will be vaccines. Just watch.

Now almost fully in control of federal biomedical science and public health, RFK Jr. is now, as predicted, using that control to generate policy-driven scientific “evidence,” á la Trofim Lysenko, that will be used to justify his removing vaccines from the schedule. He will begin with COVID-19 vaccines, likely starting the process of eliminating them by using ACIP next month to restrict access at least as much as the FDA approval by changing existing recommendations for the vaccine schedule. Then he will move on to other vaccines, particularly in the childhood schedule, likely as a result of the “evidence” that the autism study will report later this month, which will be used to justify restricting or eliminating vaccines.

If you have any doubt that this is what is happening, look no further than news reports about what precipitated Dr. Monarez’ firing, for example this NYT article, which describes how RFK Jr. decided to fire her after she had refused to rubberstamp ACIP recommendations that she didn’t view as science-based:

Health Secretary Robert F. Kennedy Jr. summoned Susan Monarez, the director of the Centers for Disease Control and Prevention, to his office in Washington earlier this week to deliver an ultimatum.

She needed to fire career agency officials and commit to backing his advisers if they recommended restricting access to proven vaccines — or risk being fired herself, according to people familiar with the events.

Dr. Monarez’s refusal to do so led to an extraordinary standoff on Thursday that paralyzed the nation’s health agency, which is still reeling from mass layoffs and a shooting this month that killed a police officer and terrified employees.

To her credit, Dr. Monarez would have none of it:

After Dr. Monarez refused Mr. Kennedy’s demands, she called Senator Bill Cassidy, Republican of Louisiana and chairman of the Senate health committee. He called Mr. Kennedy, which angered the health secretary, according to an administration official familiar with the events.

Mr. Kennedy summoned her back on Tuesday and reiterated his demands. On Wednesday, Dr. Monarez received a phone call from the White House personnel office telling her that she was being fired.

Unfortunately, this sort of resistance has been slow in coming and all too uncommon, and what she told a colleague tells me that this part of RFK Jr.’s approach to eliminating vaccines is in full swing:

He said she told him she did not expect to be long in her job — and that there were two things she would never do to keep it.

“One was anything that was deemed illegal, and the second was anything that she felt flew in the face of science,” he said. Dr. Monarez said she had been asked to do both, he continued — to fire agency leadership and “to rubber stamp A.C.I.P. recommendations that flew in the face of science.”

While there was a bright line that Dr. Monarez would not cross, for three of the others who ended up resigning on Wednesday, the process was slower:

In an interview on Thursday morning, Dr. Houry and Dr. Daskalakis said there was no single move that pushed them to resign.

Rather, it was “death by a thousand paper cuts,” Dr. Houry said. “We had so many of these instances where we just couldn’t take it.”

The three had been contemplating leaving the agency for weeks, they said. But their distress escalated sharply after the new members of the vaccine advisory panel said that they would revisit the childhood and adolescent immunization schedules when they met again in the fall.

It didn’t help that RFK Jr. appointed incompetent antivaxxer Retsef Levi, a man with no relevant experience in public health, vaccines, or infectious disease, to chair the COVID vaccine workgroup. Indeed, according to the news report, Dr. Dasakalakis characterized Levi as “frankly riddled with bias,” which is, of course, an understatement.

I’m sure that things will get much, much worse at the CDC, now that more of the firewalls in the form of career scientists with deep expertise have been forced out, so that RFK Jr. can appoint in their place his antivax sycophants, toadies, and lackeys.

2. Co-opt the NIH to direct research funds away from vaccines and towards studying “vaccine injury” and other antivax narratives (to support the policy-based evidence-making). 

I’ve already written a lot about this, in particular RFK Jr.’s having canceled $500 million in research grants to study mRNA vaccine technology and shifting NIH priorities in vaccine research towards “whole virus” vaccines, which is why I won’t dwell on this strategy much here. In any case, whole virus vaccines represent an old technology that is, in much the same way that herbal remedies are touted as superior to purified pharmaceutical drugs, being sold to MAHA as both cutting edge and being more “natural” than subunit or mRNA vaccines. Never mind that antivaxxers are, well, antivaccine and will likely not be any more accepting of “natural” vaccines produced by “Generation Gold Standard.” Unsurprisingly, the useful idiot chosen by Donald Trump, Russell Vought, and RFK Jr., Dr. Jay Bhattacharya, is more than happy to go along, gleefully implementing White House plans to place control of the distribution of research grants in the hands of political appointees and requiring that any such research grants “align with administration priorities.”

In the meantime, as mentioned in the last section, Bhattacharya is planning on awarding research grants to outside researchers who will be given access to CDC data. Does anyone want to guess who these researchers will be? The point is, this objective is also nearly complete.

3. Remake ACIP as an antivax committee, in order to remove recommended vaccines from the CDC recommended immunization schedule and refuse to approve new vaccines.

I’ve discussed this one a lot, describing how RFK Jr. sacked all 17 members of the previous ACIP, only to replace them with antivax and antivax-adjacent cranks, who promptly turned the first meeting of ACIP under the new administration into a clown car of antivax nonsense. True, the only change long desired by the antivax movement that they made was to take thimerosal-containing influenza vaccines off the CDC vaccine schedule, but they really had very little time between the time they were appointed to the time of the meeting to do their thing.

The September meeting, if it happens (and it probably will), is what I’m worried about. Then, ACIP will feature discussions and possible votes on recommendations for COVID-19 vaccines; hepatitis B vaccines; measles, mumps, rubella, and varicella (MMRV) vaccines; and respiratory syncytial virus, as well as updates from its work groups. One notes that after the previous ACIP meeting, the CDC proposed two new work groups to study the childhood vaccine schedule:

The ACIP, which helps guide the Centers for Disease Control and Prevention (CDC) on how best to implement approved vaccines, will create two new work groups to examine the cumulative effect of childhood vaccine schedules and assess shots that haven’t been subject to review in more than seven years, the committee’s newly appointed chair, Martin Kulldorff, Ph.D., said at the top of a two-day ACIP meeting that started Wednesday.

ACIP work groups act as subcommittees that are tasked with reviewing data to help inform the decisions of the federal vaccine panel’s voting members. Prior to Wednesday, the ACIP counted 11 work groups among its ranks, including a group focused on combined child, adolescent and adult immunization schedules.

“The number of vaccines that our children and adolescents receive today exceed what children in most other developed nations receive and what most of us in this room received when we were children,” Kulldorff said during the meeting.

“In addition to studying and evaluating individual vaccines, it is important to evaluate the cumulative effect of the recommended vaccine schedule,” he added. “This includes interaction effects between different vaccines, the total number of vaccines, cumulative amount of vaccine ingredients and relative timing of different vaccines.”

To that end, the ACIP will establish a dedicated work group to evaluate childhood and adolescent vaccine schedules, he explained.

Longtime readers will see exactly where Kulldorff is going with this. As evidence piled up indicating that individual vaccines didn’t cause the harms that antivaxxers claimed, the antivax movement shifted to a narrative that they liked to call “too many too soon,” which claimed that too many vaccines at too young an age somehow overwhelmed the infant immune system and caused autism and all sorts of other health issues. It’s nonsense, just like nearly all antivax narratives, but antivaxxers like RFK Jr. and the members of ACIP just can’t give it up.

In any event, ACIP is now fully under the control of members who are either antivax or at least antivax-adjacent, and I expect that ACIP will now be used to restrict the indications for various childhood vaccines and eventually remove many of them from the CDC vaccine schedule. Will Sen. Cassidy succeed in his call for this ACIP meeting to be postponed indefinitely? I’m not optimistic. After all, his time to stop RFK Jr. was months ago, during his confirmation hearing. It’s too late now. Unless someone can persuade President Trump to fire RFK Jr. (highly unlikely, as Trump seems to find RFK Jr. useful now), RFK Jr. will remain HHS Secretary until at least the end of the Trump administration in 2029. He’s a fanatic, and, I predict, nothing will make him resign.

4. Influence the Vaccine Court and the NVICP to compensate “vaccine injuries” that antivaxxers believe in but that are not supported by science.

I’ve discussed how much trial lawyers hate the National Vaccine Injury Compensation Program, (NVICP) and Vaccine Court, which were mandated under the National Childhood Vaccination Injury Act (NCVIA) of 1986 as the first court to which claims of vaccine injury must be filed. Among the reasons is that, while the Vaccine Court pays the reasonable legal charges for bringing a petition to the court, it doesn’t provide the possibility of huge payouts and the accordingly huge contingency fees that antivax lawyers seek. I discussed recently (and in a fair amount of depth) how RFK Jr. wants to “revolutionize” the Vaccine Court by changing the statute of limitations and other interventions. I also predict that RFK Jr. will use the the bogus scientific “evidence” accumulated under #1 as a rationale to add conditions not caused by vaccines to the list of “table injuries,” vaccine injuries that are considered sufficiently well proven from a scientific standpoint that compensation is automatic.

A recent NYT article suggested this very possibility:

There are some aspects of the program that Mr. Kennedy can change without Congress. That includes altering the official table detailing the injuries presumed to be linked to certain vaccines.

Changing the table to say that certain vaccines cause autism or asthma, months or years after shots, for example, could hobble the system, opening the doors to tens of thousands of new claims that would previously have been dismissed.

“He’s talking about opening a can of worms that could result in Americans losing access to some vaccines and huge expenditures in court fees,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention.

Since last I discussed this, RFK Jr. has discussed plans to “overhaul” the Vaccine Court, by ending the liability shield. As part of the NCVIA of 1986, vaccine manufacturers are shielded from liability for vaccine injuries and contribute an excise tax from every dose of vaccine sold to a fund that is used to compensate victims of vaccine injury as adjudicated by the vaccine court. Removing that shield could take us back to the bad old days of the early 1980s, when vaccine litigation clogged the courts, and the expense of defending the litigation was driving vaccine manufacturers out of the US, thus in effect taking away Americans’ vaccines without actually having to explicitly delicense or ban them. That would be, of course, a feature, not a bug in any of RFK Jr.’s plans to “reform” the system. Indeed, I suspect, as many have suggested, that RFK Jr. would be more than happy to abolish the NVICP altogether.

It gets worse. Here’s where antivax control of the ACIP affects the NVCIP. Only vaccines on the ACIP-recommended CDC schedule are covered by the NVICP. Claims of injuries from vaccines not on the CDC schedule might have to go through litigation:

If the ACIP no longer recommends a routine vaccine, it may be removed from the table. Claims would then need to go through the regular court system.

There is a higher bar in the regular courts, where claimants have to show fault, demonstrating a defective product or negligence, for instance. The rules of evidence are stricter. Claimants also have to hire a lawyer and pay the lawyer costs and the experts.

With the private US healthcare market, “if you don’t win your case, you’re going to then get stuck with gigantic medical bills”, Caplan said.

In a country like the US, where the burden is on the individual to pay their medical bills, VICP is a safety net for people having medical events after vaccination, he said.

Not that RFK Jr. cares about huge medical bills or the well-being of those who really did suffer a vaccine injury. He cares about eliminating vaccines.

No one denies that the NVICP could use some reforms and updating. There are too few Special Masters, for instance, to deal with the caseload in an expeditious fashion, and the compensation caps need to be updated to adjust for inflation. I’m not as convinced that the statute of limitations needs to be increased, but I am not totally opposed to doing that either. The overall point is that RFK Jr. is already working on actively undermining the NVICP, hoping that forcing vaccine injury claims into normal courts will more easily accomplish in effect what he can’t accomplish as fast as he wants through policy, namely forcing vaccine manufacturers out of the US market.

5. Take control of the vaccine safety monitoring systems, the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safetylink Database (VSD), to cherry-pick evidence designed to portray vaccines as dangerous.

David Geier has access to VAERS and other CDC data. I don’t know that I need to say much more than that. The only question remaining is whether RFK Jr. will manage to get full access to the VSD, the same database that the Geiers tried to go beyond their IRB purview to mine in the early 2000s. In any event, this tactic is of a piece with #1, namely to generate “data” that falsely attributes adverse events to vaccines that vaccines don’t cause, all in order to use the data as a pretext to restrict or eliminate vaccines.

6. Co-opt the FDA to make approval of new vaccines more difficult and issue black-box warnings based on antivax fear mongering for existing vaccines.

Fortunately, there’s not a lot to discuss—yet—regarding this tactic. I suspect, though, that the reason is not so much that RFK Jr. won’t do this but that because his policy-driven collection of “scientific evidence” hasn’t yet provided him with the “evidence” base to do this. The saga of Dr. Vinay Prasad and his appointment to head the Center for Biologics Evaluation and Research (CBER), his forced resignation from CBER, and then his rehiring is largely a distraction from this. I have little doubt, though, that whenever the “scientific evidence” generated by RFK Jr.’s cranks reaches fruition, Dr. Prasad and his boss FDA Commissioner Dr. Marty Makary, will suddenly lose their aversion to low quality evidence in order to do RFK Jr.’s bidding. In the meantime, they will continue to weaponize methodalatry and evidence-based medicine (EBM) fundamentalism against vaccines to falsely portray them as unsafe and by requiring saline placebo controls for testing vaccines for which it would be unethical or impractical to use such controls, even as they will tolerate a—shall we say?—more fluid concept of evidence when it comes to stem cell therapies and MAHA-approved quackery favored by RFK Jr.

Will RFK Jr. succeed in taking away Americans’ vaccines?

Whether RFK Jr. will succeed in taking away my vaccines and those of all Americans is the single most important question in public health under the Trump administration. As I hope that I’ve demonstrated, in just six months, he is much farther along in the process than I would have thought possible. He’s basically purged nearly all the scientific resistance in the CDC and cowed those remaining sufficiently that I doubt they’ll be much of a hindrance. They’ll either go along or resign, allowing RFK Jr. to replace them with more antivaxxers. He’s already taken completely co-opted the NIH using useful idiot Jay Bhattacharya as the face of its Lysenkoization. He’s purged ACIP to packed it with his preferred antivaxxers and eliminated the input from interested parties such as scientific professional associations and pharmaceutical companies, all in the name of fantastical “conflicts of interest.” The FDA and CDC are entirely under his control, and the NIH is poised to fund and pump out bad science that is “aligned with administration aims.”

Finally, I reject the argument (which I’ve heard a few times) that anyone else that President Trump might have appointed to helm HHS other than RFK Jr. would have been as bad or worse with respect to public health, if only for the simple reason that no other candidate that I can envision (and I can envision many of them) is as much a true believer in the antivax cause as RFK Jr. No other candidate that I can envision has been fighting on all fronts, particularly the legal front, to discourage vaccination as long as he has. No one else has as much practical knowledge of the best pressure points to attack in order to dismantle and destroy federal vaccination programs—or even the inclination to go about attacking them as fanatically as RFK Jr has.

Don’t believe me? Just look at what’s happened in the last six months, which support my contention and are why I am pessimistic. In that short a time, RFK Jr. has already set up the tools to do what he has always wanted to do: Take away Americans’ vaccines. (When he claims that he doesn’t want to do that he is lying, period.) That is his endgame. it has always been his endgame, and I don’t care who doesn’t like it when I say that.Taking all these developments in, developments that have occurred in just the first six or seven months of the RFK Jr. regime, I am pessimistic, given how much damage he has already inflicted on HHS agencies dedicated to medicine, public health, and biomedical research in such a short period of time and how far along in his quest to take away your vaccines RFK Jr. has already brought HHS.

In particular, I mean Senator Bill Cassidy, who had the chance to stop RFK Jr. from being confirmed as HHS Secretary and utterly failed as a physician, as a Senator, and as a human being. Thanks to him, RFK Jr. got his chance and is now much further along in his quest to eliminate vaccines than even I would have thought he could be by now. Mark my words, the situation at HHS with respect to public health, vaccines, and biomedical research is poised to become so much worse than it has already become. Damage has already been done that will take a generation to undo, if it is even repairable at all. Sadly, too many people wouldn’t believe us then when we kept warning that RFK Jr. wants to eliminate vaccines. Now that it’s starting to dawn on some of them that maybe—just maybe—we were right, it might be too late.

Make no mistake, RFK Jr. is coming for your vaccines, and people will die because of it.