Desperate Times, Desperate Measures? RFK’s Vaccine Campaign Only Breeds More Distrust

President Donald Trump’s healthcare administrators say they are on a campaign to restore Americans’ trust in vaccines—and in the government agencies that oversee vaccine approvals and issue recommendations for their use. But the administration’s approach gives the appearance that our government leaders themselves distrust the government.

“This is an anti-government administration,” Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a member of the FDA’s Vaccines and Related Biological Products Advisory Committee, told BioSpace.

This dynamic was laid bare late last month when Health and Human Services Secretary Robert F. Kennedy Jr. stood with FDA commissioner Marty Makary and NIH Director Jay Bhattacharya and announced via a video posted to X that the Centers for Disease Control and Prevention would no longer recommend COVID-19 vaccination for healthy children or pregnant women.

The CDC’s Advisory Committee on Immunization Practices (ACIP) had previously discussed changing from universal COVID-19 vaccine recommendations to a risk-based strategy and was likely to have approved this change when the committee meets for a vote later this month. But RFK Jr. sidestepped traditional protocols for altering the CDC’s recommendations, doing so without further input from the agency’s own advisors and seemingly without the knowledge of current CDC staffers. The inclusion of pregnant women was also a surprise, given the CDC’s list of underlying medical conditions conveying a higher risk of COVID-19 includes “pregnancy and recent pregnancy.”

Lakshmi Panagiotakopoulos, co-lead of the ACIP, resigned this week in protest. In an email to colleagues, Panagiotakopoulos wrote that her decision was based on the belief that she can no longer help the most vulnerable Americans, multiple outlets reported.

This is exactly the type of unilateral decision making that industry analysts had feared. “Such a possibility is likely to increase uncertainty and fear on to what degree RFK Jr. will seek to influence vaccine policy and recommendations going forward,” BMO Capital Markets analyst Evan Seigerman told BioSpace in April when rumors first circulated that RFK Jr. would be changing COVID vaccine recommendations.

From the public’s perspective, confusion also reigns. Despite RFK Jr.’s directive, the CDC was still recommending COVID vaccination for healthy children at the time of publication, but instead of a universal recommendation, the agency is advising that the decision be a shared one between parents and healthcare providers.

Beyond the COVID debacle, the government terminated Moderna’s $760 million contract for an mRNA-based bird flu vaccine, saying the technology “remains under-tested,” then days later approved Moderna’s next-generation mRNA vaccine for COVID-19. And beyond vaccines, the White House has been scrambling to walk back errors in its Make America Healthy Again report that was found to be riddled with fake citations. Meanwhile, seven former HHS employees this week filed a class-action lawsuit against RFK Jr., Makary and others, alleging they were fired based on “hopelessly error-ridden” staff records.

Such missteps do not instill trust in the government’s actions by its own employees, many of whom are waiting to hear if they will be hired back as mistakes are corrected. And when it comes to uniting the population and engendering trust in the healthcare system and in vaccine oversight specifically, RFK Jr.’s actions are failing. If anything, he’s only fueling greater dissension in America.

RFK Jr. is “basically telling you not only to not trust the government but not trust the science on which the government recommendation has been built,” Offit said. “It’s the exact wrong thing to do.”

Changing the CDC’s recommendations regarding the use of existing COVID-19 vaccines is but one of many moves the administration has made in its purported effort to restore the public’s faith in the government’s ability to keep us safe. Over at the FDA, Makary and Center for Biologics Evaluation and Research (CBER) Director Vinay Prasad announced in a New England Journal of Medicine editorial published May 20 a new strategy for COVID-19 approvals, focusing on high-risk populations.

“We are getting close to a crisis of public trust in vaccines, and in order to get over that, I think we have an obligation at FDA to generate data in populations where there is genuine, genuine equipoise,” Prasad said at a town hall at the time. The officials touted a focus on “evidence-based medicine” and “gold standard science,” while outlining how the pandemic created the deepest fissure. “There were so many things that happened in the last five years that I think have bred a broader distrust,” Prasad said.

To be sure, vaccine skepticism is at an all-time high. According to a new survey from ValuePenguin by LendingTree, 30% of Americans are vaccine skeptics. Concerns are particularly apparent when looking at childhood vaccinations, with a recent Gallup poll finding that the percentage of Americans who consider childhood vaccines extremely important has dropped from 58% in 2019 to 40% last year. That’s a massive dip in confidence in just six years’ time.

This declining sentiment has led to corresponding drops in rates of childhood vaccination, which in turn laid the groundwork for the current measles outbreak that has already killed three unvaccinated people in the U.S., including two children. “[That] equals the total number of deaths for measles over the last 25 years,” Offit said.

He added that measles isn’t the only preventable disease to tick up lately, noting that more than 230 children have died of flu this season. “[We] haven’t seen that since the swine flu pandemic.” He also listed pertussis, also known as whooping cough, which he said is rising “twice as fast as last year. It’s already 9,000 cases, and we’ve already four times more the number of cases than last year, and we’ve had a handful of states that have experienced their first pertussis deaths in years.”

Given this state of public health, one might be justified in calling these desperate times. And RFK Jr. and his team of healthcare administrators could be applauded for turning to desperate measures in an attempt to turn things around. In fact, the U.S. government has been in a similarly precarious position with regard to vaccines before, and the healthcare administration’s response helped keep the ship on course.

In April 1955, healthcare workers mistakenly injected 200,000 children with live poliovirus as part of a government-sanctioned vaccine campaign. The error, which resulted from a failure to inactivate the virus as intended, led to some 40,000 cases of polio that paralyzed 200 kids and killed at least 10—several dozen, by some estimates. At the time, Offit said, “it was arguably the worst biological disaster in our country’s history.”

In response to what has become known as the Cutter Incident after the California-based firm that manufactured the dangerous vaccine, the government stepped up. All polio vaccination was halted while the recently formed CDC investigated the incident, and the newly minted Division of Biologics Standards (DBS), then part of the NIH, was tasked with overseeing vaccine safety. The DBS eventually became part of the FDA and is now known as CBER.

The government response appeared to serve its purpose in reassuring the public that vaccination was safe—certainly safer than remaining unvaccinated. Polio is often said to have been second only to the atomic bomb on Americans’ list of biggest fears in the middle of the 20^th century. After the hold was lifted on all polio vaccination, the campaign resumed without a noticeable dip in uptake, and in 1979, wild poliovirus was declared eradicated from the U.S.

“Public health requires us to think beyond individual needs, to recognize that unless vaccines are widely distributed (and yes, even required in some cases) they will be of no use to anyone,” Laurie Maffly-Kipp, a professor of religious studies at the University of Virginia and a member of a family devastated by the Cutter Incident, wrote in STAT in January. “It also urges us to recognize that some battles have already been litigated and do not need to be revisited when the evidence of success is overwhelming.”

In terms of its stated overall mission of assuring Americans that their government can keep them safe and uniting the populace for the good of public health, RFK Jr.’s campaign looks to follow in the footsteps of the CDC of 1955. But RFK Jr. continues to spout misinformation about the technology as HHS Secretary, while failing to provide clear, consistent messaging on the topic.

In addition to the new FDA approval guidelines and CDC recommendations for COVID vaccines, HHS has said it will require all new vaccines be tested in placebo-controlled trials, a policy experts have speculated is a codification of anti-vaccine activism. In defending the move, RFK Jr. erroneously told the U.S. Senate that the only vaccines to have been tested against a placebo were the COVID-19 vaccines.

Beyond COVID-19, RFK Jr. appears to be taking aim at mRNA technology more broadly. HHS’ assertion that mRNA technology “remains under-tested” doesn’t jibe with its decision to cut Moderna’s contract aimed at studying it for bird flu or with RFK Jr.’s assertion that COVID-19 vaccines—the earliest of which were mRNA-based—were the only vaccines to have been tested against a placebo.

When it comes to restoring faith in vaccines and vaccine oversight, RFK Jr. was already facing an uphill battle given his own history of anti-vaccine rhetoric. And the changes he and his fellow healthcare administrators have overseen so far don’t appear to be steering the population in the right direction. Offit, for one, is not optimistic. “Their argument is that this is going to make people feel better, restore a trust that was lost. I think the chances of that are about zero.”