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As health secretary, RFK Jr. might have a significant impact on immunizations for children.

Convincing Senate Republicans that he does not have radical views on vaccinations may be the most difficult task facing Robert F. Kennedy Jr. as he meets with them on the Hill this week to try to get confirmed as secretary of health and human services.

That would be challenging, though, given Kennedy’s decades-long public opposition to vaccinations, which includes his affiliation with Children’s Health Defense, a prominent anti-vaccine organization, and his repeated fabrications that vaccines cause autism.

Concerns about Kennedy’s potential use of his position as health secretary have increased in recent days. The New York Times revealed this week that Kennedy’s attorney, who is vetting applicants for HHS positions, petitioned the Food and Drug Administration in 2022 to rescind the polio vaccine’s clearance. According to the Times, the petition was submitted on behalf of the Kennedy-affiliated anti-vaccine organization Informed Consent Action Network.

Donald Trump, the president-elect, fueled the debate on Monday by stating at a press conference that he thinks vaccinations have “problems” and that they could be connected to an increase in autism cases. Nonetheless, Trump declared that he is a “big believer” in the polio vaccination.

RFK Jr. at HHS? Former health secretary Kathleen Sebelius explains the limits of the role : Shots - Health News : NPR
RFK Jr. at HHS? Former health secretary Kathleen Sebelius explains the limits of the role : Shots – Health News : NPR

In a statement released Friday, Senate Minority Leader Mitch McConnell, R-Ky., a polio survivor and a possible pivotal player in Kennedy’s confirmation, took a jab at Kennedy.

“Attempts to erode public trust in proven treatments are not only ignorant, they are dangerous,” McConnell stated. According to the Centers for Disease Control and Prevention, since its approval in the United States in 1955, the polio vaccination has saved an estimated 20 million cases of childhood paralysis.

According to experts, Kennedy’s lengthy history of anti-vaccine activity may result in major adjustments to American kid vaccination laws and jeopardize decades of advancements in the fight against illnesses like whooping cough, polio, and measles.

A follow-up request for comment was not answered by a Kennedy representative. Kennedy spokesperson Katie Miller previously told NBC News that “the Polio Vaccine should be available to the public and thoroughly and properly studied.”

However, Kennedy’s earlier remarks run counter to that assertion. Kennedy said there is “no vaccine that’s safe and effective” and connected the polio vaccine to cancer during his appearance on the “Lex Fridman Podcast” last year.

Committees for advice
States have most of the power over the complicated childhood immunization laws in the United States. Kennedy might, however, have a significant impact on children vaccines, according to experts.

Kennedy would be in charge of a number of health organizations, including the Centers for Medicare and Medicaid Services, the FDA, the CDC, and the National Institutes of Health, if he were confirmed as health secretary.

Experts believe that his biggest impact on vaccines may come from the CDC’s Advisory Committee on Immunization Practices, or ACIP, an impartial panel of medical professionals that assists the agency in recommending to states and insurance companies which vaccines, particularly pediatric immunizations, to cover.

The director of the CDC is the committee’s boss. The HHS secretary is then notified of the vaccination recommendations by the CDC director. Trump appointed Dr. Dave Weldon, a former Florida congressman and doctor who has made bogus vaccination claims, to head the CDC last month.

The HHS secretary can designate new members to the committee and replace existing members at the secretary’s discretion, according to KFF, a nonprofit organization that studies health policy problems.

RFK Jr. meets with senators as questions swirl about Trump's pick to lead health agency | WJTV
RFK Jr. meets with senators as questions swirl about Trump’s pick to lead health agency | WJTV

Although ACIP now has 15 voting members, the committee may have as many as 19. According to a committee roster, a number of members have terms that expire in 2025, and committee members typically serve four-year terms. However, unless Kennedy orders them to go, many will stay until 2028.

There are two possible outcomes, according to Dorit Reiss, a vaccine policy researcher at the University of California Law San Francisco: Kennedy might persuade Weldon, the director of CDC, to disregard ACIP recommendations, or he might replace ACIP members with anti-vaccine activists who make recommendations that the CDC accepts. Although it is not necessary, the CDC director often approves the committee’s recommendations.

Parents may still decide to vaccinate their children even if there is a shake-up at ACIP and the CDC issues new recommendations against certain vaccinations, according to Dr. Sean O’Leary, head of the American Academy of Pediatrics Committee on Infectious Diseases and a nonvoting member of ACIP. While most states abide by the suggestions, they are not obligated to.

“I believe that most parents will still follow their child’s pediatrician’s advice, even though this stuff can and will have an impact,” O’Leary stated. “Parents want to do what’s best for their children when it comes to childhood vaccines, and politics aside, that matters a lot more.”

However, Reiss pointed out that the recommendations made by ACIP directly affect insurance and the vaccinations that are covered. Vaccines recommended by ACIP must be covered by insurance companies under the Affordable Care Act.

In reference to the vaccination for diphtheria, tetanus, and pertussis (whooping cough), she stated, “For instance, if the committee requests against giving children DTaP, or recommends against giving them at the ages they are now, those won’t be covered by insurance.” She noted that it will be up to the insurers to determine whether or not to cover them.

Federal funds
Concerns over Kenndy’s control over the distribution of federal funding were also raised by experts.

For instance, the CDC oversees the Section 317 program, a grant that gives money to states and local health organizations to provide immunizations. Through the CDC, public health agencies submit funding applications.

According to Dr. Paul Offit, a vaccination specialist at Children’s Hospital of Philadelphia, “he could make it harder to get paid for vaccines.” “He might reduce their availability.”

Kennedy’s influence on future vaccine approvals and his potential to hold down the clearance process are key issues that Offit and other experts expressed worry about.

According to experts, he might also oversee fresh studies on already-approved vaccinations, including the polio shot, giving the impression that there could be problems with them and inciting public mistrust.

Trump appointed Johns Hopkins University pancreatic surgeon Dr. Marty Makary to head the FDA. Although Makary has lately made remarks supporting Kennedy, it is unclear how he would function in the role. A request for comment was not immediately answered by a Trump transition official.

Kennedy may continue to disseminate false information about vaccinations, which may make parents reconsider vaccinating their children, according to Offit, who is also a member of the FDA’s vaccine advisory group.

“It’s obvious that people’s trust in vaccines and their safety has been eroding if you look at polls right now,” he remarked. He will now have a larger platform. He referred to Kennedy as “the head of the most important public health agency.”

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