Final week, the day earlier than the election, I described Robert F. Kennedy, Jr., who in return for abandoning his quixotic and weird marketing campaign for the Presidency as an unbiased to bend the knee and swear eternal fealty to former President Donald Trump had been promised management over all the federal well being coverage equipment, as an “extinction-level menace to federal public well being packages and science-based well being coverage” as I identified what RFK Jr. had been saying and promising all these years. Sadly, for federal science coverage and public well being, final Tuesday Donald Trump gained not solely properly over the 270 votes within the Electoral Faculty wanted to turn into President however a transparent majority of the favored vote (and all seven swing states) to defeat Kamala Harris and turn into President-Elect once more. Because of this, on January 20, 2025 he might be sworn in because the forty seventh President of america, which implies that that extinction-level menace to public well being is now lower than two and a half months away. It thus behooves me to followup final week’s publish by looking at what kind—many types, really—that menace would possibly take.
So, whilst I cope with a busy weekend (my father is within the hospital), let me attempt to lay out a few of my ideas and hypothesis. In lots of circumstances, I hope that I’m fallacious, however worry that I’m really not alarmed sufficient. I’ll begin with vaccines. Why? As a result of antivax is what RFK Jr. is thought for, and, regardless of his denials that he’s antivax, antivaxxer Del Bigtree is intently related to him, Bigtree and now chief government of MAHA Motion, a brand new group named after Kennedy’s “Make America Wholesome Once more” slogan that can be proposing appointees to RFK Jr.
No affirmation has come from Trump’s presidential workforce on which place Kennedy will fill. He might solely turn into an adviser, in accordance with the Kennedy marketing campaign’s former director of communications, Del Bigtree.
“President Trump is giving him two years to indicate success,” Bigtree mentioned. “President Trump is keenly within the alternatives that Bobby Kennedy thinks would get the job performed.”
He additionally mentioned that Kennedy would advocate medical doctors who haven’t any “conflicts of curiosity” with Huge Pharma firms concerned in vaccine and drug manufacturing.
That might be attention-grabbing, as any physician who believes as RFK Jr. and Del Bigtree consider about vaccines just about all have conflicts of curiosity. They’re all promoting or selling quackery to deal with both COVID-19 or “vaccine harm.” Bigtree himself has an enormous battle of curiosity, on condition that he has a podcast that makes cash selling antivax disinformation and conspiracy theories and runs ICAN, which he’s paid to run and which exists to sue governments and pharmaceutical firms over vaccines and vaccine coverage.
Worse:
Bigtree is concerned in proposing appointees to Kennedy, having turn into the chief government of the Make America Wholesome Once more Motion group, which seeks to observe on Kennedy’s healthcare marketing campaign pledges.
In the meantime, Reuters is reporting that RFK Jr. is reviewing resumes for high Trump well being jobs.
Will Trump let antivax activist RFK Jr. “go wild” on vaccines (and well being), as promised?
To somebody who has been writing about RFK Jr. for practically twenty years (as I’ve) since he first outed himself as an antivaxxer on the nationwide stage along with his publication of a conspiracy mongering “investigation” co-published by Salon.com and Rolling Stone. Within the article, Lethal Immunity, RFK Jr. falsely implicated the mercury-containing preservative thimerosal that had been utilized in quite a few childhood vaccines till round 2002 as the reason for an “epidemic” of autism, the primary query that involves thoughts is: What function will RFK Jr. have within the second Trump administration? You would possibly recall that at his Madison Sq. Backyard rally two weeks in the past, Donald Trump promised, mentioning Elon Musk:
And we even have any person that’s nice. And look, we’re not going to let him go too loopy, Elon, with the oil and fuel stuff. As a result of Robert F. Kennedy cares extra about human beings and well being and the setting than anyone. And he’s going to be absolute. Having him is such an amazing honor. I’ve been pals of his for a very long time. And I’m going to let him go wild on well being. I’m going to let him go wild on the meals. I’m going to let him go wild on medication. The one factor I don’t suppose I’m going to let him even get close to is the liquid gold that we’ve got beneath our ft. I don’t know, Elon. He may not like liquid gold. It’s oil and fuel. Typically known as oil and fuel. J. D. , I feel we’re going to should hold him away from the oil and fuel. What do you suppose, Howard? Sure?
As I famous final week, it is vitally telling that Trump promised to let RFK Jr. “Make America Wholesome Once more” (an apparent nod to Donald Trump’s “Make America Nice Once more,” or MAGA), however provided that he doesn’t go too far and really do one thing about one of the severe threats to public well being, environmental air pollution, significantly if that air pollution is a results of the fossil gas business. By “telling,” I imply telling about each males: Trump for being prepared to embrace antivax “wellness” grift however not something that may hurt the enterprise pursuits that assist him, and RFK Jr. for being wiling to neglect about his pre-antivax campaign as an environmentalist within the service of reaching energy and declaring MAHA “battle” on the FDA whereas making an attempt (and failing) to cover his true antivax nature.
After all, RFK Jr. does share one trait with Donald Trump. He’s a malignant narcissist, and two malignant narcissists usually don’t combine very properly collectively. Usually, whoever is the extra highly effective narcissist will eliminate or punish the much less highly effective one. For this reason I used to be amused to see tales like this final week:
Let’s simply say that, no less than for the second, I don’t suppose that we will rely on Trump getting so fed up with RFK Jr.’s showboating that he reneges on his promise to nominate him to a high-ranking place on well being in his administration. I’ve little doubt that, sooner or later, Trump and RFK Jr. will butt heads, actually have a falling out, however I doubt that it’s going to occur quickly sufficient to forestall large harm to the federal well being coverage infrastructure, and, even when it does, anybody ready within the wings to exchange RFK Jr.’s affect could be simply as dangerous—and even worse.
In any occasion, in accordance with the story above:
Donald Trump’s workforce gave the impression to be quietly distancing itself from Robert F Kennedy Jr within the rapid aftermath of the election amid hypothesis that the previous presidential candidate could possibly be handed management of US public well being businesses.
Advisers to the president-elect questioned whether or not Mr Kennedy, a vaccine sceptic who has additionally been the topic of a collection of weird tales involving animals, would make it by a safety test for a cupboard place.
It raises questions on what function, if any, Mr Kennedy could be given within the Trump administration, because the Republican’s transition workforce units about filling hundreds of federal posts for his return to the White Home.
Mr Kennedy had beforehand mentioned that Mr Trump had “promised” him management of the Division of Well being and Human Providers and public well being businesses just like the Meals and Drug Administration (FDA).
Nevertheless, there’s disquiet within the Trump workforce about media consideration on the previous unbiased candidate after he was pressed in a post-election interview with NBC about his vaccine scepticism.
Dammit, reporters. RFK Jr. shouldn’t be an “vaccine skeptic.” He’s antivax. In case you can’t name him antivax, no less than don’t misuse the phrase “skeptic.” Name him as a substitute a vaccine misinformation spreader and/or conspiracy theorist, or one thing like that. I’ll cease now, however that’s lengthy been one among my pet peeves about reporting on the antivaccine motion, and I couldn’t resist mentioning it.
However what, precisely, did RFK Jr. say in his NBC Information interview, given the day after the election? I think that it was an try and reassure folks after an interview earlier than the election with the co-chair of Trump’s reelection marketing campaign, Howard Lutnick, who said that RFK Jr. wished “entry to federal well being information so he can present vaccines are unsafe and result in them being pulled from the market in a second Trump administration.” Now that Trump has gained, RFK Jr. is making an attempt to sound extra “average” in an interview with NBC Information reporter Vaughn Hillyard:
Right here’s the important thing half. I’ll quote at size, so that you simply don’t have to look at the video above should you don’t need to and to debate issues that had been overlooked of the information studies on this interview, which included solely transient quotes and overlooked RFK Jr.’s complete mendacious antivax schtick, through which he tries to assert he’s “by no means been antivaccine” (though he most undoubtedly is and has been rabidly antivax for practically twenty years, with an extended historical past of antivax conspiracy mongering and misinformation) and that he gained’t endanger anybody (he most undoubtedly will). As an apart, I’ll point out my frustration at how information organizations by no means appear to supply a full transcript of interviews like this (if there’s one, I couldn’t discover it), leaving me to make use of YouTube’s AI transcript generator (which places time stamps within the transcript that must be deleted and makes a whole lot of errors) and my painstakingly watching the video to supply this:
HILLYARD: You may have been a crusader on questioning vaccines. Are there particular vaccines that you’d search to take off the market?
RFK JR: Oh, I’m not going to I’m not going to remove anyone’s vaccines. I’ve by no means been antivaccine I’ve simply…
HILLYARD (interjects): You’ll not…you’ll not take any vaccine that’s at the moment in the marketplace?
RFK JR: I’m not. If any person, if vaccines are working for any person, I’m not going to take them away. Folks should have selection and that selection ought to be told by the very best info. So I’m going to verify scientific security research and efficacies are on the market and other people could make particular person assessments about whether or not that product goes to be good for them.
HILLYARD: Would that embrace covid vaccines which can be at the moment in the marketplace?
RFK JR: I, I would like the very best science for each vaccine.
HILLYARD: It’s a part of that, in, through the pandemic, the peak of the pandemic, you had been questioning the FDA and calling them out for approving the emergency authorization of the COVID vaccines should you had been in command of the FDA at the moment would you’ve got blocked the authorization of the COVID vaccines such as you had been suggesting publicly?
RFK JR: What I used to be saying at the moment is the vaccines will not be going to forestall transmission, which they had been telling the general public that they’d. They had been saying you could take this vaccine to be able to shield Grandma. I knew in Could of 2020 that the vaccines weren’t going to guard in opposition to transmission, as a result of I used to be really studying the monkey research…
HILLYARD (interjecting): However you wouldn’t have instructed the FDA to dam the authorization of the vaccine…
RFK JR: I’d have been sincere with the American folks and…
HILLYARD (interjecting): So that you wouldn’t, you wouldn’t have blocked it?
RFK JR: I wouldn’t have immediately blocked it I’d have made positive that we had the very best science and there was no effort to try this at the moment.
Translation: RFK Jr. most undoubtedly would have blocked the mRNA COVID-19 vaccines if he had been in cost in 2020. As for his having “learn the monkey research,” my response is that it doesn’t take a lot trying to discover articles about how COVID-19 vaccines may not block transmission however that many vaccines don’t. What we would like from a vaccine is, initially, to forestall extreme illness and dying, which COVID-19 vaccines most undoubtedly achieved. If a vaccine blocks transmission, a lot the higher; that’s icing on the cake. That’s why my response to drivel like that is: So what? RFK Jr. doesn’t have important scientific experience in medication, immunology, molecular biology, virology, epidemiology, public well being, or any related specialty to evaluate the protection and efficacy of COVID-19 vaccines in a science- and evidence-based approach. What he does possess is experience in conspiracy mongering, information dredging, cherry choosing and misrepresenting research, and, typically, being a disinformation agent, experience that he’s honed over the past twenty years since Lethal Immunity.
Within the interview above he’s additionally spreading the standard antivax tropes about “selection” and “consent.” Bear in mind, as I’ve lengthy mentioned, when an antivaxxer like RFK Jr. invokes knowledgeable consent, what he actually means is misinformed refusal (a time period that applies not simply to vaccines however to all rejection of evidence-based remedies) based mostly on a completely warped risk-benefit evaluation through which potential dangers are exaggerated far past what the proof helps, whereas the advantages are downplayed to the purpose the place there are none. I’ve regularly mentioned that, if I really believed the assessments of somebody like RFK Jr. concerning the risk-benefit ratios of vaccines I’d be antivaccine too. That’s why I’ve at all times discovered RFK Jr.’s declare that he’s “not antivax” or that he’s even “fiercely pro-vaccine” to be transparently disingenuous and risible as hell. In any case, RFK Jr. has a virtually 20 12 months historical past of evaluating vaccines to the Holocaust, twisting science (with examples too quite a few to say right here), and conspiracy mongering. The underside line is that RFK Jr. is both mendacity to you or mendacity to himself when he claims he’s “not antivaccine.”
All of that is simply my ordinary extended introduction to a spoiler alert: If he turns into Trump’s “well being czar” or Secretary of Well being and Human Providers (HHS), RFK Jr. will most undoubtedly begin concentrating on vaccines at the moment permitted, if he can, to attempt to show them “unsafe,” irrespective of how a lot he and his minions should distort science and lie to perform this, all as a pretext for finally taking them off the market, all of the bromides about “selection” however, probably beginning with the mRNA COVID-19 vaccines after which continuing to vaccines just like the MMR vaccine and the hated (by antivaxxers) HPV vaccines. If there’s one factor I’ve discovered about antivaxxers (and, certainly, the “well being freedom motion”) over the past quarter century, it’s that, after they invoke “well being freedom,” what they actually imply is freedom for them and individuals who consider what they consider and make the identical choices that they need to make. These of us who attempt to champion science-based medication and well being coverage don’t rely, nor do individuals who attempt to maintain their well being following science- and evidence-based medical suggestions. Be afraid. Be very afraid.
Hillyard, to his credit score, adopted up with a really pertinent query:
HILLYARD: And if there was one other pandemic that had been to strike, why ought to the American public trust that you’d enable a vaccine to be made out there by the market even it’s…
RFK JR: Nicely, I imply, let me level this out. They need to not trust and the people who find themselves managing our pandemic we had the worst file of any nation on the earth so we had 16% of the covid deaths in america of America we solely have 4.2% of the globe’s inhabitants so no matter we had been doing on this nation was the worst of each nation on the earth…
First off, as dangerous because the US did as a nation dealing with COVID-19, for COVID-19 mortality on a per-capita foundation it was not the worst. Peru was. Sadly, that’s chilly consolation, because the US nonetheless did very poorly when it comes to deaths per 100,000 folks resulting from COVID-19 and fell in the midst of the pack when it comes to case fatality ratio.
Be that as it might, one can’t assist however level out who was in cost for many of the first 12 months of the pandemic. (Trace: It was not Joe Biden, who didn’t assume workplace till January 20, 2021. By the point Biden took workplace, the disordered response to COVID-19 led by Trump had turn into so baked in that his administration needed to spend his first 12 months making an attempt to repair the mess that he’d been left at federal public well being businesses) Sure, the person to whom he has bent the knee, Donald Trump, was President when the pandemic first hit. He’s the President who downplayed and largely ignored the warnings in December 2019 and January 2020 that the mysterious new viral respiratory illness resulting from a novel coronavirus then spreading in Wuhan, China may properly end in a significant pandemic. He’s the one who continually interfered with the CDC and FDA response to the pandemic, promoted ineffective repurposed medication like hydroxychloroquine (which was granted emergency use authorization by Trump’s FDA based mostly on far, far much less information than what had been used to grant COVID-19 vaccines their EUAs).
And what’s RFK Jr.’s reply to the issue of pandemic response? He follows the above alternate by saying that he’d eliminate “corruption” on the FDA and CDC, bragging about how he has a PhD in company corruption, after which happening a weird tangent about Fruit Loops supposedly having solely three substances in Canada whereas having 19 substances within the US—”Why do we’ve got Fruit Loops on this nation which have 18 or 19 substances and also you go to Canada and it’s received two or three?”—to be able to justify eliminating the FDA vitamin division.
That’s not all, although. RFK Jr. doubled down on his dangerous thought to advocate—”on day one”—that states cease fluoridating their water, citing the standard cherry-picked research and ranting about “corruption” on the EPA beneath the Obama administration. That is, after all, a really dangerous thought, as Steve Novella simply wrote final week, on condition that fluoride is secure and efficient and water fluoridation packages signify one of many best public well being achievements of the twentieth century. Whereas it’s true that states, not the federal authorities, make coverage choices on water fluoridation, it’s not tough to think about some Republican-led states utilizing such a advice as a cause to cease their water fluoridation packages.
What would RFK Jr. really do?
One factor that’s puzzled me ever since RFK Jr. bent the knee to Donald Trump in return for a job in his administration is the query of what, precisely, he would do, Bigtree’s pronouncements quoted earlier on this publish (which don’t make clear issues in any respect) however. What would RFK Jr.’s function be? Nothing that I’ve learn thus far has actually clarified that. I’ve heard hypothesis that he could be named HHS Secretary, however I’ve had discussions through which folks have mentioned that, even in a Republican Senate (which we can have in January), he’s “unconfirmable,” based mostly his previous and the probably issue he would have gaining a safety clearance from his earlier conduct, which incorporates images documented on this information article, such because the well-known interview this 12 months when he admitted to having dumped a bear carcass in Central Park ten years in the past:
These images don’t even embrace when RFK Jr. beheaded a beached whale and transported the top dwelling on high of his automotive.
Even with these images and RFK Jr.’s historical past I’m not so positive that he’s “unconfirmable” anymore, given what’s turn into of the GOP, however I do know that RFK Jr. doesn’t have any expertise operating a paperwork as enormous as HHS. I additionally suspect that he would chafe beneath most of the mundane particulars that include operating a paperwork as enormous as HHS, significantly given his lack of expertise. So I somewhat suspect that he’ll probably tackle an advisor or “czar” function that’s comparatively undefined and work behind the scenes to choose who runs HHS, the FDA, the CDC, and NIH, whereas letting the picks know simply what he desires them to do.
One of many names that I hold seeing popping as much as be FDA Commissioner is Dr. Martin Makary, though typically I see his title popping as much as lead the CDC. Makary is a well-published surgical oncologist at Johns Hopkins, which is why I regularly joke (as a fellow surgical oncologist) about needing to place a paper bag over my head after I see a few of his pronouncements. You in all probability recall that we at SBM don’t suppose a lot of Makary, who first got here to my consideration as one of many foremost promoters of the parable that medical errors represent the third main reason behind dying within the US, all based mostly on a risibly incompetent research that used unjustifiable extrapolation from small numbers to conclude that 250,000 deaths happen annually in hospitals resulting from medical error. As I identified on the time, everytime you see an estimate of what number of deaths are “deaths by medication,” it’s very useful to match that estimate with what we all know to evaluate its plausibility. Based on the CDC in 2016, of the two.6 million deaths that had been occurring yearly within the U.S., 715,000 occurred in hospitals, which meant that, if Makary’s estimates had been appropriate, 35% of all hospital deaths had been resulting from medical errors. However the plausibility of Makary’s estimate was worse than that. Keep in mind that the higher estimate utilized by Makary and Daniels was 400,000 inpatient deaths resulting from medical error. That was 56%—sure, 56%—of all inpatient deaths. It was by no means wherever close to believable that one-third to over one-half of all inpatient deaths within the US had been (or are) resulting from medical error.
Since then, Marty Makary began out semi-reasonable on COVID-19 however was, as our very personal Jonathan Howard has lengthy documented, fast to be captured by his viewers and absolutely embrace the “let ‘er rip” method to the pandemic in a futile effort to realize “pure herd immunity,” which, he promised, was at all times not more than six months away, after which he quickly pivoted to worry mongering about COVID-19 vaccines. I can’t determine whether or not he could be extra of a catastrophe heading up the FDA or the CDC, given his ideology and lack of {qualifications} for both.
One other title I hold seeing popping up as attainable CDC Director is Dr. Joseph Ladapo. Nevertheless uncertain I’m about simply how dangerous Dr. Makary could be at CDC, I do know that Dr. Ladapo could be an unmitigated catastrophe, given his observe file in Florida, the place he as Surgeon Basic has been in command of the Florida Division of Well being since 2021. This, after all, was by no means surprising on condition that Dr. Ladapo was a founding member of America’s Frontline Docs, which made a reputation for itself in that horrible first summer season of the pandemic by touting hydroxychloroquine as a miracle treatment for COVID-19 and later turned to telehealth grift promoting prescriptions for ivermectin to treatment COVID-19, and a signatory of the Nice Barrington Declaration, the doc revealed by contrarian scientists introduced collectively by a right-wing suppose tank to advocate a social Darwinist “let ‘er rip” method to the pandemic with poorly outlined “centered safety” for these most in danger for extreme illness and dying from the pandemic. Final 12 months, he was busted for altering a Florida Division of Well being research for mendacity with statistics to make it look as if the vaccine was extra harmful than COVID-19 for males beneath 40. Earlier this 12 months, in line with its inclusion on this “steering,” Dr. Ladapo was parroting dangerous science that massively exaggerated the issue of DNA contamination of the vaccine. I mentioned not too way back simply how dangerous he could be as a possible decide on the federal stage, particularly a lot dangerous, man. He’d be an utter catastrophe, it doesn’t matter what company he was positioned in command of CDC, FDA, or no matter.
After which I remembered a Washington Submit article that I had seen earlier than the election however forgotten, reporting that Ladapo is on the shortlist to turn into HHS Secretary, though he would possibly find yourself being Surgeon Basic, on condition that HHS Secretary is a place that requires Senate affirmation and Surgeon Basic shouldn’t be. We will solely hope it’s not HHS Secretary, as, not like the case of being Surgeon Basic in Florida, which has appreciable energy, the publish of Surgeon Basic of the US is extra a bully pulpit, with little precise political energy.
Then there’s Dr. Vinay Prasad, who earlier than the election and much more so for the reason that election appears to be furiously angling for a place within the Trump administration by kissing as much as RFK Jr. and seems to be angling for a excessive rating job at NIH. (He’s clearly too junior to be NIH Director, however I’ve little confidence that that may cease Trump from appointing him.) For instance:
The NIH is a failure. It has by no means examined tips on how to give grant cash. We don’t know if the present system is best than modified lottery or different proposal. It has no real interest in information transparency, publishing in well timed trend, and reproducibility. The company additionally wants a hair reduce, and a frontrunner who understands these considerations.
Whereas the NIH has issues, a few of which I’ve even written about, in these areas, I’ve seen nothing in Dr. Prasad’s Substack and public utterances to counsel that he has clue one what to do to deal with these issues by modifications in coverage and operation. A number of the different issues that he mentions are issues that RFK Jr. notes which can be really issues, akin to too many conflicts of curiosity in sure businesses and a revolving door between authorities and business, however I’ve zero confidence that RFK Jr. or Prasad has any workable concepts on tips on how to appropriate these issues, significantly given how gullible Prasad was in agreeing that RFK Jr. had some extent when he claimed that the childhood vaccine schedule is unsafe as a result of not all vaccines have been examined in opposition to saline placebo, a distortion that I’ve mentioned quite a few instances. Mainly, Prasad has been good at weaponizing the evidence-based medication paradigm in opposition to public well being. One additionally wonders what he thinks of RFK Jr.’s MAHA plan to dedicate half the NIH finances to finding out “integrative” well being and persistent illness.
Lastly, there’s Dr. Jay Bhattacharya, co-author in 2020 of the Nice Barrington Declaration, which advocated a “let ‘er rip” method to the pandemic, with “centered safety” of these at highest danger for extreme illness and dying, to be able to obtain “pure herd immunity,” whereas not spelling out what, precisely, was meant by “centered safety.” It’s an method that by no means would have worked and whose advocates devastated (and proceed to devastate) public well being. What place is his title popping up for? CDC Director, after all.
Quite a few pundits and apologists have been making an attempt to reassure the general public that it isn’t that dangerous, that what RFK Jr. can really do is pretty restricted on condition that a lot of the present development of HHS and the businesses that make it up is outlined by statute and would require an act of Congress to vary too dramatically. True sufficient, however that doesn’t imply that RFK Jr., by the appointment of his buddies, couldn’t do huge harm anyway. Let’s have a look at one instance, the Advisory Committee on Immunization Practices (ACIP). That is the committee that advises the CDC on vaccination coverage and which vaccines to incorporate on the childhood and grownup schedules, which is why it has lengthy been a goal of ire for antivaxxers. In August, Dr. Paul Offit wrote about what kind of mischief that could possibly be performed to ACIP by antivaxxers in a Trump administration, though he centered on The Heritage Basis’s Undertaking 2025 and the need to principally eradicate the CDC as a recommending physique for vaccines. I don’t suppose that even RFK Jr. would try this.
First, Dr. Offit describes ACIP and its historical past:
Through the Forties and Fifties, america Public Well being Service (USPHS) relied on committees that met intermittently to deal with varied vaccine points. For instance, in 1955, the USPHS convened specialists to find out who ought to get Jonas Salk’s polio vaccine. By the early Sixties, with the licensure of recent vaccines, it turned evident that these committees wanted to fulfill frequently. In March 1964, the Surgeon Basic created the Advisory Committee on Immunization Practices (ACIP), which was composed of specialists in virology, immunology, microbiology, pediatrics, epidemiology, public well being, and preventive medication. The cost to the ACIP was clear: “The Committee shall concern itself with immunization schedules, dosages and routes of administration and indications and contraindications for using these brokers. The Committee shall additionally present recommendation [to the CDC] concerning the relative deserves and strategies for conducting mass immunization packages.”
Since 1964, ACIP specialists have beneficial many secure and efficient vaccines. Prior to those suggestions, yearly in america polio prompted 20,000 circumstances of paralysis and 1,500 deaths; measles prompted 48,000 hospitalizations and 500 deaths; mumps was the most typical reason behind acquired deafness; rubella (German measles) prompted 20,000 circumstances of congenital delivery defects; rotavirus prompted 70,000 hospitalizations from extreme dehydration; and micro organism akin to pneumococcus and Haemophilus influenzae kind b (Hib) prompted tens of hundreds of circumstances of pneumonia, sepsis, and meningitis and tons of of deaths. Because of vaccines, and the clear, sturdy suggestions by the ACIP and CDC, these illnesses have been dramatically decreased or eradicated. Certainly, in a latest report revealed on August 8, 2024, researchers discovered that amongst 117 million kids born between 1994 and 2023, CDC-recommended vaccines prevented about 500 million diseases, 32 million hospitalizations, and 1.13 million deaths.
All of that is true, which is why I don’t suppose RFK Jr. would eradicate ACIP, though he may. (The ACIP constitution expires if it isn’t renewed each two years.) Slightly, extra probably he would subvert ACIP. The Secretary of HHS picks the members of ACIP, after a nomination and choice course of. These members serve staggered phrases, and the present roster has 4 members, together with the chair Dr. Helen Keipp Talbot, whose time period expires June 30, 2025, 4 whose phrases expire in 2027, with the remaining expiring in 2028. (The rationale for that is that, for no matter cause, the Biden administration left quite a few ACIP committee positions vacant after the members’ phrases had expired after which appointed a number of new members in February.) By the tip of a Trump administration, all members of ACIP could possibly be changed. Now think about placing, say, RFK Jr. or his designee in command of vetting potential new ACIP Members, a course of that could possibly be used to position 4 antivax and/or contrarian “scientists” and physicians on the committee subsequent June, {qualifications} that potential members be “acknowledged specialists with an impressive file of accomplishment in their very own discipline and an understanding of the immunization points lined by ACIP” be damned. Then in 2027, he may add 4 extra, adopted in 2028 by changing the eight remaining voting members appointed this 12 months.
Common readers can solely think about the catastrophe that may be. Probably no new vaccines could be added to the CDC-recommended schedule, whereas some would possibly even be eliminated, as committee members harass CDC and FDA scientists to torture the protection and efficacy information to make it “confess” that vaccines are unsafe and ineffective. I shudder on the thought. After all, one factor that I do find out about ACIP is that its battle of curiosity reporting necessities are fairly rigorous. That may hold the worst grifters off the committee, however I can’t assure that.
Can RFK Jr. achieve destroying federal public well being coverage and packages?
There are numerous contradictions inherent within the MAHA motion that RFK Jr. has solid with Donald Trump. For instance, RFK Jr. rails in opposition to the FDA as being too beholden to drug firms and fast to approve merchandise with out sufficient proof of efficacy and security, whereas additionally eager to decrease the bar for the approval of the assorted quack remedies that he espouses, akin to ivermectin for COVID-19 and most cancers. He desires to make the FDA extra strict and accountable, which, even when one may belief him to do that proper, would run headlong into the pursuits of huge enterprise supporters of Trump in large pharma. One would possibly simply see Trump being swayed to rein in or eliminate RFK Jr. as a result of billionaires operating pharmaceutical and medical machine firms don’t like him interfering with their enterprise. Given Trump’s historical past, who do you suppose Trump will hearken to, his billionaire supporters or RFK Jr., whom he solely took on as his well being advisor (no matter place he finally ends up occupying) as an expedience, to eliminate a possible menace to his election?
Even so, and even contemplating that it’s going to take years to perform what RFK claims to need to accomplish, be afraid. Be very afraid. Even when RFK Jr. accomplishes solely a fraction what he guarantees, the harm to public well being, the vaccination program, the FDA drug and machine approval course of, and federal science-based well being coverage typically, particularly public well being, might be incalculable. Beforehand managed and even conquered vaccine-preventable infectious illnesses are more likely to return, though it would take just a few years, by which period Trump might be out of workplace and his successor might be blamed. As for the remaining, RFK Jr. is not going to “make America wholesome once more.” Removed from it. He’ll jeopardize the well being of People by making them weak to infectious illness, maintaining the FDA from approving secure and efficient medicines whereas encouraging it approve quackery of which he approves, and subjecting them to foodborne sickness within the pursuit of the “pure,” like uncooked milk. And I haven’t even gotten into how he may change the foundations at CMS to pressure it to pay for quackery beneath Medicare and Medicaid.
The subsequent 4 years might be a catastrophe for science-based well being coverage and packages. The one query is: How dangerous? Once more, my thought is: A lot dangerous, man.