Health and Human Services Secretary Robert F. Kennedy Jr. keeps promising to “make America healthy again,” but his summer-long anti-vaccine rampage made clear that his actual impact will be to make America sicker. A lot sicker. And, in too many cases, dead.
Before we get down to cases, let’s remember why we’re here: Kennedy made a deal with Donald Trump that presumably got Trump some votes from RFK Jr.’s anti-vaccine followers, and Kennedy got the job he’s craved for years.
Like most cultists, Kennedy lives in a made-up reality in which he has a direct line to The Truth – truth that’s being hidden from you by the people who have actually devoted their lives to studying things like medicine, epidemiology, and virology. RFK Jr. is convinced he knows better than they do. He doesn’t.
Kennedy loves to claim that America was healthier when his uncle, John F. Kennedy, was president, cherry-picking a few select statistics to make his point. He conveniently omits the fact that, as NPR noted in a fact-check, life expectancy back then was nearly 10 years shorter than it is today. Black people, whose life expectancy in 1960 was just 63.6 years, have made the biggest gains, coming much closer to parity with whites in recent years—no doubt due in part to all that research on vulnerable and underserved populations that Trump and RFK Jr. have been cancelling as alleged “DEI.”
Kennedy loves to talk about the health of children, but as of 2020 the rate of childhood deaths before age five was less than one quarter of what it was in 1960. You can thank vaccination for a lot of that, but you’ll never hear RFK Jr. admit it. Instead, he’s working tirelessly to make vaccines harder to get – and succeeding.
In late August, under Kennedy’s direction, the FDA restricted its approval of COVID vaccines to those aged 65 and older or those considered especially vulnerable due to chronic preexisting conditions like chronic heart, lung or kidney diseases, depression, obesity, or diabetes. Others can still get vaccinated “off-label” with a doctor’s prescription, but the ease of simply walking into a local pharmacy and getting a shot is disappearing for many. Many Democratic-led states, including the entire West Coast and parts of the Northeast as well as Hawaii, have scrambled to change their rules to preserve vaccine access, but red states thus far have not.
Medical societies were uniformly furious, with the Infectious Diseases Society of America offering a typical response: “By narrowing its approval, FDA has made a decision that completely contradicts the evidence base, severely undermines trust in science-driven policy and dangerously limits vaccine access, removing millions of Americans’ choice to be protected and increasing the risk of severe outcomes from COVID.”
“SMOKE AND MIRRORS”
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That was just the start. A bloodbath at the Centers for Disease Control and Prevention soon followed, and the Sept. 18-19 meeting of the CDC’s Advisory Committee on Immunization Practices – moved to further discourage vaccination and make it more difficult and complicated – and not just for COVID. If you missed the press coverage of the ACIP circus, it’s worth looking up. The LA Times, for example, opened its story this way: “After a contentious discussion that at times referenced discredited theories, low-quality data and desperate pleas from physicians and patients to rely upon sound science, a key CDC committee opted Friday to punt its most consequential vaccine decisions to a future date.” More on that punt in a bit, but nothing that did come out of the meeting was good.
The committee, whose entire membership was fired by Kennedy earlier this year and replaced by Kennedy’s selections that included well-known antivaxxers, came within one vote of requiring a doctor’s prescription for anyone to get a COVID shot. Much of the COVID vaccine discussion centered on a presentation by CDC’s COVID Immunization Workgroup, newly headed by Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology who has no training in medicine, virology or epidemiology. In the past, Levi called for messenger RNA vaccines such as the COVID vaccines to be taken off the market.
While the committee did not vote to absolutely require a prescription, it recommended that the CDC tell doctors to update their warnings to patients to include a variety of supposed risks from the vaccines – risks that scientists and physician groups overwhelmingly consider to be wildly exaggerated and often based on shaky evidence. Elizabeth Jacobs, Ph.D., epidemiologist and Professor Emerita from the University of Arizona as well as a founding member of Defend Public Health, told Chemical and Engineering News, “This is all smoke and mirrors, designed to generate fear of COVID vaccines, with no actual evidence of harm. I have never personally witnessed more dangerous misinformation presented at a putative scientific meeting in my entire life.”
This is the point where I need to make my usual disclosure: I, too, am a founding member of Defend Public Health and do volunteer communications work for the organization. I’m not a disinterested observer here: As I’ve written before, my one encounter with COVID in early 2022 left me with damaged nerves, technically known as peripheral neuropathy, in my legs and feet which will cause me pain as long as I live. I do not want to get infected again, because abundant evidence shows that repeat infections increase one’s risk of Long Covid. And that leads us to a part of the issue that got fairly little attention: The impact of reduced vaccination on Long Covid, which can take a variety of forms, none of them good.
The COVID vaccines aren’t perfect. They don’t offer anything like complete protection against infection, though they do reduce your chances of getting infected, and their effectiveness gradually fades over time. But they do substantially reduce the chance of getting sick enough to be hospitalized or considered critically ill.
And if you do get infected despite being vaccinated, it greatly reduces your chance of ending up with Long Covid and having possibly debilitating symptoms for months, years, or the rest of your life. This has now been reported in multiple studies, including one from The Lancet earlier this year. Another, published late last year in the Journal of Medical Virology, looked at over 370,000 geriatric COVID patients, finding that vaccination not only improved survival, it significantly reduced the incidence of Long Covid. A massive study of over five million patients published last year in the New England Journal of Medicine found that vaccinated patients had Long Covid roughly half as often as the unvaccinated.
No one seriously doubts that by making it harder to get vaccinated against COVID and pressing doctors to give dire and largely untrue warnings about the shots, the number of Americans getting vaccinated, already in decline, will drop further. News stories from states like Florida have already reported people having trouble getting vaccinated, and Walgreen’s, which routinely offers vaccinations at its pharmacies, is not offering COVID vaccines in Florida at the moment. And there could well be problems with insurance coverage for some under the new requirements.
This can only mean more people getting infected, and at least some becoming seriously ill. And more people getting infected and reinfected with the virus will mean a lot more cases of Long Covid with the inevitable disruption of lives, families and the economy. As another of my Defend Public Health colleagues, infectious disease epidemiologist Beth Linas, wrote recently, “Long COVID isn’t an abstract data point—it’s millions of people trying, and often failing, to get their lives back… To reduce vaccine availability now is not just shortsighted, it’s reckless.”
UNLEASHING ANOTHER KILLER?
But Kennedy’s group of antivaccine advisors didn’t just mess with the COVID shots. They also started tinkering with the childhood vaccine schedule, something that RFK Jr. promised not to do while he was trying to get senators to vote for his confirmation. The panel moved to restrict access to a combination shot known as MMRV, requiring kids under four to get a separate shot for varicella, the virus that causes chickenpox. That’s always been an option, and one that many families choose, but it was a move that seemed counter to Kennedy’s repeated claims to support personal hoice on vaccines.
Even scarier, ACIP came close to ending universal hepatitis B vaccinations for newborns, though it delayed a final decision. Hepatitis B is deadly – accounting for 1.1 million deaths worldwide in 2022, according to the World Health Organization.
In the U.S., widespread vaccination has vastly reduced the toll. Writing for Forbes, virologist Matthew Binnicker explains:
“In the 1980s, an estimated 200,000-300,000 Americans became infected annually, with particularly high rates among young adults.
“Healthcare workers faced occupational infection rates as high as 1-2% per year. Following the introduction of routine infant vaccination in 1991 and catch-up programs for older children and high-risk adults, annual infections have plummeted to fewer than 20,000 cases, representing one of vaccination’s most dramatic public health success stories.”
The virus can be transmitted sexually or via blood, but, as Binnicker notes, “Perinatal transmission, occurring when an infected mother passes the virus to a newborn during childbirth, represents the highest risk. Without intervention, up to 90% of infants born to mothers with active hepatitis B infection will become infected.”
Routine vaccination at birth stops perinatal transmission, but Kennedy’s committee now seems ready to call a halt to it at its next meeting, seemingly wanting to revert to only vaccination for those with identified risks. But the hepatitis B status of birth mothers isn’t always known, and a FactCheck.org article earlier this year noted that just such a risk-based vaccination scheme was previously tried and failed. It wasn’t until universal infant vaccination was instituted that rates of infection dropped dramatically.
Across the board, experts have slammed Kennedy’s ACIP for cherry-picking data, selectively grabbing out-of-context snippets that support members’ preconceptions and ignoring the rest. That’s not how science is supposed to work, and we will all pay the price.
