There seems to be a limit to how anti-vax is too anti-vax in the Trump administration. Yesterday, hours before Dave Weldon was slated to begin his Senate confirmation hearing for CDC director, the White House pulled his nomination. Weldon, a physician and former Republican congressman, has long questioned the safety of vaccines. In a meeting last month, he reportedly told one senator that routine childhood vaccines were exposing kids to dangerous levels of mercury and may cause autism. (Both claims are false.)
Weldon has denied that he’s anti-vaccination, but his views on vaccines seem to have been his undoing. In a written statement he gave to me and other outlets, he suggested that at least two Republican senators were threatening to vote against him, and that this became “clearly too much for the White House.” But those two senators, Bill Cassidy of Louisiana and Susan Collins of Maine, voted to confirm Robert F. Kennedy Jr., an ardent vaccine critic who would have been Weldon’s boss as health secretary. Perhaps Weldon’s biggest problem was that he said the quiet part out loud. During his confirmation hearings, Kennedy sidestepped calls for him to declare unequivocally that vaccines do not cause autism, and appeared to convince lawmakers that he’d let Americans make their own decisions about vaccines. “I support the measles vaccine. I support the polio vaccine. I will do nothing as HHS secretary that makes it difficult or discourages people from taking either of those vaccines,” Kennedy told senators.
Kennedy is already breaking that promise. As cases of measles are popping up in states across the country—leading to America’s first measles death in a decade—he has propped up unproven treatments such as cod-liver oil. Though Kennedy has said that the measles vaccine helps “protect individual children from measles” and contributes to “community immunity,” he also baselessly questioned its “risk profile” in an appearance on Fox News earlier this week. (In extremely rare instances the vaccine can have serious side effects.) Kennedy’s subversion of vaccines, subtle at times, glaring at others, goes far beyond the measles outbreak. The health secretary is “using the federal government to undermine vaccination in all the ways that it can,” Matt Motta, a vaccine-communication researcher at Boston University, told me. Weldon may have crossed a red line for lawmakers. But in just over a month on the job, Kennedy has taken more steps against vaccines than perhaps any other top health official in modern American history.
[Read: His daughter was America’s first measles death in a decade]
Kennedy’s wishy-washy comments about the measles vaccine may persuade more parents not to vaccinate their children—which means that more children will get sick, and perhaps die. But his other actions will have an even broader, longer-lasting effect on the overall U.S. vaccination system. Earlier this week, the administration terminated NIH research grants probing how the government can address vaccine hesitancy. Vaccine promotion might seem separate from access, but the two are intertwined, Motta said. Research into vaccine promotion often explores issues such as whether people know where to get shots or whether insurance will cover them. (A spokesperson for Health and Human Services did not respond to a request for comment.)
All the while, the research that the government now is funding may only serve to further sow vaccine distrust. The CDC is reportedly launching a study probing the link between vaccines and autism—even though the connection has already been thoroughly studied and debunked. A 2014 meta-analysis of more than 1 million children found “no relationship” between shots and the condition. Even if the new study comes to a similar conclusion, simply funding such research has consequences, Jennifer Reich, a vaccine-hesitancy researcher at the University of Colorado Denver, told me. The NIH’s new research plays a “powerful symbolic role of making” the link “feel like it is unsettled,” she said.
A myopic focus on the purported connection between vaccines and autism is exactly what some lawmakers feared would color Kennedy’s term as secretary. During Kennedy’s confirmation, Cassidy, a physician, raised concerns that Kennedy and his MAHA movement may undermine science by “always asking for more evidence and never accepting the evidence that is there.” Cassidy, who did not respond to a request for comment, may soon have more reason for disappointment. He ultimately voted to confirm Kennedy based on a plethora of promises and his belief, as he said in a speech on the Senate floor, that RFK Jr. would “work within current vaccine approval and safety-monitoring systems.” Yet Kennedy has already hinted that he will change those systems: “We have a vaccine-surveillance system in this country that just doesn’t work,” he recently said on Fox News, adding that “the CDC in the past has not done a good job at quantifying the risk of vaccines. We are going to do that now.”
Since RFK Jr. entered office, the health agencies have not abandoned all responsibilities surrounding vaccinations. CDC officials have been directly coordinating with the local Texas health department at the epicenter of the measles outbreak, including helping design outreach materials encouraging vaccination, according to internal emails I received as part of a public-records request. A letter addressed to parents from a local health official, for example, states: “I strongly encourage you to have your child vaccinated as soon as possible.”
Perhaps Weldon’s defeat signifies that Washington wants more pro-vaccination efforts like that. But he makes for an easy scapegoat: Unlike RFK Jr., he lacks a devoted fan base backing him up. Kennedy doesn’t need Weldon to do real damage to America’s vaccine infrastructure. The changes he has made so far are likely only the beginning. If Kennedy keeps up this pace, America’s vaccine system may look fundamentally different in one year, or two. The stand against Weldon changes nothing about that.