Donald Trump’s first administration took big strides in vaccine development. Public health experts are concerned his second will try to dismantle it.
Robert F. Kennedy Jr., a vaccine skeptic, became a key surrogate for Trump in the last few months of his campaign. Both Kennedy and Trump have said Kennedy will hold a prominent role in the incoming administration, leading to concern that Kennedy would impede vaccine development from a key perch within the government.
He has personally stoked some of the concern — while Kennedy told NPR this week that he won’t “take vaccines away from anybody,” he has also said Trump has promised him “full control” of the public health agencies, including the Department of Health and Human Services, the Food and Drug Administration and the Centers for Disease Control and Prevention. It’s made public health experts uneasy, given his long track record of promoting conspiracy theories about vaccines and working for a group that opposes the FDA.
Kennedy did not respond to a request for comment. The Trump team responded to questions about actions Trump and Kennedy might take on vaccine development and access with a brief statement that did not touch on specific policy goals.
“The American people re-elected President Trump by resounding margins because they trust his judgment and support his policies, including his promise to Make America Healthy Again alongside well-respected leaders like RFK Jr.,” Karoline Leavitt, a spokesperson for the Trump transition team, said in an email.
But public health experts were nervous about the prospect of Kennedy serving in such a role.
“If Robert F. Kennedy Jr. has any impact on policy development and the vaccine space, it is going to nearly grind to a halt by rejecting existing science and demanding science at a level beyond what is necessary or appropriate in the regulatory space,” said Kathleen Hoke, who directs the Legal Resource Center for Public Health Policy at the University of Maryland School of Law.
“It may actually terminate the industry’s willingness to engage in vaccine development.”
The possibility that Trump’s second administration would take such dramatic action against vaccine development is a departure from the last time he was in office. In May 2020, Trump announced Operation Warp Speed, a program whose goal was to accelerate the development and manufacturing of COVID-19 vaccines as quickly as possible. When the first COVID-19 vaccine was authorized for emergency use by the FDA in December 2020, it had been barely a year since the first cases had been detected in humans.
It was heralded by many as a groundbreaking achievement in vaccine development — including by Trump himself.
“We were very, very happy that we were able to get things done at a level that nobody has ever seen before,” said Trump. “The gold standard vaccine has been done in less than nine months.”
Now, Trump’s enthusiasm about vaccine development seems to have faded. His previous administration’s accomplishments on vaccines weren’t touted on the campaign trail.
“I’m going to talk to [Robert F. Kennedy Jr.] and talk to other people, and I’ll make a decision, but he’s a very talented guy and has strong views,” Trump said when asked about the possibility of his administration imposing a ban on certain vaccines during an NBC News interview on Sunday.
HHS, the FDA and the CDC were not immediately available to comment on how the incoming administration could impact vaccine development and access.
An outright ban on vaccines is unlikely to be successfully implemented. Vaccines are approved by the FDA and mandated or limited by the states. They cannot be removed from the market by the president without a legal fight, said Jason Schwartz, an associate professor at the Yale School of Public Health.
But, Schwartz added, it would be possible for the commissioner of the FDA or the director of the CDC to make a unilateral decision on things like drug approval or the CDC’s recommended vaccine schedule.
“Even if they might create pushback or public scrutiny, whether they have those powers is pretty clear,” said Schwartz.
It’s rare for a political appointee to make a single-handed decision on the availability of a drug, but it’s not without precedent. In 2011, former HHS Secretary Kathleen Sebelius overruled the FDA’s decision to make Plan B emergency contraception available to those 16 or younger without a prescription. Her decision was supported by then-President Barack Obama. Plan B is still only available by prescription for those under 17.
During the first Trump administration, former HHS Secretary Alex Azar overrode the FDA’s ability to regulate some tests developed by individual labs for their own use, including those used to test for COVID-19.
Public health experts are accustomed to seeing a variety of tactics used to try to block vaccine development and strip away FDA authority. Kennedy formerly served as chair and chief counsel for Children’s Health Defense, a nonprofit group that has pursued a number of those efforts.
The Children’s Health Defense, which did not respond to a request for comment, petitioned the FDA to revoke all authorizations and approvals for COVID-19 vaccines and sued the FDA in an effort to pressure the agency to revoke the Emergency Use Authorizations granted to Pfizer and BioNTech’s COVID-19 vaccine.
Emergency Use Authorizations act as an alternative to the full FDA drug approval process, which can take years, and can be revoked by the FDA at any time.
Experts brought up a range of proposals from Children’s Health Defense like that one that would weaken the FDA’s authority or finances. They also include proposals such as ending the FDA’s user fees program, which are fees authorized by Congress that the FDA collects from companies that seek to have their products reviewed by the agency. The proceeds from user fees made up 46% of the FDA’s budget in 2022 and the program is up for congressional renewal in 2027.
“Without those user fees, either the FDA will need to get more dollars from Congress, or they will need to do less and move more slowly,” said Schwartz, adding that there has been bipartisan concern over the role that user fees play for decades.
Kennedy and Trump could also choose to make changes to the CDC or FDA vaccine advisory committees, health policy experts say, either by stacking them with members who are skeptical about vaccines or by dissolving the committees entirely. The vaccine schedule recommendations made by these committees inform state laws and general public health guidance.
While Kennedy’s track record on vaccines doesn’t inspire confidence from public health experts, it’s unclear how much he will use his newfound power within the health system he has so long opposed, said Wendy Parmet, director of the Center for Health Policy and Law at Northeastern University.
“It’s one thing to rail against the establishment when you are on the outside,” Parmet said. “It’s another thing to rail against it when you are on the inside, and public health emergencies or collapses of pharmaceutical companies happen on your watch.”
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Margaret Manto is a NOTUS reporter and an Allbritton Journalism Institute fellow.