On Sunday, Robert F. Kennedy, Jr., the recently confirmed Secretary of the U.S. Department of Health and Human Services, published an opinion piece on the Fox News website, headlined “Measles Outbreak Is Call to Action for All of Us.” The subheading was plainspoken: “MMR vaccine is crucial to avoiding potentially deadly disease.” Kennedy wrote that he was “deeply concerned” about the ongoing measles outbreak, which was first detected in West Texas in late January. The number of confirmed cases owing to the outbreak has risen to almost two hundred, at least twenty-three people have been hospitalized, and two people—a child in Texas and an adult in New Mexico, both of whom were unvaccinated—have died.
In keeping with his well-known, decades-long crusade against vaccines, Kennedy initially downplayed the West Texas outbreak, calling it “not unusual,” and, at first glance, his piece might have seemed to represent a startling reversal of his position. Kennedy founded the Children’s Health Defense, an anti-vaccine nonprofit, and served as the organization’s chairman and chief litigation counsel from 2015 until 2023. He has spoken of childhood vaccination as an evil on par with the Holocaust, and with pedophilia in the Catholic Church. He has linked the vaccine for measles, mumps, and rubella (known as M.M.R.) to autism and leukemia. In 2019, Kennedy travelled to Samoa to urge families not to accept the M.M.R., adding fuel to a measles outbreak that eventually killed eighty-three people, mostly children; Kennedy later alleged, without proof, that most of those who died never had measles. In his foreword to “The Measles Book,” a Children’s Health Defense publication from 2021, Kennedy writes, “Measles outbreaks have been fabricated to create fear that in turn forces government officials to ‘do something.’ They then inflict unnecessary and risky vaccines on millions of children for the sole purpose of fattening industry profits.”
Now Kennedy has found himself in the role of the government official who is expected to “do something” about a measles outbreak, and perhaps he sees the utility in appearing to modulate his views. But the text of his Fox News piece is more equivocal than its top lines would suggest. Kennedy has not advised parents to vaccinate their children, but rather to “consult with their healthcare providers to understand their options to get the MMR vaccine. The decision to vaccinate is a personal one.” As Paul Offit, who is a pediatrician and the director of the Vaccine Education Center, at Children’s Hospital of Philadelphia, put it, “Whether or not you want to catch and transmit this disease in an epidemic situation where a child has died—he’s saying that’s your choice.”
In an interview with Fox News that aired on Tuesday, Kennedy did not endorse vaccines but instead touted over-the-counter solutions for measles, including vitamin A (which can be toxic at high doses) and cod-liver oil—the kinds of “natural” remedies preferred by adherents of his Make America Healthy Again movement. In a 2021 podcast appearance, Kennedy recalled, “I had measles when I was a kid. I had eleven brothers and sisters—we all got measles. It was a great week. We stayed home. We watched ‘Sea Hunt.’ ” He went on, “The treatment for measles is chicken soup and vitamin A. You can’t patent those.”
Kennedy’s nostalgic memories are at odds with the well-documented long-lasting harm that the virus can wreak on patients and communities. Measles induces an acute immunosuppressed state that can last from two weeks to two months, putting a patient at high risk for opportunistic infections such as influenza and bacterial pneumonia. The virus also inhibits the immune system’s ability to recognize pathogens from previous exposures to disease for up to three years. “Immune memory is an extraordinary thing, in which your immune system learns to defend you against future exposures and future infections,” C. Jessica Metcalf, who is a professor of ecology, evolutionary biology, and public affairs at Princeton, told me. “Measles depletes exactly the cells that enable you to remember earlier infections.” This phenomenon, known as immunological amnesia, means that a child who contracts measles at age three is more likely to be hospitalized with, say, a pneumococcal infection at age five, although parents and physicians may not draw the connection.
Metcalf is a co-author of a 2015 study of measles cases in the U.S., the U.K., and Denmark that tracked how outbreaks lead to increased infectious-disease mortality over all in kids. Another study, from 2019, showed that measles caused “profound depletions of antibodies against all sorts of pathogens,” the epidemiologist and immunologist Michael Mina, who was the lead author on both studies, told me. He added, “Some kids would lose seventy per cent of all of their protective antibodies against other infections.” The insidious, lingering nature of measles means that we won’t know the full impact of the West Texas outbreak for some time.
Kennedy has indicated that, on his watch, the National Institutes of Health—which operates under the purview of H.H.S. and funds the vast majority of biomedical research in the U.S.—will provide less support to infectious-disease studies, in favor of more research into chronic conditions such as obesity, diabetes, and cancer. As a Presidential candidate in 2023, Kennedy appeared at an anti-vaccine event in Georgia, where he made a promise to his audience: “I’m gonna say to N.I.H. scientists, ‘God bless you all, thank you for public service, we’re going to give infectious disease a break for about eight years.’ ”
As for the vaccines that prevent these diseases, there’s ample reason to doubt whether Kennedy has meaningfully switched up his views. One of his current top advisers has petitioned the Food and Drug Administration to revoke its approval of the polio and hepatitis-B vaccines and to halt distribution of several others. After Kennedy took the helm at H.H.S., he paused a clinical trial for an orally administered COVID-19 vaccine, claiming in a written statement that “four years of the Biden administration’s failed oversight have made it necessary to review agreements for vaccine production.”
Kennedy also postponed the first meetings of the F.D.A.’s vaccine-advisory committee and the Advisory Committee on Immunization Practices, or ACIP, which makes recommendations to the Centers for Disease Control and Prevention. Meanwhile, President Trump’s nominee to head the C.D.C. is David Weldon, a physician and a former Republican U.S. congressman from Florida who, like Kennedy, has promoted the bogus claim that vaccines cause autism. If confirmed, Weldon will have the authority to withdraw the C.D.C.’s endorsement of certain vaccines, which would mean that insurance companies would not be legally obligated to cover them, and that eligible kids could no longer receive them under the federal Vaccines for Children program. “If R.F.K., Jr., starts meddling with ACIP, and fills it with anti-vaccine people or just bad actors—that’s how you can destroy the U.S. vaccine program from the inside out,” Mina said.
“R.F.K., Jr., is the same person he always was,” Offit told me. “He is a virulent anti-vaccine activist. I think he’s going to do whatever he can to make vaccines less affordable and less available.”
A central irony of the MAHA movement is that, though it champions disease prevention, it stands in opposition to many of the fundamental tools of preventive care, whether it’s the vaccine schedule for kids, mammograms for adult women, or annual flu shots for all. Many MAHA-focussed wellness influencers warn their followers that mammograms actually cause breast cancer by exposing patients to low levels of radiation, and Kennedy blames his voice disorder, known as spasmodic dysphonia, on the flu vaccine. The MAHA faithful are also extremely wary of antibiotics, which, beginning in the nineteen-forties, radically lowered the measles mortality rate by attacking the secondary bacterial infections caused by the virus. (The MAHA line is that measles mortality cratered solely because of improved nutrition and sanitation practices.)
Among the influencers who have acknowledged the measles outbreak—including the army of “MAHA moms,” who tailor their messaging to fellow-mothers—the refrain is that a “well-nourished” child has little to fear from measles. Their argument is that nutrition, not vaccines, protects a person against measles and other diseases; a widely circulated graphic on social media prescribes “immune-supporting foods”—bone broth, garlic, ginger, probiotics—along with Kennedy-approved doses of vitamin A and cod-liver oil. According to the MAHA moms, ultra-processed foods, additives, and refined sugar are the real breeding grounds of deadly disease.
“Part of this, and it’s subtle, is that, if you or your child gets sick, that says something about you, that you failed at some level,” Offit said, “when, in fact, you can be perfectly well-nourished and die from a viral infection.” Offit was on the front lines of the 1991 measles epidemic in Philadelphia, which exploded in a pair of churches that practiced faith healing. Fourteen hundred cases of measles were reported, and nine kids died. “Those children who died were perfectly healthy” before contracting measles, Offit said.
During Kennedy’s Senate confirmation hearings, he emphasized his belief that individual dietary choices are the key both to improving the United States’ dismal international rankings in health outcomes and to lowering over-all costs. “We need to focus more on outcomes-based medicine, on putting people in charge of their own health care, of making them accountable for their own health care so they understand the relationship between eating and getting sick,” he said. He went on, “Our country will sink beneath a sea of desperation and debt if we don’t change course and ask why our health-care costs are so high in the first place.” Debates over who should be forced to pay for care, Kennedy has said, are akin to “moving deck chairs around on the Titanic.”
Kennedy has spoken disparagingly of both Medicaid and the Affordable Care Act—two deeply flawed attempts to inch toward something resembling comprehensive coverage for everyone. Then again, it’s unclear that he understands much about health-care policy at all. He has claimed, for example, that “Medicaid is fully paid for by the federal government” (it is not), that Medicaid “premiums are too high” (Medicaid recipients, by and large, do not pay premiums), and that health-savings accounts should be introduced into Medicaid (what?). He is far more positive about Medicare Advantage, which, despite its misleading name, is facilitated through private health-care companies. These insurers include UnitedHealthcare, whose C.E.O. was assassinated in December, making a folk hero out of his alleged killer.
When Kennedy says—as he does rather relentlessly—that Americans are “the sickest people on earth,” he does not acknowledge that the nations at the top of the health-care rankings all have two things he doesn’t like: universal health care and comprehensive vaccine programs. Both rely on communality, a sense of shared beliefs and shared humanity, which does not comport with a cult of individual choice and personal accountability. In Kennedy’s view, Americans are not uniquely beset by a privatized fee-for-service labyrinth characterized by administrative bloat, scant price regulation, a hospital system hollowed out by private equity, and rampant, grotesque greed. Rather, they are beset by illness caused by the medical establishment and the pharmaceutical industry, the latter of which is, in the words of the MAHA evangelist Calley Means, “foundationally incentivized for children to be sick.” Above all, they are beset by their own ignorance and poor choices. One might say that the decision to be the sickest people on earth is a personal one. ♦
