Concerns mount over prospect of Robert F. Kennedy Jr. leading HHS

In the wake of President-elect Donald Trump announcing that he wants Robert F. Kennedy Jr. to lead the U.S. Department of Health & Human Services, many critics focused on his well-documented vaccine skepticism.

President-elect Donald Trump wants Robert F. Kennedy Jr. to lead the U.S. Department of Health & Human Services, a prospect that has alarmed public health leaders.

Kennedy has routinely spread vaccine misinformation, including citing debunked studies linking vaccines to autism, critics say. Healthcare leaders worry that Kennedy would discourage the use and development of vaccines, and undermine public confidence in their safety, if he leads the nation’s health department. Opponents of Kennedy’s nomination to lead HHS called Trump’s choice “dangerous” and “disastrous.”

But in the days since Trump has nominated Kennedy for the post, more healthcare leaders have pointed out Kennedy’s lack of qualifications to lead an agency that affects the health and welfare of all Americans. The health department oversees Medicare and Medicaid programs, along with the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, the chief source of research funding, and a host of other agencies.

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Ezekiel Emanuel, MD, a former White House adviser for health policy under President Barack Obama, told MSNBC that Kennedy is “unqualified for the job.”

Emanuel, the vice provost for global initiatives at the University of Pennsylvania, said putting someone without a scientific or medical background in charge of a health agency with a $1.7 trillion budget is a bad combination.

“He doesn't have management experience,” Emanuel said on MSNBC. “He doesn't understand how science is done. He doesn't understand how the federal government evaluates various studies. He can't actually look at a research paper and look at the data and draw conclusions.”

Emanuel doesn’t discount that some of Kennedy’s views are worthy of support, including a focus on chronic diseases and a need for more oversight of highly processed foods. He also said Kennedy is correct in drawing attention to conflict-of-interest issues in evaluating the safety of drugs, medical devices, and food.

But he said Kennedy’s worthwhile views on some health issues are undercut by Kennedy’s public statements against vaccines, “one of the greatest inventions humans have ever had.”

“It's estimated we've saved 154 million people from vaccines in just the last 50 years, in the United States alone,” Emanuel said.

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‘Absolutely terrifying’

Kathleen Sebelius, who led the U.S. Health Department under President Obama, told MSNBC that the prospect of Kennedy leading the agency “is absolutely terrifying and people should understand how serious it is.”

“This is life or death,” said Sebelius, the former Kansas governor. “The HHS affects people from birth to their grave and is intimately connected with every state in the country. So this could be very dangerous. I think it’s totally disqualifying for anyone who seeks to lead the major health agency in this country and one of the leaders in the world to just unequivocally say there is no safe and effective vaccine.”

Kennedy said on a podcast “there’s no vaccine that is safe and effective,” as the Associated Press reported.

In an interview with MSNBC, Kennedy said he wasn’t going to get rid of vaccines.

“I’m not going to take away anybody’s vaccines,” Kennedy said. “If vaccines are working for someone, I’m not going to take them away.”

Still, Kennedy’s pledge hasn’t assuaged the concerns of his critics.

Emanuel said on MSNBC that he’s concerned Kennedy won’t approve vaccines, or won’t certify them so they can be reimbursed by insurance companies. He’s also worried Kennedy will put a chill in drug companies developing new vaccines to deal with infectious diseases.

Certainly, Kennedy has supporters. U.S. Sen. Bill Cassidy, R-La., a physician who will head the Senate Health, Education, Labor and Pensions Committee next year, spoke positively about Kennedy’s nomination last week. U.S. Sen. Rand Paul, R-Ky., another physician, praised Trump’s nomination of Kennedy.

Tommy Thompson, who led HHS under President George W. Bush, told The Milwaukee Journal-Sentinel that he supported Kennedy as the department’s next leader. Thompson acknowledged concerns about vaccines, but he lauded Kennedy’s focus on chronic diseases and processed foods. He said he thought Kennedy could “reform the department.”

“He's on the right subjects that I started when I was secretary, so I'm all for it,” he said.

Another former HHS secretary, Donna Shalala, opposes Kennedy’s nomination. Shalala, who led the department under President Clinton’s administration, wrote on X that Trump’s nomination of Kennedy was “shocking.”

“Kennedy is an unqualified, know nothing,” Shalala wrote. “He is dangerous to the health and well being of every American.”

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‘Threaten countless lives’

Geeta Nayyar, MD, wrote about misinformation in healthcare in her book, “Dead Wrong,” and briefly mentioned Kennedy in that work. In a post on LinkedIn, Nayyar said she worried that Kennedy will bring vaccine conspiracies to the mainstream. She noted that Kennedy was included in the “Disinformation Dozen” that spread the bulk of vaccine misinformation online.

“He was so dangerous from the fringes. What can he accomplish from a position of power? That’s unclear. But we already know how much damage he can do simply by sowing doubt in vaccines,” Nayyar wrote in her post.

Uché Blackstock, MD, founder and CEO of Advancing Health Equity, wrote on LinkedIn that the nomination of Kennedy is “a direct threat to the integrity of public health.”

Blackstock wrote that she is especially concerned that Kennedy’s misinformation about vaccines would weaken trust in public health and disproportionately harm vulnerable groups, including Black communities and other minority groups.

“Public health leadership must champion science and equity, working to build trust rather than sow doubt,” she wrote. “The stakes could not be higher: we need leaders who will protect, not endanger, the health of communities. RFK Jr.’s track record demonstrates a clear opposition to these principles.”

Richard Besser, MD, former acting CDC director and the current president of the Robert Wood Johnson Foundation, has spoken out against Kennedy's nomination. In a post on LinkedIn, he said his concerns aren't based on partisan views.

"Indeed, the reason to oppose Robert F. Kennedy Jr.’s nomination is not because of his politics, or even the politics and priorities of the incoming Trump administration," Besser wrote. "If he’s permitted to use Health and Human Services as his soapbox to promote dangerous and unfounded conspiracies, Kennedy will literally threaten countless lives across America."

The Senate must confirm the HHS secretary and it’s still unclear if Kennedy will win approval from a majority of the Senate. Some public health leaders express doubt that Kennedy will be confirmed.

Protect Our Care, a healthcare advocacy group, is pressing senators to reject Kennedy’s nomination and targeting vulnerable Republicans, Politico reported.

Brad Woodhouse, executive director of Protect Our Care, said in a statement, “RFK Jr. is deeply unqualified, deeply unserious, and deeply dangerous. This nomination would be a joke if it wasn’t so deadly serious and every United States Senator who cares about the health of their constituents should oppose it.”

Nayyar said healthcare leaders need to be prepared for “science denial at the helm of HHS.”

“A head of HHS who casts doubt on vaccines, guts federal health agencies, and diverts resources from infectious disease prevention (have we already forgotten the 1 million+ Americans who died during the pandemic?) is not going to make our jobs any easier. But it does make our jobs — and our responsibility to stand up for science — even more important,” Nayyar wrote.