Originally published by our sister publication Infectious Disease Special Edition
By Marie Rosenthal, MS
Despite many questions about Robert F. Kennedy Jr.’s views on vaccines, knowledge of Medicare and Medicaid, and other issues, the Senate Finance Committee voted along party lines (14 to 13 ) to send his nomination for secretary of the Department of Health and Human Services (HHS) to the full senate for a vote.
Mr. Kennedy appeared before two committees, Finance and the Senate Committee on Health, Education, Labor & Pensions (HELP), although the HELP committee did not vote on his nomination. Sen. Bill Cassidy (R-La.), who sits on the Finance Committee and is the chair of the HELP Committee, questioned Mr. Kennedy extensively on his anti-vaccination statements and actions (see related story).
Sen. Cassidy, who is a former practicing physician, closed the HELP hearing on Jan. 30, admitting that he was “struggling” with this nomination. “I think I can say that I have approached [the hearings] using the preponderance of evidence to reassure [you that vaccines are save and effective], and you have approached using selected evidence to cast doubt,” he told Mr. Kennedy.
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However, by the Finance vote on Feb. 2, his struggle was over. Sen. Cassidy voted in favor of sending the nomination forward. In a speech on the floor of the Senate after his vote, he explained his decision.
“After seeing patients die from vaccine-preventable diseases, I dedicated much of my time [as a physician] to vaccine research and immunization programs, personally witnessing the safety monitoring and the effectiveness of immunization,” Sen. Cassidy said. “Put simply, vaccines save lives.”
The senator added that he investigated his decision exhaustively. “I spoke with Mr. Kennedy not once, but multiple times over the weekend, including this morning. We had in-depth conversations about the medical literature and the science behind the safety of vaccines.”
Sen. Cassidy stressed that he is not the only person in the medical community who has expressed concern about Mr. Kennedy’s nomination. Some of “the most notable opponents of Mr. Kennedy were pediatricians on the front lines of our children’s health, who regularly have to combat … vaccine skepticism with correct information,” he said. That questioning “comes from their education, training and experience as physicians,” the senator explained. “They are aware of the falling vaccine rates and the inevitability of increasing hospitalizations and deaths of children from vaccine-preventable diseases. They are aware that children are now contracting diseases that they would not have contracted if the children were vaccinated.”
Sen. Cassidy also questioned Mr. Kennedy’s repeated calls, both in past comments and during the hearings, for more data supporting widespread vaccinations. “Mr. Kennedy has been insistent that he just wants good science and to ensure safety. But on this topic, the science is good, the science is credible. Vaccines save lives. They are safe. They do not cause autism. There are multiple studies that show this. They are a crucial part of our nation’s public health response.”
However, “as someone who has discussed immunizations with thousands of people, I do recognize that many mothers need reassurance that the vaccine their child is receiving is necessary, effective, and most of all safe.”
Sen. Cassidy said he voted in favor of sending Mr. Kennedy’s nomination to the Senate for a full vote because Mr. Kennedy promised he would “work within the current vaccine approval and safety monitoring systems, and not establish parallel systems.” The nominee also assured him that, if confirmed, he “will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices [ACIP] without changes” and that the “CDC will not remove statements on their website pointing out that vaccines do not cause autism,” Sen. Cassidy said.
Mr. Kennedy also promised the senator that HHS would “provide a 30-day notice to the HELP Committee if the agency seeks to make changes to any of our federal vaccine safety monitoring programs, and HELP Committee will have the option to call a hearing to further review [such changes],” Sen. Cassidy said, adding that these assurances were enough to assuage his doubts.
ID Experts, Public Health Officials Still Concerned
“What is really disappointing to me is that there were two physicians that voted to confirm RFK Jr.,” said Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, in Baltimore, during a media briefing sponsored by American Public Health Association (APHA) after the nomination was put forward. The decision to advance Mr. Kennedy’s name was “atrocious” and “ignores the value of vaccines,” Dr. Adalja said.
Dr. Adalja added that he doubts the nominee’s reassurances given over the weekend because Mr. Kennedy “spent his career denigrating [the childhood vaccination schedule] … and trying to persuade people not to follow it or to not even engage with it.
“We just won't make substantial progress [in improving America’s health] if we continue to chase falsehoods,” Dr. Adalja said.
Tom Frieden, MD, a former director of the CDC, said Mr. Kennedy’s claims that the ACIP is biased is one reason he is concerned that Mr. Kennedy will not keep the promises he made to Sen. Cassidy. “At his first confirmation hearing, Mr. Kennedy claimed that 97% of [ACIP members] have conflicts of interest. This is … a falsehood that can undermine trust in vaccines and endanger our children,” said Dr. Frieden, who is currently the president and CEO of Resolve to Save Lives, a non-profit advocacy group focused on preventing chronic diseases in the United States and abroad. “The ACIP is composed of dedicated pediatricians, nurses, parents, public health experts and others. Every deliberation is fully transparent, and any actual or potential conflict of interest is disclosed.”
If an ACIP member is found to have a potential conflict, “they recuse themselves from related discussions,” Dr. Frieden said.
Georges C. Benjamin, MD, the executive director of the APHA, a 150-year-old group focused on public health policy and advocacy, said he was disappointed that the committee did not stop Mr. Kennedy’s nomination. “In our minds, it puts the health of Americans in the hands of someone who is not really capable of doing the job the way the job needs to get done,” Dr. Benjamin said, adding that he hopes the full Senate does not confirm him.
If the Senate does confirm Mr. Kennedy as the nation’s next head of HHS, Sen. Cassidy assured his colleagues and constituents that he will keep close tabs on him. “If Mr. Kennedy is confirmed, I will use my authority as chairman of the Senate committee with oversight of HHS to rebuff any attempts to remove the public’s access to lifesaving vaccines without ironclad, causational scientific evidence that can be defended before the mainstream scientific community and before Congress,” Sen. Cassidy said. “I will carefully watch for any effort to wrongfully sow public fear about vaccines between confusing references of coincidence and anecdote.”
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