RFK Jr. claims Trump promised to put him in charge of NIH, CDC, and more

Earlier this week, Robert F. Kennedy, Jr. used a Zoom call to tell his supporters that Donald Trump had promised him "control" of the Department of Health and Human Services (HHS), the federal agency that includes the Centers for Disease Control, Food and Drug Administration, National Institutes of Health, as well as the Department of Agriculture. Given Kennedy's support for debunked anti-vaccine nonsense, this represents a potential public health nightmare. A few days after, Howard Lutnick, a co-chair of Trump's transition team, appeared on CNN to deny that RFK Jr. would be put in charge of HHS. But he followed that with a long rant in which he echoed Kennedy's spurious claims about vaccines. This provides yet another indication of how anti-vaccine activism has become deeply enmeshed with Republican politics, to the point where it may be just as bad even if Kennedy isn't appointed.

Trump as Kennedy’s route to power

Kennedy has a long history of misinformation regarding health, with a special focus on vaccines. This includes the extensively debunked suggestion that there is a correlation between vaccinations and autism incidence, and it extends to a general skepticism about vaccine safety. That's mixed with conspiracy theories regarding collusion between federal regulators and pharmaceutical companies. While there is no evidence for any of this, and some of it is clearly wrong, the conspiracies have real-world consequences. An anti-vaccine activist in Samoa, aided by a visit from RFK Jr., helped pave the way for a measles outbreak that shut down the government and ultimately led to over 80 deaths. Kennedy has long been interested in getting access to the agencies that regulate vaccines and other interests of his, such as food safety, under the assumption they are hiding the data that would vindicate his views. And, long before his recent presidential run, he viewed Trump as the route to that access. Shortly before Trump's inauguration in 2017, Kennedy claimed that he would be appointed to head a vaccine safety commission that Trump would supposedly create once in office. Nothing ever came of that, and it was never clear whether that was due to Trump lying to him, Kennedy exaggerating his significance, or Trump simply telling him what he wanted to hear at the time and never following up. We're now back in an ambiguous situation. On Monday of this week, Kennedy used a Zoom call with supporters to announce that Trump had promised him control of a number of federal health agencies:

The key, which President Trump has promised me, is control of the public health agencies, which is HHS and its sub-agencies, CDC, FDA, NIH and a few others. And also the USDA, which is, you know, key to making America healthy, because we've got to get off of seed oils and we've got to get off of pesticides … and we need to make that transition to regenerative agriculture.

Note that "control" is exceedingly ambiguous here. HHS and Agriculture are headed by occupants of separate cabinet positions. Even assuming Kennedy could get approved in a closely divided Senate or put in place as an acting head, having a single person in charge of both agencies is unlikely for various reasons. But (assuming Trump did promise this and will follow through), the ambiguity of "control" would allow Kennedy to be appointed as some sort of unofficial health czar. (This would be similar to some of the ideas floating around about Elon Musk being appointed to a governmental position that doesn't currently exist.)

The anti-vaccine rhetoric is coming from inside the house

That potential makes Trump transition team co-chair Lutnick's appearance on CNN less reassuring than it might be otherwise. Asked about Kennedy's claims by journalist Kaitlan Collins, Lutnick said flatly that "he's not getting a job for HHS." But at the same time, he strongly suggested that Kennedy would have some sort of health role in any Trump administration that results from the upcoming election. And it was clear that, after meeting with Kennedy as part of his transition work, he was completely sold on vaccine misinformation. "A baby's born with 76 vaccines because in 1986 they waived product liability for vaccines," Lutnick claims, ignoring the fact that we now routinely vaccinate for diseases that didn't have vaccines available in 1986. He also directly tied an increase in vaccinations to rising rates of autism, a common Kennedy claim that multiple studies have shown is false. When Collins mentioned studies had shown vaccines were safe, Lutnick pushed back, saying, "Why do you think that vaccines are safe? They're not proven." Lutnick claimed that Kennedy wants access to government safety data because "they block the data." When Collins correctly interjected that safety data is available online, Lutnick simply dismissed that reality and went on to say that Kennedy has a very goal-oriented view of what he intends to do with his access: "He wants the data so he can say that these things [meaning vaccines] are unsafe." Collins admitted she was unprepared for the conversation to wade into anti-vaccine advocacy but simply said that scientists had stated that Kennedy pushes lies about vaccines. Lutnick went straight into conspiracy territory, saying that "scientists are paid to say he pushes lies." All of which is to say that at least some elements of the Trump establishment are getting a bit difficult to distinguish from Kennedy himself. So, even if Kennedy doesn't end up with any sort of position within a potential future Trump administration, it's entirely possible that someone who shares his views will. And Trump has claimed he will block funding for any schools with a vaccine mandate. So, there is little doubt that if a Republican administration takes office in January, it will be a catastrophe for public health. Since the last Trump administration, doubts about vaccine safety have become commonplace among Republicans. And that's driving some antivaccine activism at the state and local levels that will undoubtedly continue even if Trump isn't returned to office.