Robert F. Kennedy Jr., the vaccine critic who spawned a movement he calls “Make America Healthy Again,” moved one step closer to becoming the nation’s health secretary on Wednesday after the Senate voted along party lines to advance his nomination, setting the stage for a final confirmation vote, likely on Thursday.
The 53-47 vote was a stunning show of Republican support for President Trump, who embraced Mr. Kennedy, the scion of a liberal Democratic dynasty, and promised to let him “go wild” on health. And it was a sign of Mr. Kennedy’s strength; in the immediate aftermath of Mr. Trump’s election, many observers thought he would be unable to win confirmation.
Mr. Kennedy’s vocal criticism of vaccination made some Republicans deeply uneasy. During his confirmation hearings, he refused to accept the scientific consensus that vaccines do not cause autism, rejecting large scale studies that have found no link.
But at the same time, Mr. Kennedy declared himself in favor of the measles vaccine and the polio vaccine and vowed not to do anything as health secretary that would prevent or discourage people from taking those shots.
Among the most closely watched votes on Wednesday was that of Senator Mitch McConnell, the Republican leader and the Senate’s lone polio survivor, who voted in favor of moving ahead with the confirmation. That does not mean Mr. McConnell’s final vote is assured; he voted to advance the nomination of Tulsi Gabbard as director of National Intelligence, but voted against confirming her on Wednesday.
Mr. McConnell did not have a customary courtesy visit with Mr. Kennedy, and he had warned that “anyone seeking the Senate’s consent to serve in the incoming administration would do well to steer clear” of “efforts to undermine public confidence in proven cures.” Polio survivors were watching his vote closely.
Senator Lisa Murkowski Republican of Alaska, whose support for Mr. Kennedy was also uncertain, also voted in favor. Ms. Murkowski told Mr. Kennedy during his confirmation hearing that vaccination campaigns had been essential to the survival of Alaska’s native people.
Both Mr. McConnell and Ms. Murkowski had kept their plans a tight secret. Still, it was clear going into Wednesday’s vote that the nomination would move forward. Mr. Kennedy had already won the support of two other key Republicans: Senator Susan Collins of Maine, who along with Ms. Murkowski is one of the few remaining Republican centrists, and Senator Bill Cassidy of Louisiana, who chairs the Senate Committee on Health, Education, Labor and Pensions. That panel oversees the Department of Health and Human Services, which Mr. Kennedy, if confirmed, would lead.
Mr. Cassidy, a doctor, is an ardent proponent of vaccines. Early in his medical career, he cared for a young woman who required an emergency liver transplant because of her infection with hepatitis B, a disease that vaccines can prevent— a story he recounted when Mr. Kennedy testified before the health committee.
“Since then, I have tried to do everything I can to make sure I never have to speak to another parent about their child dying due to a vaccine-preventable disease,” Mr. Cassidy said in that hearing. He later had heated exchanges with Mr. Kennedy about vaccines and autism, and declared himself in a quandary over how to vote.
But in the end, Mr. Cassidy backed the nomination after winning certain concessions, including a promise from Mr. Kennedy to give Congress advance notice of any vaccine policy changes.
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