Robert F. Kennedy Jr., the nation’s most prominent vaccine skeptic, courted the votes of senators considering whether to confirm him as health secretary by promising, repeatedly and in writing, to do nothing “that makes it difficult or discourages people from taking vaccines.”
Seven months have passed since he took office. In that time, Mr. Kennedy has delivered a lukewarm endorsement of the measles vaccine; dismantled a panel of experts who make vaccine recommendations to the government; taken steps that will effectively restrict access to Covid-19 vaccines; canceled $500 million of grants and contracts for the development of mRNA vaccines; and, just last week, forced out the new director of the Centers for Disease Control and Prevention because she disagreed with him on vaccine policy.
On Thursday, Mr. Kennedy will come before the Senate again with his department in turmoil.
President Trump memorably said he would let Mr. Kennedy “go wild on health.” Now the health secretary is expected to face questions from lawmakers who suggest he may have gone a little too wild. Uneasy Republicans, who until now have been reluctant to criticize Mr. Kennedy, are wondering aloud whether his actions contradict the pledges of restraint he made to win the job. Angry Democrats say his tenure is a danger to public health and have called on him to resign.
“He’s got to reconcile what he said during his confirmation process with what we’ve seen over the past few months, particularly on vaccine policy,” said Senator Thom Tillis, Republican of North Carolina and a member of the Senate Finance Committee, which is convening the hearing.
Senator Ron Wyden, the top Democrat on the finance panel, asked the questions that elicited Mr. Kennedy’s written pledge to not restrict vaccine access. Mr. Wyden said in an interview on Wednesday that he agreed with others in his party who have called on Mr. Kennedy to resign, and he was unequivocal when asked whether Mr. Kennedy had lived up to his word months ago.
“Absolutely not. Capital A, capital N,” Mr. Wyden said, adding, “My fear is that all childhood vaccinations are at risk.”
Mr. Kennedy had already had an unmistakable effect on American culture with respect to vaccines, both for children and adults. On Wednesday, Florida officials announced theirs would be the first state to end all vaccination requirements for children attending school, a long-sought goal of the medical freedom movement that Mr. Kennedy leads.
But it was his abrupt dismissal of Dr. Susan Monarez, the C.D.C. director, that rattled lawmakers in Washington.
After the coronavirus pandemic, Congress passed legislation requiring Senate approval of C.D.C. directors. Dr. Monarez, the first director subject to the new law, was confirmed at the end of July.
Because she was a presidential appointee, subject to Senate confirmation, Mr. Kennedy did not have the authority to remove her. After she resisted his efforts to fire her, the White House announced that she had been terminated from her position.
Her removal irked senators of both parties, who say it negates their own role in the confirmation process. Among them is Senator John Thune, Republican of South Dakota and the majority leader.
“We go through all the work and confirm somebody to one of these important posts, and then a month later they’re gone,” Mr. Thune said on Wednesday, adding, “The person, whoever ends up in that position, it shouldn’t be disqualifying to be in support or in favor of vaccines.”
But much of the attention on Thursday will be on Senator Bill Cassidy, Republican of Louisiana, who is a member of the Finance Committee and also serves as chairman of the Senate’s health committee. Mr. Cassidy, a physician and a fierce proponent of vaccination, agonized publicly over whether to vote to confirm Mr. Kennedy and in the end decided to do so.
Mr. Cassidy, who is up for re-election next year and already faces primary challengers, promised after Dr. Monarez’s ouster that the health committee would “conduct oversight.” He would not say on Wednesday whether he still had confidence in Mr. Kennedy. “I am reserving judgment,” he told reporters.
Despite the C.D.C. upheaval, and Mr. Kennedy’s harsh criticism of the Covid vaccine program developed under Mr. Trump’s watch, there is little sign of a crack in the mutually beneficial alliance between the president and his health secretary.
A spokesman for Mr. Kennedy did not respond to a request for comment on Wednesday. But on Tuesday, in the wake of an essay by nine former C.D.C. directors who argued that he was dangerous for the nation, the health secretary defended himself and launched a broadside against the agency.
Writing in The Wall Street Journal, he complained about what he characterized as decades of “bureaucratic inertia, politicized science and mission creep” within the C.D.C. He also accused the agency of presiding over a rise in chronic disease — “a true modern pandemic,” he wrote — that he said caused the United States to fare far worse than other nations during the coronavirus pandemic.
Mr. Kennedy had heartily endorsed Dr. Monarez when Mr. Trump nominated her in March. He pushed back on those within his Make America Healthy Again movement who accused her of embracing vaccine mandates and other Covid-era policies concerning infectious disease control.
“I handpicked Susan for this job because she is a longtime champion of MAHA values, and a caring, compassionate and brilliant microbiologist and a tech wizard who will reorient CDC toward public health and gold-standard science,” Mr. Kennedy wrote on social media.
But it was clear from their confirmation hearings that the two had differences. Even as he insisted that he was not going to take away anyone’s vaccines, Mr. Kennedy refused to state unequivocally that there was no link between vaccines and autism — a long-ago debunked theory that grew out of a 1998 medical journal article that was later retracted.
Dr. Monarez, by contrast, told senators that she had “not seen a causal link between vaccines and autism.”
Those differences spilled out into the open last week after Dr. Monarez refused two of Mr. Kennedy’s demands: to fire top C.D.C. leaders, and to give blanket approval to future recommendations of his handpicked committee of vaccine advisers. That led, ultimately, to her firing by the White House. Three top C.D.C. officials resigned in protest.
Thursday’s hearing, planned before the firing of Dr. Monarez, was intended to give Mr. Kennedy an opportunity to testify about Mr. Trump’s budget for the C.D.C.’s parent agency, the Department of Health and Human Services, which Mr. Kennedy heads.
The sprawling department is a collection of multiple agencies, including the National Institutes of Health, which is responsible for biomedical research; the Food and Drug Administration, which oversees drug approval and food safety; and the Health Resources and Services Administration, which funds health care programs.
Mainstream public health leaders are horrified by Mr. Kennedy’s tenure so far.
“He’s worse than we thought he would be,” Dr. Georges C. Benjamin, executive director of the American Public Health Association, said in an interview on Wednesday. “Because not only has he broken just kind of simple verbal promises, but he’s also taken apart the core infrastructure of our vaccine system.”
But Mr. Kennedy, who has long insisted that vaccination should be a personal choice subject to “shared decision-making” between parents and pediatricians, has a strong base of supporters, many of whom are delighted with his changes.
“What’s clear and promising is that the very paradigms and people who drove us into this mess are finally being challenged and cleared out,” said Leah Wilson, executive director of Stand for Health Freedom, an Indiana nonprofit that recently sued the C.D.C. and asked a court to replace the agency’s vaccine schedule with a recommendation for shared decision-making.
If history is any guide, Mr. Kennedy may flash his defiant side on Thursday. His upbringing in a storied Democratic clan has given him an ease and familiarity with the ways of Washington; as a little boy, he played in the Oval Office when his uncle John F. Kennedy was president.
As health secretary, he has openly challenged and sometimes berated lawmakers during previous hearings. He once addressed Senator Bernie Sanders, the Vermont independent, as “Bernie” — a definite violation of Senate protocol — and accused him of accepting millions of dollars in pharmaceutical industry contributions.
In back-to-back House and Senate hearings this spring, he said it was not his job as health secretary to make vaccine recommendations. He also lashed out at one of his Democratic critics, saying, “I don’t know if you understand this or whether you are just mouthing the Democratic talking points.”
Axel Boada and Jamie Leventhal contributed video production.
Sheryl Gay Stolberg covers health policy for The Times from Washington. A former congressional and White House correspondent, she focuses on the intersection of health policy and politics.
Megan Mineiro is a Times congressional reporter and a member of the 2025-26 Times Fellowship class, a program for early-career journalists.
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