U.S. Health Secretary Robert F. Kennedy Jr. has inflicted immense damage on the United States’ vaccination program. Although Kennedy, a well-known critic of vaccinations, had promised Sen. Bill Cassidy, a Republican physician, that he would not undercut public confidence in vaccines during his confirmation hearings, the Trump administration has undertaken a fierce campaign to dismantle key pillars of the nation’s public health program.
Kennedy refused to strongly endorse vaccines when Texas faced an outbreak of measles shortly after U.S. President Donald Trump was inaugurated. He has sharply curtailed funding for vital research programs, including the development of mNRA vaccines. Soon after Dr. Peter Marks, the Food and Drug Administration’s top vaccine expert, resigned in March to protest Kennedy spreading misinformation, the agency informed the public that COVID-19 vaccines would only be approved for Americans categorized as high-risk and for those over the age of 65.
Kennedy fired every member of the 17-person Advisory Committee on Immunization Practices (ACIP), which is the panel of experts in the Centers for Disease Control and Prevention (CDC) that has been the scientific gold standard for information about vaccine guidelines. Kennedy will soon replace them with questionable figures who have been staunch vaccine skeptics. He also fired Susan Monarez, the CDC director who Trump appointed. She claims she was relieved of her job for refusing Kennedy’s directive to “preapprove the recommendations” of the vaccine advisory panel that he put together.
What is taking place is nothing less than a full-scale war on public health.
Trump’s point man is the nephew of the president who pushed through one of the most consequential pieces of legislation related to vaccines, which strengthened the federal infrastructure for supporting state and local governments in their efforts to disseminate them. U.S. President John F. Kennedy’s landmark Vaccination Assistance Act of 1962 embodies the partnership between government, medicine, and science that once sought to make all Americans as healthy as possible.
Vaccines have been around for centuries, as have government efforts to protect portions of the population. During the American Revolutionary War, Continental Army Gen. George Washington famously ordered his troops to be inoculated for smallpox. In 1905, the U.S. Supreme Court ruled in Jacobson v. Massachusetts that state and localities had the right to require vaccines.
Even as skepticism and opposition to vaccines have remained powerful forces within the United States’ political fabric, the drive to expand vaccines has continued. A watershed moment occurred on April 12, 1955, when the federal government declared that a polio vaccine developed by scientist Jonas Salk was “safe, effective, and potent.” U.S. President Dwight Eisenhower, a Republican, celebrated the development. The news came three years after a devastating polio outbreak had killed more than 3,000 people and left more than 20,000 paralyzed. Eisenhower, emotional as he made the announcement, proclaimed, “The work of Dr. Salk is in the highest tradition of selfless and dedicated medical research. He has provided a means for the control of a dread disease. By helping scientists in other countries with technical information; by offering to them the strains of seed virus and professional aid so that the production of vaccine can be started by them everywhere; by welcoming them to his laboratory that they may gain a fuller knowledge, Dr. Salk is a benefactor of mankind.”
Though there were many problems with the polio vaccine’s rollout and with specific batches of the vaccine, the results were extremely impressive. The World Health Organization reported that annual cases fell from 58,000 to 5,600 within just two years. On April 4, 1960, Eisenhower celebrated the fifth anniversary of the announcement of the polio vaccine by calling on citizens to celebrate a “new kind of V-Day” on April 12, a vaccination day in which more citizens took advantage of “one of medicine’s great achievements” by going to the doctor and getting vaccinated. One year later, the public learned of an oral polio vaccine created by Dr. Albert Sabin, a Jewish émigré from Poland whose family fled from religious persecution to the United States in 1921, that was much easier to administer and cheaper than the original medicine.
The problem was that state and local communities lacked the resources needed to implement effective vaccination programs, which had to include promotional efforts so that a larger number of Americans learned of the benefits. Other than a handful of exceptions, such as legislation passed in 1955 that provided states with assistance to purchase and distribute the polio vaccine, the federal government was not a major partner in this public health effort. The gap was not surprising. Resistance to government intervention in health care was so strong during the early Cold War era that most politicians were leery about proposing any federal initiative. The American Medical Association warned that public health care policies would lead to socialized medicine. As a result, while smallpox had largely disappeared within the United States by the early 1960s, other dangerous diseases, such as diphtheria and tetanus, were still highly destructive.
JFK, who struggled with disease himself, embraced health care as a signature issue. While the president remained tepid when it came to civil rights—more fearful of the political consequences of angering the South than of the moral urgency for ending racial discrimination—he took risks when it came to health care. In a message to Congress about national health care needs on Feb. 27, 1962, he spoke about why “preventable sickness, disability and physical or mental incapacity are matters of both individual and national concern.” He also outlined his vision for a health care program that would provide health insurance to Americans over the age of 65 and said that there was “no longer any reason why American children should suffer from polio, diphtheria, whooping cough, or tetanus—diseases which can cause death or serious consequences throughout a lifetime, which can be prevented, but which still prevail in too many cases.” He called on Americans to “join in a nationwide vaccination program to stamp out” those diseases and said he was proposing legislation to provide federal assistance.
The president and his allies on Capitol Hill focused much of their lobbying message on giving vaccines to preschool children, a population that received strong public sympathy (in contrast to the poor, for example). With the United States’ young population growing rapidly because of the baby boom, and with pediatrics greatly advancing as a specialty, making a case that targeted children was a strong argument, as Elena Conis documented in her book Vaccine Nation.
Congress passed the Vaccination Assistance Act in October 1962, a turning point in public health, with bipartisan support. The legislation didn’t receive much attention as it was passed during the Cuban missile crisis. There were several components. The bill allocated federal grants so that state and local governments could purchase vaccines for preschool children. Federal funds would bolster public health institutions that conducted vaccine drives; money would go toward outreach and epidemiological programs tracking diseases. The surgeon general would administer the grants and oversee federal regulations. Although Congress set the program to expire in June 1965, legislators were able to extend the its life if they wanted to do so. The legislation exempted states and localities from having to undertake programs to ease some of the political opposition. Congress authorized $14 million for the first year and $11 million for the next two years of the program.
The U.S. Public Health Service had the program up and running within a year. Tens of millions of children would be vaccinated by 1965. To expose more Americans to the virtues of vaccination, a CDC public relations campaigns featured Wellbee, a friendly bee who appeared on posters. One poster had the words “Wellbee says be well” on it, with Wellbee pointing to a message that stated: “Take oral polio vaccine” and “tastes good, works fast, prevents polio.” The bee was not alone. Private companies also understood promotional efforts. In a Peanuts strip, Charlie Brown got his measles vaccine. The federal government took on some of the work, Conis argued, that the nonprofit March of Dimes had done in the 1940s and 1950s.
In 1964, the CDC created the ACIP so that the federal government, and the nation, could count on a panel of top experts to provide guidance about new vaccines as they emerged. Immunization rose significantly in the first few years of the vaccination program, and Congress expanded the 1962 act in 1965. While U.S. President Richard Nixon did not renew funding for the program, which led to diminished immunization numbers in the 1970s, his successor, Jimmy Carter, reversed course with the National Childhood Immunization Initiative. His wife, Rosalynn Carter, undertook a campaign with Betty Bumpers, the wife of Sen. Dale Bumpers, and lobbied more than 33 states to adopt preschool vaccine requirements.
JFK’s Vaccination Assistance Act has been an integral component of the United States’ public health infrastructure. Subsequent enhancements included legislation in 1993 that provided free vaccines to the uninsured. States and localities adopted vaccine requirements because the federal government had made it possible for more families to inoculate their children.
Today, JFK’s nephew, serving under Trump, is tearing this legacy apart. Within a few months, the Trump administration has dismantled some of the most important and effective measures that Congress has adopted over the decades to keep Americans safe from deadly and debilitating diseases. Based on crank science, Kennedy is in the middle of a highly destructive political effort that will leave the United States physically weaker than when he first took the position—and which has already undermined public confidence in science and medicine.
In a better world, politics would stop at the laboratory’s edge. But as the United States is learning, such hopes don’t square with the realities of the moment.
The Republican senators who confirmed Kennedy despite all of their reservations put partisanship above public interest. Now, Americans are paying the price. Unless Congress takes action to restore some of the house that JFK built, Trump 2.0 will leave behind a nation that is much more vulnerable to pandemics, diseases, and sicknesses that will ruin lives, communities, and the country itself.
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