There are three big reasons you are alive today.
One: clean water. Congratulations! You and/or your ancestors didn’t die of dysentery. You didn’t die of cholera. You didn’t die of typhoid fever.
Two: antibiotics. Congratulations! You didn’t die of scarlet fever. You didn’t die of a urinary tract infection. You didn’t die of a tooth abscess that turned into sepsis. You didn’t die of the bubonic freaking plague.
Three: vaccines. Congratulations! You didn’t die of measles. You didn’t die of tetanus. You didn’t die of pertussis. You didn’t die of polio. If you’ve been vaccinated against HPV, you almost certainly aren’t going to die of cervical or anal or throat cancer. You have survived COVID, the deadliest pandemic in a century.
Vaccines are the most rigorously studied health interventions in the history of the world. Over the past 50 years, 13 childhood vaccines have together saved 154 million lives. One hundred and fifty-four million! Vaccines eliminated smallpox. Smallpox killed 500 million people!
The most dangerous thing Donald Trump is poised to do in his second administration—unless he barges into a nuclear war, which there is a nonzero chance of him doing—is elevate Robert F. Kennedy Jr., a messianic, conspiracy-theorist, anti-vaccine menace to society. If Kennedy stands for confirmation as secretary of Health and Human Services, as Trump has announced, we should all march on the Capitol with tetanus-tipped pitchforks (metaphorically, of course) to protect global health and prevent us from going back a hundred years in health time.
How the hecking heck did we get here? Who is this RFK Jr. guy?
First of all, obviously, is the name. No one has grifted more from or brought more shame to a respected family. (He’s the nephew of former President John F. Kennedy and the son of Robert F. Kennedy, who served as attorney general under JFK and was assassinated while campaigning for president.) He pulls a “do you know who I am” whenever he gets peeved, which is a lot. In two of my past jobs—as the science editor of the Washington Post, and before that the science editor of this magazine—he called up my boss’s boss to complain about our coverage of him. In both cases the boss’s boss asked me to talk with him because he’s a Kennedy, even though they knew he is wrong on vaccines and that the coverage I oversaw was right.
There are plenty of anti-vaccine grifters out there, people who make a lot of money selling books or vitamins, but nobody has spread misinformation more effectively than Kennedy, because people take his name seriously. He gets invited to give lectures. He has always gotten much more media coverage than a crank should. The majority of anti-vaccine ads on Facebook a few years ago (before the platform changed its ad policy) were paid for by an organization Kennedy ran and one other anti-vax group. So-called vaccine skepticism isn’t a grassroots movement of concerned parents who just want to do right by their kids. It’s a well-funded conspiracy theory.
People recognized Kennedy’s name and gave him a disturbing amount of support in early polls when he ran for president. His campaign was largely funded by conservative donors to serve as a spoiler for Joe Biden and then Kamala Harris. (His family hates him, and they endorsed Biden over Kennedy.)
He pulled out of the race, endorsed Trump, and as spoils for that endorsement is now nominated to oversee HHS, which includes the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration, Medicare, Medicaid, and basically all federal health infrastructure and medical research funding. It’s a fucking catastrophe.
Kennedy can’t ban vaccines, but he can make it harder to get them. Even if you and yours are vaccinated, most vaccines don’t provide perfect immunity, so you are at risk as diseases circulate among unvaccinated people. (This would be a good time to get boosters for measles and pertussis.) He has spoken out against fluoride, and for unpasteurized milk. Congratulations—thanks to advancements in milk hygiene, you have not died from salmonella. And, again, while he can’t ban pasteurization, he can potentially weaken FDA oversight of raw milk, make it easier for people to buy it and serve it to their children, and interfere with the agency’s messaging about whether it’s safe to drink (it’s not).
It’s bad! But it could get even worse. The H5N1 bird flu is now circulating in poultry, cows, and pigs. It has infected people. There is no better place for a virus to mix-and-match and become more virulent than in a pig farm. Pigs are considered “mixing vessels” for pathogens, and it’s possible that the last horrible pandemic—the 1918 flu—passed through pigs on the way to people. That pandemic killed 50 million people. If H5N1 starts spreading easily among people, we’re going to need a lot of vaccines, clear public health messages, and federal experts who aren’t being contradicted, let alone actively hamstrung at their place of employment, by an anti-scientific crank.
There’s still a chance Kennedy won’t take the lead of the most powerful health agency in the world. He and Trump are both massive narcissists who can’t stand to share attention, so maybe they’ll fall out. Or maybe enough courageous senators will refuse to confirm a quack. But as long as Kennedy is in the spotlight and getting respectful coverage, public health is at risk. Brace yourselves. We’re about to be deluged with the most brazen and dangerous lies of our lifetimes.
