Kennedy's early warning signs on vaccine policy

Driving the news: Kennedy drew attention last week during a Cabinet meeting, when he described measles outbreaks as "not unusual" after one now hitting west Texas and New Mexico resulted in the first U.S. death from the virus since 2015 and almost half of the cases seen last year.

• He then wrote in a Fox News op-ed over the weekend that vaccines protect individuals and communities from the disease but also that "all parents should consult with their healthcare providers to understand their options to get the MMR vaccine," and that "[t]he decision to vaccinate is a personal one."

The lukewarm support for measles vaccines came after a tumultuous few weeks in vaccine policy, including the Food and Drug Administration's cancellation of a March 13 meeting of a federal advisory panel to discuss the composition of next season's flu shot.

• Earlier this month, a Centers of Disease Control and Prevention advisory panel on vaccines was told that a February meeting on updating vaccination guidelines had been postponed indefinitely.
• The administration is also reviewing whether to pull $590 million in funding that Moderna received in the final days of the Biden administration to develop an mRNA vaccine for bird flu, reportedly as part of a bigger examination of spending on mRNA-based shots.
• "In isolation each of these actions have their own tolerable explanation, but taken collectively they raise the specter that RFK's trial-lawyer antipathy to any and all vaccinations continues to reign supreme," a person who worked on Kennedy's confirmation told Axios.

The big picture: Everything could still turn out fine, and the U.S. may resume business as usual when it comes to vaccines after a bumpy transition period. But it's hard to ignore the series of unusual vaccine-related decisions made over the last couple of weeks against the backdrop of Kennedy's decades of anti-vaccine activism prior to his government role.

• Kennedy said during his confirmation hearing that he wouldn't take away people's vaccines, but didn't disavow past anti-vaccine statements.
• The Trump administration clearly relishes disruptions to the status quo. It's plausible that these past few weeks are just the beginning of a brand-new, less transparent approach to vaccine policy under Kennedy's leadership — an approach that deeply alarms scientists and public health experts.

Kennedy's actions so far are "significant things, and I think it's just the tip of the iceberg," said Richard Hughes, a professor of vaccine law at George Washington University and a partner at Epstein, Becker & Green.

• "This is a man who was one of the most pivotal leaders in the anti-vaccine movement," he added. "It's not like he woke up one day and said, 'You know what, I feel different about vaccines.'"

The other side: "RFK has a mandate, under the MAHA movement, to allow for all of science to be critiqued and challenged," said David Mansdoerfer, a former senior HHS official in the first Trump administration.

• "These actions don't represent the rise of an anti-vaccine movement, they instead represent a return to science being able [to be] rigorously discussed in the public square," he said.

What they're saying: Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia and a member of the FDA's advisory committee, told Axios that the cancellation or postponement of meetings, combined with recent workforce reductions at health agencies, reflects "just a gradual sort of dismembering of the public health service."

• Offit said he didn't know the reasoning behind cancellation of the meeting on flu vaccine but that HHS officials said that they are going to make the decision about the vaccine internally within the FDA.
• "The irony to me is that Robert F Kennedy Jr. talks endlessly about transparency, and now you have meetings being canceled and decisions being made behind closed doors," Offit said.

Some advocacy groups were especially alarmed at the cancellation of the flu vaccine discussions, considering the severity of the current flu season and possibly delays formulating next year's shots.

• "Cancelling essential health advisory committee meetings without promptly rescheduling them is appalling," said Public Citizen Health Research Group director Robert Steinbrook.

Officials haven't said why the advisory panel's meeting on flu vaccines was canceled, but an HHS spokesperson said the FDA will "make public its recommendations to manufacturers in time for updated vaccines to be available for the 2025-2026 influenza season."

• HHS and CDC said in identical statements that the meeting on updating vaccination guidelines for infectious diseases was postponed "to accommodate public comment in advance of the meeting," adding that advisory working groups had met as scheduled.
• Addressing the review of federal funding of mRNA vaccines, an HHS spokesperson told Axios: "While it is crucial that the U.S. Department and Health and Human Services support pandemic preparedness, four years of the Biden administration's failed oversight have made it necessary to review agreements for vaccine production."

What to watch: Kennedy has considerable discretion to put his stamp on vaccine policy, drug approvals and any number of other issues.

• Some critics expect more requests for vaccine safety data and the appointment of like-minded individuals to advisory panels that could influence coverage of drugs, services and devices.
• His leadership could also result in a shift of federal health funding to chronic disease or unproven cures, and away from infectious diseases.

Tina Reed contributed to this story.