White House fed up with RFK Jr.'s sluggish press shop

• White House officials blamed Stefanie Spear, a Kennedy adviser for more than a decade who RFK Jr. has empowered as his deputy chief of staff and gatekeeper.
• "The White House was like, 'Where the f**k is the statement?' " said a White House official who was involved in the measles response. "CNN was blaring this chyron about how Kennedy was silent, and there was just nothing from the department because of Stefanie."
• On Feb. 26 — the day the Texas child died — Kennedy, long known as a vaccine skeptic, had minimized the measles outbreak during a Cabinet meeting.

Since the measles debacle, the White House communications team has handled more press relations on behalf of HHS than any other department, and often has acted as a contact between reporters and the agency.

• "This shouldn't be the White House's job, but here we are," a White House adviser said.
• Spear was unreachable by reporters last Friday after top vaccine regulator Peter Marks resigned and blasted Kennedy in a scathing resignation letter.
• The White House was left to approve the department's response, the adviser said. Pharmaceutical stocks plummeted as the industry grappled with Marks' departure. A person familiar with the situation said the ouster was forced by Kennedy.

The big picture: The dysfunction at HHS has crucial political and policy ramifications. The department oversees disease response, so public communication is at a premium. Kennedy's "Make America Healthy Again" coalition also was key to Trump's election last year.

• HHS's career employees tend to be more liberal or moderate than Trump administration officials, leading to some friction and mistrust.
• "Bobby World" Kennedy loyalists, personified by Spear, add a complicating third dimension.
• "It's a mess over there," another White House aide said. "The [career employees] hate us and are always undermining us and leaking stuff to the media. And then there's this small circle of trust with Stefanie that hasn't expanded."
• This dynamic has taken shape as HHS, like other federal agencies in the Trump-DOGE administration, has embarked on a plan for mass layoffs — 10,000 people in HHS's case.
• Spear wouldn't comment for this story, but a statement issued through the White House said: "The White House has a great relationship with Stefanie and HHS. We work closely day in and day out to Make America Healthy Again. It's disappointing that bitter, anonymous sources are attempting to create conflict where none exists."

Zoom in: It didn't take long for the White House to get concerned about the problems at HHS. Officials say Spear restricts access to Kennedy, scuttles ideas that make her uncomfortable, and insists on controlling messaging but then under-communicates.

• It's similar to how Spear essentially controlled Kennedy's star-crossed presidential campaign, two aides say.
• "Her lack of willingness to engage with the press and the lack of the campaign staff [taking] decisive stances on issues, really was detrimental," said Jeff Hutt, former national field director on the campaign and co-founder of a PAC supporting Kennedy's food and health goals.

To surround herself with allies, Spear had HHS issue a three-year, $2.5 million change order to an ongoing services contract with a consulting company so she could hire three former Kennedy campaign supporters and associates.

• They're supposed to write speeches and provide other public affairs work, according to a copy of the document reviewed by Axios.
• Spear also imposed an extensive approval process for all sub-agency communications — including during the measles outbreak, when the Centers for Disease Control and Prevention had been prevented from sharing its typical updates with the public and press.

Zoom out: The White House and supporters of Kennedy have grown frustrated by what they see as a lack of communication from HHS.

• "We're leaving points on the field," one of the White House staffers lamented. "At every step, the White House wanted the secretary to lean more into MAHA and it just bottlenecked with [Spear]."

Flashback: Critics point to a series of moves by Kennedy's top aide that they say have been a drag on his department.

• On Jan. 21, Day Two of the Trump administration, Spear halted all department external communications, including the Morbidity and Mortality Weekly Reports, which notify clinicians about the spread of disease. That action was leaked to the Washington Post.
• On Feb. 21, Kennedy quietly canceled development of a fourth Covid vaccine, saving $230 million. White House officials wanted the information blasted out, but it wasn't publicized until days later, in a leak to Fox News Digital.
• On March 2 — two days after his tweet about the measles death — Kennedy finally penned a statement about the outbreak. Information about the measles vaccine's effectiveness was buried toward the bottom of the statement.
• The same day, he posted about hiking in California's Coachella Valley.
• On March 9, a department insider leaked to Reuters that the CDC planned to study unsupported claims of a link between vaccines and autism. HHS refused to comment, initially at Spear's direction. The White House got involved and forced a response.
• On March 10, Kennedy met privately with major food company CEOs to pressure them to limit food dyes. The White House wanted more attention for the initiative. It was scooped by Politico but wasn't as widely publicized as administration officials had hoped.
• On March 11, HHS held its first "MAHA Moms" event behind closed doors with Kennedy, Education Secretary Linda McMahon, Agriculture Secretary Brooke Rollins and White House Press Secretary Karoline Leavitt. No press was notified. No professional photographer was there. Fumed one attendee: "Stefanie was in charge and created a perfect press opportunity with no press, a perfect photo op with no photos."
• On March 18, HHS announced an initiative called Operation Stork Speed to call for healthy baby food. It got scant coverage because the department didn't work closely with the press about it, much to the White House's annoyance.

Between the lines: During the Trump transition, Kennedy's team wanted to unite behind an agriculture secretary pick for him to support.

• Spear favored John Kempf, an Amish regenerative farmer and podcast host, a transition source said. Others wanted a more traditional pick: Texas Agriculture Commissioner Sid Miller, a Kennedy ally who invented his state's farm-to-school lunch program.
• Excited to meet Kennedy for the first time when the two were in Washington, Miller emailed him to have lunch. Kennedy responded by cc'ing Spear and asking her to set it up. Miller followed up with an email a day later and got no reply.
• "Never heard back from her. Still waiting on a call back," Miller told Axios. "Kinda disappointing, actually."

This story has been updated with comment from the White House.