The effect RFK Jr. could have on healthcare in the US

During his campaign, Trump said he plans to let Kennedy "go wild on health. I'm going to let him go wild on the food. I'm going to let him go wild on medicines."

For his part, Kennedy said that Trump promised him "control of the public health agencies," including HHS, CDC, FDA, NIH, and the U.S. Department of Agriculture. However, Trump transition cochair Howard Lutnick said days before the election that Kennedy would not be selected as HHS secretary.

Regardless of Kennedy's ultimate official title, here are some potential healthcare implications of his involvement in the next Trump administration. 

Vaccines

Kennedy has pushed a number of disproven ideas about vaccines, including that they cause autism, and founded a nonprofit that promotes theories linking vaccines to other conditions.

In separate interviews last week, Kennedy said he doesn't plan to take vaccines away from anybody, but repeated criticisms that health agencies haven't done enough research on vaccines.

"We are going to make sure that Americans have good information right now," Kennedy said in an interview with NPR. "The science on vaccine safety particularly has huge deficits, and we're going to make sure those scientific studies are done and that people can make informed choices about their vaccinations and their children's vaccinations."

"If vaccines are working for somebody, I'm not going to take them away," Kennedy said in an interview with MSNBC. "People ought to have a choice and that choice ought to be informed by the best information."

Experts say there are institutional guardrails in place that would prevent radical changes from happening, but they are concerned Kennedy could still have a significant impact. While Kennedy may not intend to remove vaccines from the market, experts say he could leverage government agencies to slow approvals or spread disinformation.

He could also recommend vaccine skeptics to fill roles in in the Advisory Committee on Immunization Practices at CDC, said Bryant Godfre, a partner at Foley Hoag and former regulatory lawyer at FDA. Those panel members are approved by the HHS secretary and make recommendations on vaccine policy. While the panel's recommendations aren't binding, they do help inform coverage decisions made by insurers.

Regardless of Kennedy's involvement in vaccine policy, experts noted that he'll have a bully pulpit to continue questioning vaccine science.

"I think the biggest risk of [Kennedy] is his mouth. You know, creating distrust or confusion with the [vaccine approval] process," said Georges Benjamin, executive director of the American Public Health Association. "Vaccines have been such a controversial area, and there's so many groups that he's worked with over the years that have spread misinformation. I suspect if he says something that's controversial, those groups will be poised to accelerate it, make it go viral."

Experts said that Kennedy having any role in vaccine policy could sow doubt and confusion about vaccines, which could lead states to weaken vaccine requirements to enroll in school, leading to lower vaccination rates among children.

"It gives executive leaders within a state, especially in red states, and lawmakers the license to go ahead and completely dismantle and annihilate those public health guardrails that we've had for decades," said Rekha Lakshmanan, CSO for the Immunization Partnership, a group of doctors and vaccine advocates. "We will see more schools suffering vaccine preventable outbreaks, we're going to see more children sick, we could potentially see more children being hospitalized, and, God forbid, children dying from things that are preventable."

According to CDC, last school year the share of kindergartners exempted from vaccine requirements rose to a high of 3.3%, up from 3.0% the previous year.

Fluoride

Kennedy has also been very vocal against the use of fluoride in public drinking water.

Earlier this month, Kennedy said that if Trump was elected, he would advise communities to stop adding fluoride to their drinking water. Kennedy has described fluoride as "an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders and thyroid disease."

"I am going to advise the water districts about their legal liability, their legal obligations, their service to their constituents, and I'm going to give them good information on the science and fluoride will disappear," Kennedy said on Wednesday.

According to CDC, fluoride helps make teeth "stronger and more resistant to decay" and drinking fluoridated water "reduces cavities by about 25% in children and adults."

However, U.S. District Judge Edward Chen in September ruled in favor of several advocacy groups, finding that the current practice of adding fluoride to drinking water could lead to unreasonable health risks for children's developing brains, and ordered the Environmental Protection Agency (EPA) to strengthen its regulations for fluoride in drinking water.

Experts have questioned how much of an effect the Trump administration could have on changing current regulations regarding fluoridation. According to Gostin, the power to regulate fluoridation falls to the states, and the president "has no power to ban fluoridation of water supplies."

However, Gostin noted that the Trump administration could pressure states to ban fluoride and encourage local opposition to fluoridation.

Government health agencies

Kennedy previously said in a post on X that one of his top priorities would be "to clean up" public health agencies, which he said, "have become sock puppets for the industries they're supposed to regulate."

"FDA's war on public health is about to end," including its "aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can't be patented by Pharma," Kennedy said.

Kennedy has launched a webpage called "Nominees for the People," which allows anyone to submit and vote on names to be considered for a variety of healthcare-related roles within the federal government.

Among the more popular names on the site is Casey Means, a nutrition-focused functional medicine doctor who is reportedly being considered for a job within FDA. Both Means and Kennedy have stated they want to end television drug advertisements, something that would be difficult under the First Amendment, according to David Hart, assistant attorney-in-charge of opioid litigation and recovery/pharmaceutical fraud at the Oregon Department of Justice.

Simone Gold, founder of America's Frontline Doctors, a right-wing group of physicians who have spoken out against COVID-19 vaccines and protocols and recommended ivermectin and hydroxychloroquine as treatments for COVID-19, is also among the top nominees on the site. Alongside co-founding America's Frontline Doctors, Gold was also sentenced to two months in prison for illegally entering the U.S. Capitol on Jan. 6, 2021, following Trump's failed reelection bid.

Also among the most popular nominees on the site is Zen Honeycutt, founding executive director of the nonprofit Moms Across America, which focuses on environmental toxins. Honeycutt also promotes using certain diets to cure "food allergies, autism symptoms, and asthma" and has appeared in videos by Kennedy's anti-vaccine group.

Regardless of Kennedy's specific role in the second Trump administration, Kennedy's rhetoric has unnerved public health officials and experts.

"RFK Jr. holds a series of false, non-scientifically backed beliefs, which are held with the strength of a religious conviction … even though data shows he's wrong," said Paul Offit, director for the Vaccine Education Center at the Children's Hospital of Philadelphia. "So for that kind of person to have any sort of input on agencies that are based on science is a contradiction." (Weixel, The Hill, 11/10; STAT, 11/9; Cueto, STAT, 11/8; Diamond et. al., Washington Post, 11/8)

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