In the first test of the Trump administration’s outbreak response, Health and Human Services Secretary Robert F. Kennedy Jr. has been sending mixed messages about a rapidly spreading measles outbreak in Texas.
A longtime vaccine skeptic, Kennedy initially downplayed the outbreak during a Cabinet meeting with President Trump last week, saying it was “not unusual” and falsely claimed that many people hospitalized were there “mainly for quarantine.”
Kennedy’s remarks came on the same day a child in Texas died from measles, the first recorded measles death in the U.S. since 2015.
Two days later, Kennedy in a social media post outlined how his agency is responding, including by providing the Texas Department of Health with MMR vaccines.
“Ending the measles outbreak is a top priority,” Kennedy wrote, but he did not directly call for people to get the shot.
In an op-ed published Sunday on Fox News online, Kennedy inched slightly closer to that declaration, but still stopped short.
“Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons,” Kennedy wrote.
He emphasized that the decision to get vaccinated was a “personal one,” urging parents to talk with their doctors “to understand their options to get the MMR vaccine.”
But public health experts aren’t ready to celebrate.
Kennedy has a long history of disparaging the measles, mumps and rubella (MMR) vaccine. He has falsely and repeatedly linked it to rising autism rates and questioned its safety.
In a forward to a 2021 book written by the anti-vaccine group Children’s Health Defense, Kennedy wrote that measles outbreaks “have been fabricated to create fear” to “inflict unnecessary and risky vaccines on millions of children.”
Wendy Parmet, the director of the Center for Health Policy and Law at Northeastern University School of Law, described Kennedy’s op-ed as “mealy-mouthed advice.”
“It’s not necessarily wrong, but it’s not forthright,” Parmet said. “It’s a half-attempted step. It’s certainly more than we’ve heard from him before, and … some of what is in that editorial, I think, is helpful, but it’s certainly not anything close to what we have seen in the past, or could expect to see from a secretary of HHS, given the situation.”
For instance, a nationwide outbreak of measles in 2019 led top Trump administration health officials to warn about the greatest number of cases reported in the country since measles was effectively eliminated in 2000.
Those cases were primarily driven by outbreaks in New York City and New York state in unvaccinated communities.
“This current outbreak is deeply troubling and I call upon all healthcare providers to assure patients about the efficacy and safety of the measles vaccine,” Robert Redfield, then-director of the Centers for Disease Control and Prevention, said in a statement at the time.
In a separate statement, Trump’s HHS Secretary Alex Azar highlighted the importance of vaccines.
“Vaccines are a safe, highly effective public health solution that can prevent this disease,” Azar said at the time. “The measles vaccines are among the most extensively studied medical products we have, and their safety has been firmly established over many years in some of the largest vaccine studies ever undertaken.”
During that outbreak, anti-vaccine movement leaders held rallies in the impacted communities, questioning the safety of the measles shot and likening public health measures like banning unvaccinated children from schools to the Nazi persecution of Jews.
Del Bigtree, a top Kennedy ally and head of the anti-vaccine group the Informed Consent Action Network, even wore a yellow Star of David at rallies to identify with parents who declined to vaccinate their children.
The response under Kennedy’s HHS so far has been much more muted.
“There’s been incremental movement from the sort of downplaying to [this op-ed], but it still feels to some degree halfhearted in terms of really using the megaphone, the platform of our nation’s public health agencies to speak very clearly about what individuals should do to protect themselves and their families,” said Jason Schwartz, an associate professor and vaccine researcher at the Yale School of Public Health.
“But I think the response in the past few days, especially this op-ed, should be more of a cause for alarm for vaccination programs then a sigh of relief,” Schwartz added.
Kennedy’s response to a question at the Cabinet meeting, initially directed at Trump, was his first public acknowledgement of the outbreak.
By that point, more than 100 people had been infected. The child’s death had been publicly confirmed earlier in the day by state officials.
Glen Nowak, co-director of the Center for Health & Risk Communication at the University of Georgia, said choosing to publish his “call to action” in Fox News was Kennedy’s way to potentially reach conservatives who are skeptics of public health messengers.
Nowak, who spent 14 years as a top spokesman for CDC, said Kennedy is trying to thread a needle. For instance, the statement on the public benefits of measles vaccination came after a paragraph emphasizing treatment, such as vitamin A, for people who are sick.
Vitamin A has been used for years in children in developing countries with severe measles, but doctors have said the evidence of its effectiveness is mixed. It isn’t used widely in the U.S., likely because children aren’t Vitamin A deficient.
Kennedy also pointed out that 98 percent of measles deaths were eliminated before the introduction of the MMR vaccine due to “improvements in sanitation and nutrition” and emphasized that “good nutrition remains a best defense against most chronic and infectious illnesses.”
“The references to healthy diet and vitamins are probably the way to kind of maintain credibility among [his allies],” Nowak said. “It’s much easier to be a critic of measles vaccine when you’re not responsible for what happens. But as Secretary of Health and Human Services, if people see him as impeding measles vaccination and putting children in harm’s way unnecessarily, that’s a problem.”
Kennedy’s recent comments also come as health agencies stoke broader concern about the Trump administration will approach vaccine oversight.
Shortly after Kennedy was sworn in, a public meeting of CDC’s vaccine advisory panel was postponed, with no information about it being rescheduled.
Last week, the Food and Drug Administration cancelled a meeting of outside advisors to choose the flu vaccine strain.
Given those actions and Kennedy’s history, Nowak said the next steps are crucial.
“Is this just a one-off message? Or is this going to be a consistent message going forward? “ Nowak said. “Because we know that if there’s a lot more people who are unprotected, we’re going to have a lot more outbreaks, a lot more cases of vaccine preventable diseases.”
