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cover of episode MAHA Cheers and Public Health Fears as RFK Ousts Vaccine Panel

MAHA Cheers and Public Health Fears as RFK Ousts Vaccine Panel

2025/6/11
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Sarah McCammon: 我认为本期节目主要讨论了小罗伯特·肯尼迪(RFK Jr.)重塑公共卫生机构的最新举措,以及围绕这些举措所产生的政治影响。我个人认为,肯尼迪的行动引发了广泛的争议,尤其是在医学界和公共卫生领域。许多人担心,他对疫苗的立场以及他对公共卫生机构的改革可能会对公众健康造成负面影响。我希望通过这次讨论,能够更深入地了解肯尼迪的政策,并分析其可能带来的后果。 Will Stone: 作为NPR健康团队的记者,我认为肯尼迪解雇整个疫苗顾问委员会是一个非常不寻常的举动。我了解到,这个委员会,也就是免疫实践咨询委员会(ACIP),自20世纪60年代以来一直存在,由17位独立专家组成,负责审查数据并对疫苗接种计划提出建议。肯尼迪给出的解释是,该委员会存在利益冲突,为了恢复公众对疫苗的信心,他需要清除所有人。但我通过调查发现,ACIP实际上有非常严格的道德规范,成员在投票前必须说明是否存在利益冲突,如果存在则会回避。此外,肯尼迪引用的旧报告并不能真正支持他关于广泛利益冲突的说法。我认为肯尼迪的这一举动可能会对美国的疫苗政策产生深远的影响,值得我们密切关注。 Mara Liason: 作为资深政治记者,我认为肯尼迪的这一举动背后有深刻的政治考量。我注意到,参议员比尔·卡西迪(Bill Cassidy)对肯尼迪的行为表示担忧,并表示会继续与他沟通,以确保ACIP不会被对疫苗一无所知的人填满。然而,我认为卡西迪能做的并不多,因为他需要面对来自路易斯安那州的初选压力,而路易斯安那州是一个非常红的州。在美国参议院,许多参议员为了保住自己的职位,会不顾原则地支持特朗普或他的内阁成员。我认为肯尼迪的行动表明,特朗普政府非常了解其基本盘的需求,并且愿意采取行动来满足这些需求。特朗普与疫苗的关系非常复杂,他曾经为“曲速行动”感到自豪,但他的基本盘对疫苗持怀疑态度,这导致他减少了对疫苗的宣传。我认为肯尼迪的这一举动可能会进一步加剧美国社会在疫苗问题上的分歧。

Deep Dive

Chapters
This chapter explores the recent removal of all 17 members of the Advisory Committee on Immunization Practices (ACIP) by HHS Secretary Robert F. Kennedy Jr. The discussion examines the ACIP's role in vaccine policy, Kennedy's justification for the dismissals, and the controversy surrounding claims of widespread conflicts of interest within the committee.
  • Removal of all 17 ACIP members by RFK Jr.
  • ACIP's role in vaccine recommendations and insurance coverage.
  • Controversy over Kennedy's claim of widespread conflicts of interest within ACIP.
  • Lack of evidence supporting Kennedy's conflict of interest claims.

Shownotes Transcript

Translations:
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What a great thing. That isn't important, but it sounds to me like a terrifying job. Hey there, it's the NPR Politics Podcast. I'm Sarah McCammon. I cover politics. I'm Mara Liason, senior national political correspondent. Today on the show, we're talking about Robert F. Kennedy Jr.'s latest moves to reshape public health agencies, and of course, the politics around all of that. Will Stone from NPR's health team is here to help us make sense of all of it. Hey there, Will. Hey there. Hi there.

I want to start with the news this week that the Health and Human Services Secretary, RFK Jr., has removed all 17 members of a committee that helps craft vaccine policy. Now, this is not a committee that we talk about a lot. So what does this committee do and why did RFK Jr. decide to clean house here?

Sure. This is the Advisory Committee on Immunization Practices, ACIP for short. It's a CDC committee. It's been around since the 60s, actually. And you're right. We don't think a lot about them. They're pretty technical. It's filled with

17 independent experts who are appointed through a pretty rigorous process at the CDC. And they review data, they make recommendations on the vaccine schedule for adults and for children. And this also influences insurance coverage for vaccines.

they have been a topic of criticism for Secretary Kennedy for quite a while. And some had, you know, wondered whether he would, if he was eventually Secretary, come in and clean house like he did. And basically, the...

Kennedy gave the explanation that this committee is just kind of rife with conflicts of interest and that in order to restore public confidence in vaccines, he needed to basically get rid of everyone. And we will see who he decides to replace them with. And will this idea that committee members and others involved in public health have these huge conflicts of interest? I mean, this is something we've heard from RFK. How much truth is there to that claim?

Okay, well, I spoke with the former chair of ACIP who said, you know, actually, there are very tough ethics rules here. And if you just watch the meetings, you see people have to mention whether they have conflicts of interest before a vote. And if they do, they recuse themselves. Now, Kennedy likes to cite this old report that was done a number of years ago where they looked at

conflicts of interest across all CDC advisory committees. And he likes to cite that as proof that there are kind of widespread, uh, severe, serious conflicts of interest. And actually, uh, my colleague, uh, Ping Wong has looked into this, tracked down the people who were involved in that report and found that actually it does not really back up that claim. Uh, so this is not a

place where we see just no rules around conflicts of interest. And even one doctor I spoke to, Jeffrey Klausner at USC, who has actually given Kennedy some recommendations in the past about who might be new ACIP members. He told me he does not think, you know, this claim about conflicts of interest is really founded.

Now, turnover in the federal government with a new administration is pretty common. But this, as you said, was the entire committee. How are members of this committee normally chosen or replaced? I mean, how unusual is this? To clean house, as we've seen, is quite unusual.

These are experts who are appointed for four-year terms, and it's usually not thought of as a political kind of process. Obviously, we are in a new moment where Kennedy is really wanting to revisit vaccine policy in the U.S., but this came as a shock. Actually, my

colleague Ping Huang here at NPR just spoke with one of the booted members. He did not know he was going to be kicked off of the committee until he saw the Wall Street Journal opinion piece that was authored by Kennedy. And then shortly after that, he got an email notifying him that he was no longer going to be serving there. That is one way to send a message. That's right. Mara,

During RFK's Senate confirmation hearings, his views on vaccines, his record on vaccines were a big focus. As you'll remember, Republican Senator Bill Cassidy, who is also himself a medical doctor, said on the floor at the time that he had received some assurances from Kennedy that he would maintain this committee known as ACIP. It confirmed he will maintain the Centers for Disease Control and Prevention's

Advisory Committee on Immunization Practices, recommendations without changes. I mean, Mara, what do you make of this reversal? Well, I think that Senator Cassidy...

is in a very difficult position because there's not much he can do. Now that Kennedy is leading HHS, he certainly seems to have taken an action that's contrary to what he promised Cassidy. Cassidy posted this on X. He said, of course, now the fear is that the ACIP will be filled up with people who know nothing about vaccines except suspicion. He goes on to say, I've just spoken with Secretary Kennedy and I'll continue to talk with him to ensure this is not the case.

I don't think there's much that Cassidy can do. He's also up for reelection in 2026. He comes from Louisiana, a very red, Trumpy state.

And he has to face a primary. And I think that this is a story that is repeating itself over and over again in the United States Senate, which is if your principles suggest that you would be opposing President Trump or some of his cabinet secretaries on some issue, your devotion to him and the necessity of staying on his good side if you want to keep your job just overwhelms every other consideration. And I think that's what's happening here.

Will, what are you hearing about all of this from the group that's going to be in some ways most affected by this, the medical community? Yeah, the reaction has been widespread condemnation of this decision. It's exactly what people had worried about. We had the American Medical Association, the Infectious Diseases Society of America, past CDC directors all coming out and saying they're concerned about what this could mean

Who will be the new members? Will they have the credentials you expect or will they just be pushing their own agenda maybe to undermine vaccine policy? And they said this is basically a reckless move that takes some guardrails off of our efforts to set vaccine policy in the U.S. And do we have a sense of what that might mean for patients who these vaccines ultimately serve?

It remains to be seen because, again, we don't actually know what changes they will make to the committee. Kennedy did take questions on this decision on ACIP the other day, and he said these are not going to be anti-vaxxers. These are going to be highly credentialed experts in the field. And so we'll see who ends up filling these roles. I spoke to some folks who

aren't as concerned and say, hey, they will be if they see people who are kind of wellness influencers and don't have the expertise, but they're reserving judgment until they see what happens. Again, you know, this is a committee that most people don't pay attention to, usually is not national news. But the future makeup of this committee, I think, will tell us a lot about the direction that RFK intends to go. Let's take a quick break. More on this when we get back.

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You know, we should say Kennedy spent decades promoting false claims about vaccines. And this action, getting rid of these committee members, is something that a lot of his supporters have wanted. They've been calling for this.

But, you know, is there a risk of alienating people by playing to the base to this degree? I mean, there's a faction of people who I think resonate with RFK's calls to reform the food system, but may also support vaccines and want to see stability in the vaccine system. Is there a risk of going too far with this?

I don't think the White House thinks so. I think this is a very base-oriented president. He is finely attuned to what his base cares about. He usually leads with that. And don't forget, MAHA, Make America Healthy Again, which is RFK's base, is really a subsidiary of MAGA, Make America Great Again.

And I think that's why he chose RFK. He understood that a lot of vaccine skeptics were his supporters. So I don't think he's going to alienate anybody that he cares about by sticking with RFK. In fact, I would say that this was an important action by Secretary Kennedy to really show this wing of this Maha coalition, which does have different factions involved.

that he has not forgotten about his work in the anti-vaccine movement, that he is still looking at revisiting vaccine policy because there has been some concern and kind of fighting within that Maha movement around whether kind of focus on healthy eating and other issues that are also central to the Maha platform might end up taking more precedent over actually looking at changing vaccine policy.

And you know, Trump has such an interesting and complicated relationship with the vaccine that he helped get online. He was responsible for Operation Warp Speed, which was the effort to get a COVID vaccine online very quickly, and it succeeded. But his base is very vaccine skeptical, and he's run into some pushback from his base, some boos at rallies when he talks about the vaccines that he takes credit for. And he is a politician who never likes to get

crosswise with his base. And that's why over time he talked less and less about the vaccines that at one point he was so very proud of. Yeah. Where is that Trump of 2020 and 2021, Mara, the guy who was, you know, touting his achievement with getting the vaccine online and telling people he took it? He's left the building.

Now, I want to look forward just a little bit. Well, this week, we've seen this shakeup at ACIP. Last month, Kennedy announced that the government would no longer recommend COVID vaccines for pregnant women or for healthy kids. What

What reasons did Kennedy give for that decision? Well, there were concerns about the data that were articulated by, you know, Kennedy and others. A lot of folks in this camp of Maha who see the mRNA vaccine platform, you know, which was used obviously for the COVID shot, they want to see that gone. They think it's responsible for all kinds of harms, which, you know, have not been backed up by studies.

This, interestingly, was not a decision that went through ACIP, although typically, you know, this is the committee that tries to make these calls and recommendations. And I think, you know, it's just one more data point here for people who are very concerned about undermining confidence in vaccines. They see this as just one more action. And actually, I spoke with the former chair of the ACIP.

Dr. Jonathan Temte, who's now at the University of Wisconsin.

Here's what he had to say to me about where he thinks all this is headed. ASAP has been across the entire world, the paragon of good, solid, well thought out, evidence-based vaccine policy. I hate to say this, we are heading in the direction of U.S. vaccine policy becoming the laughingstock of the globe. Some strong words there. Yep. And you hear that kind of language from others in the medical and public health establishment.

And then there are obviously people in Maha land and supporters of Trump who think this is overdue and actually want to see, you know, real changes to the vaccine schedule, which is very concerning for public health. Particularly, remember, we still have measles cases and, you know, declining trust in vaccines. Well, again, lots of eyes will be on that committee, the committee that

I don't think I knew existed until this week. So we're going to leave it there for today. Will, thanks so much for being with us. Thanks for having me. I'm Sarah McCammon. I cover politics. I'm Mara Liason, senior national political correspondent. And thank you for listening to the NPR Politics Podcast.

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