What Impact Could RFK Jr. Have on Public Health?

On November 6, Americans woke up to the news that Donald Trump had defeated Kamala Harris in the presidential election, thus ushering in four more years of chaos and fear. Another potential consequence of this election: It may make us all sick, too. Trump announced Thursday that noted conspiracy theorist and anti-vaxxer Robert F. Kennedy Jr. will serve as his secretary of Health and Human Services — despite the fact that he has no background in science or medicine.

According to previous reporting from the Hill, Kennedy said on a Zoom call with supporters that Trump had promised him “control of the public-health agencies” overseen by the Department of Health and Human Services, including the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. During his campaign, Trump also repeatedly stated his intention to give Kennedy carte blanche in his administration. “He’s gonna do pretty much what he wants as far as I’m concerned,” he said at a rally last Monday. “He wants health for women, for men, for children.”

Kennedy has focused particularly on the latter demographic in his messaging, building his campaign around what he has framed as the skyrocketing rates of chronic disease in children. In a speech in June, Kennedy alleged that nearly 60 percent of American children “now have autoimmune diseases, neurological diseases, obesity, peanut allergies, food allergies.” (This figure is disputed by the Annenberg Public Policy Center, which was unable to find a source for Kennedy’s claim.) Kennedy has also maintained an obsessive focus on the conspiracy theory that vaccines cause autism, pointing to the rising rate of diagnoses to support his claim. (The theory has been widely debunked by medical experts, and the increase in diagnoses is likely attributable to factors such as increased screening and expanded diagnostic criteria.) He’s also claimed that antidepressant use is linked to school shootings (a claim that has gone viral in far-right circles, despite having no basis in fact) and that HIV does not cause AIDS, attributing the disease to the widespread use of poppers (a theory that was debunked by researchers at the start of the epidemic in the early 1980s).

But what do RFK Jr.’s views on vaccines and reproductive rights mean for children and families in the United States? Here’s what we know so far.

What role will RFK Jr. have in Trump’s administration?

Prior to his announcement that Kennedy would serve as secretary of the Department of Health and Human Services, Trump had been cagey about Kennedy’s precise role, saying at a Madison Square Garden rally that he would let him “go wild on the food” and “go wild on the medicines.” In an interview with CNN last week, Trump transition team leader Howard Lutnick denied that Trump planned to appoint Kennedy HHS head. Lutnick did say, however, that the team had met with Kennedy for more than two hours to discuss research on childhood vaccines (and expressed his own skepticism regarding whether certain vaccines are safe and effective).

As the head of the HHS (pending confirmation), Kennedy would oversee government health agencies such as the FDA. Prior to Trump’s announcement, Kennedy had already made it clear he had big plans for the FDA. On October 25, he tweeted that the agency’s “war on public health is about to end,” citing its “aggressive suppression” of alternative, non-evidence-based treatments such as ivermectin, hydroxychloroquine, and raw milk. After Trump’s win, Kennedy doubled down on this view in an interview with MSNBC, saying that “entire departments” of the FDA have to go. “They’re not doing our job. They’re not protecting our kids,” Kennedy said, bizarrely citing the chemical composition of American Froot Loops versus Canadian Froot Loops as an example of the FDA’s supposed dereliction of duty.

What could RFK Jr. do with vaccines?

Perhaps the most salient concern among public-health experts stems from Kennedy’s long-held views on childhood vaccines and whether they may influence parents to delay or opt out of vaccinations for their children. Although Kennedy has balked at being labeled an “anti-vaxxer,” he has spent the past few decades rallying against vaccine requirements and promoting the repeatedly debunked theory that the childhood MMR vaccine can cause autism. Despite being banned from Facebook and Instagram for promoting misinformation, he is a highly influential voice in the alternative wellness space, with celebrities such as Alicia Silverstone, Jenny McCarthy, and Jessica Biel rallying behind him.

The prospect of Kennedy shaping public-health policy regarding vaccines is particularly frightening considering that vaccination rates are already on the decline: Last month, a CDC study found that the percentage of U.S. children receiving vaccine exemptions was at an all-time high, and rates of preventable (and potentially fatal) childhood diseases like measles are also slowly climbing. In states like Idaho, kindergarten vaccination rates have plummeted to 81 percent, and the national average has plummeted to 93 percent — below the 95 percent vaccination threshold that keeps children safe from preventable diseases like measles.

Pediatricians and public-health experts are terrified that vaccination rates could plummet even further with the Trump administration, which could lead to potentially fatal outbreaks of preventable diseases like measles. Such fears were stoked further when Trump indicated on Sunday that he seemed open to a full-stop “ban” on certain vaccines, telling NBC News he will “make a decision” about a prospective ban after consulting with Kennedy.

In an interview with NBC News, Kennedy clarified that he does not plan to “take away anybody’s vaccines,” saying he hopes to use whatever role he assumes in the Trump administration to spearhead more research on vaccine safety and efficacy. “If vaccines are working for somebody, I’m not going to take them away. People ought to have [a] choice, and that choice ought to be informed by the best information,” he said. It’s also worth noting that Trump does not have the authority to issue a vaccine “ban,” though he could theoretically pressure the FDA, which authorizes vaccines, to revoke approval or appoint federal judges who attempt to limit the power of agencies like the FDA, according to the New York Times. 

Now that Trump has announced his intention for Kennedy to serve as the head of the HHS, the concern is that he will use this incredibly important position to erode public trust in life-saving childhood vaccines. “An administration that is supportive of anti-science rhetoric and misinformation will only cause the vaccine coverage to decrease further, and we will see more vaccine-preventable illness, death, and disability,” says Wallace.

What’s his stance on reproductive rights?

Like Trump himself, who has both said he wants to leave the issue of abortion rights to the states and signaled support for a nationwide 20-week ban, Kennedy has been wildly inconsistent on the topic of reproductive rights. Although he previously supported a federal abortion ban after three months, his campaign walked back this stance in 2023, and earlier this year he said he believed the cutoff should be around “fetal viability.” (He did not specify what he meant by this, but most reproductive health experts agree a fetus is considered viable at 23 to 24 weeks.)

There are certainly pathways by which Kennedy could potentially limit abortion access as a Trump appointee — for instance, now that he may have oversight of the FDA, he could, theoretically, rescind licensing of abortion medication or restrict access to the drug (though he has given no indication that he has any interest in doing this).

The fact that Kennedy does not appear to have a clear and consistent opinion on abortion rights comes as no source of comfort to Jessica Malaty Rivera, the senior science communications adviser at the Debeaumont Foundation, an organization focused on public health. “He dodges clear and direct questions, and talks about being progressive, and then says he’s okay with abortion bans,” she says. “That’s what makes all of this so scary — we don’t actually know what any of this means, so the worst is possible.”

What’s this about fluoride?

One thing Kennedy has been clear and consistent about is his desire to ban fluoride from public water systems. An initiative that has been in place for more than 60 years, the introduction of fluoride into public water systems is correlated with a dramatic decrease in childhood cavities, to the degree that the initiative is considered by the CDC to be one of the “10 great public health achievements of the 20th century.” While safe in small amounts, exposure to fluoride in much larger amounts has been linked to lower IQ in children and a higher risk of bone disorders like joint pain or osteoporosis, prompting Kennedy to rally against its use in public health. “We don’t need fluoride in our water,” he told Steve Inskeep on Morning Edition, adding that he would encourage Trump to institute a fluoride ban when in office. “It’s a very bad way to deliver it into our systems.” (For what it’s worth, the CDC has stated that the amount of fluoride in drinking water — .7 milligrams per liter — is significantly below the threshold needed to cause harm, which is at or above 1.5 milligrams per liter.)

Like most other things Kennedy has said about his role in a Trump administration, it is not entirely accurate that Trump could institute a “ban” on fluoride when he takes office. About 70 percent of Americans have access to fluoridated water, and the decision to add fluoride to water systems takes place on a local, rather than a federal, level. But as HHS head, Kennedy could theoretically pressure the CDC to alter its current federal recommendations for fluoride use in drinking water.

Why should we be concerned?

As the secretary of Health and Human Services, not only could Kennedy have ultimate authority to undermine the role of regulatory agencies in keeping children and families safe, it could also lead to brain drain within the institutions themselves. Rivera says she has heard from multiple employees at government agencies like the CDC who are “already prepping their resignation letters.” “They refuse to work for this administration,” she says. “I understand it, but it’s terrifying. Because we don’t want to be in the position where everyone working at these agencies is anti-medicine, anti-science.”

To a large extent, the damage of Kennedy’s rhetoric has already been done. With vaccination rates declining and trust in public institutions lower than ever before, keeping the American public healthy and informed was already an uphill battle, and it is bound to become even more difficult during a Trump administration. “It’s gonna be a really difficult four years,” says Rivera. “But a lot of people are not going anywhere and are committed to the work of advocacy. Our democracy and our public health depend on it.”

This story has been updated with additional information.

An earlier version of this story misstated the name of the nonprofit RFK Jr. founded. It is the Children’s Health Defense.