Many of President-elect Donald Trump\u2019s candidates for federal health agencies have promoted policies and goals that put them at odds with one another or with Trump\u2019s choice to run the Department of Health and Human Services, Robert F. Kennedy Jr., setting the stage for internal friction over public health initiatives.<\/p>\n
The picks hold different views on matters such as limits on abortion, the safety of childhood vaccines, the covid-19 response, and the use of weight-loss medications. The divide pits Trump picks who adhere to more traditional and orthodox science, such as the long-held, scientifically supported findings that vaccines are safe, against often unsubstantiated views advanced by Kennedy and other selections who have claimed vaccines are linked with autism.<\/p>\n
The Trump transition team and the designated nominees mentioned in this article did not respond to requests for comment.<\/p>\n
It\u2019s a potential \u201cteam of opponents\u201d at the government\u2019s health agencies, said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian policy organization.<\/p>\n
Kennedy, he said, is known for rejecting opposing views when confronted with science.<\/p>\n
\u201cThe heads of the FDA and NIH will be spending all their time explaining to their boss what a confidence interval is,\u201d Cannon said, referring to a statistical term used in medical studies.<\/p>\n
Those whose views prevail will have significant power in shaping policy, from who is appointed to sit on federal vaccine advisory committees to federal authorization for covid vaccines to restrictions on abortion medications. If confirmed as HHS secretary, Kennedy is expected to set much of the agenda.<\/p>\n
\u201cIf President Trump\u2019s nomination of RFK Jr. to be secretary is confirmed, if you don\u2019t subscribe to his views, it will be very hard to rise in that department,\u201d said Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security. \u201cThey will need to suppress their views to fit with RFK Jr\u2019s. In this administration, and any administration, independent public disagreement isn\u2019t welcome.\u201d<\/p>\n
Kennedy is chair of Children\u2019s Health Defense<\/a>, an anti-vaccine nonprofit. He has vowed to curb the country\u2019s appetite for ultra-processed food and its incidence of chronic disease. He helped select Trump\u2019s choices to lead the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. If confirmed, he would lead them from the helm of HHS, with its more than $1.7 trillion budget.<\/p>\n Clashes are likely. Kennedy has supported access to abortion until a fetus is viable. That puts him at odds with Dave Weldon, the former Florida congressman whom Trump has chosen to run the CDC. Weldon, a physician, is an abortion opponent who wrote one of the major laws allowing health professionals to opt out of participating in the procedure.<\/p>\n Weldon would head an agency that\u2019s been in the crosshairs of conservatives since the covid pandemic began. He has touted his \u201c100% pro-life voting record\u201d on his campaign website. (He unsuccessfully ran earlier this year<\/a> for a seat in Florida\u2019s House of Representatives.)<\/p>\n Trump has said he would leave decisions about abortion to the states, but the CDC under Weldon could, for example, fund studies on abortion risks. The agency could require states to provide information about abortions performed within their borders to the federal government or risk the loss of federal funds.<\/p>\n Weldon, like Kennedy, has questioned the safety of vaccines and has said he believes they can cause autism. That\u2019s at odds with the views of Marty Makary, a Johns Hopkins surgeon whom Trump plans to nominate for FDA commissioner. The British American said on the \u201cBrian Kilmeade Show\u201d on Fox News Radio that vaccines \u201csave lives,\u201d although he added that it\u2019s good to question the U.S. vaccine schedule for children.<\/p>\n The American Academy of Pediatricians encourages parents and their children\u2019s doctors<\/a> to stick to the recommended schedule of childhood vaccines. \u201cNonstandard schedules that spread out vaccines or start when a child is older put entire communities at risk of serious illnesses, including infants and young children,\u201d the group says in guidance for its members.<\/p>\n Jay Bhattacharya, a doctor and economist who is Trump\u2019s selection to lead NIH, has also supported vaccines.<\/p>\n Kennedy has said on NPR<\/a> that federal authorities under his leadership wouldn\u2019t \u201ctake vaccines away from anybody.\u201d But the FDA oversees approval of vaccines, and, under his leadership, the agency could put vaccine skeptics on advisory panels or could make changes to a program that largely protects vaccine makers from consumer injury lawsuits.<\/p>\n \u201cI do believe that autism does come from vaccines,\u201d Kennedy said in 2023 on Fox News<\/a>. Many scientific studies have discredited the claim<\/a> that vaccines cause autism.<\/p>\n Ashish Jha, a doctor who served as the White House covid response coordinator from 2022 to 2023, noted that Bhattacharya and Makary have had long and distinguished careers in medicine and research and would bring decades of experience to these top jobs. But, he said, it \u201cis going to be a lot more difficult than they think\u201d to stand up for their views in the new administration.<\/p>\n It\u2019s hard \u201cto do things that displease your boss, and if [Kennedy] gets confirmed, he will be their boss,\u201d Jha said. \u201cThey have their work cut out for them if they\u2019re going to stand up for their opinions on science. If they don\u2019t, it will just demoralize the staff.\u201d<\/p>\n Most of Trump\u2019s picks share the view that federal health agencies bungled the pandemic response, a stance that resonated with many of the president-elect\u2019s voters and supporters \u2014 even though Trump led that response until Joe Biden took office in 2021.<\/p>\n Kennedy said in a 2021 Louisiana House oversight meeting<\/a> that the covid vaccine was the \u201cdeadliest\u201d ever made. He has cited no evidence to back the claim.<\/p>\n Federal health officials say the vaccines have saved millions of lives around the globe and offer important protection against covid. Protection lasts even though their effectiveness wanes over time.<\/p>\n The vaccines\u2019 effectiveness against infection stood at 52% after four weeks, according to a May study<\/a> in The New England Journal of Medicine, and their effectiveness against hospitalization was about 67% after four weeks. The vaccines were produced through Operation Warp Speed, a public-private partnership Trump launched in his first term to fast-track the shots as well as other treatments.<\/p>\n Makary criticized covid vaccine guidance that called for giving young children the shots. He argued that, for many people, natural immunity from infections could substitute for the vaccine. Bhattacharya opposed measures used to curb the spread of covid in 2020 and advised that everyone except the most vulnerable go about their lives as usual. The World Health Organization warned that such an approach would overwhelm hospitals.<\/p>\n Mehmet Oz, Trump\u2019s choice to head the Centers for Medicare & Medicaid Services, an agency within HHS, has said the vaccines were oversold. He promoted the use of the anti-malaria drug hydroxychloroquine as a treatment. The FDA in 2020 revoked emergency authorization of hydroxychloroquine for covid, saying that it was unlikely to be effective against the virus and that the risk of dangerous side effects was too high.<\/p>\n Janette Nesheiwat, meanwhile, a former Fox News contributor and Trump\u2019s pick for surgeon general, has taken a different stance. The doctor described covid vaccines as a gift from God in a Fox News opinion piece<\/a>.<\/p>\n Kennedy\u2019s qualms about vaccines are likely to be a central issue early in the administration. He has said he wants federal health agencies to shift their focus from preparing for and combating infectious disease to addressing chronic disease.<\/p>\n The shifting focus and questioning of vaccines concern some public health leaders amid the spread of the H5N1 bird flu virus among dairy cattle. There have been 60 human infections<\/a> reported in the U.S. this year, all but two of them linked to exposure to cattle or poultry.<\/p>\n \u201cEarly on, they\u2019re going to have to have a discussion about vaccinating people and animals\u201d against bird flu, said Georges C. Benjamin, executive director of the American Public Health Association. \u201cWe all bring opinions to the table. A department\u2019s cohesive policy is driven by the secretary.\u201d<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n