A number of American commenters have been hand-wringing about Robert F. Kennedy Jr.’s nomination to be the secretary of Health and Human Services, which would put him in charge of such critical agencies as the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).
“He supports people being able to purchase raw milk, don’t you know!”
“He wants to discourage municipal water plants from adding fluoride!”
“He says MMR vaccines cause autism!”
After Donald Trump nominated RFK Jr. for the post, Time magazine called him “a vaccine skeptic who spreads medical disinformation and conspiracy theories,” and quoted Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law as saying of his nomination, “I can’t think of a darker day for public health and science.”
But I think we need to draw distinctions.
After looking at the whole range of RFK Jr.’s positions, I’ve come to the view that while some are extreme, others are genuinely worthy of debate—and still others are correct. And there is a way to sift the good from the bad and the debatable. When you hear one of RFK Jr.’s ideas, ask yourself a simple question: Do other nations do what he thinks the U.S. should do? If the answer is yes, then the HHS nominee’s idea is not necessarily apocalyptic, and we should be able to discuss it openly.
Let’s take a look at some of his most controversial opinions:
Raw Milk
The government has mandated that milk be pasteurized since 1924. It is a process that prevents the growth of bacteria that can lead to illness. But RFK Jr. wants Americans to be able to buy raw milk, which has many adherents who believe, as Bon Appétit once put it, “the lack of processing makes the vitamins, minerals, enzymes, and fats easier for our bodies to absorb.” Others think it simply tastes better. This will mean, however, that healthy people will have to tolerate some risk of infection. Brown University economist Emily Oster calculates that this would mean an annual risk of infection of 7 in 100,000 unpasteurized milk drinkers. That might be a risk some people choose to accept. Soft cheese also carries health risks, and the FDA currently allows it to be sold in America. If the agency were to minimize all dangers, soft cheese would be banned, but it isn’t.
And now, for my litmus test: Do other nations do it?
The answer is yes. Raw milk is legally available from farms in England, New Zealand, France, Italy, Germany, Norway, and many other countries. I should also note that it is available in most American states via private buying clubs and farm gate sales but, as The Free Press has reported, the government has targeted those who make and sell it.
Just because other nations do it doesn’t mean we should go all-in on raw milk. I personally think healthy adults should be able to accept the risk of choosing to drink raw milk if they want to. Americans are allowed to bungee jump, smoke cigarettes, and take part in all sorts of activities riskier than consuming raw milk. It is not the job of the state to eliminate all possible risks at the expense of pleasure.
The MMR Vaccine
For years, RFK Jr. has pushed the long-debunked link between the MMR (measles, mumps, and rubella) vaccine and autism. He has, in fact, made millions from peddling this bunk through a best-selling book and nonprofits that pay him a salary. He picked up on the idea from a disgraced British scientist, Andrew Wakefield, who argued a causal link in an article published in The Lancet in 1998. That article was retracted in 2010, and Wakefield was stripped of his UK medical license that same year, but unfortunately RFK Jr. has still continued to push the idea.
It is true that, in the U.S. and throughout the West, there has been a shocking increase in childhood autism, but as Jill Escher, the mother of two severely autistic children, noted in The Free Press last week, “Every epidemiological study on the topic has confirmed zero association between vaccination status and the development of autism.” I don’t know what is causing the rise in autism, and I would be hesitant to venture a guess. But I agree with both RFK Jr. and Escher that the rise in childhood autism needs to be studied more formally.
In the meantime, let’s return to my litmus test: All European countries recommend using MMR vaccines in children. No country I am aware of warns against using it because it leads to autism. If RFK Jr. uses his perch as HHS secretary to discourage parents from getting their children inoculated with the MMR vaccine, severe negative repercussions could result, including measles outbreaks and childhood deaths. This is not a good policy.
Covid-19 Policy
RFK Jr. has said a great deal about the government’s Covid-19 policy: He opposed masking kids. He opposed Covid-19 vaccines for kids. He said that Covid vaccines wouldn’t stop transmission. And he railed against lockdowns, noting they were not effective for children, and actually led to learning loss. Much of what he said was treated as “misinformation,” resulting in Facebook and other social media sites removing posts made by his organization, Children’s Health Defense.
But in each case he was right. Sweden never masked kids under the age of 12, nor did it mandate lockdowns or other severe measures. According to the Organization for Economic Cooperation and Development in 2020 and 2021, the U.S. had a 19 percent excess death rate, compared to four percent for Sweden. Although cross-country comparisons are never perfect, all data suggests that Sweden did quite well, and did not pay a massive price for its decisions.
Many European nations did not give Covid vaccines to kids, and that makes sense. Although the CDC was never willing to acknowledge this, children were at far lower risk from becoming infected than their elders. And it is now widely accepted that school lockdowns harmed the health of kids long-term a great deal more than they ever protected them in the short-term.
RFK Jr. also said Covid was a great opportunity for corporations like Pfizer and Moderna to make hundreds of billions selling vaccines to people who didn’t need them. I think the vaccines did save lives—especially when given to the elderly or the immunocompromised when they were first made widely available in early 2021—but here too, I also think he is mostly correct. The companies pushed vaccinations and repeated boosters on kids to make more money without proof this was ever necessary.
Finally, this all relates to another RFK Jr. policy: that vaccine manufacturers should not be indemnified from prosecution for negative side effects. A 1986 law prevents vaccine makers from being litigated in court—even though drugmakers can be litigated. This is based on the idea that the manufacturing of vaccines is not a lucrative business, and indeed this has been true for the tried-and-true vaccines that have been in use in the ’60s and ’70s. Yet, in the modern world, vaccines can generate large profits. For example, the new maternal RSV vaccine costs nearly 10 times the cost of DTap, the series of shots for kids under 7 that protect against diphtheria, tetanus, and pertussis. For Pfizer alone, the Covid vaccine earned $100 billion just in 2022.
I tend to agree with RFK Jr. that makers of the new, costly vaccines should be held accountable when their products lead to harm. This means vaccine makers could be sued for Covid vaccines that caused myocarditis in young men, and Johnson & Johnson could be sued for causing VITT (vaccine-induced immune thrombocytopenia thrombosis) in young women. Litigation is an important check and balance on drug safety.
What’s more, RFK Jr. wants to put an end to FDA officials cashing in on their government stints by joining pharma companies as soon as they leave the agency. To give just three examples: Mark McClellan, who was the FDA commissioner under George W. Bush, is on the board of the giant pharmaceutical company Johnson & Johnson. Scott Gottlieb, who headed the FDA during the Trump administration, is on the board of the giant pharmaceutical company Pfizer. And Stephen Hahn, who succeeded Gottlieb at the FDA, is now the CEO of Flagship Pioneering, the venture capital firm behind the Covid-19 vaccine manufacturer Moderna. In The BMJ, my research team showed that over 60 percent of FDA cancer drug reviewers go to work in biopharma when they leave the agency.
This policy proposal from RFK Jr. is most definitely not a crazy idea. In fact, I think it would be incredibly popular with Americans—and might help restore trust in the government’s vast health apparatus.
Fluoride
Like pasteurization, adding fluoride to drinking water has been going on for a long time—since 1951. The primary reason is it prevents cavities and other forms of tooth decay in children. But on November 2, RFK Jr. tweeted that “the Trump White House will advise all U.S. water systems to remove fluoride from public water. Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease.”
It is true that the benefits of fluoride have eroded over the years, especially since most toothpastes contain fluoride. Harvard researchers state that there have been reductions in cavities even in countries without routine fluoridation of water. Finally, some economic literature has sought to connect fluoride in the water to lowered cognitive performance, but in my opinion, these papers remain weak and uncertain. Having said this, I think this is a topic that warrants further discussion and cannot be summarily dismissed.
Just look at this recent piece from The Economist on Kennedy’s concerns that excessive fluoride consumption could lower IQ: “As far-fetched as that sounds,” the outlet says, “it is something scientists are investigating. A report by the National Toxicology Program within HHS found that high levels of fluoride exposure, at twice the legal limit, were associated with lower IQ in children. Other researchers found that even fluoride levels within the legal range were associated with that risk. And one study of American mothers found that pregnant women who drank fluoridated water were more likely to give birth to children with lower IQs.”
And again, here is the litmus test: Germany, Norway, and Sweden don’t put fluoride in water. Neither does Portland, Oregon. Again, we can debate the policy, but it is not crazy to think fluoride is unnecessary.
Hepatitis B Vaccine
In the U.S., the hepatitis B vaccine is recommended within 24 hours of a baby’s birth, and that’s what happens most often. The likely reason is that doctors worry parents won’t come back in, so they insist all vaccinations are done as soon as a child is born.
RFK Jr. does not like administering this vaccine at birth, and he has good company in countries like Switzerland and Austria, which do not recommend hep B vaccination at birth for low-risk babies.
But take a look at the chart below. It shows all sorts of different schedules in 14 European countries for the hep B vaccine. Only two of them follow the U.S. recommendation of inoculation immediately after birth. Three countries—Finland, Hungary, and Iceland—don’t require it at all.
The point here is that an honest scientist would admit that we have no idea which country has the correct schedule, and some childhood vaccines should be reconsidered.
Moreover, doctors who say “all vaccines are safe and effective” are usually idiots. They haven’t studied the topic or thought about it for one second. Some vaccines are vital. Some are debatable, and some can be harmful (mRNA for young men during Covid, for instance, too often led to myocarditis). Vaccines are like drugs. We need better evidence.
A simple way to answer definitively which childhood immunization schedule works best is to conduct a series of cluster randomized control trials in the U.S. Have different states or counties or cities give vaccines with different schedules. This would allow researchers to account for additives or combined side effects, a claim that vaccine-hesitant folks have made for years. If he were the head of HHS, RFK Jr. could certainly do this. And he should.
Additives in Food
RFK Jr.’s stance on food dyes in breakfast cereals was recently fact-checked by The New York Times. And, as a result, The New York Times ended up with egg on its face.
In the original version of the Times article, reporters stated that RFK Jr. objects to the U.S. version of Froot Loops because it contains artificial colorings that are not used in the Canadian and European versions. On this point, he is correct. Those foreign versions use “concentrated carrot juice, annatto turmeric, concentrated watermelon juice, concentrated blueberry juice” instead of the American version, which uses the colorings Red 40, Yellow 5, and Blue 1.
In a later version of the article, the Times claimed RFK Jr. was objecting to the total number of ingredients being lower abroad—which the outlet said is untrue. But, when you consider all of Kennedy’s statements, it is clear he objects to the dyes, not the number of ingredients. By the Times’ twisted logic, Kennedy would object to Indian food over sushi because it has more spices added. That is not his position.
What’s more, he might even be right about fewer ingredients appearing in U.S. cereals. Just look at this example:
In Conclusion
Just because another nation does things differently does not mean it is correct. What it usually means is the other country’s health rules are worth studying and debating. Right now, the media is covering RFK Jr. poorly and unfairly, giving him no credit for ideas that are well within the bounds of discussion. My simple rule makes sense: If other nations are doing it, we should be willing to look into it. And RFK Jr. should not be called a conspiracy theorist for holding that view.
Vinay Prasad is a hematologist-oncologist and a professor of epidemiology and biostatistics at the University of California, San Francisco. This article is adapted from his Substack, Vinay Prasad’s Observations and Thoughts. You can follow him on his YouTube channel Vinay Prasad MD MPH, or on Twitter (now X) @VPrasadMDMPH.
For another view, read Jeffrey Flier, former dean of Harvard Medical School, make the case against RFK Jr. as Trump’s pick for head of Health and Human Services.
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