Top advisers to Robert F. Kennedy Jr. are debating how aggressively to target vaccines in his first days as the nation’s health secretary, fearing a political backlash that could quickly swamp his agenda and derail his relationship with President Trump.
The internal debate has pitted Kennedy’s closest and most strident anti-vaccine allies against a separate faction of advisers and Trump officials, slowing efforts to finalize his policy plans.
according to five people familiar with the deliberations who asked to remain anonymous because the discussions are private.
“The people he really trusts are obviously trying to carry out a plan to completely eliminate vaccines,” said one of the people familiar with the discussions. “The risk of overreach, I don’t think is zero.”
Within Kennedy’s orbit, there is little doubt that he will change the federal government’s stance on vaccines, a shift that public health experts warn will undermine Americans’ trust in vaccinations and pave the way for a resurgence of vaccine-preventable diseases.
Before Trump appointed him to lead the government’s health agencies, Kennedy chaired a group that questioned the safety of widely used vaccines.
Some of Kennedy’s fellow anti-vaccine activists have advocated for immediate and concrete steps that could undermine immunizations.
This has concerned other Kennedy allies and Trump officials, who have advocated for a more measured approach centered on encouraging more research into vaccines and their potential side effects.
Kennedy has yet to determine the scope of his agenda, resulting in competing efforts to shape his ambitions for the Department of Health and Human Services.
The jockeying highlights the sensitivity of the vaccine issue, even within Kennedy’s camp, as he tries to allay lingering concerns about his previous anti-vaccine activism and win Senate confirmation.
Kennedy’s spokesperson did not respond to requests for comment.
Kennedy has discussed more far-reaching options with allies, including disbanding the main panel of experts that advises the government on vaccines, evaluates their safety, and recommends which vaccines should be routinely administered to children and adults.
Its decisions may also influence whether public and private insurers cover the cost of vaccinations for patients.
The HHS secretary has broad authority to alter the mission of the Advisory Committee on Immunization Practices and appoint its members. That means Kennedy could reorganize the panel and fill it with allies who will be far more skeptical of the new vaccines that come before them.
Those new members may also change ACIP’s existing recommendations by reclassifying some standard childhood vaccines as “shared clinical decisionmaking” — or shots that should be administered only after consultation between a parent and a doctor, rather than as part of a regular immunization schedule.
“You can have ACIP questioning certain vaccines and casting doubt in the public’s mind about them,” said Larry Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law.
“Adding that doing so may prompt states to reconsider the vaccinations required for children to attend public schools. That’s going to particularly affect state policymakers in red states, who will then loosen childhood vaccination laws.”
Some of Kennedy’s anti-vaccine allies have also looked into ways to undermine longstanding legal protections for vaccine manufacturers, which they frequently use to advance theories that vaccines are less safe than other drugs.
And it is widely expected that Kennedy will order significant changes to how the health department discusses vaccines on its website and in other educational materials, though the extent of those changes is still unknown.
“They’re deadly serious,” said another person with knowledge of the discussions. “He’s going to move on vaccines and I think he feels he has a mandate.”
Aaron Siri, a vaccine injury lawyer who has petitioned the FDA to revoke or pause the distribution of several vaccines, and prominent anti-vaccine activist Del Bigtree are among Kennedy’s close advisers as he prepares to join Trump’s Cabinet.
The health nominee has also sought input from a variety of friends and former colleagues, including those involved in the anti-vaccine movement.
Siri and Bigtree did not respond to requests for comment.
Kennedy has stated that he wants to change the government’s approach to vaccines, and he has previously spent years raising concerns about their safety and supporting legal efforts to challenge immunizations and health mandates.
In an ethics agreement released Wednesday, Kennedy detailed plans to keep his financial stake in an ongoing lawsuit against drugmaker Merck over the safety of its HPV vaccine.
But since his nomination, Kennedy has denied being anti-vaccine. In private meetings with senators, he has also downplayed his focus on vaccines, claiming that he is more concerned with promoting transparency than restricting access to them.
Some more cautious advisers have encouraged him to stick to that pledge once he arrives at HHS, by pursuing a broader chronic disease agenda that promotes healthier eating and investigates the primary causes of chronic conditions.
That would still entail increasing research into vaccines and their side effects, including a link to autism, which Kennedy has long claimed exists despite scientific consensus.
Another potential study topic is the childhood vaccine schedule, which Kennedy and his allies claim vaccinates children against too many diseases too quickly.
However, those advisers have also stated that Kennedy’s popularity in the “Make America Healthy Again” movement stems from his desire to improve Americans’ overall health rather than his credentials as an influential anti-vaccine activist.
Despite recent declines in routine vaccination rates, polling indicates that the vast majority of Americans believe childhood vaccinations are important and support mandating them in public schools.
Perhaps more importantly, some Kennedy advisers and Trump officials are concerned that aggressively targeting vaccines will spark outrage among some members of Congress and the general public, creating a distraction that could divert attention away from Trump.
While they believe Trump is willing to let his HHS nominee dictate large swathes of the health agenda, they are also concerned that if Kennedy makes any major mistakes, Trump will lose faith in him quickly.
“It will stop when it becomes a headache for people at the White House,” a third person familiar with the discussions said of Trump’s leeway toward Kennedy.
Nonetheless, according to those familiar with the discussions, there is little assurance that, despite the warnings, Kennedy will disregard the wishes of a community of ardent vaccine skeptics whom he regards as a core part of his base.
Kennedy was honored at the MAHA Inaugural Ball, which took place blocks away from the White House on the night of Trump’s inauguration. It was a celebration organized by MAHA Action, a nonprofit founded specifically to support Kennedy and his agenda, and led by Bigtree.
“It’s an open story, and it’s unclear how much he’ll be pushed by his grassroots supporters to focus on potential areas that could alienate Trump,” the first person familiar with the discussions said.
“But it is not bullshit mainstream media reporting to continually ask what the deal here is, given the fact that the people he’s surrounded by come from this world.”