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When 12,000 public health professionals gathered in Minneapolis last week for the annual meeting of the American Public Health Association, Dr. Jerome Adams, who served as surgeon general in the first administration of President-elect Donald J. Trump, issued a pointed warning about Robert F. Kennedy Jr.
“If R.F.K. has a significant influence on the next administration, that could further erode people’s willingness to get up to date with recommended vaccines,” Dr. Adams said. “I am worried about the impact that could have on our nation’s health, on our nation’s economy, on our global security.”
Now, Mr. Kennedy, a vocal skeptic of vaccines, is in a position to have significant influence, and over a broad range of policy. Mr. Trump’s sweeping electoral victory, with Mr. Kennedy at his side, is — in the eyes of their supporters — not only a mandate but also a repudiation of the public health establishment that has long kept Mr. Kennedy at bay.
As an independent presidential candidate and as a surrogate for Mr. Trump, Mr. Kennedy pledged to upend the nation’s agriculture system and public health bureaucracy, effectively gutting whole swaths of the regulatory state, under the rubric of rooting out “cronyism” and corruption.
After Mr. Trump was first elected in 2016, Mr. Kennedy told reporters that Mr. Trump promised to let him chair a vaccine commission, but it never came to pass. Now, Mr. Kennedy has a much stronger hand, having rallied his followers behind Mr. Trump. The president-elect has indicated that Mr. Kennedy will play a role in his new administration and recently said he would let Mr. Kennedy “go wild on health,” but he has not been specific about what that means.
Some have speculated that Mr. Trump will make him a “health czar” inside the White House, to guide the president on public health matters; a person familiar with the transition said Mr. Kennedy was at Mar-a-Lago on Wednesday and spoke with Trump insiders about the public health agenda.
Mr. Kennedy’s worldview is embodied in two of his most frequent refrains: “There is nothing more profitable for much of the health care system than a sick child” and “Public health agencies have become sock puppets for the industries they are supposed to regulate.”
Now that Republicans will control the Senate, Mr. Kennedy could theoretically win confirmation for any one of a number of top health jobs: secretary of Health and Human Services, commissioner of the Food and Drug Administration or director of the Centers for Disease Control and Prevention.
“There is a real mandate victory here, with many millions of people who are first-time Trump voters,” said Calley Means, a health care entrepreneur who has been an adviser to Mr. Kennedy and who was instrumental in connecting him to Mr. Trump. “It is a true mandate to take on broken health care institutions, and to deliver the change.”
Mr. Kennedy did not respond to requests for comment. In an interview with NPR on Wednesday, he said his role in the new administration had not yet been decided. But he said Mr. Trump had given him three instructions: to rid regulatory agencies of “the corruption and the conflicts,” to “return the agencies to the gold standard” of “empirically based, evidence-based science and medicine” and to “end the chronic disease epidemic with measurable impacts” within two years.
As for vaccines, he said, “We are not going to take vaccines away from anybody.” He said he wanted Americans to be able to make “informed choices” about vaccination — an idea that worries public health experts, who say that school vaccination requirements are especially important because vaccines are most effective in slowing the spread of infectious disease when entire communities are vaccinated.
As a presidential candidate, Mr. Kennedy moved away from his focus on vaccines to a broader theme: Americans, he argued, are suffering from an epidemic of chronic disease. And when he aligned himself with Mr. Trump, that theme got a name: “Make America Healthy Again.” It quickly caught on.
Today, he is the undisputed leader of a burgeoning “medical freedom” movement that marries fierce resistance to public health measures and deep suspicion of industry with an embrace of alternative medicine and natural foods. In a recent opinion essay in The Wall Street Journal, Mr. Kennedy called for half of the budget of the National Institutes of Health to be devoted to “preventive, alternative and holistic approaches to health.”
As a candidate for president, he vowed to prosecute the N.I.H.’s most prominent alumnus, Dr. Anthony S. Fauci, “if crimes were committed.” Dr. Fauci, who retired as the director of the National Institute of Allergy and Infectious Diseases in 2022, declined to comment on Wednesday.
