RFK Jr.’s MAHA Commission: A battle plan to dismantle federal science and health

Three months ago, after Donald Trump had won the 2024 election—and even before he had chosen longtime antivax activist Robert F. Kennedy, Jr. as his nominee for Secretary of Health and Human Services (HHS)—I characterized RFK Jr. as an “extinction-level threat to federal public health and science-based health policy.” The reason was simple. Last summer, RFK Jr. had abandoned his quixotic and doomed campaign for President as an independent and bent the knee to Donald Trump. As a result, he was rewarded with a promise to be, in essence, Trump’s health policy czar and to have a prominent role in health policy in his administration if he won. During the campaign, RFK Jr. even came up with a slogan that riffed on the long familiar Trump slogan “Make America Great Again” (MAGA) by changing it to “Make America Healthy Again” (MAHA). Cleverly, he said nothing at all about vaccines in his “MAHA manifesto“—an absence that his antivax minions noticed right away and were dismayed by—instead planning to “reform” the FDA, emphasize healthy food (depending on your definition), and legalize psychedelics and stem cell clinics. A couple of weeks after the election, President-Elect Trump nominated RFK Jr. for HHS, a nomination that I referred to as a “catastrophe for public health and medical research.”

Of course, RFK Jr. was “controversial” (translation: a batshit) nominee. I will even admit that, after RFK Jr.’s disastrous confirmation hearings, in which he lied repeatedly and blatantly about being “pro-vaccine” and in which Sen. Bernie Sanders embarrassed him over the organization that he founded, Children’s Health Defense, selling baby onesies with antivax slogans on them—asking RFK Jr, “Are you supportive of these onesies?“—and Sen. Elizabeth Warren pointed out how much money he makes assisting a law firm suing vaccine manufacturer, I briefly held out a tiny hope that a few Republicans would vote against him, denying him the nomination, but I soon realized that none of it mattered and that he would definitely be confirmed.

Sometimes I hate being right. I might not be right all the time, but this is one time where I would have been happy to be spectacularly wrong.

A week and a half ago, the Senate confirmed RFK Jr. as HHS Secretary, with only one Republican, Mitch McConnell (who is a polio survivor), voting against his confirmation. On Friday, RFK Jr. wasted no time beginning to do what he had promised to do all along, going back to 2023, namely mass firing scientists at the CDC and NIH. Of course, as I wrote last week, President Musk Trump and the “department of government efficiency” (DOGE) hadn’t waited for RFK Jr. to be confirmed as HHS Secretary or for Dr. Jay Bhattacharya to be confirmed as NIH Director to cancel study section meetings and travel by NIH scientists to present their findings, all in the name of attacking DEI (diversity, equity, and inclusion) and, soon after, to start gutting payments to universities for indirect costs with no warning, thus threatening biomedical research at a large number of US universities, who could not easily make up the shortfall. That a federal judge quickly issued a temporary restraining order to block the policy doesn’t mean that it won’t ultimately go into effect after the court cases all make it up to the Supreme Court, which is likely who will have to decide.

Then RFK Jr. arrived on Friday, February 14. St. Valentine’s Day. Great..

So it begins

Surprising no one other than those who hadn’t been paying attention while portraying RFK Jr. as “not that bad” or even as potentially good, RFK Jr. started his tenure as HHS Secretary with what some have called the “St. Valentine’s Day Massacre,” namely firing scientists en masse:

President Donald Trump’s administration today moved to fire 5200 workers at the Department of Health and Human Services (HHS), using supervisors across the vast agency to warn probationary employees that they would soon receive termination notices. It also fired the director and much of the staff of the Advanced Research Projects Agency for Health (ARPA-H), a $1.5 billion agency created 3 years ago to fund high-risk, high-payoff research.

The move came on the first full day in office of HHS Secretary Robert F. Kennedy Jr., who had promised to eliminate hundreds of jobs at federal health agencies “on Day 1.”

This is pure irony. Remember how sycophants, toadies, and lackeys of RFK Jr.—I’m talking to you, Dr. Vinay Prasad—lambasted the NIH for supposedly funding useless “safe” research that didn’t advance science? Here we see RFK Jr. defunding and moving to eliminate ARPA-H, a program designed to address that perceived problem by funding high risk, high payoff research projects. But what else? Nothing good.

It wasn’t just the NIH, of course, but the hated CDC too:

At the U.S. National Institutes of Health (NIH), where institute directors were hastily summoned to a meeting this morning to alert them of the imminent firings, some 1500 employees were initially scheduled to be let go; at the Centers for Disease Control and Prevention (CDC) the number was 1269.

It turns out that 50 of the fired CDC scientists were members of the first-year class of the Epidemic Intelligence Service, the CDC’s prestigious “disease detective” training program for young epidemiologists. Moreover, three division directors in the National Center for Emerging and Zoonotic Infectious Diseases, a key front in pandemic prevention, were also on a list of targeted employees. It’s almost as though RFK Jr. is trying other make us less prepared for another pandemic. No, strike that. He is, just because he hates what the CDC said about COVID-19, nonpharmaceutical interventions (e.g., masks, social distancing, business closures) to slow the spread of the virus, and, above all, vaccines.

It was the NIH that suffered the most from the initial round, however:

At NIH, many of those fired were junior employees. But the vast cull also took out senior employees who had been recently converted to staff positions after years as contractors—as well as division directors at NIH who were new to their positions. In some cases, the directors had to call junior staff to inform them of their impending firings while knowing they, too, were about to be terminated.

“This will decimate our ability to function as an institution,” says one senior NIH scientist who had to notify staff that HHS was firing them. “Whatever the opposite of government efficiency is, this process will take us there.”

Indeed. It is frequently a mantra among CEOs like Elon Musk that all they’re cutting is fat, that they can “do more with less,” but when the cutting is indiscriminate, basically anyone still on probation, regardless of their performance or the importance of their work, what will happen is that the work of the NIH will be degraded. For example, scientific studies, once halted, are often difficult or impossible to resurrect, and even the ones that are successfully resurrected usually end up costing more, not less. Worse, this cull is affecting senior employees recently promoted who, as a result of their new position, were on probation, thus removing institutional knowledge that helps large organizations with continuity.

In case you wondered what was happening with research grants to universities, given the pause in study section meetings and the attempt to slash university indirect cost rates to 15%, it’s not good either:

Also among those slated for termination at NIH were grants administration and program officers, who ensure the smooth disbursement and functioning of more than $30 billion in grants to university scientists. The NIH grants process has already ground to a halt because study sections and advisory councils are not meeting because of a Trump ban on posting required notices about upcoming meetings in the Federal Register.

“Over the past year, NIH has brought in some spectacular people who are critical for programs. It will be a great loss,” former NIH Director Monica Bertagnolli, who stepped down last month, told Science.

Lest you think that intramural clinical trials and translational research (research done at the NIH itself, rather than at universities funded by NIH grants) won’t suffer:

The imminent terminations included many of NIH’s 483 research fellows. Some of its roughly 260 clinical fellows were initially on lists of targeted employees Friday morning, although at least some were spared later in the day. (The Clinical Center, where hundreds of clinical trials are underway, would have to “shut down” if the clinical fellows and nurses with probationary status were let go, one source who asked not to be identified told Science.) But animal care staff were among those fired.

Again, here’s some irony. You might recall that Dr. Prasad did an oncology fellowship at the National Cancer Institute and the NIH Clinical Center. I don’t know what happened there, but he came out very bitter about the NIH, a bitterness that grew with his apparent failure ever to obtain NIH funding as a principal investigator. Is he rejoicing at the potential firing of all the fellows? What about all the research fellows, who took what in the past would be considered a fantastic opportunity to do research training at the NIH, only to have the rug pulled out from under them this way?

The likely result will be, as described by former NIH Director Monica Bertagnolli:

“We’re going to lose the next generation, that is the most difficult loss. This just sends, sends a chill,” Bertagnolli told STAT in an interview Saturday on the sidelines of the American Association for the Advancement of Science annual meeting in Boston. “It’s hard work, to get an education and be a scientist. Some of the fellows trained for so many years, and it’s a mission that requires great, great dedication. We’re very worried that our brilliant next generation isn’t going to want to do that, if they’re not very, very clearly supported.”

Indeed. Imagine that you’ve spent a couple of years doing a research project at the NIH, only to have a conspiracy theorist like RFK Jr. come in and fire you just as you’re getting results.

Meanwhile:

It is negligent to report firings at HHS as “an attack on science.”

FACT: Career leaders at the HHS have overseen a breakdown of science, where corporate interests took over the FDA, NIH, CMS and CDC and American health has plummeted.

It would be irrational not to make changes. pic.twitter.com/1EesnbLNcd

— Calley Means (@calleymeans) February 15, 2025

Unfortunately, this is clearly only the beginning. On Thursday afternoon, right after RFK Jr. was confirmed, the White House posted an executive order establishing the President’s “Make America Healthy Again” Commission. It’s full of misinformation and represents a blueprint for dismantling US public health and medical science policy and efforts in favor of the sort of quackery that RFK Jr. prefers.

The MAHA Commission

Let’s take a look at the executive order establishing the President’s MAHA Commission. The first thing I noticed is that it starts out with the usual MAHA tropes:

American life expectancy significantly lags behind other developed countries, with pre‑COVID-19 United States life expectancy averaging 78.8 years and comparable countries averaging 82.6 years.  This equates to 1.25 billion fewer life years for the United States population.  Six in 10 Americans have at least one chronic disease, and four in 10 have two or more chronic diseases.  An estimated one in five United States adults lives with a mental illness.

The wag in me can’t help but note that, of all the things that the MAHA Commission goes on to suggest as contributors to the lagging life expectancy, a problem that has been much discussed, very little is mentioned about poverty and nothing is mentioned about how our lack of a government-funded universal health insurance plan is one big difference between the US and the “comparable countries” cited and doesn’t suggest expanded health insurance for anything other than supporting “beneficial lifestyle changes and disease prevention,” which, if science-based (doubtful) would be good but not enough.

The second thing I noticed about this executive order is that, under the first section (Purpose), it trots out a lot of statistics, none of which are referenced and some of which I know are completely wrong. For instance, it claims, “Further, from 1990-2021, the United States experienced an 88 percent increase in cancer, the largest percentage increase of any country evaluated.” All one has to do is to look at last month’s American Cancer Society annual report on cancer statistics to demonstrate this, specifically Figure 2, which presents age-adjusted rates of cancer incidence and mortality in the US:

Do you notice anything? First of all, cancer incidence has not increased by 88% since 1990, or even since 1975. Indeed, cancer incidence is the same as—or only slightly higher than—it was in 1975, adjusted for age and delays in reporting. I rather suspect that whoever wrote this executive order used raw numbers that were not age-adjusted, but, again, no reference is provided. (I tried a bit of Googling to try to find the reference, but gave up.) The population, after all, is aging; so it would be expected that cancer incidence would climb just from that, as many cancers, particularly malignancies arising from organs like colon, breast, etc., tend to be, in essence, diseases of aging.

Did you notice anything else? It’s something that I like to point out any time I give a talk on cancer. Specifically, mortality rates from cancer have been steadily declining since 1990. I also point out that this is mortality from all cancers, because there are cancers for which the mortality and incidence rates have fallen more rapidly than the chart, and there are some cancers whose incidence and mortality have increased. The overall picture, though, is very different from what RFK Jr. and the Trump administration paints. There are challenges to be met and progress to be made, but the situation with respect to cancer has actually been improving over the last three decades. It might not seem like it because the population is aging and many cancers are much more likely in old age, thus producing the illusion “on the ground” that there is more cancer and death from cancer, but when you look at statistics adjusted for age it’s true.

The White House further claims, “Across 204 countries and territories, the United States had the highest age-standardized incidence rate of cancer in 2021, nearly double the next-highest rate.” Again, there is no reference, but this too is easily disproven. For example, if you look at Our World In Data, it shows that, yes, the US does have the highest age-standardized incidence of cancer, but barely and that other countries have had higher incidences in the past. For example, I picked some developed industrialized countries and used the tool on the site to create this graph:

Notice how the US has very similar cancer incidence to New Zealand, France, The Netherlands, and Australia. Notice, also, that the difference in age-standardized incidence of cancer is nowhere near two-fold different between the US and other countries. For some, it’s barely distinguishable. Further note that the age-adjusted incidence of cancer in the US is not climbing. It’s actually falling slightly. I suspect that whoever wrote this dreck simply compared US cancer incidence to that for the world (which I included in the graph), not noting that many countries have cancer incidence similar to that of the US, mainly wealthy industrialized countries. Of course, this is not a new observation that people in wealthy industrialized nations tend to have a higher cancer incidence; it is, however, profoundly deceptive to claim that this is somehow a uniquely American phenomenon, with no country even close to our cancer incidence.

The same sort of exaggeration is apparent for the claim that in 2021 “asthma was more than twice as common in the United States than most of Europe, Asia, or Africa.” While it’s sort of true, when you look at individual countries, there are a lot of them with asthma prevalence similar to that of the US. Poland and the UK, for instance, have very similar asthma prevalence rates. Again, from Our World In Data:

Asthma prevalence, of course, is correlated with environmental factors, such as animal hair and dander, pollen, and mold (fungal) spores, food allergens, tobacco smoke, or other pollutant exposures. If MAHA were really serious about reducing asthma burden, it would have to look at environmental pollutants, particularly air pollution, something that I don’t see the Trump Administration acting to decrease any time soon, if ever.

Then, of course:

Autism spectrum disorders had the highest prevalence in high-income countries, including the United States, in 2021.  Similarly, autoimmune diseases such as inflammatory bowel disease, psoriasis, and multiple sclerosis are more commonly diagnosed in high-income areas such as Europe and North America.  Overall, the global comparison data demonstrates that the health of Americans is on an alarming trajectory that requires immediate action.

This concern applies urgently to America’s children.  In 2022, an estimated 30 million children (40.7 percent) had at least one health condition, such as allergies, asthma, or an autoimmune disease.  Autism spectrum disorder now affects 1 in 36 children in the United States — a staggering increase from rates of 1 to 4 out of 10,000 children identified with the condition during the 1980s.  Eighteen percent of late adolescents and young adults have fatty liver disease, close to 30 percent of adolescents are prediabetic, and more than 40 percent of adolescents are overweight or obese.

Of course, we here at SBM have written about the increasing prevalence of autism and its causes (not vaccines) on a number of occasions, most recently here. It’s an old antivax narrative that “something” must be causing this increase other than the causes that scientists have identified, such as the broadening of diagnostic criteria in the 1990s, increased screening and recognition, decreased stigma, and the like. I could trot out yet again my example of a condition that whose diagnostic criteria hasn’t changed much in 50 years but whose incidence has increased 16-fold just due to screening; you can read about it here if you’re interested. As for obesity and diabetes in children, that is a complex topic oversimplified by RFK Jr. (as usual). For instance, the US actually has rates of childhood obesity that are similar to that of other industrialized countries and lower than some outliers. For example, according to the Global Obesity Observatory, the US is actually ranked #22 in the percentage of obese children, with countries like Samoa, Qatar, and others having higher rates. This is not to say that childhood and adult obesity are not a problem—indeed, the US does lead the world in adult obesity, although Australia, New Zealand, the United Arab Emirates, and the United Kingdom aren’t far behind—or that they haven’t been increasing. It is simply to say that there is nothing uniquely American about this phenomenon, as RFK Jr. wants to imply.

Now note the pivot to implying that correlation equals causation:

These health burdens have continued to increase alongside the increased prescription of medication.  For example, in the case of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder, over 3.4 million children are now on medication for the disorder — up from 3.2 million children in 2019-2020 — and the number of children being diagnosed with the condition continues to rise.  

This poses a dire threat to the American people and our way of life.  Seventy-seven percent of young adults do not qualify for the military based in large part on their health scores.  Ninety percent of the Nation’s $4.5 trillion in annual healthcare expenditures is for people with chronic and mental health conditions. In short, Americans of all ages are becoming sicker, beset by illnesses that our medical system is not addressing effectively.  These trends harm us, our economy, and our security.

Vaccines weren’t mentioned, but I’m sure that RFK Jr. knows that his fans will know that they are implied, along with medications for ADHD. It’s also implied that way fewer people are exercising, but, by coincidence, I happened to have listened to a recent episode of the Conspirituality podcast where they discussed this very thing:

Now, what about exercise? Available data says that about 24% of Americans exercised regularly in the 1960s. And today, about the same, 24% meet recommended levels of aerobic exercise plus strength training.

But an impressive 46% get sufficient aerobic exercise alone. I can’t find a stat for that in the 1960s. They probably weren’t thinking about it that way because so much of this has been culturally sort of emergent.

But commercial gyms, yoga studios, cycling apps and jogging clubs may be a more contemporary phenomenon because more of the population got their exercise from physically demanding jobs in the 1960s. But you know what else was different? 42% of Americans were smokers back then.

And it’s a little bit controversial, but smoking has been repeatedly shown to be correlated with lower BMI due to appetite suppressant and metabolic effects. A 2015 study showed that only 30% of smokers are overweight or obese. So that’s one way to make America healthy again, I guess.

I don’t want to belabor this point, because there are some real problems with obesity, type II diabetes, and other chronic health problems. It’s just that RFK Jr. oversimplifies and implies that a lot of it’s due to vaccines and pharmaceuticals.

What to do? Well, if you didn’t know RFK Jr., you’d think that this next part sounds pretty good:

To fully address the growing health crisis in America, we must re-direct our national focus, in the public and private sectors, toward understanding and drastically lowering chronic disease rates and ending childhood chronic disease.  This includes fresh thinking on nutrition, physical activity, healthy lifestyles, over-reliance on medication and treatments, the effects of new technological habits, environmental impacts, and food and drug quality and safety.  We must restore the integrity of the scientific process by protecting expert recommendations from inappropriate influence and increasing transparency regarding existing data.  We must ensure our healthcare system promotes health rather than just managing disease.

Of course, we know that RFK Jr.’s “fresh thinking on nutrition, physical activity, healthy lifestyles, over-reliance on medication and treatments, the effects of new technological habits, environmental impacts, and food and drug quality and safety” involves a lot of pseudoscience and quackery, as well as a hostility to psychiatric drugs as nasty as the anti-psychiatry beliefs held by any Scientologist; for example, he has recently characterized antidepressants as addictive and the cause of violent behavior, such as school shootings and has even proposed the creation of “wellness farms”:

…Kennedy said he planned to dedicate money generated from a sales tax on cannabis products to “creating wellness farms—drug rehabilitation farms, in rural areas all over this country.” He added, “I’m going to create these wellness farms where they can go to get off of illegal drugs, off of opiates, but also illegal drugs, other psychiatric drugs, if they want to, to get off of SSRIs, to get off of benzos, to get off of Adderall, and to spend time as much time as they need—three or four years if they need it—to learn to get reparented, to reconnect with communities.” The farm residents would grow their own organic food because, he suggested, many of their underlying problems could be “food-related.”

It sounds a lot like Mao’s “down to the countryside” initiative, doesn’t it? The problem thus identified, the executive order moves on to policy and the MAHA Commission.

RFK Jr. and “science”

So let’s first see what the policy is that RFK Jr. wants:

It shall be the policy of the Federal Government to aggressively combat the critical health challenges facing our citizens, including the rising rates of mental health disorders, obesity, diabetes, and other chronic diseases.  To do so, executive departments and agencies (agencies) that address health or healthcare must focus on reversing chronic disease.  Under this policy:

(a)  all federally funded health research should empower Americans through transparency and open-source data, and should avoid or eliminate conflicts of interest that skew outcomes and perpetuate distrust;

(b)  the National Institutes of Health and other health-related research funded by the Federal Government should prioritize gold-standard research on the root causes of why Americans are getting sick;

(c)  agencies shall work with farmers to ensure that United States food is the healthiest, most abundant, and most affordable in the world; and

(d)  agencies shall ensure the availability of expanded treatment options and the flexibility for health insurance coverage to provide benefits that support beneficial lifestyle changes and disease prevention.

Again, this all sounds great on the surface. However, I know what RFK Jr. really means, which is why I think I will provide a translation:

It shall be the policy of the Federal Government to aggressively combat the critical health challenges facing our citizens, including the rising rates of mental health disorders, obesity, diabetes, and other chronic diseases.  To do so, executive departments and agencies (agencies) that address health or healthcare must focus on deprioritizing science-based medicine with respect to chronic disease.  Under this policy:

(a)  all federally funded health research should empower Americans through transparency and open-source data, and should avoid or eliminate conflicts of interest that skew outcomes and perpetuate distrust, in order to allow antivaxxers and quacks to manipulate the data to show that vaccines and FDA-approved drugs are dangerous, some even addictive;

(b)  the National Institutes of Health and other health-related research funded by the Federal Government should prioritize gold-standard research on the root causes of why Americans are getting sick that will exclude anything having to do with actual science or science-based medicine that doesn’t comport with our preconceived conclusion that vaccines, pharmaceuticals, and “bad food” is the cause of all chronic disease;

(c)  agencies shall work with farmers to ensure that United States food is the healthiest, most abundant, and most affordable in the world (even as we deport all the undocumented agricultural workers); and

(d)  agencies shall ensure the availability of expanded treatment options and the flexibility for health insurance coverage to provide benefits that support beneficial lifestyle changes and disease prevention; i.e., we don’t care about universal national health insurance, just that existing insurance transfers coverage away from drugs, vaccines, and surgery to woo.

But what about the MAHA Commission? It will be chaired by RFK Jr., of course, and be co-charied by the Assistant to the President for Domestic Policy serving as Executive Director (Executive Director). Committee members will include Secretaries of Agriculture, Housing and Urban Development, Education, and Veterans Affairs, as well as the administrator of the EPA and the Directors of OMB, the National Economic Council, NIH, CDC, and Office of Science and Technology Policy, plus the Chairman of the Council of Economic Advisors and the Commissioner of the FDA—oh, and “other members of my Administration invited to participate, at the discretion of the Chair and the Executive Director.”

Let’s look at some of the biggest red flag items that this commission is tasked with. First, with respect to childhood chronic disease, the commission is tasked to:

(a)  study the scope of the childhood chronic disease crisis and any potential contributing causes, including the American diet, absorption of toxic material, medical treatments, lifestyle, environmental factors, Government policies, food production techniques, electromagnetic radiation, and corporate influence or cronyism;  

A few translations:

• Absorption of toxic materials = vaccines, pharmaceuticals, and “chemicals”
• Environmental factors = “chemicals,” whether shown to be harmful or not
• Electromagnetic radiation: “Cell phones and wifi cause cancer and other diseases!” (They don’t.)
• Corporate influence and cronyism = vaccines and big pharma, but not supplements, alternative medicine and what I now like to call “big wellness”

Next up:

(b)  advise and assist the President on informing the American people regarding the childhood chronic disease crisis, using transparent and clear facts; and

(c)  provide to the President Government-wide recommendations on policy and strategy related to addressing the identified contributing causes of and ending the childhood chronic disease crisis.

Translations:

• Transparent and clear facts = Cherry picked studies and data that show what we want them to show.
• Strategy related to addressing the identified contributing causes of and ending the childhood chronic disease crisis = Get rid of vaccines, pharmaceuticals, and science-based interventions that we don’t like, all in favor of woo.

Seriously. I know you, RFK, Jr. You don’t fool me with:

…assess the threat that potential over-utilization of medication, certain food ingredients, certain chemicals, and certain other exposures pose to children with respect to chronic inflammation or other established mechanisms of disease, using rigorous and transparent data, including international comparisons;

Spoiler alert: The MAHA commission will find that we vaccinate too much, use too much “artificial” ingredients in foods, that wifi causes cancer and chronic disease, while the “rigorous data” will be cherry picked and/or gathered by hand-picked crank scientists and doctors in order to come to preordained conclusions.

Also:

…assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs;

See what I mean? RFK Jr. is coming after psychiatric medications in addition to vaccines. I know, I know. He says nothing about vaccines in this document, but, once again, given how much he was grilled on vaccines during his confirmation hearings and how he’s been playing coy with the question of vaccines ever since he bent the knee to Trump and came up with “MAHA,” does anyone doubt that he’s coming for vaccines? I’ve been following him and documenting the antivax misinformation that he’s promoted since 2005. For him not to go after vaccines using deceptive science, conspiracy theories, and cherry-picked data would be so unlike him as to strain credulity, as demonstrated by his two decade track record in this sphere, so much so that I absolutely do not believe him when he says he won’t go after vaccines.

Similarly:

…restore the integrity of science, including by eliminating undue industry influence, releasing findings and underlying data to the maximum extent permitted under applicable law, and increasing methodological rigor; and

…establish a framework for transparency and ethics review in industry-funded projects.

If RFK Jr. were really about eliminating “undue industry influence,” I could actually get behind that, depending on the details. That’s not what he is about. What he is really about is shifting allowable “undue industry influence” away from big pharma to big wellness, away from companies that at least try to develop treatments rooted in science to companies that sell outright snake oil. Similarly, “increasing methodological rigor” will involve, at least for vaccines and pharmaceuticals, impossible standards for safety and efficacy.

Again, everything that I know about RFK Jr.’s history, studied over the last two decades, tells me that this is what he will do and what he really means. I will give RFK Jr. and whoever else wrote this credit. They are very good at couching what they really mean in language that on the surface seems unobjectionable. If you don’t know RFK Jr.’s history or are sympathetic to parts of his message that you want to believe that he’s being sincere rather than disingenuous, you might be swayed. Certainly, I expect RFK Jr. apologists and cheerleaders like Dr. Prasad to enthusiastically embrace this document, taking it at face value and selling it that way. Unfortunately, I know RFK Jr.’s MO all too well, and I know what is really behind this document, as likely do most of our readers.

This is:

President Donald Trump on Friday signed an executive order that would strip schools of federal aid if they mandate COVID vaccines, a pool report said — a largely symbolic move considering that no states currently require them.

The order applies to students and not to teachers or staff.

“People wanted that very badly,” Trump said.

In a fact sheet provided to reporters, the White House said the order was necessary because COVID vaccine mandates were “threatening educational opportunities for students.”

And so is this:

Louisiana’s health department “will no longer promote mass vaccination”, including using media campaigns or health fairs to promote vaccines against preventable illnesses, according to an internal memo issued by the surgeon general in the state of 4.5 million people.

The memo from surgeon general, Dr Ralph Abraham, immediately ignited fears of lower vaccination rates leading to increased sickness, hospitalization and death – as well as a return of diseases such as measles and polio that had all been mostly eradicated by vaccines.

Appointed to his position in June by Louisiana’s extremist Republican governor, Jeff Landry, Abraham wrote that the state would continue to “encourage each patient to discuss the risks and benefits of vaccination with their provider”. But, characterizing it as a matter of personal choice, Abraham said the state’s health department would do away with promoting the practice of mass vaccination – even as Louisiana has grappled with a surge in influenza, for which vaccines are offered seasonally.

Yes, I know. It’s a state government, not the federal government, giving up promoting the most effective public health intervention against infectious disease ever discovered. The initiative, is, however, very much in line with MAHA ethos, which is starting to metastasize beyond RFK Jr. and the federal government. Basically, this is an example of a populous Trump-supporting state giving up on public health and instead framing public health as a matter of “personal choice.” Nor will Louisian be the only state to do this, I predict (an unfortunately easy prediction to make). I’m only surprised that Florida didn’t beat Louisiana to a policy like this, given that its health department is run by COVID-19 contrarian Dr. Joseph Ladapo, who’d better get cracking now.

Meanwhile:

Bill Cassidy, the Republican US senator, has said his home state of Louisiana’s recent decision to cancel the promotion of mass vaccination against preventable diseases is a disservice to parents who want to keep their children healthy.

And:

Cassidy on Friday joined the chorus of detractors questioning the wisdom of the policy unveiled by Abraham, who has been in his position since June. He issued a statement saying the policy’s removal of vital vaccine-related resources “is not a stand for parents’ rights”. Rather, “it prevents making health care more convenient and available for people who are very busy”.

The senator said the health fairs shelved by his state had been a boon for parents who “suddenly realize their child needs to be immunized and they can’t get in to see the doctor”.

“It may be six weeks or longer for a routine visit,” Cassidy’s statement said. He added that was why, in his prior career as a physician, he had run “large-scale immunization programs to bring health care and immunizations to the patient”.

“Things like vaccine fairs keep a child from having to miss school and a mother from having to miss work,” Cassidy said. “That is the reality of today’s medicine. To say that cannot occur and that someone must wait for the next available appointment ignores that reality.”

He continued: “Advertising the benefit of vaccines and where to get them helps parents improve the health of their child. It’s important information they may not have known or needed to be reminded of.”

Sen. Cassidy is, of course, quite correct about all of this. Unfortunately, it’s way too little, way too late. Not only that, but his words belie his recent actions. Yes, he’s speaking out about antivaccine policies in his state, but, really, what is happening in Louisiana is completely of a piece with the realignment of the Republican Party to embrace antivaccine tropes. Moreover, before this Sen. Cassidy had just exhibited willful blindness and, through his failure to live up to what he said was his conscience, helped to install the most (in)famous antivaxxer in the world (with the possible exception of Andrew Wakefield) as head of all non-military federal health, public health, and biomedical research programs. Sen. Cassidy could have stopped RFK Jr.’s nomination dead in its tracks, by voting against its being forwarded to the full Senate for a vote. He chose not to, even after he had acquitted himself well during the confirmation hearing by grilling RFK Jr. about his antivax views, giving him many opportunities to recant his oft-stated belief that vaccines cause autism. that RFK Jr. awkwardly refused, dodging and weaving. Yet, in the end Sen. Cassidy still voted to forward RFK Jr.’s nomination to the full Senate. The vote was 14-13. Had Sen. Cassidy voted no, the nomination would not have advanced. Then Cassidy voted again to confirm RFK Jr. when the nomination came up for a vote by the full Senate. As I said above, Sen. McConnell was the only Republican to vote against confirmation.

Worse, Sen. Cassidy voted for confirmation after having given this self-serving obsequious speech to the full Senate in support of the nomination, in which, from my perspective, he basically admitted to having been duped by more of RFK Jr.’s lies. I’m going to quote it at length, because his statement really is…something; that is, something nauseating to any physician who supports public health, science-based healthcare, and, as a result, vaccines:

Now, Mr. Kennedy and the administration reached out seeking to reassure me regarding their commitment to protecting the public health benefit of vaccination.

To this end, Mr. Kennedy and the administration committed that he and I will have an unprecedently close collaborative working relationship if he is confirmed. We will meet or speak multiple times a month. This collaboration will allow us to work well together and therefore to be more effective.

Mr. Kennedy has asked for my input into hiring decisions at HHS, beyond Senate-confirmed positions. This aspect of our collaboration will allow us to represent all sides of those folks that were contacting me this weekend.

He has also committed that he would work within the current vaccine approval and safety monitoring systems, and not establish parallel systems. If confirmed, he will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without changes. CDC will not remove statements on their website pointing out that vaccines do not cause autism. Mr. Kennedy and the administration also committed that this administration will not use the subversive techniques employed under the Biden administration, like sue and settle, to change policies enacted by Congress without first going through Congress.

Mr. Kennedy and the administration committed to a strong role of Congress. Aside from us meeting regularly, he will come before the Committee on a quarterly basis, if requested. He committed that the HELP Committee Chair, whether it’s me or someone else, may choose a representative on any board or commission formed to review vaccine safety.

If he is confirmed, HHS will provide a 30-day notice to the HELP Committee if the agency seeks to make changes to any of our federal vaccine safety monitoring programs, and HELP Committee will have the option to call a hearing to further review.

These commitments, and my expectation that we can have a great relationship to make America healthy again, is the basis of my support. He will be Secretary, but I believe he will also be a partner in working for this end.

If Mr. Kennedy is confirmed, I will use my authority as Chairman of the Senate Committee with oversight of HHS to rebuff any attempts to remove the public’s access to life-saving vaccines without ironclad, causational scientific evidence that can be defended before the mainstream scientific community and before Congress. I will carefully watch for any effort to wrongfully sow public fear about vaccines between confusing references of coincidence and anecdote.

But my support is built on assurances that this will not have to be a concern and that he and I can work together to build an agenda to make America healthy again.

Cowardice, thy name is Senator Cassidy, who betrayed his Hippocratic oath as a physician. Seriously, he seems to think that he will be HELP Chair indefinitely. I also have to ask rather pointedly: If Sen. Cassidy was too cowardly to buck Trump by voting against forwarding RFK Jr.’s nomination out of committee to the Senate and voting against the nomination directly, how can he honestly expect us to believe him when he bloviates that he’ll be this bulldog, this unstoppable watchdog, who will make sure that RFK Jr. doesn’t do what he’s been promising his followers that he’d do if ever given power over the CDC, namely carrying his antivaccine crusade to the halls of power and doing his damnedest to destroy the federal vaccination program? Does Sen. Cassidy seriously believe that RFK Jr. won’t change ACIP, as I predicted he would, stacking it with antivaxxers? Does he really believe that the CDC will leave intact statements that vaccines don’t cause autism and not at least add qualifying statements or equivocations to them that make the statements a lot less definitive?

I suppose that RFK Jr. probably won’t develop parallel systems to monitor vaccine safety, but that will be because he won’t need to. He’ll be able to change and distort existing systems, bending them to his will to twist data in any way necessary for him to “prove” that vaccines are “unsafe” and cause autism (not to mention all sorts of other conditions and diseases). If RFK Jr.’s testimony was a tour-de-force study in disingenuousness, Sen. Cassidy’s performance was a tour-de-force performance in either gullibility or cowardice, likely both. I’m sure it didn’t hurt that apparently Vice President J.D. Vance leaned on him as well.

I’m not Sen. Cassidy, and I know that RFK Jr. can’t be trusted when he lies and lies and lies and lies about being “pro-vaccine,” no matter how much the media sanewashes him as being seemingly reasonable and no matter how much they try to call him a “vaccine skeptic” rather than what he is, an antivaccine activist. Because of my two decades studying RFK Jr.’s antivax propaganda, pseudoscience, and conspiracy theories, unlike Sen. Cassidy, I know what RFK Jr. is really saying, and I know what the executive order establishing the MAHA Commission is really saying, what it really means, and what it is hiding, I will conclude by noting that the executive order ends by tasking the MAHA commission to draft a report of its findings and recommendations within 180 days of the date of the order. Because I can translate RFK Jr.-speak, I therefore know that, whatever horrors come between now and summer, August will be an “interesting” month, and by “interesting” I mean truly alarming, because the MAHA commission report will be RFK Jr.’s roadmap for dismantling science-based public health, medical, and biomedical research policy. He’s already begun in a haphazard way, but this will give him the appearance of an evidence-based plan.