I’ve been writing about the antivax activism, conspiracy theories, pseudoscience, and quackery of Robert F. Kennedy, Jr. for nearly 20 years now, having written so many posts about him that I’ve lost count. Indeed, when Donald Trump, having won the 2024 election, nominated RFK Jr. to be his Secretary of Health and Human Services, I was appalled enough to refer to him as an impending catastrophe for public health and medical research. So it was with some surprise that I awoke yesterday to be made aware of an op-ed published in Fox News by our new HHS Secretary entitled Measles outbreak is call to action for all of us. Even more shocking, the tagline for the article stated MMR vaccine is crucial to avoiding potentially deadly disease. Holy crap! I wondered. Has RFK Jr. gone pro-vaccine? On the surface, it looks that way, but if you dig deeper into the article, you’ll find that the picture is not quite as clear as it’s being portrayed.
First, a bit of background. There has been, in fact, a rather large measles outbreak raging in western Texas since late January, which, according to the Texas Department of State Health Services, has as of Friday sickened 146 (and counting), hospitalized 20, and claimed the life of one unvaccinated child, the first child to die of measles in the US since 2023. In fairness, RFK Jr. as HHS Secretary can’t be directly blamed because the outbreak started before he was confirmed and sworn in. However, there’s plenty of indirect blame attributable to him and his sycophants, toadies, and lackeys who have been spreading antivax misinformation, disinformation, pseudoscience, and conspiracy theories for years and years. This constant stream of antivax propaganda on social media and legacy media has been a powerful force to promote fear, uncertainty, and doubt (FUD) about vaccines that has driven vaccine uptake in some areas of the country sufficiently low to fall below the threshold necessary for herd immunity.
As I’ve described for two decades, RFK Jr. has been not just antivaccine, but rabidly antivaccine. Moreover, he has consistently demonized the measles-mumps-rubella (MMR) vaccine with all the standard antivax tropes, including false claims like:
- MMR causes autism. (It doesn’t.)
- Measles is a harmless childhood disease. (It isn’t.)
- The MMR vaccine makes measles more virulent. (Nope.)
There are lots of other claims that RFK Jr. has made in the past, but let’s focus on the supposedly new and improved RFK Jr. After starting out simply describing the outbreak and mentioning the death of the child, the first measles death since 2015, RFK Jr. actually mostly gets the facts about measles right, which is highly unusual for him, although I’m sure he now has people at the CDC who can do this for him. What surprised me is that he let them:
Measles is a highly contagious respiratory illness with certain health risks, especially to unvaccinated individuals. The virus spreads through direct contact with infectious droplets when an infected person breathes, coughs, or sneezes. Early symptoms include high fever, cough, runny nose, and red, watery eyes, followed by a characteristic body rash. Most cases are mild, but rare complications can be severe, including pneumonia, blindness, and encephalitis. Prior to the introduction of the vaccine in the 1960s, virtually every child in the United States contracted measles. For example, in the United States, from 1953 to 1962, on average there were 530,217 confirmed cases and 440 deaths, a case fatality rate of 1 in 1,205 cases.
I said “mostly” correct, but note the spin; “Most cases are mild.” To that, I respond: Define “mild.” Even children who do not suffer consequences like pneumonia or encephalitis do not necessarily have a “mild” disease. It’s a miserable disease, with several days of high fever and rash, along with respiratory symptoms. However, the framing is there: Measles is mostly mild.
RFK Jr. then rattles off some statistics about the outbreak, noting that 79 of the confirmed cases “involved individuals who had not received the measles, mumps, and rubella (MMR) vaccine, while 62 cases had unknown vaccine status,” with “at least five” who had received an MMR vaccine. Note the framing there as well. He’s trying mightily to imply that more of the cases had been vaccinated; if he weren’t doing that, he would have just cited the last statistic that there were five cases in children who had received at least one dose of MMR without the “at least.”
This next part sounds a bit better:
In response to this outbreak, I have directed the Centers for Disease Control and Prevention (CDC) and the Administration for Strategic Preparedness and Response (ASPR) to work closely with the Texas health authorities to provide comprehensive support. HHS’ efforts include offering technical assistance, laboratory support, vaccines, and therapeutic medications as needed.
Offering technical assistance, laboratory support, and vaccines is good. I was, however, curious what RFK Jr. meant by “therapeutic medications,” given that measles is a viral disease and there are no medications that directly treat the disease. It didn’t take long to find out:
It is also our responsibility to provide up-to-date guidance on available therapeutic medications. While there is no approved antiviral for those who may be infected, CDC has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection. Studies have found that vitamin A can dramatically reduce measles mortality.
It’s a common antivax claim that measles is not only harmless, but that it can be treated with vitamin A. Remember that claim? It showed up a lot among antivaxxers during the Samoan measles outbreak in 2019. Here’s the thing, though. While there is evidence that administering vitamin A to children with severe measles can decrease the risk of hospitalization and death and it is indeed used in developing countries for that very purpose because children there often have vitamin deficiencies, there is little or no evidence that vitamin A makes a difference in children with normal pre-existing vitamin A levels:
Vitamin A is less commonly used for measles cases in the U.S., according to the National Foundation for Infectious Diseases. Doctors say one reason may be that most Americans have enough vitamin A in their diet.
“I think the big caveat of all of this is that there’s a significantly higher rate of vitamin A deficiency in developing countries,” said Dr. Alexandra Yonts, infectious disease specialist at Children’s National Hospital in Washington, D.C. “So it is less clear whether there is any benefit in populations like in the U.S. and other developed countries.”
There’s probably little harm in recommending vitamin A, but mentioning it as well as the MMR vaccine appears strategic. Why? Doing so downplays the importance of the MMR vaccine, implying that it’s just one of multiple options, when in reality the MMR vaccine is by far the best strategy to prevent measles, with vitamin A maybe doing some good in children with measles, but in an industrialized country like the US, probably little, if any, good. Mentioning it also serves to promote the “make America healthy again” (MAHA) narrative, in which diet and exercise are everything (whether they are or not for specific conditions).
Don’t believe me? Well, then, take a look at these antivax dogwhistles embedded in a seemingly pro-vaccine article:
Parents play a pivotal role in safeguarding their children’s health. All parents should consult with their healthcare providers to understand their options to get the MMR vaccine. The decision to vaccinate is a personal one. Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons.
Previous messaging would have just said that parents should be encouraged to get their children vaccinated. It would not have added that qualification that the “decision to vaccinate is a personal one.” Here’s where the antivax dogwhistles really get the dogs howling:
Tens of thousands died with, or of, measles annually in 19th Century America. By 1960 — before the vaccine’s introduction — improvements in sanitation and nutrition had eliminated 98% of measles deaths. Good nutrition remains a best defense against most chronic and infectious illnesses. Vitamins A, C, and D, and foods rich in vitamins B12, C, and E should be part of a balanced diet.
The claim that improvements in sanitation and nutrition had reduced the death rate from measles by 98% before the vaccine is a classic antivax narrative designed to imply that the vaccine isn’t necessary. Also, holy hell! “Died with, but not of, measles?” That’s pure antivax dogwhistling, in which he’s clearly implying that most people with measles didn’t actually die because of the measles but of something else. (In other words, the implication is that the disease isn’t as deadly as normally thought.) We saw a very similar narrative about COVID-19 about dying “with” COVID-19 and not “of” COVID-19; it was bullshit too.
There’s even a clever embedded antivax dogwhistle in the link about “eliminated 98% of measles deaths.” I clicked on the link. It doesn’t go to any scientific reference—or even a lay publication explaining the point; rather, it goes to Our World in Data, producing a graph that is quite amazingly deceptive:
First, note that the scale is logarithmic, which is designed to flatten the appearance of changes in the incidence rates in order to make them look less dramatic, particularly the case rate, where the transition point around 1963 (the year the measles vaccine was first licensed) that is so obvious in graphs of incidence with time becomes obscured. Moreover, if you look run your cursor over the graph at the link, you’ll see that the death rate fell from 0.22 per 100,000 in 1960 to 0.0092 per 100,000 by 1974. So, contrary to antivax claims, the measles vaccine the vaccine did dramatically decrease the death rate from measles after all! Thanks, RFK!
I can’t stop, though. Let’s take a look at the data as they are normally graphed:
This was very much an intentional tactic designed to make the vaccine look as though it didn’t do much. Moreover, harping on the decline in the death rate from measles before the vaccine, while accurate, is also misleading. I also like to point out that measles is a virus that is transmitted through the air. Sanitation doesn’t do much to control an infectious respiratory disease. Although better nutrition could also have helped, this narrative also neglects the improvements in medicine and supportive care that allowed more people with measles to recover.
Indeed, this is an antivax trope that in 2010 I dubbed “vaccines didn’t save us,” a highly intellectually dishonest argument, as explained in the link. The short version is that, while it is true that mortality from measles had plummeted in the decades before the vaccine due to better medical care and nutrition, every year there were still 400-500 people dying of measles, a number that antivaxxers appear to consider unimportant and want to see again (more, actually, given the increase in the US population since the early 1960s), and considerable misery from from the huge numbers of new cases every year (most people caught measles before they turned 15), which resulted in roughly 48,000 hospitalizations per year and 1,000 cases of encephalitis. I don’t know about you, but I consider that many deaths and hospitalizations to be a big problem.
Also note the pivot to diet, where RFK Jr. states that good nutrition “remains a best defense against most chronic and infectious illnesses and then recommends foods rich in vitamins A, C, D and foods rich in vitamin B12, C, and E. First, I have to ask: Who edited this? He mentions vitamin C twice. Second, and more importantly, here RFK Jr. is clearly implying that good nutrition and foods rich in the listed vitamin can prevent measles. They can’t. Measles is one of the most highly contagious viruses known to science. Only the vaccine or immunity from a previous infection can prevent your catching measles if you are exposed to the virus. RFK Jr. is doing nothing more than rehashing a common antivax narrative that you can prevent nearly any disease if you are sufficiently “virtuous” with respect to diet and lifestyle. It reminds me of when Bill Maher claimed he didn’t need the flu vaccine because his diet and lifestyle would protect him, leading Bob Costas to retort incredulously, “Oh, come on, Superman!“
All of this leads me to consider the questions: Has RFK Jr. gone provaccine? Has he really betrayed the antivaccine movement? The answer to the first question is: Probably not. I tend to think that RFK Jr. knows that politically it’s a very, very bad look if he doesn’t take some conventional public health action to address the outbreak, given his past history. In this context, I see the mentions of dying “with” measles, vitamin A to treat measles, emphasizing “choice” about vaccines, and the like are winks and nods to antivaxxers that he’s still one of them.
Amusingly, not all of them are getting it, as The Real Truther documents:
I’ll add a couple more:
Of course, RFK Jr. did the same sort of thing when his “MAHA manifesto” didn’t include even one reference to vaccines and antivaxxers noticed. That’s what he gets for having been an antivax activist for so long. Antivaxxers are so annoyed with and disappointed in RFK Jr.—they feel so betrayed— that it’s even bubbled over enough that mainstream media has noticed:
- RFK Jr. Sparks Anti-Vaxxer Anger: ‘No Different Than Fauci’ (Newsweek)
- ‘Not MAHA’: Anti-Vaxxers Rage at RFK Jr. Over Flip-Flop (The Daily Beast)
- RFK’s Flip-Flop on the Measles Shot Is Ripping the Anti-Vax World Apart (Mother Jones)
Even Del Bigtree is at a loss for words, which almost never happens:
One of the major architects of the MAHA movement has yet to say anything at all. Film producer, Kennedy’s former campaign manager, and longtime fixture in the anti-vaccine world, Del Bigtree, is now the CEO of MAHA Action, a group made up of former team Kennedy staffers explicitly dedicated to furthering Kennedy’s MAHA agenda. Bigtree didn’t respond to requests for comment from Mother Jones about Kennedy’s remarks. He previously tried to reassure the faithful that Kennedy would remember his friends and principles when ensconced in the halls of power. “For all the doubters,” he tweeted in December with a link to a story about how, if confirmed, Kennedy would “investigate” the link between vaccines and autism. (Vaccines do not cause autism and such a purported link has been debunked many times over.)
So what is really going on? I suspect that it’s RFK Jr. trying to be too clever by half and failing. He’s spent the last 20 years promoting the most bonkers antivax misinformation, conspiracy theories, and pseudoscience, and now, as improbable as it is, he is in control of all nonmilitary medical, public health, and medical research programs. He thinks he has to do this because if he went too antivax too fast he might risk going too far and being ousted. So he advocates for the MMR, but he dilutes the recommendation with all sorts of antivax dog whistles. Unfortunately, his fans are insufficiently subtle to realize that that’s what he’s doing and view him as having betrayed them. In a way, he has—for now. What I fear is that he will redeem himself in their eyes.
One reply on “Has RFK Jr. betrayed the antivax movement?”
I suppose it was inevitable though.
Fanatics always wind up complaining about how other fellow travellers are not dedicated enough.