Kennedy Says He Won’t Take Away Vaccines. Don’t Believe Him.

I was recently counseling a patient who was planning to become pregnant. In addition to prenatal vitamins, I discussed the vaccines recommended by the American College of Obstetricians and Gynecologists. My patient cut me off, “Is it a choice or is it mandatory?”

“It’s your choice, of course,” I replied, although I explained why vaccination during pregnancy is important to help protect newborns from an array of serious diseases. Because of Health Secretary Robert F. Kennedy Jr., however, I wonder how much longer I’ll be able to offer my patients the choice of that protection.

This month, Mr. Kennedy testified before Congress, and repeated what he’d promised before his Senate confirmation: “I’m not taking vaccines away from anyone.” But this flies in the face of what Americans are experiencing. As a result of Food and Drug Administration restrictions on Covid vaccines put in place last month, vaccines are suddenly harder to get. Average-risk adults in many states can no longer walk into their pharmacy and get the vaccine as they had last year. Most children will need a medical evaluation before they can get it.

Even those considered high risk are struggling to find shots. A 76-year-old teacher in the Pacific Northwest told me that employees at every pharmacy he called said they were unsure when the vaccine would be available “due to government rules.” Even his doctors’ office didn’t have it.

There are certainly valid scientific reasons to consider dialing back Covid vaccine recommendations for low-risk individuals, given that the virus is a different beast than it was at the beginning of the pandemic. But what riles medical professionals is that these changes have not been issued as a result of a standard scientific process. It seems that a political goal was set — to diminish use of the Covid vaccine — and processes were manipulated in order to achieve the desired outcome, while inconvenient scientists, like the director of the Centers for Disease Control and Prevention, were jettisoned.

For many of us in health care, this unscientific rollback of the Covid vaccine feels like the warning shot. This week’s meeting of the Advisory Committee for Immunization Practices, the C.D.C.’s advisory committee on vaccines, is scheduled to include votes not only on the Covid vaccine, but also the hepatitis B vaccine and the combined measles, mumps, rubella, varicella vaccine, or M.M.R.V. for short.

There is good reason to fear that this meeting will be more political theater than scientific debate; all of the original vaccine experts on the committee were sacked by Mr. Kennedy three months ago and replaced by a new panel that included several people known for vaccine misinformation and anti-vaccine views. On Monday, five more members were added, including one who’s promoted unproven Covid treatments like ivermectin.

Some experts worry that the committee will do away entirely with recommending hepatitis B vaccines at birth. This vaccine, which helps prevent liver infection, cirrhosis and cancer, has long been a target of several of Mr. Kennedy’s allies. The committee may recommend against the M.M.R.V combo that has been in use for two decades. Children could still be vaccinated against these diseases with a two-shot regimen of the M.M.R. vaccine and the varicella vaccine, but for some patients extra shots represent an additional barrier to vaccination.

And Covid shots could become even harder to get. The Washington Post reported last week that government officials plan to link the deaths of 25 children to the Covid vaccine based on information submitted to the C.D.C.’s open reporting system. (Anyone can submit unverified reports of “vaccine adverse events,” even if it’s unclear that the vaccine was the cause.) Extensive studies have demonstrated far more severe outcomes in children from Covid infection than from Covid vaccination.

Many states and school districts tie their vaccine guidelines to the advisory committee’s recommendations, which are cited in nearly 600 statutes and regulations nationwide. The recommendations affect school enrollment policies, vaccinations for health care workers, vaccine reminder systems, standing orders that allow nursing homes to vaccinate residents, authorizations for pharmacists to administer vaccines, even state purchasing protocols. Most insurance companies base their coverage on its recommendations. If certain vaccines are no longer recommended, people can face prohibitive out-of-pocket costs. (M.M.R.V. vaccines, for example, cost $300 or more without insurance).

I suspect Mr. Kennedy would be happy to ban many vaccines outright, but that probably wouldn’t go over well with the overwhelming majority of Americans who support vaccinations for preventable diseases. So he’s tackling the vaccine infrastructure, instead. A recent poll suggests that most Americans believe that vaccines should be made more available, but many feel that Mr. Kennedy is doing just the opposite.

And it’s not just the meeting of the vaccine advisory committee that worries experts. Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, expects Mr. Kennedy will tackle the production of vaccines next — adding costly and burdensome requirements to slow their development and manufacture.

Dr. Paul Offit, a vaccine expert and professor of pediatrics at Children’s Hospital of Philadelphia, warned me that Mr. Kennedy may soon turn his sights on the National Vaccine Injury Compensation Program, a federal program created to curb frivolous litigation against vaccine makers, while giving people an avenue to petition for compensation for vaccine injuries. Before this program began in 1986, many drug manufacturers simply stopped producing vaccines because the liability threats were too great.

“There is no better way to harm vaccines,” Dr. Offit said of dismantling the compensation program, “and then we’re right back to where we were in the 1980s.” This may be Mr. Kennedy’s way of hobbling vaccination without even needing to ban vaccines outright.

How should ordinary people — and ordinary health care professionals — respond to deliberate steps to make vaccinations less available? At this point, it’s fair to say that the F.D.A. and the C.D.C. and its vaccine advisory committee have been scientifically neutered. The recent decision of California, Washington and Oregon to form a regional alliance for health recommendations is both a reasonable response and a depressing necessity. The best sources of scientifically validated recommendations at this moment are the medical professional societies such as the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the Infectious Diseases Society of America.

Medical groups with lobbying muscle, such as the American Medical Association, need to start listening to their members and use their full force to oppose Mr. Kennedy’s efforts to make vaccines less accessible. Insurance companies need to base their coverage guidelines on the evidence-based recommendations of medical professional groups, rather than the eviscerated federal agencies.

State governments need to provide legislation or executive orders that allow pharmacies to easily administer vaccines, as Gov. Kathy Hochul recently did for New York. Doctors and nurses will have to spend precious medical time during visits to focus on vaccine access and countering growing vaccine hesitancy, not to mention begin treating illnesses from their grandparents’ generation.

In the end, though, the prescription for this mess is political rather than medical. Americans need to confront their cowardly elected officials before the vaccines that have saved more than 150 million lives globally in the last half century become unobtainable in this country. And when the hospitalization rates and deaths begin to rise — as they inevitably will — we will communally suffer the painful lesson that politics and incompetence cause far more side effects than any vaccine ever could.

Danielle Ofri, a primary care doctor at Bellevue Hospital, is the author of “When We Do Harm: A Doctor Confronts Medical Error” and editor of Bellevue Literary Review.

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