A U.S. health secretary prepared to spend billions to seek a link between vaccines and autism. Vaccine skeptics shaping policy. A proposal to eliminate the entire federal immunization schedule for American children.
Robert F. Kennedy Jr. has brought a series of once-unthinkable public-health proposals to the highest levels of the Trump administration since becoming health secretary early last year, according to Reuters interviews with 16 current and former officials with direct knowledge of the discussions.
The officials, from the U.S. health department and White House, shared details of internal discussions on condition of anonymity. Their first-hand accounts of Kennedy's previously unreported efforts reveal a tenacious activist who has pushed through some of the biggest changes to U.S. vaccine policy in decades – and who sought to go much further than previously known to dismantle the status quo.
"He's an anti-vaccine activist. That's who he is. That's who he's been for 20 years. To expect that as secretary of Health and Human Services he'd be anything other than that is wishful thinking," said Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia and a long-time immunization adviser to the CDC.
Kennedy's efforts to cast doubt on the safety of shots for common diseases are making it harder to curb outbreaks, including the biggest U.S. resurgence of measles in more than three decades, Offit said.
"He scares people about vaccines, which only causes them not to get them," Offit said. "We're screwed."
The Department of Health and Human Services did not make Kennedy available for an interview. Provided with details of Reuters' reporting, spokeswoman Courtney Spencer disputed key details as untrue or inaccurate, including the plan to eliminate the entire childhood immunization schedule. Spencer didn't respond to a request for clarification about what was incorrect.
Kennedy has been unable to implement several elements of his vaccine agenda in the face of resistance from different corners of the government, including within the health department and the White House, the Reuters reporting found. Furthermore, one of his most ambitious changes to public health - removing vaccines for six out of 17 diseases from the recommended childhood vaccination schedule - has been put on hold by a federal judge in response to a lawsuit from the American Academy of Pediatrics and other medical groups.
Despite the setbacks, Kennedy has pushed through major changes in his time at the health department, which oversees national health agencies including the Food and Drug Administration, National Institutes of Health and Centers for Disease Control and Prevention. The reforms include winding down mRNA vaccine development, withdrawing funding for an international vaccine alliance and tightening access to COVID shots. Many health experts have said his use of his position to elevate concerns about vaccine safety has sown confusion about which immunizations, if any, parents should give their children.
Early this year, Kennedy went to his director of the NIH, Jay Bhattacharya, with a costly proposal, according to two officials familiar with the request: The research agency should spend $5 billion studying the link between vaccines and autism. That would have dedicated more than a tenth of the NIH's annual budget to investigating a hypothesis already refuted by scientists worldwide.
Kennedy ultimately dropped the plan, which likely would have required congressional approval, after Bhattacharya convinced him the agency had dedicated enough resources to researching autism's causes, including a $50 million effort launched in September, the officials said.
Kennedy's proposal came shortly after he agreed to avoid talking publicly about vaccines, bowing to the request of several senior White House aides who feared his medical theories would damage Republicans politically.
But behind the scenes, the health secretary has continued to seek evidence for his theory that many vaccines have not been properly tested and can cause a range of dangerous side effects, according to eight of the current and former officials.
The NIH and Bhattacharya did not respond to requests for comment. HHS did not comment on the $5 billion funding idea.
The NIH research request is one of several episodes recounted by current and former officials in the health department and White House that cast light on Kennedy's mission as health secretary. It's the latest chapter for the scion of one of America's political dynasties, whose life has veered from the trauma of the assassinations of his uncle and father and a years-long heroin addiction to becoming a powerful anti-vaxxer and flag-bearer of the Make America Healthy Again (MAHA) movement.
Kennedy won renown as an environmental lawyer who spent years fighting corporations over pollution and toxic chemicals. That contributed to his broad influence promoting anti-vaccine theories for two decades, including that many vaccines are more dangerous than the diseases they prevent, that they cause autism and autoimmune disorders in children and contain debris from aborted fetuses. His views are contradicted by scores of studies showing vaccines have saved millions of lives and prevented long-term health problems from common diseases, while side-effects remain relatively rare.
The 72-year-old's popularity boomed during the pandemic, when his insistence that COVID vaccines were dangerous and his opposition to lockdown restrictions attracted many Americans distrustful of government policy. He amplified conspiracy theories that accused U.S. government scientists of deliberately profiting from the pandemic.
He has also spoken about startling incidents from his own life, including discovering a worm had lodged in his brain, causing memory issues, and dumping the carcass of a bear cub in New York City's Central Park. He said it was roadkill he had intended to take home to skin and store the meat, before deciding to leave it in a park bike lane as a prank.
Kennedy was named health secretary after he cut short his own run for president in 2024 and instead endorsed Trump. He promised not to take vaccines away from Americans, both during his curtailed presidential campaign as well as his confirmation hearings in Congress needed to approve his nomination to Trump's cabinet.
He and Trump meet in the Oval Office every few months, most recently in June, according to four people briefed on the conversations. The president will often ask what new efforts are underway on vaccines broadly and whether the health secretary believes he will ultimately prove a link with autism, the people said. Kennedy interprets the questions as a directive to forge ahead with research on vaccine safety, they added.
The White House did not dispute details about its relationship with Kennedy or conversations between the health secretary, Trump and the president's top aides. Spokesman Kush Desai said the president supports Kennedy's efforts to reduce the U.S. childhood immunization schedule in line with other peer nations, which he didn't specify. The Trump administration "continues to seek out answers for countless parents whose questions and concerns have long been ignored," he added.
HUNT IS ON FOR A LINK TO AUTISM
One of Kennedy's earliest moves in office was to elevate the question of whether childhood inoculations can cause autism.
The health secretary has rejected studies involving millions of people over the past two decades which have concluded there is no credible link. Leading medical organizations including the American Academy of Pediatrics and American Medical Association say Kennedy's refusal to accept such findings both increases vaccine hesitancy and devalues more evidence-based efforts to help families struggling with autism.
In November, Kennedy ordered the website of the Centers for Disease Control and Prevention to be updated to say the claim that vaccines do not cause autism is "not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism." For years previously, it had said that "studies have shown there is no link between receiving vaccines and developing autism," citing a 2012 National Academy of Medicine review of scientific papers and a 2013 CDC study.
The CDC didn't respond to a request for comment for this article.
The health secretary has tasked Stefanie Spear, his closest adviser, with leading his department's efforts to unearth any evidence of a link, including launching a series of studies into vaccine-related injuries. The pair go back many years, having partnered together on an environmental website called EcoWatch in 2011. Spear then joined Kennedy at Children's Health Defense, the anti-vaccine organization he founded, in 2020, and served as press secretary during his 2024 presidential campaign. Kennedy, Children's Health Defense, and others have sued several news outlets, including Reuters, alleging the media organizations colluded to exclude and censor them because of their posts on COVID- and vaccine-related topics. A motion to dismiss the lawsuit is pending in D.C. federal court.
Spear has no scientific or public health background, according to her bio. Before joining Kennedy at Children's Health Defense, she was a longtime environmental activist and communications professional.
In HHS leadership meetings, Spear often speaks for Kennedy even when he is present, three people familiar with the matter said. Kennedy has told his top officials to seek Spear's approval for their new initiatives, three people said. In staff meetings, Kennedy has directed officials to "run everything" through Spear, according to two people who have heard the directive.
Spear, through HHS, declined an interview request and didn't respond to questions about her role at the agency.
Beginning this year, Spear and other Kennedy aides asked officials at the U.S. Food and Drug Administration numerous times for access to the FDA's Sentinel BEST safety system to help HHS staff conduct studies, including into rates of autism and other conditions among vaccinated versus unvaccinated children, according to four people familiar with the request.
The database is designed to monitor the safety of FDA-approved products including vaccines after they hit the market by tracking the health insurance claims and medical records of more than 100 million Americans. Access to such systems, which contain sensitive information, is highly restricted even within HHS, typically limited to a small number of career officials and experts.
The FDA initially refused Spear and other aides' requests for access out of concern that Kennedy and Spear were on a "fishing expedition" for information to back up their autism argument, according to two people familiar with the matter.
Shortly after taking office, Kennedy began expressing interest in looking at rates of autism and other conditions among vaccinated versus unvaccinated children, and has raised the idea multiple times, according to five current and former officials. Leading health experts have said such a comparison would be invalid because vaccinated children typically visit doctors more often than unvaccinated kids do, so they tend to receive more diagnoses for various conditions.
"With scientists at NIH, FDA, CDC, and universities, we are continuing to conduct studies to better understand vaccine safety and efficacy and to assess how vaccine exposure, timing, and patterns affect health across the lifespan," Spencer said in response to detailed questions about HHS's vaccine efforts. "This work will generate evidence to inform vaccine recommendations."
The FDA didn't respond to a request for comment. Reuters could not determine whether Spear eventually got access to the data system.
TAKING THE AXE TO CHILD VACCINE SCHEDULE
Kennedy and Spear have worked to rewrite decades' worth of U.S. vaccine policy within months, sidelining a large network of experts at federal agencies and their collaborators in the medical and scientific communities, a dozen current and former officials said. They have instead worked with a tight circle of longtime allies largely outside the government.
Chief among those changes was a decision to shrink the CDC's childhood immunization schedule, which guides state vaccination requirements and health insurance coverage. By January, they had removed vaccines for six diseases out of a list of 17 routinely given to children, which have all been shown to prevent illness and death from common diseases.
Last summer, though, Kennedy and Spear had bigger ambitions, according to three people with direct knowledge of their plans: to eliminate the entire childhood schedule.
They wanted to tell families that the use of the vaccines for all 17 diseases could be left to "shared clinical decision-making," meaning parents would decide with their healthcare providers which shots, if any, to give their children. They expected that state health officials and medical groups like the American Academy of Pediatrics would provide their own guidelines to fill the gap, the three people said.
The idea of abandoning the whole schedule alarmed several health officials, including then-FDA commissioner Marty Makary and Tracy Beth Høeg, one of his top deputies, four sources said. Makary and Høeg created a list of "core essential vaccines" in an effort to steer the health secretary away from the extreme path. They ranked the recommended immunizations in order of importance and showed which ones were also considered crucial by peer nations.
Public health experts have widely said that the U.S. schedule was broader than some other developed nations including Denmark, Norway and Sweden but not an outlier, and met the specific health needs of Americans. They argued that dropping vaccines without evidence would needlessly expose many more children to complications and even death from preventable diseases. The likes of Germany, Britain, France, Canada and Australia also recommend vaccinating children against roughly 15 to 17 diseases.
By the fall, under the pushback from health department officials at the FDA and elsewhere, along with White House aides, Kennedy agreed to only reduce the childhood schedule, according to three people familiar with the discussions. He and his advisers targeted a slimmer program in line with the length of the schedule in Denmark, which only has 6 million residents, provides universal health care and immunizes its children against far fewer diseases than most developed countries. Medical experts broadly said that schedule does not translate to a country like the United States, with more than 300 million residents and large gaps in access to medical care and health insurance.
Still, the health secretary kept changing his mind on what to remove.
Kennedy and his advisers debated eliminating the measles, mumps and rubella (MMR) shot in the fall, according to the three people. He did not move forward because of possible political blowback, with a measles outbreak raging in South Carolina at the time, they said.
Some of his other suggestions – including removing the polio vaccine from the schedule – were discarded after pushback from White House officials, the three people said. HHS spokeswoman Spencer said that removing MMR and polio shots "had never been considered."
A recommendation for COVID shots for children had already been dropped in May, when it was announced in a social media post featuring Kennedy and Makary. Spear personally intervened to help draft the U.S. vaccine protocol for hepatitis B shots in December, three sources said. She provided language endorsed by Kennedy's hand-picked board of immunization advisers, many of whom share his skepticism of vaccines, to remove a universal recommendation for hepatitis B shots starting at birth.
In the end, the shorter childhood schedule was largely identical to Denmark's when vaccines for four more diseases were removed in January. Kennedy made the changes unilaterally rather than going through a panel of experts, as has long been standard, and Spear wrote the accompanying report justifying the changes, according to three people familiar with the process. Trump hailed the new schedule as "rooted in the Gold Standard of Science". "Many Americans, especially the ‘MAHA Moms', have been praying for these COMMON SENSE reforms for many years," he wrote on social media, referring to parents who back Kennedy's policies.
However, in March a federal judge blocked Kennedy's reduced childhood schedule, also ruling the health secretary's vaccine advisory board was not lawfully constituted after he fired all its members and replaced them. HHS has appealed the ruling.
SIRI ON SPEAKER
In his mission to rewrite U.S. immunization practices, Kennedy has also relied on Aaron Siri, a long-time ally and litigator. Siri is one of the most prominent advocates challenging American health agencies and vaccine makers over alleged injuries.
Siri has repeatedly argued that many childhood vaccines have been recommended by the CDC without sufficient safety data. In 2019, he filed a lawsuit against the CDC demanding it produce studies demonstrating that vaccines routinely given to infants don't cause autism, or admit it did not have such studies. Both sides agreed to dismiss the lawsuit after the CDC produced a list of studies. Siri says that the research the agency provided did not disprove a link to autism for those shots.
In 2022, he petitioned the FDA to revoke approval for two COVID vaccines and one polio shot, alleging their safety testing in clinical trials was inadequate. The FDA denied the former petition, and hasn't yet ruled on the latter.
Siri is not a government official. But he helped Kennedy and Spear vet potential appointees across the HHS, FDA and CDC during the presidential transition in early 2025, three people familiar with the process said.
Kennedy on multiple occasions told aides last year that any vaccine-related policy or change should receive input from Siri before it went out, according to two people directly familiar with the remarks. The health secretary frequently conferenced Siri into internal health department policy meetings via speaker, according to the two people. Siri participated in the discussions about whether to remove the MMR and polio shots from the childhood schedule, the administration officials said.
Siri said in response to Reuters' questions that he was not aware of a plan to remove those vaccines, or of a Kennedy requirement to run policy changes by him.
"I sure wish they would have followed that purported directive," Siri said. "I would not need to continue to send them demands, keep following up when they get ignored, and continue to fight HHS and its agencies in dozens of lawsuits related to vaccine policy."
VACCINE INJURY DAMAGES
HHS policy action could have an impact on Siri's own law business, according to four legal experts interviewed.
Siri and Kennedy have for years called for a reexamination of the process for seeking compensation for vaccine injuries. Patients who were harmed by shots on the U.S. immunization schedule can only seek a limited amount of damages from a fund run by HHS, known as the Vaccine Injury Compensation Program (VICP).
Congress created the program in the 1980s to ensure an adequate supply of vaccines. Vaccine makers often operate on thin profit margins for shots used by millions of people and argue they would be forced out of business if patients could file lawsuits without restraint.
Yet Siri has argued that Americans harmed by vaccines should be able to sue drugmakers directly, instead of going through a government program. Suing a drug manufacturer in civil court allows plaintiffs to seek higher damages and demand that the companies disclose internal data on product safety and decision-making. Pharmaceutical companies don't have this protection for other medicines.
Siri said recently that removing routine recommendations for shots on the CDC schedule, as Kennedy has tried to do, would allow such lawsuits to proceed. He has also publicly called for more side effects to be included on the list of health problems recognized by VICP. That would allow more people to file claims for compensation.
Kennedy has said he is working to change VICP from within the government, though has not specified what reforms he is seeking. As health secretary, he has authority to set many rules governing the scheme, including which vaccine-related medical conditions are compensated quickly and which are subject to extensive litigation by plaintiffs.
HHS spokesperson Spencer said Siri is "one of many people who have made recommendations about how to improve the VICP."
Siri's firm represents people who say they have been harmed by vaccines and is currently litigating over 400 pending VICP claims, according to Westlaw data. In March, Siri filed a petition on behalf of the Informed Consent Action Network — a group that has continually attacked vaccine safety — asking Kennedy to add over 300 types of injuries to VICP, including several conditions related to autism.
Richard Hughes IV, the lead attorney suing HHS on behalf of the American Academy of Pediatrics over the childhood vaccine schedule changes, said he disagrees with Siri's petition, believing it would bloat VICP with inappropriate injuries. But he acknowledges the program needs reform. Claimants face long delays in getting paid, while damages amounts need to be raised, he said. "We want the program to work," he added.
Dorit Reiss, a professor at UC Law San Francisco, said that if the health department added the injuries Siri called for in his petition to the program, his firm and others like them would be in a position to file thousands more vaccine injury claims and earn mandated attorneys fees paid from the VICP fund.
Siri told Reuters that his firm works on behalf of Americans injured by vaccines to bring the relief they are entitled to under VICP. If the compensation system were to be reformed to allow more claimants to sue drugmakers directly, he said, there should be "very few, if any" major awards of damages if vaccines are as safe as advertised.
Reuters
