The R.F.K. Jr. Effect – The New York Times

A midair collision

An American Airlines jet and an Army helicopter collided just outside Washington D.C. last night and plunged into the Potomac River.

Sixty-four people were on the plane, which was coming from Wichita, Kan., including U.S. and Russian figure skaters returning from a training camp. The military aircraft carried a crew of three.

Emergency responders are searching cold and murky waters for survivors, and Reagan National Airport will be closed until 11 a.m. See photos and the latest news from the rescue efforts.

The R.F.K. Jr. effect

Robert F. Kennedy Jr. has a history of calling attention to overlooked public-health problems, whether it’s autism, river pollution, food additives or the toll of Covid school closures. But Kennedy also has a history of backing solutions that are inconsistent with scientific evidence, especially on vaccines. He has repeatedly made false claims about their effectiveness and their side effects.

At Kennedy’s Senate confirmation hearing yesterday, Democrats — and a few Republicans — confronted him about these claims. Ron Wyden, an Oregon Democrat, read a 2023 quote in which Kennedy said that “no vaccine is safe and effective,” and Bernie Sanders displayed a photo of a baby’s onesie, promoted by a group Kennedy ran, with the words “No Vax, No Problem.” At times, Kennedy tried to distance himself from his past vaccine skepticism.

His chances are likely to come down to a small number of Republicans who seem conflicted about whether to support him. If no Democrats or independents support Kennedy, he can lose only three Republican senators and still be confirmed. (These are the Republicans to watch.)

In today’s newsletter, I’ll explain three ways that Kennedy may affect the use of vaccines if the Senate confirms him as President Trump’s secretary of health and human services.

1. Hamper development

Bird flu — specifically the H5N1 virus — has spread rapidly over the past year. It has infected nearly 1,000 cattle herds in the U.S. and caused serious illnesses in a small number of people. If the virus mutates to jump more easily between humans, it may become a major problem. (Here is The Morning’s recent bird flu explainer.)

An H5N1 vaccine exists, although the supply is modest. If the virus spreads, the federal government, including the Department of Health and Human Services, will likely need to play a central role in accelerating production. Yet Kennedy has criticized the vaccine as dangerous, despite evidence to the contrary.

If bird flu exploded into a full pandemic — or an unexpected new virus emerged — the country might also benefit from powerful vaccines using mRNA. That’s the technology that the federal Warp Speed project used to create the Covid vaccines, and Kennedy has inaccurately criticized mRNA vaccines for killing many people. “It’s hard to see him championing their development like Warp Speed did,” said my colleague Apoorva Mandavilli, who’s covering bird flu.

Kennedy could also push the F.D.A., which he would oversee, not to approve vaccines that are in the pipeline. One potential example is a vaccine for Lyme disease.

2. Encourage lawsuits

In 1986, the federal government created a program to compensate families whose children suffer rare side effects from vaccines. The health secretary has the power to choose which vaccines and which side effects are part of the program, which uses a special court to decide claims.

If Kennedy expanded the list of supposed injuries eligible for compensation, it could lead to a flood of claims. He could also remove vaccines from the court’s purview, meaning their makers could be sued in a traditional court. “Such an event could lead vaccine makers to take their products off the market,” my colleague Christina Jewett told me.

Kennedy has a personal stake in these anti-vaccine lawsuits, The Wall Street Journal’s editorial board noted. He has received payments from a law firm that sued a large vaccine maker, and he plans to continue receiving them even if he becomes health secretary. Some of the cases involve a vaccine called Gardasil, which protects against a group of viruses that cause cervical cancer.

3. Restrict access

Kennedy would also have authority over Vaccines for Children, an $8 billion program that helps provide lower-income children with access to vaccines for polio, measles, whooping cough and chickenpox.

He has promised not to take vaccines away from people who want them. But he could still alter the program in ways that would make vaccines harder to get or foment doubt about them, as Christina and Sheryl Gay Stolberg have pointed out. The health secretary oversees the contracts that pay vaccine makers to make and distribute the shots.

More broadly, Dr. Tom Frieden, a former C.D.C. director, expressed concern about the possibility of a “soft recall” in which “certain vaccines remain technically available but are no longer widely recommended or reimbursed by insurance, making them effectively inaccessible to much of the public.” (Frieden asked one of the 13 questions for Kennedy in a recent Times Opinion article.)

The bottom line: Vaccine skepticism, often disconnected from the facts, has been Kennedy’s signature issue for years. It’s a major reason he wants the job of health secretary. If he gets it, the most likely scenario is that vaccine use will decline and the incidence of the underlying illnesses — like measles, which can be fatal — will increase.

More on the hearing

• Kennedy blamed pesticides and processed foods for the rise in chronic disease among American children. He denied that he was anti-vaccine and noted that his children were vaccinated.

• Democrats pressed Kennedy over his position on abortion. He called himself “pro-choice” when he entered the presidential race in 2023, but he said yesterday that states should be able to set restrictions.

• Kennedy stumbled over a Republican senator’s questions on Medicare and Medicaid. He confused the programs several times.

• Other Republicans praised Kennedy as a rebellious truth teller. The crowd in the hearing room, which included many of his supporters, called out,“Make America healthy again” after the hearing ended.

• Here is a fact-check of Kennedy’s statements. He will appear before the Senate’s health committee today for another hearing.

• Kash Patel and Tulsi Gabbard, two of Trump’s other high-profile picks, will also make their cases for confirmation today.

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