Hiltzik: A GOP senator finally strikes back against RFK Jr.

A physician, Sen. Bill Cassidy (R-La.) had long enjoyed bipartisan respect for his record of supporting child vaccinations. Indeed, as a doctor in Baton Rouge, he had personally played a role in getting hepatitis-B and flu vaccines into local schools.

But Cassidy’s reputation as a stalwart defender of public health crumbled on Feb. 4.

That’s when he took to the Senate floor to announce that he would vote to confirm the noted anti-vaccine activist Robert F. Kennedy Jr. as secretary of Health and Human Services. Kennedy’s nomination had hung by a thread while Cassidy’s GOP colleagues waited to see how he would vote. His decision to confirm Kennedy put the nomination over the top when the confirmation vote was held on Feb. 13.

Kennedy had assuaged Cassidy’s doubts about him by promising that he and Cassidy would have “an unprecedentedly close collaborative working relationship if he is confirmed,” Cassidy said.

Among other promises, Kennedy pledged to maintain the key Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention “without changes.”

He even promised to give Cassidy, the chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), the right to appoint a member on “any board of commission formed to review vaccine safety.”

It has since become clear that Kennedy thoroughly bamboozled Cassidy. On June 9, Kennedy fired all 17 members of ACIP and handpicked eight new members. The new cadre included “antivaxxers, the antivax-adjacent, and the unqualified,” as veteran pseudoscience debunker David Gorski noted. None of them was nominated by Cassidy.

Cassidy remained silent — until Monday, two days before the reconstituted ACIP is scheduled to hold its first two-day conference.

In a post on X, Cassidy decried Kennedy’s appointments. Many of them “do not have significant experience studying microbiology, epidemiology or immunology,” he observed. “In particular, some lack experience studying new technologies such as mRNA vaccines, and may even have a preconceived bias against them. (The mRNA vaccines are the COVID vaccines in global use marketed by Pfizer and Moderna.)

Cassidy said the conference should be delayed until the panel is “fully staffed with more robust and balanced representation — as required by law — including those with more direct relevant expertise.”

It was Cassidy’s first overt criticism of Kennedy’s management of Health and Human Services, and long overdue. It wasn’t entirely free of the pusillanimous approach he has taken thus far to Kennedy’s regime, however.

“He asks for a delay until this committee is more ‘balanced,’ but ‘balanced’ in what way?” asks Paul Offit of Childrens Hospital of Philadelphia, one of the nation’s most eminent vaccine experts (and a former ACIP member). “Does that mean you have anti-vaccine activists and people who actually support the science? Does that mean you have an adequate balance of people who are good scientists and people who aren’t?”

There’s also reason to wonder whether credible immunologists, epidemiologists and vaccinologists would even accept appointment to ACIP as long as anti-vaxxers are on the panel. “I’m not sure many will be knocking down the door to sit with antiscience activists on the other side,” says Peter Hotez, a leading vaccine developer and expert. “At this point the current committee needs to be dissolved.”

Cassidy’s reference to the law’s requirement looks like something of a dodge. The law he refers to — the Federal Advisory Committee Act of 1982, or FACA — does require the membership of advisory committees to be “fairly balanced in terms of the points of view represented.” But that doesn’t require just any views about vaccines to be represented.

“That does not mean ‘put science deniers on a vaccine advisory committee to represent the anti-science perspective,’ ” Dorit R. Reiss, an expert on vaccine law at UC College of the Law, told me. The committee’s charter anticipates that the members will have varied expertise in different vaccines and vaccine-preventable diseases: “It’s not a violation of FACA to not appoint anti-vaccine activists,” she says.

A spokesman for Kennedy didn’t respond to my request for comment on Cassidy’s statement. The meeting convened Wednesday morning in Atlanta as scheduled and is set to continue Thursday with the eight members Kennedy appointed.

A final agenda posted Tuesday lists a presentation by Lyn Redwood on thimerosal in vaccines. The item was not present on earlier agenda drafts.

Thimerosol is a preservative previously used in vaccines that long has been a target of anti-vaccine activists who asserted that it caused autism in children given the shots; that claim has been decisively debunked. Redwood is a former president of Children’s Health Defense, an anti-vaccine organization long associated with Kennedy. Its resurrection as an agenda item suggests that Kennedy has not given up on the debunked claim that vaccines and autism are linked.

I asked Cassidy to expand on his tweet, but a spokesman told me he wouldn’t have anything to say beyond that.

When I asked earlier whether Cassidy thought he had been deceived when Kennedy reneged on his pledge to keep ACIP functioning “without changes,” his spokesman replied that Kennedy’s commitment “was about the ACIP process, not staffing.” That’s not at all how Cassidy described Kennedy’s commitment on Feb. 4.

ACIP’s recommendations on vaccine use don’t become law until they’re accepted by the head of the CDC. At this moment, however, the CDC doesn’t have a director.

Donald Trump withdrew his first nominee for the post, former Republican Congressman Dave Weldon of Florida, after the emergence of his anti-vaccination views, including his support for the long-debunked claim that the MMR vaccine causes autism — a view also espoused by Kennedy.

Trump subsequently nominated Susan Monarez, who is currently the agency’s acting director, but she hasn’t been confirmed by the Senate. Monarez holds a doctorate in microbiology but would be the first CDC director since 1953 not to have a medical degree.

The vacuum atop the CDC facilitated Kennedy’s unilateral decision to take the COVID vaccines off the recommended list for pregnant women and healthy children, which ran counter to the position of the larger medical community.

It doesn’t seem likely that Cassidy’s modest pushback against Kennedy’s evisceration of ACIP will restore his standing as the Senate’s go-to authority on vaccines and public health, given the deference he showed to Kennedy up to now.

“I don’t think he can do anything,” Offit told me. “His moment came when he voted ‘yes’ ” on Kennedy’s confirmation. “Cassidy keeps drawing lines, RFK Jr. crosses them, and he draws another line, and another line. He said that RFK Jr. promised he wouldn’t change existing recommendations, and that’s just what he did, for pregnant people and young children for the COVID vaccine. He said he wouldn’t alter the [ACIP] panel, and that’s exactly what he did. Worse, he brought people on who don’t have the expertise to give us the kind of advice we need.”

Even if Kennedy takes Cassidy’s advice and postpones the ACIP meeting to give the membership “balance,” the damage to its authority will be lasting.

“The entire medical and scientific community will now reject the ACIP — and for that matter, the CDC — as a source of information,” Offit says. “That’s what Cassidy has done while standing back and letting all this happen.”

Kennedy has plunged ACIP and the CDC into a partisan and ideological morass. “Until Kennedy, this was a non-political expert committee,” says Reiss. “He is reshaping it to promote an anti-vaccine agenda, and likely in an effort to deny people vaccines.”

Thanks to Kennedy, America’s once-vaunted expertise in public health has been infected with the anti-science virus. For that virus, there doesn’t appear to be a vaccine on the horizon.