Trump’s health picks signal new era of vaccine scrutiny

Donald Trump has picked a raft of medical contrarians and government outsiders to run the nation’s top health agencies, alarming experts who are bracing for changes to vaccines and other bedrock treatments.

His nominee to lead the Food and Drug Administration, Marty Makary, has questioned the timing and frequency of certain vaccines. His choice for director of the US Centers for Disease Control and Prevention, Dave Weldon, has promoted the discredited idea that vaccines cause autism. Trump’s pick for US Surgeon General, Janette Nesheiwat, has criticized Covid vaccine mandates.

Trump’s picks, made late Friday, did little to dispel the notion that the nation’s federal health agencies, under the potential leadership of Robert F. Kennedy Jr., are facing a major shakeup. Kennedy Jr., a prominent vaccine skeptic, has been tapped to run the Department of Health and Human Services, which houses the CDC, FDA and Surgeon General’s office. 

Trump is turning to people who have raised doubts about the agencies they are in a position to lead, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. 

“The implication being that we’re going to, at the very least, shake things up, or at the very worst, tear things down,” Offit said.

The nominees need Senate approval and they have not said how they will lead their agencies. But their positions on topics like vaccines have at times put them outside the mainstream of public health.

“They are all scientific contrarians, but not flame throwers,” said Lawrence Gostin, a professor of global health law at Georgetown Law.

Some nominees are more controversial than others.

Wall Street seems less concerned about Makary. Mizuho Securities healthcare equity strategist Jared Holz said in a note prior to Trump’s announcement that Makary “will be fine” for the drug industry and “is clearly pro-science/innovation.” 

Ashish K. Jha, the dean of the Brown University School of Public Health, called Kennedy “an absolutely terrible choice” for HHS secretary. But he said Makary and Mehmet Oz, the celebrity doctor tapped to lead the Centers for Medicare and Medicaid Services, are “pretty reasonable.”

“I have plenty of policy disagreements with them,” Jha wrote on X on Sunday. “They are smart and experienced. We will need them to do well.”

Makary is a surgeon, author and Johns Hopkins University professor who has a master’s degree in public health. He has said that he supports vaccines. His latest book focuses on questioning medical orthodoxy on topics from peanut allergies to antibiotics. He has also questioned hepatitis B shots for newborns and been critical of broad vaccine mandates, like giving multiple Covid shots to boys, citing the risk of heart muscle inflammation. As head of the FDA, he would oversee the nation’s drug approval process, including for new vaccines. 

Public health experts expressed more concern with Weldon, a former Florida politician and physician. Like Kennedy, Weldon has claimed that immunizations have links to autism, which scientists have debunked. As a congressman, he promoted the idea that a mercury-containing preservative in vaccines causes the disorder and sought to remove the CDC from vaccine safety research. Among other roles, the CDC director decides whether to approve an advisory committee’s guidelines on vaccine use. 

“I would like to see Weldon distance himself from false and misleading information about vaccine safety before taking up the mantle of CDC Director,” Georgetown Law’s Gostin said.

Offit, of the Children’s Hospital of Philadelphia, said that Weldon “has shown that he’s a science denialist,” adding, “that’s not the kind of person who should head a scientific agency.”

Joel Zinberg, director of the Public Health and American Well-Being Initiative at Paragon Health Institute, said Trump’s picks show a desire to prevent chronic diseases and reform agencies like the CDC that are still trying to regain public trust after the pandemic. Too much of health policy has been on expanding insurance coverage and “not enough on understanding and preventing what makes us sick,” Zinberg added.

Trump’s decision to nominate Weldon drew praise from Del Bigtree, a prominent anti-vaccine advocate.

“THIS IS HUGE!!” he tweeted on Friday. “If you are the parent of an autistic child then you know why!! #MAHA”

On Friday, Trump also nominated Janette Nesheiwat to be US Surgeon General, the nation’s spokesperson for public health. Nesheiwat is a doctor who has been a Fox News contributor. 

In 2022, she encouraged the network’s viewers to get the Covid booster. But last year, she criticized Covid vaccine requirements at places like Rutgers University, calling it “illogical to mandate something that’s ineffective.”

She sells her own line of vitamin supplements and is the author of the forthcoming book “Beyond the Stethoscope: Miracles in Medicine,” which includes stories that “illuminate the transformative power of prayer and unwavering dedication to healing and service,” according to the publisher’s website.

There are still many unanswered questions about federal health agencies in the Trump administration, said Michael Osterholm, a professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota. 

What matters more, he said, is who gets lower level roles because they are more involved in the day-to-day at the agencies, and whether Kennedy tries to push out many scientific experts, likening it to “cutting someone’s head off and telling them to go run a marathon.”

Osterholm said he worries about giving new momentum to diseases if the heads of federal health agencies are raising doubts about vaccines.

“That’s the world we can slip back into if we’re giving the public the sense that these vaccines are not that necessary or safe,” he said. “That would be a huge tragedy.”

© 2024 Bloomberg L.P.