By Emily Anthes and Emily Baumgaertner
A veteran in the anti-vaccine movement. A well-qualified surgeon. A seven-time congressional representative. A Fox News contributor with her own vitamin brand.
President-elect Donald Trump’s diverse selection of individuals to head federal health departments is nearly finalized — and with it, his plans for a comprehensive transformation are becoming clearer.
Trump’s selections represent a range of backgrounds and perspectives on public health. However, they have all opposed COVID policies or endorsed views that diverge from mainstream medical practices, including vaccine skepticism. Collectively, they represent a significant departure from the status quo.
“By making these appointments, they are indicating that they lack confidence in the current officials,” stated Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and an FDA advisor.
Several medical professionals and researchers are preparing for a potential dismantling of public health agencies, a decline in scientific knowledge, and the infusion of political ideology into areas traditionally dominated by academia. The consequences, they worry, may include poorer health outcomes, increased preventable deaths, and a diminished capacity to address pressing health challenges such as future pandemics. “I am extremely concerned about the unfolding situation,” Offit remarked.
Nevertheless, some experts who expressed worries about anti-vaccine sentiments within national health agencies acknowledged that certain aspects of the appointees’ unconventional methods might be beneficial.
“We are risking a lot with these changes and selections, but at this stage, transformation is necessary,” said Dr. Michael Mina, an epidemiologist and former Harvard professor. He observed that agencies frequently moved too slowly and were overly bureaucratic, and their leaders were often reluctant to address public concerns. “There’s at least a greater likelihood of positive change compared to stagnation and continuation of the same,” he noted.
One thing appears to be certain: It will not be business as usual.
During the closing months of Trump’s campaign, he enlisted Robert F. Kennedy Jr. with the message that a complete revamp of the nation’s public health system was essential, as indicated by Kennedy’s own presidential campaign slogan to “Make America Healthy Again.”
Shortly after the election, Kennedy was appointed to lead the Health and Human Services Department, a massive federal entity that encompasses the Centers for Disease Control and Prevention, the FDA, the National Institutes of Health, as well as Medicare and Medicaid.
Kennedy, an environmental attorney, has a long history of disseminating misinformation about vaccines and utilizes his nonprofit, Children’s Health Defense, to advocate a misleading interpretation of research data.
Kennedy “is truly in a league of his own,” remarked Jennifer Nuzzo, director of the Pandemic Center at Brown University in Providence, Rhode Island. “RFK Jr. deliberately ignores established evidence and leans on talking points that have been repeatedly disproven.”
If confirmed by the Senate, Kennedy would manage the agencies responsible for vaccine regulation and national vaccine policy, with the heads of those agencies reporting directly to him. “His influence will be immense,” noted Dr. Ashish Jha, dean of the Brown University School of Public Health, who coordinated the Biden administration’s response to the coronavirus crisis.
Dr. David Weldon, Trump’s selection to lead the CDC, has also advocated anti-vaccine positions. A trained internist, Weldon served seven terms in Congress from a district on Florida’s central east coast before returning to medicine.
During his congressional tenure, Weldon promoted the unfounded belief that thimerosal, a preservative in some vaccines, was responsible for an increase in autism diagnoses.
“The idea that a person with a series of misguided beliefs about science and medicine could ascend to the role of heading the CDC is, in some respects, alarming,” Offit commented.
Weldon also proposed a “vaccine safety bill” in 2007 aimed at transferring most vaccine safety research from the CDC to a different entity within the Health and Human Services Department. The bill did not progress past committee. The concern is whether Weldon will bring similar ambitions with him to Washington, advocating Congress to limit the scope of his agency.
Trump’s nominee for FDA commissioner, Dr. Martin Makary — a pancreatic surgeon at Johns Hopkins School of Medicine in Baltimore — has been largely supportive of childhood vaccines. However, he has raised doubts about the necessity of certain immunizations, such as the hepatitis B vaccine for newborns and a third COVID booster for healthy children. “I believe there are critical questions that need to be revisited,” he shared with The Wall Street Journal.
Nuzzo, who was previously a colleague of Makary’s at Johns Hopkins, commented that while she disagreed with several of his opinions, she believed him to be qualified for the role.
“I consider Marty to be a scientist,” she stated. “I think he will thoroughly evaluate the scientific evidence and interpret it using his expertise.”
But it remains uncertain how much Makary could distance himself from Kennedy. “How will he manage the influence of an HHS secretary who fundamentally opposes modern medicine?” Jha posed.
Trump’s selection for surgeon general is Dr. Janette Nesheiwat, a medical director of CityMD, a chain of urgent care facilities. Nesheiwat, also a Fox News contributor, provided frontline medical assistance following Hurricane Katrina and a tornado in 2011 that impacted Joplin, Missouri, per a statement from Trump.
Generally supportive of the COVID vaccines, she referred to them as “a gift from God” in a 2021 editorial for Fox News. However, she has opposed COVID vaccine mandates and criticized the dismissal of service members who declined vaccination.
Her upcoming book, “Beyond the Stethoscope: Miracles in Medicine,” reveals the “transformative power of prayer,” according to a description on the publisher’s webpage. She also markets her own line of dietary supplements.
“I have a positive feeling about the surgeon general appointment,” remarked Dr. Peter Hotez, a vaccine authority at the Baylor School of Medicine in Houston. “I’ve had numerous discussions with her and communicated during the pandemic. She exhibits an open mind, is thoughtful, and relies on evidence.”
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, expressed his intent to closely monitor lower-level appointments — those who execute the everyday operations of these agencies. He is particularly concerned about the potential for the administration to dismiss federal scientists serving as civil servants.
“Everything we’ve seen thus far indicates that significant changes are imminent,” Osterholm remarked.
