was originally reported by Barbara Rodriguez of .

In mid-March, the parents of a 6-year-old girl in Texas who died of measles complications 鈥� the 鈥� decided to speak out about what happened to their daughter.

But it was not an interview with a news outlet. The parents had agreed to an exclusive on-camera interview with staff from the Children鈥檚 Health Defense (CHD), a nonprofit that promotes anti-vaccine sentiment and policies. Their daughter, Kayley, had been unvaccinated, a point the parents defended in the interview.

Kayley鈥檚 father, who spoke at times in a German dialect through a translator, said that measles is 鈥渘ot as bad as the media is making it out to be.鈥�

A few weeks later, the father of an 8-year-old who became the second measles-related death, according to public health officials, also spoke with CHD through video. Asked if he regrets not vaccinating his child, Daisy, or his other children, the father said: 鈥淎bsolutely not. And from here on out, if I have any other kids in the future, they鈥檙e not going to be vaccinated at all.鈥�

Health and Human Services Secretary Robert F. Kennedy Jr. met with these parents in April, he said , 鈥渢o console the families and to be with the community in their moment of grief.鈥� He advocated for the highly effective measles-mumps-rubella (MMR) vaccine in that same post. Hours later, in a separate post, .

As Kennedy tries to respond to the spread of measles cases in the United States 鈥� more than 700 cases have been reported in at least 25 states as of April 10, according to the Centers for Disease Control and Prevention (CDC) 鈥� medical experts say that messaging has been mixed. But any focus on vaccination is also being undermined by CHD, the anti-vaccine nonprofit Kennedy chaired from 2015 to 2023, the year he launched a presidential campaign.

As of , Kennedy has said he is no longer officially affiliated with the group, which has repeatedly questioned the safety of vaccines, . But CHD still prominently displays its former ties to Kennedy. The secretary has a standalone tab on the group鈥檚 鈥淎bout鈥� section, which credits him as its founder. Its video site features public appearances that Kennedy has made in his current role as secretary, including a recent trip to Indiana and his first major news conference in the role.

This year, CDH published a website that mimicked the design of a CDC site 鈥� with nearly identical layout, logos and typefaces 鈥� that laid out what it called research that vaccines cause autism () alongside some data debunking the theory. first reported on the existence of the mock site.

When asked about the site by The New York Times, the secretary would send a request to ask the group to take down the site.

An HHS spokesperson for Kennedy did not immediately respond to a request for comment. Representatives for CHD, contacted through a form on their website, did not immediately respond to a request for comment.

CHD boasts a media apparatus that includes a video-focused site and podcast that shares claims about vaccine safety, including about the MMR vaccine. On these platforms, commentators and an array of guests openly criticize news coverage on the growing measles cases and related deaths, which public health officials say includes an unvaccinated adult in New Mexico as well as the two children. (Many of the videos also note that the hosts鈥� and guests鈥� views are not necessarily the views of Children鈥檚 Health Defense.)

鈥淭his constant fear mongering by the media 鈥� to see them rampage like this on inaccuracies and peddling falsehoods and just distortions, it’s terrible,鈥� said one guest identified as a doctor to discuss one of the girls鈥� medical histories.

Measles, a highly contagious airborne disease, can appear through fever and a rash. It : 1 in 20 people get pneumonia; 1 to 3 in 1,000 people get brain swelling known as encephalitis; and 1 in 1,000 people die.

The scope of the CHD messaging 鈥� including interviews with parents expressing vaccine skepticism 鈥� shows how so-called anti-vaxxers may be weaponizing tragedy to promote an agenda, said Kelsey Suter, a partner at Upswing, an opinion research and strategy firm that supports Democratic candidates and progressive causes. Suter has monitored online disinformation about vaccines since around the start of the pandemic for several clients.

鈥淭his group in particular has long cherry-picked individual stories and sort of held them up to represent a broader trend that doesn鈥檛 exist,鈥� she said, noting that CHD has shared parent-centered videos in the past about purported vaccine injuries.

Kennedy who tried to distance himself from that record during his contentious to lead the country鈥檚 expansive health department. Before Kennedy鈥檚 longshot bid for the Democratic presidential nomination 鈥� which culminated in an independent candidacy and subsequent endorsement of Republican President Donald Trump 鈥� he was closely tied to the Children鈥檚 Health Defense.

The nonprofit, previously known as the World Mercury Project, says it aims to end 鈥渃hildhood health epidemics by eliminating toxic exposure.鈥� Kennedy, also its former chief litigation counsel, took a leave from CHD in 2023 to run for office. During a Wednesday news conference, could play a role in autism 鈥� a framing that autism groups . (CHD has publicly linked vaccines to autism, .)

CHD鈥檚 messaging 鈥� which includes a standalone site for 鈥渘ews and views鈥� and an accompanying newsletter 鈥� highlights an evolution of how misinformation and disinformation over vaccines is being directed at parents at a time when vaccination rates for kindergarteners . Parents are already targeted by social media influencer accounts about their children鈥檚 health and wellness. Some of that information is packaged in video that can be more widely shared than in previous eras of vaccine skepticism, a phenomenon that has existed since the development of the first vaccine more than 200 years ago.

Some of the misinformation circulating online is that measles was not a dangerous disease when it spread rampantly in the 60s. (In the decade before a vaccine was available in 1963, . Between 400 and 500 died and thousands were hospitalized each year at the time.)

鈥淚t鈥檃 this kind of broader lifestyle perspective that incorporates vaccine hesitancy and is being sort of packaged up and targeted for moms in particular, but parents generally,鈥� Suter said.

The two-dose MMR vaccine is safe and . Side effects, which pediatricians share with parents when their children are vaccinated, can include a sore arm and mild rash. Medical professionals say the benefits of the vaccine far outweigh the risks of being unvaccinated.

鈥淲e鈥檙e not hiding the side effects, we鈥檙e just telling you what they are and we鈥檙e putting it in context,鈥� said Dr. Kathryn Edwards, a longtime expert in infectious diseases who recently retired. 鈥淲hat is a more grave danger 鈥� to get infected with measles or to get the vaccine? And that is a really easy question. , it is much, much better to be immunized than to get the disease.鈥�

The videos on 鈥淐HD.TV鈥� run the gamut in terms of programming. In the video of the parents of the 6-year-old girl, they say their child had a fever, leading to a visit to a nearby hospital where her condition worsened. She died in February. Her siblings were also infected with measles, according to her parents, but they recovered. They credit treatments that medical experts say do not have a therapeutic role in treating or preventing measles infection. Still, Kennedy has defended the treatments for secondary symptoms.

In a separate video, staff speculated about whether the 8-year-old died from a different ailment related to her hospital stay 鈥� a sentiment also expressed by her father and . CHD staff also criticized the scope of hospital care that the girls received.

Abram Wagner is an assistant professor of epidemiology at the University of Michigan who studies vaccine hesitancy. He said building trust within a community that is hesitant about vaccines relies on messengers who are well-known members of that community. He said it can be potent for an anti-vaccine group to travel to these communities and highlight the personal stories of parents 鈥� including the narrative technique of imagery and voice through video 鈥� to emphasize an agenda because those parents are themselves potentially trusted messengers.

Wagner said it鈥檚 important for the public to take into account the framing of these interviews involving the parents of unvaccinated children. He noted they had experienced trauma 鈥� the loss of a child 鈥� and that makes them vulnerable in such settings. He also wondered about the social impact of losing a child in a close-knit community. Both families are members of a at the epicenter of the outbreak in West Texas.

It sets up hard work for the public health officials, including state officials, who go into these communities to counter anti-vaccine messaging, Wagner added. This week, a CDC official told a vaccine committee that federal officials were 鈥渟craping to find the resources and personnel needed to provide support to Texas and other jurisdictions鈥� as it relates to the outbreaks.

鈥淭he issue is, how do you create trusted messengers and how do you develop that over time?鈥� said Wagner.

Suter said she is not surprised that the MMR vaccine has been targeted in disinformation messaging, since falsely tied that vaccine to autism.

鈥淭he MMR vaccine was really the first modern vaccine to be targeted with this kind of disinformation questioning its safety,鈥� she said.

Suter said that before the pandemic 鈥� which propelled distrust of COVID-19 vaccines 鈥� being against vaccines still included some left-wing partisan perspective that included 鈥渃runchy鈥� mothers. But vaccine hesitancy is now rooted in a broader topic of distrust of government officials and of the health care system.

鈥淣ow, being anti-vaccine is not exclusively right-wing coded, but is much more integrated into right-wing politics than it used to be,鈥� she said.

Edwards said Kennedy has opened a messaging vacuum on measles and the MMR vaccine that groups like CHD have filled. Edwards noted that when Kennedy was asked in late February about the growing measles outbreak that began in Texas, he said such outbreaks are 鈥渘ot unusual,鈥� a description that . Kennedy later said that the decision to vaccinate 鈥渋s a personal one鈥� for parents 鈥� a framing that Edwards disagrees with.

鈥淎t that point, there should have been a strong message that vaccination should be done and will prevent disease,鈥� she said. 鈥淭he fact that there has been so much indecision and lack of clarity, in terms of what Secretary Kennedy has said and what he lets other people say, has really confused things. That has made families think that it鈥檚 appropriate not to vaccinate.鈥�

The former independent presidential candidate has a complicated past as a member of a famous Democratic political dynasty that includes his uncle, former President John F. Kennedy, and his father, U.S. Sen. Robert Kennedy, both assassinated in his youth. He struggled with addiction, and an arrest for heroin possession in the 1980s led him to volunteer with the Natural Resources Defense Council to fulfill community service hours, which jump-started his career in . 

Then, about two decades ago, Kennedy became interested in vaccine conspiracy theories, including the disproven link between vaccines and autism, which has become a focal point of much of his work since. He has peddled other , including that Wi-Fi causes cancer, that chemicals in water can lead to children becoming transgender and that AIDS may not be caused by HIV. In 2021, he was named one of the of misinformation about COVID vaccines on social media. 

Doctors and advocates have expressed alarm about the impact he could have on the department, while some have applauded his more mainstream views, such as a focus on preventative care through healthy eating and exercise and a commitment to removing processed foods from .

His beliefs and proposals are particularly relevant for kids, amid heated debates around school vaccination policies and a in the percentage of kindergarteners who have gotten state-required vaccinations.

If confirmed by the Senate, Kennedy would take control of an agency with one of largest federal budgets 鈥� 鈥� that employs about 90,000 people across 13 agencies, including , (the latter pays for a host of for eligible children), the and the

To better understand the pediatric and school-based health care implications of some of Kennedy鈥檚 proposals, 社区黑料鈥檚 Amanda Geduld spoke with Leana Wen, an emergency physician and contributing opinions columnist for . The parent of two school-aged kids is also a professor of health policy and management at George Washington University, a non-resident senior fellow at the and Baltimore鈥檚 former health commissioner.

Geduld then spoke with medical legal expert Richard H. Hughes IV about how likely Kennedy鈥檚 confirmation is and what kind of power he would wield if confirmed. Hughes is a professor at George Washington University鈥檚 law school, where he teaches a course on vaccine law, and a partner at the firm . He formerly worked as the vice president of public policy at Moderna 鈥� one of the co-producers of the first FDA-approved COVID-19 vaccines 鈥� guiding the company鈥檚 policy strategy during the pandemic.

These interviews have been edited for length and clarity.

The medical perspective

社区黑料: Kennedy has a long record of promoting and even before the pandemic had built a following through his anti-vaccine nonprofit group, . 

In the past few weeks, he鈥檚 backed off these assertions a bit, but I鈥檓 still wondering what impact his rhetoric around vaccines could have鈥� especially around parents vaccinating their kids. Can you also speak to some of the science behind vaccinating kids in the first place and what impact that鈥檚 had on pediatric health care?

Leana Wen: I think it’s important for us to start with the facts and to talk about what happened before there were vaccines for a variety of diseases. In the decades past, prior to vaccines, we used to see children succumbing to diseases that we now do not see anymore. We used to see children becoming paralyzed from polio and their parents being too scared for them to interact with others and go to school. We used to see children with severe, lifelong problems 鈥� including with their brains and other organs 鈥� because of measles, mumps and other diseases that we now consider to be eliminated thanks to vaccines. 

And so I think part of why vaccine misinformation has caught on is that the current generation of Americans have not experienced how terrifying these diseases have been that vaccines prevent. And I would really hate for us to see these diseases return before people recognize how much vaccines are life saving. 

I think it’s also important for us to mention the facts. It’s a fact that in 1900, 30% of all deaths in America occurred in kids under 5. Now that number is 1.4%. Back in 1900, the three leading causes of death were all infectious diseases. Now they aren’t. Thanks to antibiotics, thanks to sanitation, also thanks to vaccines. 

There was done recently that was published in the journal The Lancet. The study found that vaccines against the 14 most common pathogens saved 154 million lives globally over the past five decades, and that these vaccines cut infant mortality by 40%. 

And so it’s really heartbreaking to hear anyone spread misinformation about vaccines, but certainly it would be extremely concerning from a public health standpoint, if the individual in charge of science and health in this country is the one spreading such falsehoods. This could have a huge impact on trust in vaccines. And unfortunately, that could reduce vaccine uptake and lead to the return of these diseases that we thought were eliminated.

Kennedy has proposed removing processed foods from and limiting the use of food dyes, saying that the U.S. obesity epidemic, as well as a rise in chronic diseases like diabetes, are the result of He recently called out the nutrition department, which he says is Can you talk a little bit about what impact the food that we see showing up in school lunches has on kids, and what we know about food dyes?

I want to focus on ultra-processed food. We know that ultra-processed foods are associated with a whole variety of health problems 鈥� certainly things like diabetes, obesity, other chronic diseases like that 鈥� but also with depression and early dementia and potentially behavioral developmental issues in children as well. 

Unfortunately, some studies show that as much as 70% of the diet that Americans consume come from ultra-processed foods 鈥� that the calories from these diets come from ultra-processed food. I think it would be great if we can start reducing or removing ultra-processed food from school lunches. There has been some research done on food dyes and other additives. Reducing these in school lunches would also be a positive step.

He’s also mentioned that the same way that a doctor can prescribe Ozempic to treat obesity, they should also be able to prescribe, say, and have that covered by health insurance policies. I’m wondering what that might look like for kids as well, and what role pediatricians might play.

I don’t think any pediatrician would disagree with the idea that we have to focus more on prevention 鈥� that promoting healthy lifestyle, increasing exercise, improving diet, these would all be excellent for the promotion of health and well-being in our children. 

To be clear, it’s not these ideas that Kennedy is promoting that the medical profession would have an issue with. It鈥檚 that mixed in with many of these good ideas, are our concerns about misinformation around vaccines and that traditionally have not been considered to be safe and effective. 

After Kennedy’s nomination, he wrote on on Jan. 20, 鈥淭he Trump White House will advise all U.S. water systems to remove fluoride from public water.鈥� Can you talk a little bit about the role of fluoride in drinking water 鈥� specifically for kids.

This is an area where re-examination of the current policy would be a good idea, because this is a nuanced and complicated issue. On the one hand, we know that fluoridating the water supply has reduced cavities in children, but that effect was seen the most before widespread use of fluoride toothpaste.

We also know that fluoride in large quantities has toxic effects, including on bone development, on teeth discoloration and potentially on the developing brain if consumed by the pregnant woman. And so the question then is, what is the amount of fluid that would be optimal for promoting both dental health and reducing other effects? 鈥�

I think these are all reasonable questions to be asking 鈥� again, though, using science as the basis and not approaching this as an activist who already has a preconception in mind.

Are there any other policy ideas that Kennedy has put forward that you have thought of as either welcome news and an exciting change or particularly concerning?

None of what we’re talking about here is new. I think we can divide the proposals by Kennedy into three categories. One are things that are good ideas. For example, removing ultra-processed lunch or ultra processed food from school lunches. 

The second category are things that deserve a re-examination, and depending on what we find, may or may not be a good idea. That includes the fluoridation.

And then the third area would be things that have been proven to be wrong. For example, misinformation around vaccines.

And so again, I think to your point, none of these things that have been brought up in the category of good ideas is new, but that’s how I would think about this.

The legal perspective

社区黑料: Speaking about Kennedy at a rally recently, Trump said, How accurate is that? Can he really go wild on health? What are some of the congressional stopgaps there, and how much power does Kennedy actually have to enact these proposed policies? 

Richard H. Hughes: I think we could break that down into sort of two parts: Is Trump going to make good on that promise? and How far will RFK go? 

I would say that President Trump is very intent on making good on that promise. He went through with the selection of RFK. If you look at the appointments across the board, the nominees he selected are very unconventional. He’s very intent on disruption. 

And if you look at the health appointees in particular, there is some consistency there, right? They all hold really unconventional views. They come from very unconventional backgrounds for these types of roles. There are some questions about the adequacy of some of their experience and qualifications for these roles. There is also some consistency across the nominees that this sort of unconventional, non-mainstream views on COVID and the COVID response, as well as this focus around infections versus chronic disease. A lot of them have said we think we should be focused on chronic disease. A lot of them have espoused misinformation about vaccines. 

In terms of the legal authority, Congress has given a lot of really sweeping power to the secretary. When Congress gives the authority to the executive branch to do something, and it does it really clearly, the executive branch has a lot of leeway 鈥� 

So I’ll just give you an example. A lot of the questions I’m getting are about vaccine recommendations and vaccine requirements. There is the (ACIP). That is a committee that is created by the secretary鈥� 

There are all of these requirements for programs or payers to provide coverage of the vaccines that are recommended by the committee. And so there are really interesting questions about, well, if he stopped convening the committee, if he eliminated the committee, what impact would that have?

There’s a potential trickle down effect, because a lot of states actually either look to that committee to determine what their [vaccine] policy should be, or they just refer to the committee and require, say, you know, for school entry, they require vaccination in accordance with the schedule that’s determined by the ACIP. 

That’s sort of a very specific area 鈥� 

At the FDA, there’s a lot of room for someone to come in, introduce subjective views on science, and say, 鈥淲ell, what do we mean by safety? What do we mean by efficacy? Your traditional randomized, controlled trial, that doesn’t tell me what I need to know鈥︹�� [That] might be the view of somebody at the agency in this administration, and they might try to introduce alternative evidence, and they would have some latitude to do that.

Just turning a little bit more to vaccines, it sounds like whoever is running this agency and convening this committee has a lot of power to potentially help determine what vaccines are going to be covered by health insurance. Is that correct?

That’s right. Congress requires payers to cover vaccines that are recommended by that committee. If those recommendations are rescinded by the secretary, which the secretary has the authority to do, that really throws a lot into question there. 

Now I’m having a really healthy, friendly debate with one of my mentors over the legal challenges that one could bring to challenge that sort of decision. There are some potential checks on this in the courts, but it’s all going to be really circumstantial.

Thinking specifically about schools, you mentioned that folks look to this committee to help determine what vaccines are required for students. Can you explain a little bit about how that works? How might RFK鈥檚 policies impact that?

If you鈥檙e interested 鈥� it鈥檚 open access 鈥� I just wrote in this month鈥檚 issue of Health Affairs on the relationship between ACIP recommendations and state school requirements 鈥� 

But, this is the authority of the states, and it’s really interesting in a Republican administration to think about the federalism debate 鈥� and you’re going to see this tension play out in this administration over the role of the states and the federal government. 

And it’s going to play out in the arena of public health and around vaccine policy 鈥� The federal government can come in and play a really important role when you have a threat that, say, goes across state lines. But states have to be able to enact these measures to protect themselves, to protect their people. 

The Jacobson v. Massachusetts case recognized that states can require immunization. [In] 1922, [in] the case Zucht v. King 鈥� lesser known but very important case when we talk about school requirements 鈥� the Supreme Court came back and said that a school district was able to exclude a young girl from school when she wasn’t vaccinated, even though there was no active outbreak. 

And so that’s a really, really important case, because if you think about why we require kids to get vaccinated to go to school, it’s a decision that the state makes to impose these requirements so that we don’t have disease outbreaks. It’s the suppression of endemic disease. You take those requirements away, you weaken those requirements, you’re going to see outbreaks potentially. And we’ve seen that with measles outbreaks, where we weaken those policies. 

So it sounds to me less like RFK can put out a mandate that schools federally cannot require vaccines, but more that there could be a trickle-down effect of some of what he does at the federal level, and that might impact then state policies. Is that correct?

Well, yes, but this is something I鈥檓 thinking a lot about right now because there is this statute that some of us have looked at over time 鈥� 鈥� which is the old isolation and quarantine statute that allows, essentially, the CDC to come in and and impose certain measures when necessary to control communicable disease. 

And every semester, I ask students, 鈥淲ould this actually allow the federal government to impose a vaccine mandate?鈥� And we debate that endlessly, whether that language actually would allow it or not. 

And right now, I think that poses the question: there is preemption language in that statute, so could it potentially be used to set a policy that would undermine state requirements or weaken state requirements? And it’s just a really interesting academic question. I don’t know that realistically that’s something that RFK or the CDC would pursue, but I think we’re living in an era where everything’s on the table.

Well, all of that said, how likely is Kennedy to actually get confirmed? And could there be, from a policy or a legal standpoint, any roadblocks put up in his way?

Yeah, so I do think he’ll get confirmed. I think that what you have seen is President Trump came forward and put together a slate of nominees very rapidly. And all of the ways that you could say that President Trump is inconsistent, he has been very consistent with his health nominees 鈥� a lot of similarly held views, a lot of unconventional backgrounds. 

I think just if you look at the pool of appointments as a whole, there’s a lot to take aim at, whether it was Matt Gaetz, his AG nominee () or the selection of the defense secretary nominee (), there’s a lot to provide sort of political fog. And I think that in all of that noise you lose sight of the fact that RFK does not have really the ideal qualifications for the role [and] holds some views that are anti-science. 

And you look to the Senate and ask, 鈥淲ell, is someone going to stand up and push back and say, 鈥榃e’re not going to confirm this nominee because they lack the qualifications?鈥欌�� 鈥� No one has come out and sort of put a stake in the ground and said, 鈥淲e’re not going to confirm nominees who don’t meet these qualifications,鈥� or 鈥淚f they hold these views, there’s no way that they’re going to get a hearing.鈥� 

We just haven’t seen that. And so I do think they’ll get confirmed. I think President Trump expects loyalty from his party.