Promises Made and Not Kept to Secure Confirmation

Taking this piece from “MedPage Today,” a site that I follow from time to time when the articles are interesting. I had worked in various segments of the medical supply and pharmaceutical industry planning the needs of various product. It is interesting enough to keep one on their toes.

Not much of a surprise in this taken word for word report by author Joedy McCreary about Robert Kennedy’s role as HHS Secretary.

Broken Promises: RFK Jr.’s First Year at HHS, MedPage Today

He (Kennedy) made pledges to Sen. Cassidy, then overhauled ACIP, changed vaccine schedules, website wording . . .

As Robert F. Kennedy Jr. made a series of promises to secure Senate confirmation as HHS secretary, Georges Benjamin, MD, executive director of the American Public Health Association, predicted he would not keep them — even quipping at the time that “you can take that one to the bank.”

A year later, Benjamin says his bet paid off.

“I’m a wealthy man,” he told MedPage Today.

As the anniversary of Kennedy’s confirmation approaches, public health experts say broken promises — either explicitly or in spirit — define his first year leading the nation’s health agencies.

As told by Giridhar Mallya, MD, MSHP, of the Robert Wood Johnson Foundation. “I think we’ve seen a systematic dismantling of our health and public health infrastructure in this nation, and just an acceleration in distrust in our system, because of the actions of Secretary Kennedy and his other senior leaders (Medpage Today).

Last February, as he weighed his pivotal vote, Sen. Bill Cassidy, MD (R-La.), outlined a series of assurances  — largely centered on vaccines — that he said he received from Kennedy (a noted vaccine skeptic) and others in President Donald Trump’s administration. Among them:

The Senate confirmed Kennedy by a 52-48 vote on Feb. 13, 2025. MedPage Today reached out to Cassidy multiple times through his spokespeople but did not immediately receive a response.

In a statement, HHS spokeswoman Emily Hilliard told MedPage Today that Kennedy “continues to follow through on his commitments” to Cassidy, engages with him “on a regular and frequent basis,” has accepted staffing recommendations from Cassidy without providing specifics, retained “particular language” about vaccines on the CDC’s website, and adopted ACIP recommendations.

Benjamin sharply rejected that account.

“He absolutely broke every single promise that he’s made — and in some ways gone beyond those promises,” Benjamin said. “Because those are pretty superficial promises. You’re not going to go after vaccines. You’re not going to screw around with [ACIP]. You’re going to respect the science. And he’s broken all of those promises.”

Ann Keller, PhD, an associate professor of public health politics and policy at the University of California Berkeley, said Kennedy likely knew “what he needed to say in order to give Cassidy cover for his approval.”

Richard Frank, PhD, the director of the Center on Health Policy at Brookings and former HHS assistant secretary for planning and evaluation in President Barack Obama’s administration, contrasted the current moment with his own experience before the Senate.

“When you make commitments in a confirmation hearing, you should expect to stand by them, and the senators would let you know if you didn’t,” he told MedPage Today. “There would be a consequence to not standing by your statement, and in fact, most of the preparation was, what are you allowed to commit to and what can’t you commit to? So I thought, on one hand, Cassidy’s trying to do that.”

“On the other hand, I think the zeitgeist of the Trump administration is pretty different from that of the Obama administration,” he added. “The rules of the game seem to be really different.”

Some pledges were vague. Others were more concrete. Here’s how those played out:

Maintaining ACIP Recommendations

Kennedy technically followed ACIP recommendations — but only after reshaping the committee.

In one of the most consequential moves of his tenure, Kennedy fired all 17 ACIP members and replaced them with appointees largely aligned with his vaccine-skeptical views, many of whom lacked traditional immunology credentials.

The reconstituted committee later recommended dropping the hepatitis B vaccine birth dose, prompting Cassidy to call the panel “totally discredited” and accuse it of failing to protect children.

“What Sen. Cassidy, I think, was trying to get at is a commitment to not changing evidence-based recommendations on childhood vaccines,” Mallya said. “And that clearly has not been a promise kept.”

Maintaining Vaccine Approval Systems

In announcing major changes to vaccine recommendations, Kennedy repeatedly bypassed ACIP.

Last May, he unilaterally announced that COVID-19 vaccines would no longer be routinely recommended for healthy children and pregnant women. In January, his CDC reduced the number of universally recommended pediatric immunizations from 17 to 11. There is no public evidence that ACIP was consulted before either decision.

“The biggest changes to the childhood vaccine schedule were actually not made through ACIP,” Mallya said. “They were made by the secretary directly.”

Vaccines, Autism, and the CDC Website

This promise was kept — on a technicality.

The CDC site does indeed state that “vaccines do not cause autism.” However, an asterisk now notes that the language only remains because of Cassidy’s agreement with Kennedy. The same page includes language suggesting existing studies have not “ruled out the possibility” that infant vaccines could cause autism.

“The word ‘propaganda’ comes to mind,” Benjamin said. “They’re using half-truths and innuendo to undermine people’s confidence in everything that’s happened.”

Kennedy told the New York Times in November that he personally directed the change.

“What it demonstrates is that the secretary was very savvy about his confirmation hearing, and he said what he felt like he needed to say to get confirmed,” Mallya said. “But he had a very clear agenda that he was going to carry out once he was confirmed.”

HELP Committee Notice

Kennedy has said he wants to overhaul the vaccine monitoring system, including expanding automated data collection.

Nine months later, it remains unclear whether formal changes are imminent — or whether HELP received the promised 30-day notice.

“That he would collaborate with the Senate committee and brief them and get their advice, and that he would get Cassidy’s advice — clearly, given how outraged Cassidy was about the childhood vaccine episode and the changes to the website, he was clearly not consulted about those,” Frank said.