Robert Kennedy Jr. speaks at a D.C. rally against vaccine mandates in January 2022, one year before announcing his bid for president. (Matt McClain via Getty Images)

What RFK Jr. Gets Right—and What He Gets Wrong

Dr. Vinay Prasad fact-checks the presidential candidate on vaccines, regulatory capture, and more.

Robert F. Kennedy Jr. is running for president on a platform that claims to reveal hidden truths about the damage rich, powerful people and institutions—the pharmaceutical industry, the government, the media, etc.—are doing to average citizens. His promise to voters is that he can bring the unaccountable to heel.

I am a hematologist-oncologist who is also a professor of epidemiology. Some things Kennedy says about biomedicine are, in my opinion, wrong or overstated. But he also gets some things right, including deep truths about the public’s current—and very understandable—epidemic of distrust, the corruption of our institutions, and more.

I believe Kennedy will be an important force in the Democratic Party. But he is currently being dismissed by elites as a guy with a famous name and nutty ideas whose candidacy is a joke. Recall that this playbook was used against Trump in 2016. It only strengthened him. 

Since Kennedy announced his candidacy, the legacy press, while criticizing him, has largely avoided speaking to him. On an occasion when ABC did so, they deprived the audience of the ability to hear his remarks on vaccines in full. This form of censorship is insulting and infantilizing to their own viewers and helps explain why so many are tuning out.

At the same time, Kennedy has been widely interviewed in the world of independent media—including on the current episode of Honestly. These conversations are free-flowing and far longer than cable news hits, so they offer a more detailed portrait of his ideas. 

Given that recent polls show about 20 percent of Democratic voters favor Kennedy, and in an Economist and YouGov poll, his favorability rating beats everyone, including Biden and Trump, I think it’s important to take him seriously. That’s why I want to address some of his recent remarks about public health and medicine, and consider what he gets right, and what he gets wrong. 

The Death of Trust: Got It Right

I am largely sympathetic to Kennedy’s views on the mishandling of the Covid-19 pandemic. In general, Kennedy thinks lockdowns were antithetical to public health, is critical of prolonged school closure, and is against Covid-19 vaccination mandates.

When Covid-19 emerged, Kennedy said that “instead of a public health response to a public health crisis, we had a militarized and monetized response, which is the inverse response you want.” The Democratic Party—my party—used to pride itself on holding power to account. Instead, during the past few years, the party has reveled in its power to shut down society. 

I think Kennedy is correct that lockdowns were a colossal failure, one that will especially harm the future prospects of poor children who lost years of school or left the education system for good. He also had early insight into the excesses of the lockdown, and how foolishly many officials responded. He said on one podcast, “Police were pulling surfers out of the ocean and ticketing them.” He’s right to point out the absurdity. There is no doubt that closing playgrounds and ticketing surfers were an abuse of power that provided zero public health benefit. Amazingly, those who put these policies in place have yet to apologize. 

He’s also correct to fault the social media environment that has repeatedly, over the past few years, suppressed videos or speech raising questions about public health policies—and even the origin of Covid-19—that some elites found objectionable. Unfortunately for public debate and public health, people with great scientific expertise who objected to how Covid-19 was handled were silenced and demonized. This has been a black mark on science, public health,  tech companies, and too many journalists.

Kennedy is not a scientist or a doctor—he’s a lawyer and an activist. But one reason I think he is resonating is that he makes Americans feel that they are being spoken to honestly, answering a deep longing from a public who feels battered by officials and skeptical of “approved” experts. 

Regulatory Capture: Got It Right

I agree with Kennedy’s view that regulatory agencies are held captive by the corporations the agencies are supposed to protect us from. There have been recent scandals about industry influence over drug approvals at the FDA. My research team has found that when high-ranking officials at the U.S Food and Drug Administration leave government service, they commonly go to work for the biopharmaceutical industry they previously regulated

Here’s a prominent example: Scott Gottlieb is a former FDA commissioner who now works as a healthcare investor at a venture capital firm, sits on the board of Pfizer, and makes many media appearances during which he promotes pharmaceuticals. No doubt Dr. Gottlieb is a decent man, but the system we have in place has made this kind of obvious corruption normal.

Kennedy is willing to say that Democrats have become captives of big industry—especially Big Tech—and that they have acted as shills for the pharmaceutical companies, especially Pfizer, the manufacturer of the most widely distributed Covid-19 vaccine in the U.S. Pfizer is also the maker of Paxlovid, an antiviral pill to treat Covid-19 for which this administration has spent more than $10 billion. Unfortunately, as a colleague and I wrote, there is no evidence that Paxlovid improves the course of the illness in people who have been vaccinated against Covid-19. Taxpayers spent billions to enrich a company without government officials demanding sufficient data. This reeks of corruption, an issue Kennedy speaks passionately about.

Then there is the question of how our regulators have handled this issue of myocarditis, an inflammation of the heart muscle. This is a rare but concerning side effect, seen primarily in young men, of the mRNA vaccines made by Moderna and Pfizer. As a colleague and I wrote in The Free Press in January, at first officials in the U.S. Centers for Disease Control and Prevention and the Department of Health and Human Services downplayed the risk of this illness. But young people are at very low risk of serious outcomes from contracting Covid-19—which was not prevented by the vaccines in any case. Any heart inflammation is a concerning diagnosis, especially so in otherwise healthy people. This is why some other Western countries have limited the vaccines to older adults. 

We are now long overdue for the Pfizer study, authorized by the FDA, to report on the incidence of subclinical myocarditis in vaccine recipients ages 16 through 30. Kennedy may be mocked for raising concerns about myocarditis and vaccines, but he was absolutely right to do so. 

Ivermectin and Hydroxychloroquine: Got It Wrong

When a new disease presents itself, physicians turn to existing medications to see if they might work. Sometimes there is preliminary evidence that a repurposed drug is beneficial. But the most conclusive way to validate such hopes is to conduct randomized controlled trials, the gold standard for such evaluation.

When Covid-19 hit, two drugs were touted as possible treatments: ivermectin, used to treat parasitic worms; and hydroxychloroquine, used for arthritis, lupus, and malaria. Dozens of randomized trials were launched to answer the questions about the efficacy of both. Ultimately, the cumulative effect across the totality of the data is that ivermectin and hydroxychloroquine are not treatments for Covid-19. 

That should have been the end of it but for the fact that early in the pandemic, then-president Donald Trump touted the curative properties of hydroxychloroquine. Ever since, this drug, and later ivermectin, have become symbols to some Americans of safe and effective treatments being dismissed because they aren’t advancing the interests of the vaccine manufacturers. 

Unfortunately, Kennedy has decided to side with the believers in ivermectin and hydroxychloroquine. The main source of his positivity about these quite thoroughly discredited treatments appears to be simply that they aren’t vaccines. While the totality of the randomized trials of these drugs show they don’t work, Kennedy wants to exclude some trials and focus on the more promising ones. In my opinion, this is unjustified and ripe with potential for bias.

At this point, the burden of proof for these two drugs falls on people like Kennedy who support their use in defiance of robust evidence. He has been right to call out public health officials and others who made pronouncements and policies they couldn’t back up with facts. But the same rules apply to him. Continuing to tout these discredited medications undermines his own credibility and hurts his core agenda. 

Childhood Vaccines Cause Autism: Got It Wrong

When it comes to vaccines, I often feel Kennedy sees only harms and never sees benefits. This is dangerous. Vaccines are one of the great medical innovations in human history, one that has saved countless lives. This is not to say all vaccines are the same as far as safety and risk are concerned. But far too often, Kennedy paints with a broad brush, and broadly disparages all vaccines. More than that, he makes unfounded leaps of logic to blame vaccines for a variety of ills. 

I vehemently disagree with Kennedy’s belief that early childhood immunizations with the measles, mumps, and rubella (MMR) vaccine and the Diptheria-Tetanus-Pertussis (DTaP) vaccine causes autism. These vaccines have been thoroughly investigated, and there is no proof of any connection to autism. Over the decades, these vaccines have also prevented many cases of disability and death. Their net impact is overwhelmingly positive. 

Polls show that faith in standard childhood vaccines is declining, which I think is an unmitigated public health disaster. Covid-19 vaccination policies, especially the many mandated shots for children and young people at little risk from the virus, have certainly been a part of this. But Kennedy, too, has used his prominence to unnecessarily scare parents about the safety of vaccinations.

Kennedy’s case for this frightening assertion is that since 1989, two things occurred together: there has been a rise in neurologic and autoimmune diseases; and, we give children more vaccines. In the interviews I have listened to, he doesn’t take the argument much further than this, and I find it to be entirely lacking. It is low-quality causal reasoning, and is unpersuasive. First, I am not clear that 1989 is the magic year that things changed. Second—and crucially—a lot of things changed around that time. There is also real evidence that other factors, such as parental age, have an impact on autism. Here I believe Kennedy is undermining both himself and the public health benefit. 

But I do think that all the concerns that have been raised about vaccines, and the crumbling public support for them, need a response from officials. The two major Covid-19 vaccine concerns—one that the Johnson & Johnson shot caused a small number of life-threatening blood clotting disorders, the other that the mRNA shots caused myocarditis—were both initially discovered and reported outside of the U.S. This suggests to me that our system of vaccine safety surveillance is suboptimal. Rather than enter into decades of debate with Kennedy’s growing supporter base, I think public health officials ought to design and implement a new vaccine surveillance system for the twenty-first century. 

So where do I stand on RFK Jr.? 

I have not reached a final verdict. The parts of his platform that challenge corporate cronyism speak to me, but his loose comments about other medical issues (Wi-Fi causes blood brain barrier permeability/childhood immunization has been linked to autism) repel me. But I strongly disagree with ostracizing him.

RFK Jr.’s emergence as a figure of interest for many Democratic voters is a warning about the distrust Democratic leaders have sown among the public. This includes a growing distrust in experts that I believe will be incredibly disruptive to science and medicine. To many citizens, Kennedy sounds like a man who can’t be bought and won’t be silenced. Those in power should be listening closely.

Vinay Prasad is a columnist for The Free Press. His last piece was about the Epidemic of #DiedSuddenly.

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