Public Health 2025: MAHA and contrarians

Early attempts to understand the sea change

Over the last few months, I’ve been covering the abrupt ideological transformation of our healthcare system for The Atlantic. Unfortunately, I was already familiar with some of the key players. They have been influential in the anti-vaccine and health conspiracy communities. Now they are influential everywhere. You can catch up on my stories below:

RFK Jr., America’s Leading Advocate for Getting Measles

“It’s not unusual.” That’s how Robert F. Kennedy Jr., the anti-vaccine activist and secretary of Health and Human Services, described an ongoing measles outbreak in and around Texas that has already infected more than 100 people and killed one child. This incident is, in fact, unusual. Until this week, someone hadn’t died of measles in this country since 2015, and endemic spread of the virus was declared eliminated in the United States 25 years ago. As the leader of our health-care system, Kennedy could have used his political megaphone to encourage vaccination. But he is a vocal critic of the measles shot, which has saved more than 90 million lives, and has claimed (with very modest evidence) that catching measles may reduce the risk of heart disease and certain cancers. In keeping with those views, he has passed on the opportunity.

Kennedy’s “Make America healthy again” (MAHA) movement is not content with simply ignoring the need for vaccination. It also has a habit of dismissing pediatric death and disability.

RFK Jr. Is an Excellent Conspiracy Theorist

Robert F. Kennedy Jr., President Donald Trump’s nominee for secretary of Health and Human Services, is a longtime conspiracy theorist and anti-vaccine activist. He thinks Anthony Fauci and Bill Gates are leaders of a “vaccine cartel” that intentionally prolonged or even started the coronavirus pandemic in order to promote “mischievous inoculations.” Kennedy also blames immunizations for autism and obesity (among other chronic diseases) in children. In the meantime, he isn’t really sure whether HIV causes AIDS, or whether vaccine-preventable diseases such as measles are actually dangerous.

As a doctor, I have spent years following—and fighting—anti-vaccine falsehoods. Along the way, I’ve learned an important lesson: Despite RFK Jr.’s fringe beliefs, he often seems to make sense.

Revenge of the COVID Contrarians

On Christmas Eve of 2020, my father was admitted to the hospital with sudden weakness. My mother was not allowed to join him. She pleaded with the staff—my dad needed help making medical decisions, she said—but there were no exceptions at that grisly stage of the coronavirus pandemic. I contemplated making the trip from Maryland to New Jersey to see whether I, as a doctor, could garner special treatment until I realized that state and employer travel rules would mean waiting for a COVID test result and possibly facing quarantine on my return. In the end, my father spent his time in the hospital alone, suffering the double harm of illness and isolation.

These events still frustrate me years later; I have a hard time believing that restrictions on hospital visitation and interstate travel helped more people than they hurt. Many Americans remain angry about the pandemic for other reasons too: angry about losing a job, getting bullied into vaccination, or watching children fall behind in a virtual classroom. That legacy of bitterness and distrust is now a major political force.

The Sanewashing of RFK Jr.

Let’s be clear: Many scientists consider Kennedy to be a fool, and a ludicrous pick to run HHS, because the evidence supports that assessment. Wen nods to this in passing—Kennedy has a “long history of antiscience propagandism,” she writes—but otherwise she’s focused on the nitty-gritty of one particular public-health debate. So allow me to fill in some gaps: According to his 2021 book, The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health, RFK Jr. believes that Fauci and Gates are members of a “vaccine cartel” trying to kill patients by denying them hydroxychloroquine and ivermectin. He argues that this cartel secretly funded doctors to produce fraudulent studies showing that the drugs were ineffective against COVID—and that it did so in order to orchestrate global lockdowns and accelerate the construction of 5G cellular networks, which, in Kennedy’s understanding, are very, very bad.

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Ben