At his confirmation hearing to be the 26th Secretary of the Department of Health and Human Services (HHS), Robert F. Kennedy Jr. was confronted by Senator Bill Cassidy (R-LA) about his endorsement of a debunked link between vaccines and autism. Senator Cassidy, a physician, expressed concern for what this view would mean from the helmsman of American public health. Mr. Kennedy assured the Senator: “I just want to follow the science.”
Since his confirmation, Mr. Kennedy has done just the opposite. The science has said very clearly that there is no link between vaccines and autism. Dozens of sound studies have investigated this link and have found no connection whatsoever. A 2014 meta-analysis of these studies, “Vaccines are not associated with autism: an evidence-based meta-analysis of case control and cohort studies,” answered the question in its very title. The most recent rebuke comes from a Danish study published this July which surveyed the records of over 1 million children. As has been found over and over again, there was no link. The science is very clear.
Yet, none of these studies have convinced Mr. Kennedy. He still insists there is a link and attacks those that say otherwise. In an op-ed, he challenged the Danish study and called for its retraction, a move inexplicable for an HHS Secretary following the science, but very characteristic of Mr. Kennedy. His diatribe was full of errors, confusing standard scientific methods for biases, and trying to impugn the public research institute performing the study by calling it a private “company.” He accused the researchers of having “meticulously designed [the study] not to find harm.” To single out this one study—which categorically rejects his unsubstantiated belief—from the thousands of studies published every day strongly suggests Mr. Kennedy has a particular commitment, not to science, but to the public believing what he does.
The studies that Mr. Kennedy himself cites were “meticulously designed”—but to find harm from vaccines. Andrew Wakefield’s 1998 Lancet paper that introduced the public to the supposed link between vaccines and autism was retracted. Wakefield and his colleagues were found guilty of manipulating data, and Wakefield subsequently lost his medical license. The studies that have come afterwards that Mr. Kennedy loves have been of the same abysmal quality. Many have been retracted for poor scientific analysis, and those that remain often have troubling conflicts of interest. One paper Mr. Kennedy cited in his confirmation hearing was funded by two now defunct, explicitly anti-vaccine organizations (Generation Rescue and Children’s Medical Safety Research Institute).
In a recent stunning announcement, Mr. Kennedy promised to publish a report on the causes of autism by this month, saying HHS will identify and “eliminate those exposures.” It is widely anticipated the report will make claims unsupported by science, as Mr. Kennedy has done his entire career. Already, leaks suggest the report will tout an unestablished link between Tylenol-usage during pregnancy and autism. Given Mr. Kennedy’s track record, it will find some way to still blame vaccines; if not in this report, then in surely what will follow. His appointment of David Geier, a pseudo-scientist known for publishing fraudulent research about the dangers of vaccines, to head a federal study examining vaccines and autism makes that intention clear.
Mr. Kennedy’s claimed mission in all of this is to fight what he calls the “autism epidemic” – a constant talking point of his alluding to the rapid twenty-year rise in autism rates. While it is correct that there has been a rise, most scientists attribute it to factors Mr. Kennedy ignores. Released in 2013, the DSM-V expanded the earlier definition of autism, which explains some of the increase. In the updated diagnostic manual, several formerly separate conditions like high-functioning autism, atypical autism, and Asperger’s disorder, were lumped into Autism Spectrum Disorder (ASD). Another driver has been an increased awareness and thus screening of individuals for autism, fueled by the tireless efforts of non-profits like the Autism Society of America. While some of the increase is attributable to more diagnosis, the overall explanation is multi-factored and complex, with some risk from genetics, air pollution, and increasingly older parents, with no smoking gun.
Mr. Kennedy’s answers to why the jump in autism diagnoses, while wrong, are simplistic and thus appealing. It is comforting to be able to point to one thing that can be easily avoided with a simple “no.” Mr. Kennedy offers people an immediate explanation, and with it, immediate agency—just don’t vaccinate, don’t take Tylenol, and your child will be safe. Unfortunately, because of science’s honesty, it cannot offer the public the kind of answer that Mr. Kennedy will. Real science is stuck with the unsatisfying truth: autism is complex, and so are its explanations.
Nominally, Mr. Kennedy’s efforts are to help America’s children. But making vaccines the scapegoat for autism, which he continues to do, threatens all children. Despite his disrepute, his decisions hold wide influence; shortly after it was merely suspected he would link Tylenol to autism, stock prices in its proprietor company Kenvue dropped. Immunization rates are already falling, producing a rise in disease with the power to kill or disable many children. Already, we are seeing a nationwide outbreak of measles which emerged from Texas to kill two children and infect thousands nationwide. Much of the existing misinformation was pushed by Mr. Kennedy as a citizen, but now he has the bully pulpit of the most powerful health office in the nation. All children are at risk from Mr. Kennedy’s actions, but more than any are children with autism.
Mr. Kennedy has cruelly caricatured people with autism in public, stating that those with autism “will never pay taxes…hold a job…use a toilet unassisted.” The self-declared savior of those with autism fails to recognize that it is a complex condition as individualized as those living with it. Along the autism spectrum is a diverse set of individuals that contribute powerfully to American society—including Mr. Kennedy’s former colleague and the world’s richest man Elon Musk, who helped him dismantle health research in America. Rather than fund research into reputable links or support for people living with autism and their families, he has used taxpayer dollars to rehabilitate discredited links.
Mr. Kennedy, despite his own chronic disability, has no sympathy or empathy for those with autism and their families. Incredibly, he just wants them invisible no matter where the real science leads, seizing what were the greatest health agencies in the world for his purposes.
Nathaniel Mamo, MA (@mamo_nate) is a Program Coordinator at the Division of Medical Ethics at NYU Grossman School of Medicine.
Arthur Caplan, PhD is the Drs. William F. and Virginia Connolly Mitty Professor and founding head of the Division of Medical Ethics at NYU Grossman School of Medicine.