RFK Jr. could further deter childhood vaccinations as rates fall in the U.S.

The nation’s new top health official could further erode already falling U.S. vaccination rates against once-common childhood diseases, a development that comes as a growing measles outbreak has led to the first U.S. death from the disease in a decade.

Robert F. Kennedy Jr., a prominent vaccine skeptic, now leads the Department of Health and Human Services and wields enormous power over the federal agencies that regulate vaccines and set shot recommendations. 

Kennedy tried to distance himself from his previous views during his Senate confirmation hearings, claiming that he isn’t “anti-vaccine” and would not make it “difficult or discourage people from taking” routine shots for measles and polio. 

But some health policy experts said his early moves as HHS Secretary are concerning and suggest that he could undermine immunizations in other, less direct ways, which could increase the risk of children catching preventable diseases.

“The steps that he’s taken so far seem to be in line with his views of skepticism about vaccines and their safety, of wanting to allow for parents to not get their children vaccinated. It’s all things he’s championed,” said Josh Michaud, associate director of global health policy at KFF. “There might be more dominoes to fall coming.”

Kennedy has said he will review the childhood vaccination schedule, and is reportedly preparing to remove and replace members of external committees that advise the government on vaccine approvals and other key public health decisions, among other efforts. Some experts said he could also amplify data highlighting the risks of vaccines, promote unfounded claims about shots and undermine legal protections for vaccine makers. 

If rates drop even more, there could be major consequences, such as renewed outbreaks of vaccine-preventable illnesses in certain communities.

“Within the next couple of years, we could see major drops in childhood vaccination rates,” Lawrence Gostin, professor of public health law at Georgetown University, told CNBC. “He has all the powers he needs to sow public distrust in vaccines. He has a history of doing that and he has a desire to do it.”

“This could lead to significant outbreaks of vaccine-preventable diseases throughout America, with the disproportionate impact on red states that President Trump carried in the 2024 election,” Gostin added. 

Kennedy has a long track record of making misleading and false statements about the safety of shots. He has claimed they are linked to autism despite decades of studies that debunk that association. Kennedy is also the founder of the nonprofit Children’s Health Defense, the most well-funded anti-vaccine organization in the U.S. In a government ethics agreement in January, he said he stopped serving as chairman or chief legal counsel for the organization as of December.

But vaccines have saved the lives of more than 1.1 million children in the U.S. and saved Americans $540 billion in direct health-care costs over the last three decades, according to Centers for Disease Control and Prevention research released in August.

States and local jurisdictions set vaccine requirements for school children, but the federal government has a longstanding system for approving and recommending shots for the public. That includes creating the childhood vaccination schedule, which recommends when children should receive certain shots. It’s used by states, pediatricians and parents. 

The Department of Health and Human Services did not immediately respond to CNBC’s request for comment.

But the share of kindergarten children who are up to date on their vaccinations has dipped since the pandemic, according to data collected and aggregated annually by the CDC from state and local immunization programs. Less than 93% of kindergarteners had received all state required vaccines in the 2023-2024 school year, data shows.

Exemptions from school vaccination requirements, particularly non-medical exemptions, have also increased, according to the CDC. The share of U.S. children claiming an exemption from one or more shots rose from 2.5% in the 2019-2020 school year to 3.3% in the 2023-2024 school year, the highest national exemption rate to date. Nearly all of that increase was driven by non-medical exemptions, such as religious or personal belief reasons.

That decrease appears consistent with the public’s perception of childhood immunizations. A Gallup survey released in August found only 40% of Americans said they considered childhood vaccines extremely important, down from 58% in 2019 and 64% in 2001. 

The overall decline is fueled in part by vaccine skepticism, a trend that “certainly existed far before the pandemic,” KFF’s Michaud said.

Vaccine hesitancy and the anti-vaccine movement have been around globally for decades. They are often intertwined with political, moral and spiritual ideas around the rights of an individual versus the community, the limits of government power over bodily autonomy, mistrust of medical institutions and misinformation about shot safety and efficacy. 

The politicization of the pandemic only fueled more doubts about vaccinations. 

It created a partisan divide on the public’s acceptance of the Covid vaccine, according to Sean O’Leary, chair of the American Academy of Pediatrics committee on infectious diseases. Social media and public figures amplified misinformation about Covid jabs, and some of those “falsehoods about Covid shots spilled over to an extent to other types of vaccinations,” he said. 

“There was a very precipitous drop [in vaccination rates] right when the pandemic hit, in those first few months afterwards,” O’Leary said. “And we never really completely caught up.” 

O’Leary noted that the vast majority of parents on both sides of the political spectrum continue to vaccinate their kids. 

Still, surveys suggest that the partisan division on immunizations has deepened in recent years. In 2024, 63% of Democrats and Democratic-leaning voters said childhood vaccinations were “extremely important,” compared to just 26% of Republicans and GOP leaners, according to the August Gallup survey. 

Five years earlier, enthusiasm was just slightly higher among the Democratic group at 67%, and double among Republican respondents at 52%. 

There are “certainly political ideologies that are driving vaccine policy in certain areas of the country,” which has a “clear downstream impact on vaccination levels,” said Dr. Neil Maniar, a public health professor at Northeastern University. 

Over three-quarters of U.S. states, or 39, had vaccination rates for the MMR shot below the “Healthy People 2030” target rate of 95% during the 2023-2024 school year. That refers to the level needed to prevent community transmission of measles, a highly contagious and deadly virus. 

The data means that roughly 280,000 school children were unvaccinated and unprotected against measles during that school year, according to the CDC. MMR vaccination rates among kindergarteners vary across states, ranging from a low of around 80% in Idaho to a high of more than 98% in West Virginia. 

Moss noted that clusters of unvaccinated people within a specific community increase the risk of disease outbreak. 

“That’s where you’re going to get these larger outbreaks like we’re seeing in Texas right now with measles,” Moss said. 

A child who wasn’t vaccinated died in the outbreak in rural West Texas, state officials said in late February, the first U.S. death from the disease since 2015. The childhood vaccination rate for measles in Gaines County, the epicenter of the current outbreak in Texas, is just below 82%.

A second patient, an unvaccinated adult in New Mexico, tested positive for measles after death, state officials said Thursday.

Kennedy last week said shots protect communities from measles, but emphasized that the decision to vaccinate “is a personal one.” He also pushed unconventional treatment regimens for measles, including cod liver oil, which is rich in vitamin A. 

The government postponed a meeting of vaccine advisors to the CDC and a separate meeting of advisors to the Food and Drug Administration, the latter of which is crucial to determining the flu strains in next season’s shots. It is unclear why the meetings were canceled or when they will be rescheduled.

One “clear step” Kennedy can also take to undermine vaccinations is removing members of those advisory panels that shape the government’s shot recommendations, including which jabs are covered at no cost by different types of insurance, according to Georgetown’s Gostin. 

Several reports have said Kennedy plans to replace members whom he perceives to have “conflicts of interest,” though it is unclear how many people will be outed or when. 

Gostin called conflicts of interest one of Kennedy’s “code words” for “simply purging hard working, experienced scientists from advisory committees and replacing them with those that are more skeptical of shots.” All HHS agencies and their advisory panels have rigorous policies for conflicts of interest, and there have been no related issues for years, he noted. 

Kennedy’s shake-up of advisory committees could produce “bogus recommendations” that highlight the harms rather than the benefits of shots, according to Gostin. He said those recommendations could influence governors, legislatures and school boards in red states, which could adopt policies that reduce childhood immunizations and “create wide-open opt outs of shots.” 

Those recommendations could also create greater distrust in the CDC and Trump administration among scientists and public health experts, including Gostin himself, he said.

“It will have a longer-term corrosive effect on the value of science in America, which is already under severe attack,” he said. 

Kennedy is also reviewing the childhood immunization schedule. Experts said that could lead to removing recommendations for certain vaccines or changing their suggested use from “routine” – when the default approach is to vaccinate – to more of an individual choice guided by discussions with a health-care provider. 

The hope is that officials on the state and local level influence policy or implement practices to drive higher vaccination rates, said Northeastern’s Maniar. State and local governments may need to “expand the work they do” in some cases to “make up lost ground” and advocate for vaccinations, he added.

Kennedy is reportedly shelving promotions for a variety of shots, including a campaign touting seasonal flu jabs. He wanted the CDC’s advertisements to promote the idea of “informed consent” in vaccine decision-making instead, STAT News reported in February. That refers to giving patients important information, including possible risks or benefits of a medical treatment, such as adverse events associated with shots. 

Experts have said while informed consent is important, shifting the framing of advertisements for shots that the CDC has long recommended to focus more on the potential risks could undermine people’s willingness to get vaccinated.

“When a parent exercises informed consent not to have their child immunized with measles, it certainly puts that child at risk, but it puts every child in that school with them at risk,” Gostin said. 

Kennedy would need approval from Congress to change the existing legal liability protections in place for vaccine makers, but he could still undermine them in other ways, experts said. HHS’ National Vaccine Injury Compensation Program currently pays patients injured by standard childhood vaccines and shields drugmakers from litigation. 

As HHS secretary, Kennedy can remove or add to the list of vaccines and injuries included and covered by that program, Michaud said. Any changes to the list could change some liability protections for vaccine makers, potentially spurring a wave of litigation over alleged injuries from the shots, he added.