To win the votes he needed to be confirmed as US secretary of health, Robert Kennedy Jr made a firm promise to one sceptical Republican senator.
Kennedy told Bill Cassidy of Louisiana that he would not change the US’s current vaccination schedule — the programme of shots protecting children from tetanus, diphtheria, measles and other dangerous diseases.
Once confirmed, he appeared to back away from that pledge. Last week, Kennedy said he was convening a “Make America Healthy Again” commission that would look into issues such as the use of antidepressants and ultra-processed foods and the schedules of childhood vaccinations.
“Nothing is going to be off limits,” he said.
Vaccine scepticism was long a fringe phenomenon, with anti-vaxxers treated as cranks. But now its leading proponents are grabbing the political limelight in a manner that would have been unthinkable even a few years ago.
While traditional political parties around the world are struggling to appear relevant, the anti-vaccine movement is one of the new anti-establishment political forces that is filling the vacuum, its claims and conspiracy theories often amplified by social media.
No one embodies this shift better than Kennedy himself. A successful environmental lawyer and campaigner, he has become better known in recent years for his embrace of outlandish conspiracy theories.
He once argued that Covid-19 was “ethnically targeted” to spare Ashkenazi Jews and Chinese people and called the Covid jab the “deadliest vaccine ever made” — although Kennedy also insists he is “not anti-vaccine”, just “pro-safety”.
He is now in charge of 80,000 employees and a trillion-dollar budget, and overseeing insurance, food and drugs and medical supplies.
“It shows clearly how the anti-vaccine movement is growing in political power,” says Adam Ratner, a paediatric infectious diseases specialist and author of Booster Shots, a new book warning of the resurgence of measles. “And that is very, very concerning.”
The movement is by no means confined to the US. Across the world, anti-vaxxers have seized on growing public mistrust of the medical establishment — particularly since the start of the Covid pandemic — to reach an ever larger audience that cuts across both left and right. That scepticism often then feeds hostility to other institutions.
“You start with mistrust of public health, then all of a sudden that morphs into mistrust of the intelligence community, or democratic leaders,” says Bret Schafer, an expert in digital disinformation at the Alliance for Securing Democracy. “The sceptical communities cross-pollinate and reinforce each other.”
The growing clout of anti-vaxxers has also been on full display this week when the Alternative for Germany (AfD), a far-right, ethnonationalist party, came second in Germany’s Bundestag election with 20.8 per cent, just 8 points behind the victorious centre-right.
Best known for its anti-immigration views, the AfD is also the only large German party that opposes any vaccination mandates, a standpoint that has attracted tens of thousands of Germans sceptical of orthodox medicine.
“We’re of the view that vaccines are a massive encroachment on people’s bodily autonomy and every one should be free to decide whether they want them or not,” says Martin Sichert, the AfD’s spokesman on health policy.
In the US, public health experts worry that Kennedy’s mere presence as the administration’s senior health official could have a significant impact on vaccination rates.
“He has a big bully pulpit,” says Ashish Jha, dean of the Brown University School of Public Health who co-ordinated the response to Covid during Joe Biden’s presidency. “Even if he doesn’t actively dismantle the vaccine infrastructure of our country, which he could . . . he’s not somebody who’s going to be an advocate for vaccines, and I worry that he will undermine it.”
The rise in vaccine scepticism has contributed to a political shift in Germany, where the AfD has evolved into a formidable political force.
Starting off as a grouping opposed to the euro bailouts, the party moved sharply to the right in 2015, capitalising on widespread public anger at the arrival of more than 1mn asylum seekers into Germany.
During the pandemic, it positioned itself as the main opposition to government-sponsored stay-at-home orders, quarantines, curfews and proposals for vaccine mandates.
That stance brought a new surge of support, often from sections of the population that had long been impervious to its hard-right, xenophobic messaging.
“Hippies, vaccine sceptics, people of a mystic bent, were, like us, labelled Nazis because they opposed the lockdowns, and so became disillusioned with the regime and switched to us,” says Alexander Sell, who sits for the AfD in the European parliament.
Axel Salheiser, a sociologist with the Research Institute for Social Cohesion in Jena, Germany and an expert on the extreme right, says the AfD was able to elaborate a populist narrative based on the idea of an “overreaching state, that they equated with a dictatorship”.
“It’s a narrative that is highly emotive, that incites negative emotions like fear, anger and indignation, and is for that reason ideally suited to mobilising people,” Salheiser says. It was through this kind of rhetoric that the AfD was able to “establish itself as the sole mouthpiece of the protest movement”.
Björn Höcke, AfD leader in the eastern state of Thuringia and one of its most radical figures, personified this approach. He likened Covid vaccines to the Nazis’ experiments on humans, calling them “the breaking of a historic taboo”.
“We must assume that by now, thousands of people have been euthanised by injection with mRNA vaccines,” he told the local parliament in Thuringia in 2022.
Middle-of-the-road Germans were often turned off by such hyperbole. But Sichert insists that the AfD’s refusal to support draconian public health measures during the pandemic, particularly the vaccine mandates, won it hordes of new supporters.
“People are still coming up to me saying, ‘We know it was you who defended our freedom over the past three years,’” he says. “It’s still a very important issue for them.”
The AfD’s vaccine scepticism has parallels elsewhere. In its manifesto for last year’s general election, Reform UK, the rightwing party spearheaded by Nigel Farage, promised a public inquiry into “excess deaths and vaccine harms”.
Richard Tice, one of the party’s most senior figures, said last February that there was a “serious problem” with thousands more people dying than expected in recent years and suggested the side-effects of jabs against coronavirus could be responsible. Some scientists have questioned his data.
Perhaps the most notable anti-vax politician in Europe is Călin Georgescu, the nationalist who won the first round presidential election in Romania in November. The poll was later annulled by the country’s constitutional court over alleged Russian interference.
In 2020 Georgescu shared a video of himself bathing in cold water, saying it was the best vaccine against Covid. In a podcast in 2024 he said the virus did not actually exist and that “the only real science is Jesus Christ”.
Georgescu has described vaccines as tools of population control, saying “globalists” were using them to undermine national sovereignty.
His anti-vaxxer rhetoric has often been combined with broadsides against multiculturalism and the LGBT movement, and warnings that Romania’s Christian identity was being attacked by “secular forces”.
So far, European anti-vaxxers are far from real political power. Despite the AfD’s success in Germany, it has little prospect of entering government because no other party will form a coalition with it.
But it is different in the US where the political influence of sceptics was growing even before Kennedy was tapped to work in the Trump administration.
Republican lawmakers in New York, Virginia, Connecticut and Mississippi have introduced bills that would allow more people to waive routine vaccinations for their children. Oklahoma and Alabama are considering proposals that would require parental consent for any jab administered to minors.
The Republican governor of West Virginia, Patrick Morrisey, signed an executive order in January directing the state to allow parents to claim religious and moral exemptions from school-mandated vaccinations.
In Florida, Joseph Ladapo, a noted vaccine sceptic, was appointed surgeon general in 2021. The following year, he recommended children not be vaccinated against Covid-19, contradicting the advice of federal public health leaders. In 2024 he called for a halt in the use of mRNA vaccines against Covid, for adults as well as children, citing widely debunked claims that contaminants in the vaccine can permanently integrate into human DNA.
In 2023, the Centers for Disease Control and the US Food and Drug Administration sent a letter to Ladapo rebuking him for spreading misinformation about Covid vaccines. “It is the job of public health officials around the country to protect the lives of the populations they serve, particularly the vulnerable,” the letter said. “Fueling vaccine hesitancy undermines this effort.”
Official statistics show that the routine childhood vaccination rate for kindergartens in Florida fell since Ladapo became surgeon general. In 2021, it was 93.3 per cent. By 2023, the last full year for which statistics are available, it had dropped to 90.6 per cent. Ladapo’s office did not respond to a request for comment.
Kennedy’s confirmation hearing also revealed how much anti-vaxxer sentiment had penetrated the Republican party. Three senators — Rand Paul of Kentucky, Markwayne Mullin of Oklahoma and Tommy Tuberville of Alabama — all praised Kennedy for questioning vaccination.
Paul said infants did not need to be given a jab against hepatitis B at birth. Mullin said: “I don’t understand why we can’t question the science.” And Tuberville, a former football coach, said his son and daughter-in-law had “done their research” and were not going to have their child immunised on the recommended schedule.
Vaccine scepticism has a long tradition in the US. In 1721, Boston was swept by an outbreak of smallpox, which prompted Cotton Mather, a Puritan minister, to undertake one of the American colonies’ earliest experiments with public inoculation.
But Mather was targeted by angry mobs who feared the disease would spread from patients who had received the jab. One critic threw a bomb into his house with a note saying: “You dog, and damn you, I will inoculate you with this!” It failed to explode.
Later, as vaccines replaced live smallpox inoculations, public acceptance grew. But opposition continued in some quarters, which coalesced in the Anti-Vaccination Society of America, formed in 1879. It pushed for homeopathic alternatives and launched legal challenges against vaccine mandates.
Helen Murphey, a postdoctoral scholar at Ohio State University who researches populist political culture and disinformation, says such movements are almost unavoidable in a liberal democracy.
“I think with any initiative [of this kind], there’s going to be a discussion about what measures are needed in order to protect public health and when that impinges theoretically on individual liberty,” she says.
In the 20th century, anti-vaxxers in the US tended to be on the left of the political spectrum. “The stereotype of the time was that it was left wing, crunchy, hippy-dippy,” says David Gorski, professor of surgery and oncology at Wayne State University School of Medicine, and an outspoken critic of the anti-vaccine movement.
That changed, he says, after a measles outbreak at Disneyland in 2014-15, which prompted the state of California to limit non-medical exemptions from vaccine mandates for children.
“During the campaign for and against I noticed that anti-vaxxers were using a lot of language that would appeal to the right, you know, freedom, government over-reach, parental rights,” he says. “There was this rightward shift.”
In the ensuing years, says Brown University’s Jha, an increasing number of Republican counties became sceptical of immunisation programmes. “That’s a terrible trend in the long run because once you tie political identity to vaccine confidence, then you’re no longer asking people to be confident in their vaccines,” he says. “You’re almost asking them to change their political stripes, which is, of course, a much harder task.”
Social media has provided a space for people with unconventional views to coalesce. In the process, many became increasingly sceptical of the advice of public health professionals.
“Social media has made it easier for those who want to spread mistrust [of the medical establishment],” says Schafer. It’s one of the reasons why “mistrust of the expert community has moved to outright hostility”.
Some experts say that part of the problem is vaccines became a victim of their own success. Evidence shows that vaccines are safe and effective, having helped to prevent millions of deaths around the world. “There is now more of a discussion in the general public about whether we even need them, because we’ve never seen mumps, we’ve never seen rubella,” says Rupali Limaye, an associate professor of George Mason University’s College of Public Health. “People say, ‘You’re asking me to take this vaccine against hepatitis — but I’ve never seen hepatitis in my life.’”
But she also blames the spread of online misinformation. “Twenty years ago you’d go to your doctor for information about vaccines,” she says. “Now they go to social media.” Add to the mix a growing distrust towards state institutions and “this idea of liberty, where you as the government can’t tell me what to do”.
It is unsurprising, then, that vaccine hesitancy is on the rise. Ratner, the infectious diseases specialist, says 95 per cent or more of any particular population needs to be vaccinated with the MMR jab to ensure effective protection against the spread of measles. Prior to Covid that level was reached, he says. But “we now have a large number of states in the US where the kindergarten MMR vaccination rate is under 90 per cent”, he says.
Texas is experiencing its worst outbreak of measles in nearly 30 years. State health officials say the cases have been concentrated in a “close-knit, under-vaccinated” Mennonite community in Gaines County, in the rural west of the state. “That’s a county with one of the lowest vaccination rates in Texas,” Ratner says.
Other diseases are rearing their head. Last year there was a fivefold increase in the incidence of pertussis, or whooping cough, in the US, according to official data. In 2022, a case of paralytic polio was confirmed in an unvaccinated adult in the state of New York, the first known US case in almost a decade. “That’s in large part due to decreasing vaccination rates,” Ratner says.
If the hesitancy persists, Limaye at George Mason University predicts more outbreaks. “And what that means is that we will see more people in the hospital. We will have more deaths that are attributable to vaccine preventable diseases.”
That is one of the reasons why Kennedy’s confirmation is causing such angst among public health officials.
Kennedy himself stressed during his confirmation hearing that all his children were vaccinated, adding that he supported both the measles and polio jabs. “I believe that vaccines play a critical role in healthcare,” he said.
In a meeting with health department employees last week he also held out an olive branch to his critics. “Let’s all depoliticise these issues and re-establish a common ground for action, and renew the search for existential truth with no political impediments and no preconceptions,” he said, adding: “I promise to be willing to be wrong.”
But Jha is not convinced. “If you’re a parent you need high-quality, trusted information about why you should be vaccinating your children,” he says. “And if that’s not coming from the government, then it creates a real vacuum for other people to step in.”
Ratner warns of the fragility of the scientific advances made over the past 100 years in pushing back diseases such as measles, whooping cough and diphtheria.
“This march of progress is not preordained,” he says. “And the fallout from any policy decisions [on vaccines] will be felt by the most vulnerable — in this case the children.”
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