US Health & Human Sciences Secretary Robert F. Kennedy Jr’s push to remake the US vaccination schedule is on hold after a federal judge’s decision last month, but he’s still wielding his power to affect which shots are received by children in poor countries, reports POLITICO.
Kennedy says the children are getting obsolete shots with dangerous ingredients that America has long since phased out, and is stubbornly holding up $600m Congress appropriated for the vaccines to pressure Gavi, the international humanitarian group that distributes them.
“Gavi has refused to provide the United States with the specific data, studies, or detailed accounting of how US funds are used,” Emily Hilliard, senior press secretary at the Health and Human Services Department, said in a statement to POLITICO.
The US co-founded Gavi a quarter of a century ago to get vaccines to the world’s poorest nations, and Congress has long provided a big chunk of its budget. But Gavi says it hasn’t received the money it’s due for the current and last fiscal years, which makes up about 15% of its budget.
The funds are due to expire on 30 September if the Trump administration doesn’t release them.
The group provides vaccines for 20 diseases, including measles, malaria and polio, to more than 50 low-income countries across the globe.
Gavi’s funding is officially controlled by the State Department, but Kennedy’s influence shows how his sceptical views about vaccines are still affecting government policy.
That’s despite a Boston federal judge’s decision last month declaring that most of the vaccine policy changes Kennedy had ordered in the US, including a significant reduction in the number of shots recommended routinely for children, were invalid because he hadn’t followed his department’s own procedures.
Kennedy has long believed, in defiance of research showing otherwise, that some vaccines have dangerous side effects.
Susan Collins, the chair of the Senate Appropriations Committee, told POLITICO that her staff has been in touch with Gavi about the US funding and that she plans to send a letter to Secretary of State Marco Rubio urging him “to quickly move to provide the US contribution to Gavi, consistent with congressional intent”.
Collins said Gavi has helped vaccinate more than 1bn children in the world’s poorest countries and purchased more than $12.5bn of US-made goods and vaccines to achieve that goal.
Advocates for Gavi say the withholding of funds will cost children’s lives. They also say the vaccines the group uses are safe and are better-suited to the challenges of immunising people in the developing world, where refrigeration is spotty and it’s harder to get people boosters, than the vaccines used in the US and other wealthy countries.
Hilliard said Gavi has thus far declined to develop a plan for phasing out a mercury-based vaccine preservative called thimerosal that Kennedy believes is likely to cause autism. The Trump administration has asked Gavi to stop using vaccines that contain the preservative.
Kennedy wrote a 2014 book arguing that the preservative is dangerous, Thimerosal: Let the Science Speak, and moved to phase it out in the US – where it is still used in some flu shots – last year.
The Boston judge’s decision reversed that decision, finding the Kennedy-appointed panel that had advised the change was not properly appointed.
Given concerns about the safety of thimerosal, the CDC worked with vaccine-makers in the 1990s to phase it out in the US, and it was largely removed from paediatric vaccines offered to Americans by 2001. But at the same time, the agency has said the preservative is safe.
Thimerosal is used in several vaccines Gavi provides, including in a shot against five diseases, according to the group’s former chief executive, Seth Berkley. He said many developing countries lack adequate refrigeration to store vaccine vials containing a single dose, which are often used in America, and don’t contain thimerosal.
But developing countries often use vials of multiple doses, which take less refrigeration space but in some cases contain thimerosal to prevent bacterial contamination.
Without the shots with thimerosal, “kids would go without vaccines – which maybe is the desire – but that would lead directly to deaths from those diseases”, Berkley added, referencing the commonly held view that Kennedy’s goal is to broadly reduce vaccination.
During testimony before the Senate Appropriations Committee last week, Kennedy cited a different concern about a vaccine that Gavi distributes to combat three serious bacterial infections – diphtheria, tetanus and pertussis (whooping cough). Kennedy said it had been discontinued in the US because it was causing brain injury.
“They’re still giving it to 161m African and Asian children a year,” Kennedy said in response to a question, adding that Gavi had told him it didn’t want to use a newer vaccine, which he called safer.
While a study conducted in the late 1970s in the United Kingdom linked the shot in rare cases to permanent brain injury, more recent studies haven’t found evidence of it, according to the World Health Organisation. But the US discontinued it in 1997 amid those concerns.
Gavi said in a statement that it continues to use the shot because it offers longer lasting protection than the one given in the US and other higher income countries. The shot Gavi uses also requires fewer doses than the one used in America for protection against whooping cough.
“The vaccine is safe and effective and estimated to have saved 40m lives in the past 50 years,” Gavi added.
Berkley, an American infectious disease doctor who led Gavi for more than a decade and spoke to POLITICO in his personal capacity, said the WHO recommends the shot Gavi is using because it helps avoid outbreaks of whooping cough in places where access to healthcare services is limited, and where giving booster shots is more logistically challenging.
But President Donald Trump withdrew from the WHO, an arm of the United Nations, in January.
Kennedy said his health department and the State Department are also concerned Gavi would funnel US funding to the WHO, and that Gavi has refused to say whether it would do that. Both Gavi and the WHO are based in Geneva, Switzerland
Gavi declined to comment, but Sania Nishtar, its CEO, said the lack of US funding combined with cuts from other donors has hit Gavi’s malaria programme the most. Gavi has helped deliver 39m deliver 39m doses of a new malaria vaccine to 25 African countries where the disease is endemic and has been killing mostly children under five years old.
Nishtar estimated that tens of thousands of children would die due to the cuts.
In its 2027 budget request, the State Department said any future funding for Gavi for 2027 “is contingent on the organisation making necessary reforms and meeting certain benchmarks on vaccine safety”.
Politico article – RFK Jr. is holding up $600M in vaccines for poor countries (Open access)
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