Bulwark Takes - RFK Jr. Cuts America’s Childhood Vaccine Schedule
Episode Date: January 6, 2026JVL and Jonathan Cohn give their take on the shocking changes coming from Robert F. Kennedy Jr.’s Department of Health and Human Services. The federal government is now recommending fewer vaccines f...or American children, including RSV and Hep B, while flu, COVID-19, and rotavirus vaccines move to “shared clinical decision-making.” What does this mean for parents, pediatricians, and public health? How could it affect vaccine access, liability, and supply? And is this just the first step in a larger anti-vaccine agenda? We break it all down.
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Hello, everyone. I'm JVL here with my bulwark colleague, Jonathan Cohn, and we have news coming out of Robert F. Kennedy Jr's Department of Health and Human Services. They have rejiggered the vaccine schedule for American children. They are downgrading it from a recommendation of 17 vaccinations to 11 vaccinations. They're cutting out a bunch of things, leaving some in.
Jonathan, this is all, I mean, it's slightly confusing, and there are some nuances that we're going to get into.
But the very bottom line is, as of now, the government is going to recommend fewer vaccines, which may make it harder for people to get their kids vaccinated to all the stuff that they would have gotten vaccinated a week ago, correct?
Correct.
Yes.
I mean, I'll just take off some of the ones here that are no.
longer covered. R.S.V. I remember the days before the RSV vaccine. Miserable. Meningococcal disease. Hep B. Hep B. These things are
now out. I think chicken pox and polio and MMR still in. Yay. Yay. You could still get your measles
vaccine. So talk to me, Jonathan. Was this, first of all, was
this expected or is this a surprise? Yeah, no, it was totally expected. They've been building up to this
for a while now. You know, if you remember back in early December, there was this big meeting of
the advisory council that it's the official CDC committee of outside experts that, you know,
makes recommendations to the CDC director about what America's vaccine schedule should look like.
And at that meeting, and I remember that committee has been, you know, replaced, right? It used to be
all these very prominent, outside experts, you know, widely respected scientists.
RFK Jr. came in. He sacked all of them. He stacked the committee with people who in one way
or another were sympathetic or had expressed sympathy to at least parts, if not all of his
anti-vaccine agenda. And I do call it an anti-vaccine agenda, even though he does not call
it that. And there was a presentation there that said, hey, you know, we give all these vaccines,
we give 17, you know, we recommend 17. And we shouldn't do that. It's too many. And they
said, look, there's a country abroad, Denmark that recommends only 10, 11, the way you count
these berries on what method you use, but we'll go with 11. And we should do what they do. And it was
then reported that they were gearing up to make the announcement right before Christmas. They held off
on it. It wasn't clear, sort of conflicting accounts, both officially and unofficially, was this a
political move because Trump wanted to announce some other things on that same day, where there
legal concerns because you know about how this was being rolled out what you know what was being
changed because you can't just despite what how the trump administration frequently acts you can't
just snap your fingers and change a policy like this um but i guess whatever legal concerns
they thought they had they've decided they have overcome and so now we have this new set of
recommendations yeah it's just great hHS also going to say that vaccinations against flu the flu shot
COVID-19 and rotovirus, they are going to be now shared clinical decision-making, meaning that if
you want to get those, you can't just, like, show up at your pharmacy to get them. You now have to
go in, see your doctor, and ask for it. One of my questions, Jonathan, is to what extent this is
going to really restrict access. So obviously, for the ones we just talked about, you know,
Like, you are now going to have to go and seek out the vaccinations in a slightly more complicated way.
The HHS said, as part of their announcement, that the insurers will continue to cover these vaccinations.
But there's very little detail on this statement as far as I can tell.
How does the Department of Health and Human Services know what health insurance companies will or won't do?
It's all very murky.
and, you know, we're waiting to see more details on this.
And, you know, what it looks like where you live and getting these shots is going to depend a lot.
I mean, it's actually CDC doesn't make binding recommendations, right?
I mean, they kind of make these recommendations.
It's states who make these sort of recommendations within states about what you get
and what you can get a pharmacy versus what, you know, you need to get a prescription for.
And then insurers can make their own decisions.
There are certain things that are required to cover.
You know, there are various regulatory tools that HHS has,
for requiring certain kind of preventative medicine has to be covered without cost sharing.
So it's a little murky right now exactly what this is going to mean.
And we're waiting all of us to see what details they come forth with and how this all shakes out.
And we've seen in the past, like when they change the recommendation from the COVID vaccine,
they sort of announced, it, you know, Kennedy made this very big splashy announcement
on video that they were sort of withdrawing it.
And then it turned out, well, they weren't exactly withdrawing it.
And then they changed the recommendation a few times.
And the way it kind of shook out, on the one hand was, you know, a lot of insurers said, hey, we're just going to keep doing what we were doing before.
You know, a lot of states said, we're just going to keep recommending what we recommended before.
We're just not going to listen to CDC or HHS.
We don't even, you know, we're going to go with what we were doing before.
But we also saw when that happened, not every state did that.
And there were all kinds of reports right away, people trying to get their COVID vaccines.
Even people who fell within the groups that CDC had said, you should get the COVID vaccine because you were high.
risk. And they would go to the pharmacy, like so many people do now, to get your shot. And the pharmacist
would say, oh, you know, you can't get this unless you get an actual prescription. And it wasn't actually
clear if that was actually true. There was just so much confusion going on. Right. That fewer people
ended up getting the vaccine as a result. So a lot of this is going to depend like so much else in
American life, where you live, because we are now breaking down in ways where fundamental rights and
freedoms very drastically based on whether or not you live in a red state or a blue state. That's
great. Nothing bad has ever come of that. And I would say it does seem to me that the end goal here
is not to let people opt out of vaccines, right, which was essentially was the thin end of the
wedge for the anti-vax movement. They were like, we just don't want to be told that we have to
vaccinate our kids. You know, we don't want, we want our kids to be able to enroll in public schools,
without being vaccinated.
And that sort of sounds like my body, my choice.
But it does seem like the larger project is,
no, we want to stop other people from getting vaccinated.
And the part, you and I talked about this offline,
the thing which I keep coming back to is
what malpractice insurers will allow providers to do.
Because if you live in a state where the state will not recommend a vaccine
and you're a provider,
you know, malpractice insurance is phenomenally expensive.
It's the single biggest cost for medical providers in their industry.
Are those insurers going to allow providers to prescribe a vaccine, which their state does not recommend?
Would they be allowed to administer it?
I mean, again, we just don't know what this is going to look like.
And I don't know.
Do you have any thoughts on this?
Yeah.
So I will say, first of all, that.
question of sort of private malpractice insurance and what those carriers tell their practicing
physicians is a really interesting one. I don't know the answer. We haven't, you know,
that's sort of a people haven't even started talking about that yet. It's absolutely a really
good question to answer. You know, what we do know is that liability is a really important issue
in vaccine production for the manufacturers, right? And, you know, you know, you know this history,
but for a long time, you know, the vaccine makers were subject to any kind of, you know,
the same kind of lawsuits as anyone when the, and there would be reports of vaccine issues.
injuries, people would go to jury trials and they got these very big awards. And it would frequently
turn out later on that there really wasn't anything there. But it's, you know, it's not hard
to make one of those cases in a courtroom. Now every once in a while, you're going to get a
sympathetic jury, a sympathetic kid or something that's thing happened to them had nothing to do
with a vaccine, but, you know, jury's going to want to award money for it. So they created, as you
know, they created, we created this vaccine liability system where basically it's like a no-fault
system where we basically say to the manufacturers, you know, anybody who has anything that could
plausibly said to be a sort of, you know, a side effect that, you know, it's going to damage
from a vaccine. And, you know, it's like any medication, occasionally there are going to be
side effects. Occasionally there are going to be serious consequences, health effects.
You, if you're, you can show that you had that condition happen. You just file, you show it,
goes through a review, and then you can just get paid right away. You don't have to go through
a whole lawsuit. So it speeds up the process for you and you're guaranteed money. And the vaccine
makers don't have to constantly labor under this specter of a giant judgment against them
that's going to turn the whole business and something less profitable. And that's something
society has an interest in because, you know, if you make vaccines, you can make money lots of
other ways. And we don't want shortages. So this was the arrangement we. And vaccines only work
if they're broadly distributed. Like this is a classic public health thing, right? Because we're
talking about communicable diseases. It's a public good. You know, one of the possibilities it was raised
and was raised by a lawyer who was an advisor to Kennedy,
who was sort of the most famous critic of vaccination,
who said that when vaccines come off the schedule,
as several just did, right?
That's what the decision does.
We pulled those vaccines off the schedule.
It will be, he thinks he was making the argument
that that means that they might not fall under this liability shield for manufacturers,
and we'd be back to a world where manufacturers were in that.
Now, I don't know if he's right.
There's some, it's a legal argument.
I've heard lawyers who say, no, he's wrong about that, but, you know, I've heard lawyers
who say, yeah, he might have the case. Who knows? But again, it adds to the unknowns here of threatening
a vaccine availability by threatening the supply. We wouldn't have enough vaccines. And this has
happened before. So it's not like a purely hypothetical. We could be in a situation where you want
to get your kid inoculate, you know, against RSV or Hep B or whatever. And you can't because
there aren't any vaccines in supply. I mean, while we're talking about, you know, ratchets turning and
thin ends of wedges. Is this the beginning, or is this the end? Is the anti-vax project over now?
They got what they wanted? Or do you think a year from now, two years from now, we're going to
revisit, say, MMR? Oh, I don't think this is over by any stretch. I mean, they clearly, this is,
this is a big step they took, and I think this was one they've been eyeing for a while, but there
is more to come. You know, it could be anything from taking, you know, what we were just saying
about that compensation program, that liability program,
If they add autism to that, you know, they say if you have autism, your child has autism,
you can apply for an injury reward under this system.
That could bankrupt that whole program because there's just, you know, so many cases of autism
out there.
And just to be clear, anyone watching this, there's no link, you know, we've investigated this
exhaustively and found no link between vaccines and autism.
But, you know, that would be something they could do just as one example.
There is more to come.
I mean, the idea that this is not.
about that this is simply giving more choice. It doesn't hold up to even casual scrutiny.
And, you know, and remember, you know, people, you know, they talk about, well, now it's going to
be shared decision making. Well, it was always shared decision making, right? I mean, you could
always go to your doctor and talk about it. And lots of people didn't get some of these newer
vaccines. But this is about putting a thumb on the scale against vaccines with no scientific
backing. And again, I just, you know, I'm a process guy. I care about this. You know, to me,
The reason we have a CDC, the reason we have these scientific advisory communities is that we want to make these decisions carefully and with deliberation in a transparent way and taking the best possible evidence out there.
And that doesn't always lead to the right decision, but the process, I think, is the right process.
And that has been completely jumped.
I mean, this is not how this decision was made.
This was basically some of Kennedy's handpicked people putting up this idea and then greenlining it.
And it's just, it's very sad because there was a time when the CDC was the gold standard for these kinds of decisions.
And now you have, you know, lots of people basically walking around saying, don't listen to the CDC, which is just a very tragic thing.
So this is my, this is my last question for you.
And this is a, I have a version of this conversation with basically all of our colleagues at the bulwark, which is how are we supposed to go back from this?
So, I mean, let's just pretend three years from now.
there's a new president, maybe it's a Democrat, maybe it's a Republican, but this person
is a normal human being and they decide, hey, we got to undo all this stuff. This stuff is
crazy town. We're not going to, and they try to bring all the experts back to the CDC. They
try to reinstate the vaccine recommendations. You can't have a rules-based system which only
exists like every four years, can you? Like, at some point, if it is in constant flux like that,
and, you know, it depends on what 40,000 voters in Wisconsin do every four years as to whether or not
a system of vaccinations is recommended by the federal government, that just destroys the entire
public health thing, doesn't it? I mean, do you see one driving at here? Like, you know, can you say,
like, oh, we can trust the CDC
every four years.
It's just, you know, then
in the other times, that's when the rest of the world
understands that you can't trust the CDC
because the crazy people are in charge of it.
If that's the arrangement, then
you don't have a CDC
to begin with, really. I mean,
yeah. No, no, no. You and I
have talked about this, online,
offline, and I've been thinking about this
because I actually think I owe you a Slack message on this.
You would hit me up on this. My not
great answer, I'm not going to pretend this is
the greatest answer in the world, is that you can rebuild it. Part of that, though, is really
making sure this current period is both seems and is thought of as an outlier. And I think
that's why it's so important to pay attention to you. I mean, this is going to keep happening
over the next however long RFK Jr. is in charge of HHS and the Trump administration and the
Republican Congress are willing to give him this much room. We're going to keep seeing decisions
like this. And I think to the extent that we write about them, we talk about them, and we hold
them up to scrutiny, we say, hey, this is not what a real scientific consensus would say.
This is not what people who you can trust would say. That makes it possible three years from now
or whenever it is, that when you bring in, you know, a more sort of respected, more knowledgeable,
more trustworthy group of people in charge, you can say, look, that was, we said all along,
we told you that that's not how this is supposed to work we're back to doing things the way
they should be run you need that to kind of keep that drum beat up so people understand
this was something outside the lines this was this was the this was the exception to the rule and
then you know beyond that you just have be the exception why would this and this is a very serious
question yeah yeah yeah yeah i know why would this be the exception we have a fairly large
percentage of America that affirmatively wants this. And they have all coalesced in one political
party. They used to be spread out across the spectrum. So they would cancel each other out. Some were
Democrats. Some were Republicans. All the people want this for Republicans now. And so they are
an important constituency within the party. Why would they not get what they want whenever they are
in power? You know, I guess I am hopeful.
I said hope, not expect.
But I am hopeful that as people see the consequences of this, that more and more turn against it.
And, yeah, you're going to have some pretendage of the country that wants this.
But if it's a small percentage and, you know, going down the road, we have voices, you know, political defeats for the party that stands for this, that maybe, you know, we snap out of this.
Jonathan, a million people died from COVID-19 in the greatest public health failure in this.
nation's history, and three years later, this same country reelected the guy who did that
failure.
So I don't know, man, like anything that's like, well, people will see the bad outcomes and
then we'll, you know, change course.
Dude, I just don't see that.
I don't think that's how America works.
I guess I have more faith.
I'm not going to pretend that I have good reason for that faith, but I'm a hopeless
optimist so i'm gonna we'll see where we are in a couple years guys thanks for sitting with us
uh i mean spoiler i'm going to wind up being right on this one hit like hit subscribe follow
us as we continue the rocket's led to hell hello 2026 we're back with the bulwark good luck america
