The United States was once a world leader in research, development, and policy. Robert F. Kennedy Jr, the US Secretary of health, is now undermining America’s vaccine program and escalating vaccine skepticism.
Two weeks ago RFK Jr sacked all members of the Advisory Committee on Immunisation Practices, who were responsible for reviewing the most recent scientific evidence on vaccines. selected a new panel after RFK Jr alleged conflict of interest.
RFK Jr announced on Wednesday that the US will stop funding Gavi’s global vaccine alliance because “when science was not convenient today, Gavi ignored science”. RFK Jr questioned about the safety of COVID vaccinations for pregnant women as well as the Diphtheria, Tetanus, and Pertussis vaccine.
Lyn Redwood , who was the first to draw RFK Jr. into vaccine scepticism , shared disproved claims that a chemical in flu vaccines called thimerosal is harmful.
As debunked claims gain new levels of legitimacy, the undermining and reversal of regulatory, advisory, and funding processes will have a global impact. These impacts are slow and subtle.
What should we think of the latest funding cuts and claims?
Thiomersal can be a distraction
The preservative Thiomersal, or Thimerosal as it is known in the US, prevents the contamination of vaccines in multi-dose vials by bacteria and fungi. It is , a salt which contains a small amount of mercury.
In Australia, Thiomersal has been phased out as a vaccine preservative. It is still used for the Q-fever vaccine.
When single-dose vials of thiomersal are too costly, other countries use multi-dose vials.
In the US, only 4% adult influenza vaccines are thiomersal-free. Focusing on the removal of vaccines that contain thimerosal would be a distractor for the committee.
COVID vaccines in pregnancy prevent severe illness
On Wednesday, RFK criticized Gavi for encouraging pregnant women to get COVID-19 vaccinations.
Even a mild COVID-19 infection can double or quadruple the chances of miscarriage .
Vaccination during pregnancy can be safe, and reduce hospitalisations of both pregnant women and infants.
In Australia, women who are pregnant and have not received the primary COVID-19 vaccination are advised that they should receive one. They are generally not recommended to get a booster, unless they suffer from underlying risk factors or want to. This is because of population immune.
The COVID-19 vaccine recommendation should be updated to reflect changes in disease risks and vaccine benefits. This does not mean that previous decisions were incorrect or that vaccine boosters have been unsafe.
RFK’s criticism of COVID-19 vaccinations during pregnancy could influence decisions made by individuals in other countries even when pregnant women who are not vaccinated are encouraged to consider vaccination.
The vaccine against diphtheria tetanus pertussis is safe
RFK Jr. also questioned safety of the combined DTP vaccine, as he announced that the US would no longer be funding Gavi.
Three community-based studies conducted in the early 2000s reported an association between the DTP vaccination and an increased risk of infant death.
A few studies have also shown an association with a higher risk for girls. This prompted a World Health Organization review on safety.
The data from real world studies can be confusing and difficult to interpret. Many of the same factors that affect whether someone is vaccinated are also associated with other health risk.
The WHO committee did not find any serious adverse effects when it reviewed all studies in 2014. The committee concluded that there was substantial evidence to support these claims.
What will the defunding of Gavi mean for vaccination rate?
Gavi, or the vaccine alliance supports vaccine purchases in low-income nations.
The US has historically contributed 13% to all donor funds.
RFK Jr. said that Gavi had to regain the trust of the public and “considered the best science available”, before the US would provide funding again.
Gavi predicted that in March, the impact of US funding reductions could result in a million deaths due to missed vaccines.
Could this happen in Australia as well?
Australia is fortunate that it has buffered these impacts.
The Australian Technical Advisory Group on Immunisation has a vaccine advisory group with people who have a deep understanding of vaccination. Our decision-making processes are robust, weighing evidence critically and making careful recommendations to the government.
Our governments are committed to vaccination. In mid-June, the federal government published National Immunisation Strategy with a Comprehensive Plan for further strengthening our program.
The federal government also announced A$386 millions to support Gavi’s work from 2026 to 2030.
All of this helps to keep our vaccine policies strong. They prevent disease and increase life expectancy both here and abroad.
To counter the potential influence of the US on Australia, governments, health professionals, and the public must be prepared to quickly tackle the misinformation and distortions that RFK Jr cleverly packages – with high-quality information.
Julie Leask is funded by the NHMRC, WHO and NSW Ministry of Health for research. Sanofi funded her travel to a meeting overseas in 2024. She receives consulting fees from RTI International, Task Force for Global Health and Task Force for Global Health.
Catherine Bennett has received funding from NHMRC, VicHealth, and MRFF for unrelated projects. She was a health lead for the Independent Inquiry Into the Australian Government COVID-19 response.
