When President Bill Clinton collaborated with a two -fold congress to perform a federal program to guarantee vaccines for poor children, they agreed that the authority should rest on buying drug makers with the health secretary. The clients of the bill did not believe that an extremely vocal critic of vaccines would arise as a candidate for the role.
That critic, Robert F. Kennedy Jr., is coming for the Senate for confirmation hearings this week. If confirmed, he would have the authority to limit or even cut contracts with the makers of vaccines for more than half of the children of the country among the vaccines of $ 8 billion for children.
The program is credited for increasing national vaccination rates and protects nearly 38 million children with a low income and working class against diseases such as polio, measles, whooping cough and chickenpox.
Mr. Kennedy said that he would remove vaccines from no one, but he has a long history of questioning the safety of vaccine. The far -reaching authority that he would exercise over the vaccine policy has become increasingly worrying for experts in the field of public health, researchers and legislators of both parties.
Some architects of the program try to persuade senators to resist his nomination.
“I think he is dangerous for children's health,” said Donna E. Shalala, Mr. Clinton's health secretary and a former Democratic congressman, in an interview. She said she had spoken with Republican senators who have expressed unrest about Mr. Kennedy, but would not call them.
Confirmation hearings for Mr. Kennedy start on Wednesday for the Senate Finance Committee and will continue on Thursday for the Senate Health, Education, Labor and Pensions Committee. The back-to-back sessions will give senators of both parties the opportunity to ask Mr. Kennedy, raised questions about how he would supervise the major health authorities and the vaccine policy of the nation.
The laws have already started asking questions about which authority the health secretary would have about vaccines. At a round table about vaccine policy of senator Bernie Sanders, regardless of Vermont, Senator Lisa Blunt Rochester, Democrat van Delaware of Delaware, asked last week,: “What are the protection and what are the ways in which someone could come in and an impact could be about Reducing vaccine use? “
Experts told the senators that the authority included the executive of the power over approvals of vaccine and the use of the prominent position that may be anxious or things that are not true.
A spokeswoman for Mr. Kennedy, Katie Miller, refused to respond directly to a question about Mr Kennedy's vision about the children's program.
For decades, Mr. Kennedy has sown doubts about the safety of vaccines and their ingredients. In 2021 he asked federal officials to withdraw the authorization of all coronavirus vaccines at a time when thousands of Americans died of Covid every week.
Mr. Kennedy has also worked for years on lawsuits who claim that Merck's vaccine against HPV, an important cause of cervical cancer, caused injuries. Records released prior to the confirmation hearings also show that he intends to keep his financial interest in keeping vaccine disputes if he is confirmed.
His activism has made legislators uncomfortable in both parties. Various Republican senators, including Mitch McConnell from Kentucky, Lisa Murkowski from Alaska and Bill Cassidy from Louisiana, have suggested that they are on the fence about how to vote.
Mr. McConnell, a survivor of Polio and former Republican leader, has said that everyone involved in “efforts to undermine the trust of the public in proven healing” will take care of the confirmation of the Senate. Mr Cassidy, a doctor and chairman of the Help Committee, did not say how he will vote. Mrs. Murkowski told CNN that she was worried and added: “Vaccins are important.”
The program for vaccines for children was established in response to outbreaks of measles that disproportionately influence bad children who could not afford vaccinations. It now protects against 19 diseases, according to the Centers for Disease Control and Prevention.
The law that the program has adopted indicates the health secretary on contracts to buy millions of vaccine doses, including the authority to enter into the agreements, to change or refuse. Since the start of the program, drug makers have delivered 71.5 billion doses to around 37,000 medical care providers in the United States and its territories.
Federal officials “Check the entire means of delivery and distribution,” said Sara Rosenbaum, a professor Emerita of Health Law and Policy at George Washington University, who was asked by the Clinton administration to build the program.
“Who would have thought it was a problem to give the secretary this kind of power?” she asked.
Some defenders of the program are worried that it could only endanger the vaccines program if Mr. Kennedy takes the lead.
“People are very nervous about speaking out loud things because they don't want them to happen,” says Richard Hughes IV, a lawyer who represents vaccine makers and is a teacher at George Washington University. “But these are things that can happen very well.”
Lawyers who specialize in vaccine policy pointed to other areas where the health secretary of the nation authority has about vaccines. One is the vaccine compensation program, which was established in 1986 to protect vaccine makers against liability and to create a court system to compensate for people who are damaged by vaccines.
Although Mr. Kennedy has suggested that the liability shield offers stimuli to vaccine makers to cut the corners, he would not have any authority to remove it – that lies with the congress. However, the health secretary can add injuries to a table with damage that is assumed to be caused by vaccines. The secretary can also add vaccines or remove the reach of the court.
As a civil servant above the Food and Drug Administration in the Executive Chain of Command, the secretary could encourage the agency to pause or withdraw the approval of established vaccines or to withhold approval from those looking for authorization.
“Those are real possibilities,” said Denise Hill, a lawyer in Iowa who specializes in vaccine legislation. “And if you had asked me five, 10 years ago, I would say it will never happen, but now I can't say that with certainty.”
Mrs. Hill said that it would also be possible for the Trump administration to try to set the conditions for the children's vaccine program, such as dropping his mandate for students who come in to be immunized.
The secretary would also have the authority on an influential advisory panel on the CDC, called the Advisory Committee for Immunization Practices or ACIP, the Commission could be dissolved, according to Mr Hughes. The secretary can also re -visit vaccine safety issues and reject the recommendations of the committee.
That committee tends to influence policies at state level, doctors and private insurers. But it has more direct authority on which vaccines are distributed by the children's program. Dr. Walter Oenstein, who led the CDC immunization programs when the children's program was started, said he was worried that Mr. Kennedy could change the composition of the committee.
“There is the potential that they can really put a considerable number of anti-vaccine people in the ACIP, and that would have a number of potentially negative effects, in terms of changing current recommendations,” Dr. Earenstein. “It could mean that vaccines would not be provided via the Vaccins for Children program.”
Mrs. Rosenbaum, who helped create the system, said that vaccines covered by medicaid and the costs of managing them decades ago. Yet many doctors did not want to go to the problems to pay in advance to keep vaccines in their offices.
Mrs. Rosenbaum said that the system that they built was revolutionary because it enabled the health secretary to negotiate prices with vaccine makers and to have the doses sent directly to thousands of providers.
The program has been expanded to cover working class -families above the Medicaid income limits that depend on chip or the child insurance program for children. These programs cover around 38 million babies, children and adolescents, including those who rely on Indian health systems.
Thirty years later, Mrs. Rosenbaum, as Mr. Kennedy is confronted with confirmation, people who are familiar with the program have assumed that it can be a target if he is confirmed. “For no reason, people did not respond with alarm,” she said.
