Dr. Deborah Howery (2:43)

AmericasT, AmericasT from BBC News.

Unknown Commentator (2:47)

You hear that sound? Oh, I think when I hear that sound, it reminds me of money.

Justin (2:52)

We didn't start this war, but under President Trump, we are finishing it.

Dr. Deborah Howery (2:56)

This is a big cover up and

Mariana (2:58)

this administration is engaged in it. This guy has Trump derangement syndrome.

Justin (3:02)

I have four words for you. Turn the volume up. Hello, it's Justin in Bath in the English west country.

Mariana (3:14)

And it is Mariana in the worldwide headquarters of AmericasT in London.

Justin (3:18)

And we should say right at the start, we're going to be joined in a second or two by Deborah Howery. Dr. Deborah Howery, who used to work for the CDC, the Centers for Disease Control, resigned her position because of Robert Kennedy's leadership. We talked to her before. It's going to be very interesting to get an update from her what is actually going on at the moment. Because that is the point, isn't it, Marianna, that there has been, there seems to have been really quite a big spanner in the works of what RFK wants to do when it comes to vaccines.

Mariana (3:51)

Yeah, there has been. So a federal judge has blocked proposed changes that RFK Jr. Wanted to make to kids vaccines. He suspended a key panel which advises on vaccine safety. And this is a panel which RFK actually gutted last year and replaced with his own picks, many of whom are vaccine skeptics. The judge said in doing that that RFK failed to do the required quote. And this is what the judge said, rigorous screening when choosing panel members and had moved away from, quote, a method scientific in nature. In other words, the decisions were being made more on ideology than on science. To be clear, the proposed changes to vaccines included cutting down on the number of vaccines that kids get recommended shots for children from 17 to 11. And that includes vaccines for flu or for hepatitis B.

Justin (4:38)

And we should hear from Kennedy himself because he's on the Joe Rogan show recently. We can play a clip of that. I think the fascinating thing about what we're about to hear is he's talking about how he came to get the job and the closeness that there was then to Donald Trump. Because we're going to talk in a minute or two about whether Trump is fully on board with all of this at the moment. But here is Robert Kennedy claiming in a podcast that was recorded last month how he got the job and whether he thinks the president is on board for all of these things that he wants to do.

Robert F. Kennedy Jr. (5:13)

The first time he asked me whether I wanted to be hhs secretary. I said, I don't think so. I wanted to do some, I wanted to be maybe a health czar in the White House. And then I thought about it for a while and thought, no, I really won't be effective unless I'm in this agency and can actually get into the weeds. And it has 82,000 employees and the biggest budget in government and that would actually give me the power to change the system. And so then I went back to him and I said, you know, I want hhs. And he said, fine. And then he allowed me to appoint all of my sub, you know, agency heads, which no president has ever done with an HHS secretary in history. I don't want to say sound like, you know, but because of the great team that we have and because of the support of the president, we've been able to accomplish more in one year than I think any other HHS secretary has done in history in four years.

Justin (6:17)

That last claim, Mariana Rather put to one side by the judge's decision on vaccines, because whatever he might claim to have made in progress in other areas, it's fair to say at the moment on vaccines, it's all a bit of a mess. It's not clear that they've gone back to how they were. In fact, we'll discuss that with our expert in just a second second. But it's equally not clear what the immediate future holds because they're, they're appealing. I mean, he's, he's succeeded in throwing everything up into the air. Let's just put it like that. We, we don't quite yet know where

Mariana (6:49)

the pieces are landing. Yeah. And I think that, you know, we spoke about this. I, I remember when we were doing our predictions for the year, we were talking about sort of who might fall out of favor, who's in favor with Donald Trump. And one of the people that I spoke about was RFK Jr. Because if you actually look at polling and what it suggests in America, vaccines are generally quite popular. I mean, there's some very hardcore vaccine skeptics or even you might go as far to say sort of anti vaxxers, people who spread misinformation about vaccines. But that is a very loud and small minority of people. Actually on the whole, people in the US Kind of do want vaccines. And I wonder whether Donald Trump, Justin, will realize that there feels like there is a kind of tension here. Putting to one side the bits of the Maha Make America Healthy Again movement that are about, you know, healthy eating and well being and stuff like that, which is Broadly, actually quite popular. I think social media has popularized that kind of stuff a lot. But when it comes to vaccines, particularly when you are seeing the possible harm caused to people when they don't have it, you wonder if Trump might say, oh, hold up a sec, I'm not sure this is what the people who voted for me are actually worried about or what they want.

Justin (8:00)

And you could argue he's already saying it in a way. So he's asked recently, wasn't he, about what's going on in Florida where they're basically saying, essentially they want to say to Floridian parents, you take your own decisions. We're not suggesting that you need to have any kind of vaccines. If you want to have them, you can have them. And Trump was asked about that. And to be honest, he was pretty cautious, wasn't he? So this is at the end of last year.

Unknown Commentator (8:23)

I think you have to be very careful when you say that some people don't have to be vaccinated. It's a very, you know, a very tough position. So I'd give you an answer, I'll give you a feeling. But just initially, I heard about it yesterday and it's a tough stance. Look, you have vaccines that work. They just pure and simple work. They're not controversial at all. And I think those vaccines should be used otherwise some people are going to catch it and they endanger other people. And when you don't have controversy and at all, I think people should take it.

Justin (9:00)

He didn't separate out those vaccines that he thought weren't controversial from those that apparently are. But to your point, he has, and we've discussed this before, he has quite a fine set of antennae when it comes to when he's gone too far. Look at the ICE actions in Minnesota and the decisions he made there. Look at his view of abortion and the way in which he hasn't gone and done the things that the anti abortion people really wanted him to do. And I wonder whether this is another. I mean, we don't yet know, do we, Marilla? But this could be another of those cases.

Mariana (9:35)

Yeah. And it's important to remember that while Donald Trump himself has been accused of spreading health misinformation, there was that infamous bleach Covid presser that happened. He also was actually very supportive of vaccinations during the pandemic. It was like one of his big achievements. So it's kind of interesting when he talks about vaccines. Vaccines because like in some ways the most controversial, if we're going to call them that Vaccinations have been the COVID vaccinations because they were rolled out really quickly. And a lot of people there are a lot of founded concerns, but then also conspiracy theories and misinformation about them. And it's interesting that he doesn't name. I think that's what he means when he kind of says controversial, or maybe he's talking about the MMR vaccine and those false claims that are made about the link between autism and mmr. But he never goes as far exactly like you say, as. As RFK Jr. And actually he's pretty. He's pretty astute when it comes to. Yeah, finger on the pulse in terms of public opinion. But thinking of that, Justin, I mean, what does this mean for the midterms? Do you think that. Do you think that Donald Trump will say, maybe I need to sort of fall out with RFK Jr. Before the midterms?

Justin (10:38)

Because that would be a big deal.

Mariana (10:40)

It would be a really big deal.

Justin (10:41)

I think not, actually, because I think he's got enough on his plate already without having a whole load of angry Maha people led by Robert Kennedy.

Mariana (10:50)

Not happy with him on that front.

Justin (10:51)

Yeah. I don't myself, I'm here to be proved wrong, as I often am, but I don't at the moment see him, partly because he's not a big enough sacrificial lamb to win the elections, it seems to me, because that's not actually what people are voting on. So it's not going to make a massive amount of difference. But partly, also, I don't think he really wants to make that much of an enemy of him. I think he wants to maybe change him a bit from inside. And who knows whether it's possible to do that. We've discussed before the American Cabinet system. The cabinet secretaries do what the President tells them to do. Although Kennedy has been given this incredibly free reign, it doesn't have to be given it. It could be equally reined back.

Mariana (11:34)

Yeah. Yeah.

Justin (11:35)

So let us welcome back to the pod now, Dr. Deborah Howery, who is a former medical director at the CDC. She resigned back in August 2025. She said science and data were being censored and ignored. We talked to her in September of last year. And Dr. Howie, it's really nice to have you back. Thank you for sparing us the time.

Dr. Deborah Howery (11:54)

My pleasure.

Mariana (11:55)

In terms of this legal action. So why this decision has. Has been taken, made by a judge who, who brought this about, why did they do it? Did you get involved at all?

Dr. Deborah Howery (12:05)

I was definitely not involved in the lawsuit. But, you know, many physician organizations, including the Infectious Disease Society of America and the American Academy of Pediatrics, and they were concerned that what was done was going to harm children. The judge really set politics aside and just looked at was the law followed. And there's something called the Administrative Process act in the United States. And that's where you look at federal advisory committees. Did they follow how they select members, how they post and solicit public input, how they make recommendations? Do they follow science? And the judge found they hadn't followed the process.

Justin (12:47)

So at the moment, an average kid in an average corner of the United States is getting the same vaccines that they're used to or is not what's actually happening on the ground.

Dr. Deborah Howery (12:57)

So you're right, this can be very confusing. But right now, children should be able to get the vaccines that have been recommended all along by the American Academy of Pediatrics and the CDC prior to this new committee.

Justin (13:11)

Right. And just to make it plain, it's quite a long list. I mean, I remember from my time in the States having young children there, you couldn't go to school unless you had all these vaccines. In many ways much stricter than Britain. But basically the standard is at a standard American school. You do need to have them to turn up. That's been the case, hasn't it, for years, maybe even decades.

Dr. Deborah Howery (13:34)

So each state has different school requirements in the United States, and it's determined by the states. And different private schools may have different requirements. And what I would say about the US versus the UK is when you look at vaccine requirements, they're actually very similar, the U.S. and the U.K. denmark was the outlier that had far fewer vaccines than most of the European Union countries. And so Denmark was actually the outlier that had significantly less.

Mariana (14:04)

And on that point, Deborah, when it comes to the specific proposals, changes that the Secretary of State for Health and others were putting forward, talk me through those, because when we first spoke back last year, it was just when a lot of those movements were happening. Remind me exactly what they wanted and in your view, whether that matches up with the data and the science available or not.

Dr. Deborah Howery (14:29)

So they wanted to move a lot of the vaccines to shared clinical decision making. They probably actually would have taken them off the list, but I think there would have been so much pushback that they were moving vaccines to shared clinical decision making. That sounds okay, but really, doctors are already talking with patients and having these conversations. Shared clinical decision making means that you go over the risks and the benefits which you would with anything. It moves it off the Recommended list, though to this kind of extra list is what they were doing, making them likely not as important for schools. And also parents might then not think their child needs the vaccine and, and it might also impact availability and at some point insurance coverage. So we were concerned about longer term effects of this policy. It hadn't really taken impact yet, particularly with the lawsuit, but things like rotavirus flu, meningitis. I did a lumbar puncture, you know, a spinal tap in the er and I've seen people with meningitis. It's horrifying. And to think that, you know, we'd be moving meningitis vaccine off of a recommended list in this day and age is absurd.

Mariana (15:40)

Yeah, talk me through hepatitis B in particular and the issue around that and childhood vaccinations, what was being suggested?

Dr. Deborah Howery (15:48)

So they were moving it to a later start date around two months and making it shared clinical decision making versus recommended at birth. And in the United States, you know, decades ago, when they first, you know, were suggesting the hepatitis B vaccine, when they weren't giving it to everybody and only to high risk, they didn't see a significant reduction in hepatitis B cases. When they recommended for all, that's when they saw a 90% reduction in cases. And that's because you don't know who, you know, the status of a caregiver, you know, in a daycare or a school that a child could be exposed to. And so it was important to really have that universal hepatitis be vaccination recommendation. And Senator Cassidy has been a big supporter of that in the United States. He went around personally vaccinating. There's been stories on him around hepatitis because he has seen the impact on, you know, children that have had hepatitis

Mariana (16:49)

and the flu vaccination. What, what changes were possibly being floated about.

Dr. Deborah Howery (16:55)

So for the flu vaccination, you know, that was still, I believe, under discussion as to whether or not it should be recommended for children or not. But again, We've had over 100 pediatric flu deaths this year in the United States and 85% of those were un or under vaccinated. So I would suggest that if we have got a vaccine that can save lives, we should be recommending it.

Mariana (17:20)

And actually RFK is, he's spoken about this, so he's insisting that vaccines will still be available and haven't been withdrawn. Let's hear him speaking to CBS earlier this year about the flu vaccine in particular.

Robert F. Kennedy Jr. (17:32)

First of all, people should know we're not taking vaccines away from anybody. If you want to get the vaccine, you can get it. It's going to be fully covered by insurance, just like it was before.

Mariana (17:42)

But it is more difficult now for parents to get their children immunized for the flu. Right. They can't just go to a pharmacy. They'll have to consult with their doctor first.

Robert F. Kennedy Jr. (17:50)

You have to. You need to do shared decision making with your physician, which is how it would be.

Mariana (17:55)

So fewer people will get the flu vaccine?

Robert F. Kennedy Jr. (17:58)

Well, that may be, and maybe that's a better thing.

Mariana (18:01)

Based on what evidence? There are 280, 290 kids who died last year due to the flu. There's no evidence that any kids died or were harmed due to the flu vaccine. So isn't this inevitably going to lead to more children dying?

Robert F. Kennedy Jr. (18:16)

The Cochrane Collaboration, which is kind of one of the ultimate arbiters of vaccine safety and clinical data, has done an extensive meta review of the flu vaccine and they found that there is no evidence that the flu vaccine prevents serious disease or that it prevents hospitalizations or death in children.

Mariana (18:38)

What do you make of that, Deborah?

Dr. Deborah Howery (18:39)

There have been many studies that have shown that the flu vaccine prevents hospitalizations and deaths and that it is safe and effective. We also did see that people had a difficulty getting flu vaccines when shared clinical decision making was initially recommended because people didn't know what that meant. Pharmacies weren't sure how to implement it. Each state was doing it different. Some state health officers were then issuing universal recommendations so that people could get it. These policies have implementation difficulties and I worry about disparities across communities when they are being implemented unevenly. The Secretary's words have impact and have had really a detrimental effect on, I'd say, the world.

Justin (19:27)

There's this weird situation, isn't there, where we keep being told, and the polls seem to bear this out, that vaccinating children is broadly popular in the United States. And yet at the same time, there is this kind of head of steam, or was wasn't there when Trump came to power, and particularly when Robert Kennedy Jr. Took over as Health Secretary, that seemed to go in the other direction. I just wonder whether at some stage people like you are going to be able to say, or maybe you're already saying to the public, look, people have died, young children have died who wouldn't otherwise have died as a result of your policies. And in a sense that then in a horrible way brings it home. Are we there yet or not?

Dr. Deborah Howery (20:11)

I think we are getting there. We're starting to see already a decrease in measles vaccinations in the United States. And now after the attention around the hepatitis B vaccine, and we're already hearing about delays or people turning down the hepatitis B vaccine for newborns. And in the United States, 90% of hepatitis B cases, you know, in young children were eliminated after having the hepatitis B vaccine. So we're gonna start to see an uptick. And we have seen, you know, the largest number of measles cases in the United States in 30 years.

Justin (20:43)

And is that getting through politically from your standpoint? Are you seeing things changing back in the direction that you would approve of or not?

Dr. Deborah Howery (20:53)

So, you know, I think what I try to do is separate politics from ideology, and I think the secretary has a lot of ideology. I think, you know, a Republican and a Democrat both care about the health of children and believe in science and data. You have a group that's very ideologically focused that has been saying things that are not correct on vaccines. You know, the secretary has said that there's fetal parts in vaccines. That's not true. You know, he's promoted things that are not science based. And the issue is that really spreads, you know, vaccine misinformation and vaccine hesitancy versus just having that conversation with a doctor and a patient about the risks and benefits. Politics shouldn't be getting involved in this. It's ridiculous.

Justin (21:39)

Can I ask you as well about this new technology that was so important when it came to Covid vaccines mRNA and what has happened to that? Because it's fascinating, isn't it? There are these, you say it's not political, and of course it shouldn't be political. Most people would say it shouldn't be certainly ideological, it should be science based. But on the other hand, when you think of all the divisions there are in the Republican party and the broader right, and we talk about them a lot on this podcast, there is this division, isn't there, between those who want America to be in the absolute forefront of everything that's tech and forward looking and industrially important, and those who say, no, hang on a second, there are other things that we ought to be thinking about. And when you look at the tech side of it and you look at the MRNA vaccines, how much damage is Kennedy doing to an industry that America has already shown, as it so often does, that it can be in the forefront of and might be in the forefront of again in the future if it wasn't for him?

Dr. Deborah Howery (22:46)

The secretary has done significant, unparalleled damage to the vaccine structure in the United States as well as the pharmaceutical industry. Under President Trump's first term, he had Launched Operation Warp Speed, which really allowed for pharmaceutical companies to do innovation and look for a vaccine for Covid. He took a risk, really invested in pharmaceuticals, which was the right thing to do. Kennedy is undermining that. And now we are seeing less vaccines in the pipeline for the future. You know, vaccines that we are aware of for different diseases. Now in the United States, vaccine manufacturers are worried about, you know, will they have the support. We saw that with FDA even looking at one vaccine, saying they weren't going to review it, and then they changed their mind and agreed to review it. That doesn't, you know, promote confidence for vaccine manufacturers to pursue development of new vaccines.

Justin (23:43)

So it's actually actively holding them back, is it?

Dr. Deborah Howery (23:45)

Yes, we are seeing that there are, you know, even when you look at funding now too, there is less, you know, funding for science that's going out the door. Congress has appropriated, but it's not getting to the researchers. And we saw that there was the cut to the MRNA funding and MRNA vaccines have the potential to really look at, you know, preventing things like cancer as well. So this is really slowing down scientific progress in our country when it comes

Mariana (24:14)

to the impact on wider public health, Deborah, and particularly attitudes towards vaccinations and trust in vaccinations. I mean, RFK Jr, before he took on this role, was frequently accused of spreading misinformation about vaccines. He pushed back and said, I'm not anti vax when he was being quizzed at those Senate hearings before he was sworn in. Lots of the decisions he's made are very different to what lots of experts who know a lot about vaccines say are the right course of action. What do you think is the wider impact on sort of public opinion and belief? Or do you actually think that maybe it's gone in the opposite direction, which is people realizing, oh, hold up a sec, maybe we do actually want to follow the science here more so than other things.

Dr. Deborah Howery (24:56)

I think with a number of misstatements the secretary has done, even around things like Tylenol and pregnancy. You know, he's back walked that Lucavorin now for autism. They've only approved it for very small, you know, indication for a genetic condition. He has said all of these things that ended up not being correct and that information hurts the American public and the children. I think people at some point hopefully will realize that, you know, science is what we should be listening to, not a secretary who says things, you know, on a whim and then has to back walk them.

Justin (25:32)

What do you think about the President's place in all of this, because we were mentioning earlier, he does seem to have changed his tune a bit. Maybe worried about all of the things you've just been talking about. I mean, are you getting any kind of sense behind the scenes that he's not as enthusiastic about Kennedy as he once was?

Dr. Deborah Howery (25:51)

My advice to him would be get a new advisor. He had two very successful secretaries, Secretary Price and Azar, in his first term, that followed Data and Science. And Secretary Price was a physician. Secretary Kennedy is giving him bad advice.

Justin (26:07)

Yeah. I mean, it's interesting, isn't it? Because the thing about Trump, and we talk about him a lot, as you can imagine, on this podcast, you can say all sorts of things about him. I don't think people would generally say that he is ideological. He just isn't, is he really? He's not got a kind of settled thing. There isn't a thing. Kind of lodestar, that is, that he's following.

Dr. Deborah Howery (26:25)

That's why I've been very, like, focused on the secretary. The secretary is the one that's misspeaking. The secretary is promoting cures and treatments that don't work. And the secretary is harming children. You know, when there's measles deaths. Focusing instead on Budesonide or clarithromycin, unproven treatments and highlighting those instead of vaccinations. That's just unacceptable.

Mariana (26:47)

One of the things. So in my day job, I investigate what's popping up on social media, and it's so interesting how the Maha movement feels like it's very much a product of the algorithms and the kind of content that performs well online. Often that shows quite extreme acts like, yeah, drinking loads and loads of raw milk or deciding to eat only one type of food or anything that will essentially kind of get eyeballs and clicks and attention. And actually, RFK Jr. In some ways is a product of those algorithms as well, particularly because during the pandemic, his posts were incredibly popular, some of which asked legitimate questions about restrictions, others which went that bit further and spread misinformation. Do you think that asides from the impact on trust in vaccinations or public health, that actually this could in some ways prove to be quite a turning point for the US in that people will think, actually, we do want to have people in charge of health and science who we can trust and who are led by the science? Like, in some ways, if this hadn't happened. Do you see what I mean? Do you think that there could be kind of positive consequences of this in the long run?

Dr. Deborah Howery (27:53)

I hope so. You know, it's one of those things, too. When you look at how the public health system has really been dismantled in the United States, it's the opportunity to rebuild it in a different way. You know, we've reached that pivotal point. And so I do hope that people now recognize the importance of relying on science versus ideology. And you know, I think at heart, you know, I'm an ER doc. And so I think you just look at having those conversations with patients versus a politician.

Justin (28:20)

And on that rather gloomy note, we should leave it. Deborah. Dr. Deborah Harry, thank you so much again for talking to us. A real pleasure always to talk to you and thank you for sparing us the time.

Dr. Deborah Howery (28:30)

Pleasure.

Justin (28:36)

Okay, we'll watch this space because plainly there is going to be this appeal and there's going to be not just the politics of it, but also the legality of it has got to be wound out somehow. And that crucial question of what it actually means on the ground. So the extent to which life changes for American children and illnesses that they haven't seen for some time become more prevalent.

Mariana (28:58)

And as ever, we love to hear from you AmeriCasters, whether it's questions about RFK Jr. And this vaccine stuff or anything else, you can get in touch WhatsApp 443-301-2390, 480. You can email americastb BBC.co.uk, the hashtag is of course americast. You can join our Discord server. The link is in the description. And Remember, you hear AmericasT first and in full as a podcast on BBC Sounds. See y' all later.

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