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- [00:00]
Sam Stein
Hey guys, it's me, Sam Stein, managing editor at the Bulwark. And I'm joined by Jonathan Cohn, author of the Breakdown. We are here to talk about the big event, big news from this afternoon. RFK Jr. In a op ed that he wrote for the Wall Street Journal has announced that he is going to be disbanding a critical committee at the CDC which handles the vaccines approval process there. It is officially the Advisory Committee on Immunization Practices. Basically, he announced that he's going to was a forced retirement for the 17 members of that committee. And we presume, I mean, it's obvious that he will be involved in appointing the 17 new members. Since Jonathan's way smarter than me, I'm going to have him explain the significance of it. It's true, you are, don't worry, I'm comfortable with that. Let's start with the basic gist. What is this committee? What does it do? How significant is it?
- [00:56]
Jonathan Cohn
Yeah, so it's a very significant committee. It has 19 members. Actually there were two vacant seats right now, as you said. It's sort of, you know, called the Advisory Committee on Immunization Practices. And that's what it does. It is a committee of experts and representatives from different groups who get together. They look at vaccines as they are coming up and getting ready to be approved or have been approved by the fda. And their basic job is to say, well, who should get this vaccine? They make recommendations. The membership is actually fairly. There are sort of rules about who are members so that they want to make sure they have someone who's got background in infectious disease, someone who's got background in pediatrics, someone background in different fields. There's also a sort of secondary group of people who are not official members, but sort of advisory members. They're not voting members and I don't know, we haven't heard anything about them being released or anything, but who knows? But they serve staggered terms and they're volunteers, by the way. None of these people are getting paid for their work on this, but they are very serious. They meet three times a year typically, and they are constantly looking at information about new vaccines, about vaccines they know are gonna be coming up for approval because they want to be able to act quickly. They make recommendations, they'll say, this is who we think should get the vaccine. It then has to go to the director of the Centers for Disease Control and Prevent CDC who then can modify, accept or reject the recommendation, at which point it then goes to the Secretary of Health and Human Services for final approval. At least that's how it's supposed to work in normal times. Close followers of these videos and readers or anybody following the news may recall there is.
- [02:40]
Sam Stein
This is not normal times, man.
- [02:43]
Jonathan Cohn
And there's no one actually there is no CDC director right now, among other things. But that's, that's like a side issue.
- [02:48]
Sam Stein
So anyway, I totally forgot about that. What are we doing here? Okay, now, so it's obviously very significant committee. You know, basically recommendations on vaccines get translated into what insurers cover in terms of the vaccinations. So absent, you know, respected scientists on this committee, we have to worry about who might be appointed. There's no indication yet who he's going to appoint, correct?
- [03:18]
Jonathan Cohn
There isn't. Although he has said the next meeting and I can't remember if it was June or July. It's scheduled for, but it's scheduled for the not too distant future.
- [03:27]
Sam Stein
Typically you would get some sense by then.
- [03:30]
Jonathan Cohn
Yeah, well again, you know, I was typically you vet people for this for several months. So that would imply he's already got some people in mind. Unless he's just going to pick them out of a hat. Although I mean you never know. You never know. Hey, hey, you know, maybe with some of our readers they want to ready know you want to be on the, you know, send your, you know, qualifications hhs.
- [03:54]
Sam Stein
Probably some Twitter follower of Tucker Carlson's on there. All right, so let's go through the, let's go through the, the journal op ed because what stood out to me was the chutzpah here, like just pure chutzpah for why he did this. And it starts with the very first line. I'm just going to read it and we're going to react to it. This is RFK Jr. The chief vaccine skeptic in America for many years prior to his appointment and confirmation at his hhi secretary writing about why he did this quote, Vaccines have become a divisive issue in American politics. I wonder how. But there is one thing all parties can agree on. The US faces a crisis of public trust. Again, we wonder how we got here. Whether toward health agencies, pharmaceutical companies or vaccines themselves. Public confidence is waning. Again, who did this? Some would try to explain this way by blaming misinformation or anti science attitudes. To do so, however, ignores a history of conflicts of interest, persecution of dissidents, dissidents, a lack of curiosity and skewed science that has plagued the vaccine regulatory apparatus for decades. Okay, I'm going to stop there. Obviously my opinions on this are fairly obvious. I think Robert F. Kennedy, Jr. Is chiefly responsible for why vaccines are a divisive issue and for why people distrust vaccine in this country. And it's because he believes in conspiracies and quackery and he skews, he himself skews the science. And yet here he is saying that everything that he's responsible for is just some sort of feature that he's trying to tackle without any culpability ascribed to him at all. That's just me, Jonathan. I don't know how you feel about it.
- [05:32]
Jonathan Cohn
I mean, I'm not going to argue with any of that. I thought, you know, this was a very interesting writing tick. Vaccines have become, it was very divisive issue. I know, right? I mean, I've become an, you know, gosh, what could have happened? You know, they are divisive, you know, and there's, you know, and there's, and then I like how you can see him thinking, there are going to be some people who are familiar with my record and familiar with the fact that I've been accused of misinformation. I better take that on. And he says, some people say it's misinformation. But no, the real problem here is skewed science. What's skewed science? I mean, what he has called skewed science is the sort of repeated findings that vaccines are safe, that they have been tested. And remember, this is somebody who, you know, is constantly still even now he goes on tv, he goes, you know, he'll say in front of a Senate committee sometimes he'll say, I, I'm not going to question vaccines. I mean, right, that's what he said in his confirmation hearings. And then you find out he went on some podcast or he went on some show and he, he, you know, spouted one of his regular myths about vaccines, that they've hurt more people than they helped on Covid or, you know, that they were, you know, they aren't being safety tested. And he just goes down the list.
- [06:49]
Sam Stein
What about the conflict of interest part? Because that's really, he's hang. He goes on in the op ed and people can read it for themselves. It's in the journal. It's going to be passed on. You're probably seeing your feed. But a lot of this, I mean, a lot of the editorial sort of hinges on this idea that these people on this advisory committee are hopelessly compromised because they have conflicts of interest because they're associated with pharmaceutical companies in some way, shape or form. Now, I admit I have not really Dug into it. But I did read some reporting that emanated from this op ed and the gist of it is that no, that's not the case. This is a wild misrepresentation of people that you are supposed to be vetted prior to appointment to this committee to make sure that you don't have those conflicts of interest. But again, my understanding is very limited on this. So what is the actual reality here? Is there massive conflicts of interest at play that could in theory raise some alarm that people are just on this committee to make sure that. I don't know. Eli Lee's bottom line is buffeted?
- [07:48]
Jonathan Cohn
No simple answer. No longer answer. Look, I take a backseat to nobody and my being critical of the pharmaceutical industry. There are lots of ways it has too much influence. There's a very smart, sensible case that it has much influence over the regulatory process, the regulatory drugs. And there is a thoughtful, important conversation to have about that doesn't look like this. The people who do go on the committee, they are vetted. And also something else to remember is there are rules for when you vote on a vaccine. If it's your company, it's company that you've gotten funding from, or your institution, you have to recuse yourself. And they police that fairly very seriously. So there are rules about conflicts. I mean, do are there people. And I have not gone down in the three hours since this news has broken and looked at all the sort of 17 members and see who had done what work in the past for what company. I'm sure there are several that have done some. But, you know, what he's really trying to say here basically is that anybody who's ever, you know, anybody who does work in this field that has at some point intersected the pharmaceutical industry is by definition biased. And this is, you know, given how common this is, I mean, if you're working in this field, you're a good chance you're going to work with a pharmaceutical company at some point. This is really his way of sort of tarring the entire mainstream scientific community. And so, you know, that's not really, there's no reason to worry about that in this context, for sure.
- [09:28]
Sam Stein
So we can't disassociate this obviously incredibly important health care implications. And I get really anxious actually thinking about where we are a year, two years from now when the full effect of this decision is felt, but we can't disassociate it from politics. And the reason I'm bringing this up is that when he was confirmed, obviously in contentious hearing and the key senator involved in the confirmation was the chair of the Hub Committee, Bill Cassidy of Louisiana, who, former physician or doctor, was skeptical, I mean, outwardly skeptical of rfk, but not to the extent that he was willing to vote him down. And he got very specific assurances, he said from RFK Jr. Before voting for his confirmation. I want to play what Cassidy said literally on the floor of the Senate explaining why he would vote yes for RFK Jr. Let's play the clip if we have it. He is also committed that he had worked within current vaccine approval and safety monitoring systems and not established parallel systems. If confirmed, he will maintain the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices Recommendations without changes. But that's just it. If confirmed, he will maintain the Centers for Disease Control Prevention's Advisory Committee on Immunization Practices Recommendations without changes. Now, it's funny, the word recommendations is not necessarily in all the write ups of this, but we heard it, he said it. Cassidy was pressed about this on the Hill today and has disputed the notion that RFK Jr broke his commitment to him on the CDC vaccine changes. He said to Igor Bobick, our former colleague at HuffPost, RFK promised not to change, changing the process, not the committee itself. I call, I just call bullshit. I think Cassidy was misled, maybe willingly or not by RFK Jr knows that he was misled and clearly is trying to cover his ass now. And you can also say one other thing. Cassidy tweeted out himself from his own account, quote, of course, now the fear is that the ACIP will be filled up with people who know nothing about vaccines except suspicion. I've just spoken with Sen. Secretary Kennedy and I'll continue to talk to him, with him to ensure this is not the case. He's then said he's spoken with Kennedy at least twice tonight. I, I don't know what to. I mean, my disappointments are evident, but I feel like Cassidy was just completely duped and looks like a fool right now and is watching as our vaccine culture is being taken over by an outward skeptic, if not conspiracy theorist.
- [12:10]
Jonathan Cohn
Yeah, I mean it sure looks like that to me as well. The politics of this are weird. Most Americans approve of vaccines. Most Americans want the vaccines to be available. Most Americans do not believe the conspiracy theories about vaccines. Cassidy is a doctor. He has in the past taken stands very strongly in favor of certain public health positions. Clearly he knows, I mean, you remember during the confirmation hearings he gave Kennedy a pretty hard time and there was some, you know, for a While there was doubt. Is he going to vote yes or is he going to vote now? I, you know, I guess he's, you know, worried about, he's not sure. I think we haven't heard yet if he's running for reelection. He's worried about a right wing primary challenge. And I guess, you know, he doesn't want to be against Trump's appointee. And I guess that's what it all comes down to.
- [13:01]
Sam Stein
I mean, that's it, right? It's like this is Trump's guy. Trump made it very clear that he won. And I think we report, I think Caputa reported so. But they view this as sort of the horseshoe theory, horseshoe theory of politics, which is Kennedy was bringing them these kind of liberals that they hadn't had in their coalition. And, and of course then the Joe Rogan types and, you know, and they wanted that and to vote Kennedy down, they were worried was going to be a huge political setback for them. So they put a lot of pressure on Cassidy.
- [13:28]
Jonathan Cohn
Yeah. Yeah. So I mean, the, the thing that makes that I think is weird about this. I mean, I, you know, that part all makes sense to me. But he looks so weak, right. And isn't that like, isn't that the worst thing to be in mega world, to look like a weak.
- [13:41]
Sam Stein
Is it worse to look weak or is it worse to, you know, stand up?
- [13:45]
Jonathan Cohn
I guess, I guess we should ask Vice President Vance which is, which is worse.
- [13:51]
Sam Stein
Exactly. And it's so, it's like I, I look at this and I think to myself, like, you surely Cassidy looks and says, oh my God, the damage that's being done, I mean, he knows it's being done and is it worth it? Like, is it actually worth it? Because he could have voted against the guy, he could have spared this or spared us from this and he and could have fought it out and figured it out. He had a year and a half to figure it out after that. Instead, we're left with this. And frankly, I wonder if he got a primary challenge, if he'd even survived after this. So I don't know. Yeah, I wish to think there's regret. I wish to think there's regret.
- [14:31]
Jonathan Cohn
Well, and however he's thinly, he's parsing the language on, well, Kennedy promised not to change the process. He didn't say he wouldn't change the members or whatever. Well, who knows? But this is coming after the decision on pulling the funding for the Moderna MRNA vaccine. It comes on the heels of the decision about who should get the COVID vaccine. I mean, we very clearly going in the direction, doing the sorts of things he very clearly promised Cassidy and promised the American people he would not do as HHS secretary. He's very clearly doing those things, and Cassidy's letting it happen.
- [15:09]
Sam Stein
And here's the thing. It's like we should have expected this. This is what the RFK Jr. Was not hiding the ball. Like, this is who he is. Right. Like, there was no, I don't really know people who are like, ah, maybe it was all for show. When he's HHS secretary, he'll be buttoned up and, you know, a little bit more moderate and thoughtful in his approach. This is. Everyone knew this was going to happen, so you can't delude yourself into thinking it wasn't. Although I guess Cassidy did. Are you surprised at anything RFK Jr has done? Maybe it's even the speed at which he's done this, or is this all sort of what you expected?
- [15:42]
Jonathan Cohn
No, I am surprised. I mean, I don't know. I'm surprised by so many things that have happened. I mean, I'm not surprised. Given everything else that has happened in the Trump administration. I think I expected. It took me a while to realize. I sort of figured this is where they were going and where he would be going. I kind of figured it'd be a little more subtle. I thought it'd be a little more gradual, but. But again, this seems to be the pattern in the Trump administration. It's what we saw they did with Doge. It's what we've, you know, what they're doing with this bill on Capitol Hill. It is, go, go, go. Just, you know, don't worry about the critics. Don't worry if you look hypocritical. Don't worry if you have to lie about it. Just move as fast as you can, overwhelm the political and media, media ecosystem and just push through your agenda. And that's so true.
- [16:30]
Sam Stein
It is absolutely overwhelming. It really is. It's one thing after another. Every day you look up and like, holy shit, wait a second, that just happened. I mean, this is coming amidst, like, you know, a militarization of Los Angeles. And it's just like, this is a huge deal and you can't really, you can't stop and take stock of it on occasion. But we try to. That's why we have you.
- [16:53]
Jonathan Cohn
Yeah. The number of times a day I look at a story and I think, like, why aren't we spending more time talking about this deal? And then I remember, oh, right, because there's 10 other huge deals.
- [17:06]
Sam Stein
It's nutty. All right, well, we'll keep on this. I know we're tackling it in tomorrow's morning shot, so people should be on the lookout for that. Edgar's got some good interviews. You got some good interviews for it. I'm excited to hear it. And yeah, I mean, we just. Just keep covering it, figure out who the people are, who he's appointed to this count Committee, press Cassidy on the hill, etc. Etc. Con, thank you for doing this. I appreciate it. For unpacking it. It's really helpful. And thank you guys for watching us. I should have mentioned earlier, subscribe to the feed. We appreciate your subscriptions. And spread the word about this feed. We hope we bring you some good stuff, good products, good conversation. Till we meet again. Take care.