Transcript
Jonathan Cohn (0:00)
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Andrew Egger (0:15)
Hey, it's Jonathan Cohn from the Bulwark here with my colleague Andrew Egger. We are here to talk about healthcare today, public health, rfk, vaccines and, and then government healthcare programs and what the Donald Trump and the Republicans want to do to Obamacare. Before we begin, if you like what we're doing here at the Bulwark, please Follow us on YouTube. Subscribe to our podcast subscribethebullork.com Andrew, you wrote this morning a real call to arms, I think, about some news that came out late last week from RFK at the Department of Health and Human Services about vaccines. Before we get into what your argument was, what was the news?
Jonathan Cohn (0:59)
I hadn't even realized until I read your newsletter this morning that we're really getting it with both barrels right now. Right? I mean, we've got this stuff that I wrote about happening in the White House at Health and Human Services, kind of like the destruction from within. And then on the other side of things, we've got congressional Republicans gearing up to make all these sort of cuts, from outside cuts to the money going in, changes to the programs in various ways. We're going to talk about all that. So let's start with what I wrote about, which is the RFK stuff. I don't think it's, it's blowing anybody's mind to hear that Robert F. Kennedy, Jr. Is not a major fan of vaccines. That's been basically a through line of his political project for decades. I mean, for, for going back long before he was ever on Donald Trump's radar as Health and Human Services, this is kind of the first thing he and Trump bonded over way back in the day was their shared suspicion that that vaccines were childhood vaccinations, were related to autism, which has been thoroughly debunked by many, many times since he got into hhs. He has been sort of laying the groundwork for, for a number of these things. He's been mostly working in kind of the messaging realm and the personnel realm. He's been saying a lot of things about, you know, vaccine injury and making a lot of claims about supposed insufficient safety testing for vaccines. And he has also been kind of shedding tons of top vaccine officials at the FDA and cdc, people who are resigning, basically saying they can't work with this guy communications high ranking HHS communications staff and the FDA's top vaccine official Both resigned back in March. And meanwhile he has been kind of bringing on some real cranks, some anti vax types in order to spearhead some of these quote unquote just asking questions type research efforts that he seems pretty confident are going to get the stamp of hhs, HHS approval to supposedly buttress this non existent link between vaccines and childhood autism. All of that was kind of preliminary. So that's all Big throat clear to what has happened the last couple of days, which is that we are finally starting to see kind of the first real putting into practice of this posture from rfk. Last week it was the removal of FDA authorization for Covid booster shots for most healthy adults under 65. So if you're over 65, if you have one of a number of conditions that in theory put you at higher risk or that the data has shown put you at higher risk for Covid, you are still authorized to get those shots. But for most healthy adults who are not seniors, that authorization is being pulled off of the table for boosters. So if you've previously had the shots, the annual kind of refresher shots to keep immunity topped off, that was last week, that was on Friday or maybe Thursday today or what I wrote about today, just yesterday, what RFK announced was kind of the, the second tranche of, of the same sort of thing where he, he, he this time came out and said that the CDC would be removing the same shot, the COVID vaccine, from its recommended vaccine schedule for healthy pregnant mothers and for healthy children. Children. So essentially what, what, what you're getting there is formerly, even under the, even under the, the, the scheme laid out just last week by the fda, pregnant women would still be able to receive that shot because pregnancy is, is correlated with a higher risk for Covid as well as Covid being still somewhat dangerous, you know, at an elevated risk relative to other populations for very young children. So the idea was a pregnant mother would get the shot, it would protect her and some antibodies to that child in the first, in the opening months of their lives before they're eligible to get their own Covid shot starting around six months. That's now off the table. RFK has pulled that in a video that he put out yesterday where he, he called it. What exactly did he call it? He said it was, you know, another step toward making America healthy again. So this is, this is kind of dangerous and frightening and alarming kind of on two tracks here. One is just the, what it, what it is. I mean, one is just that the news itself, right? If you are a healthy adult. If you are a pregnant mother, if you have very young children, you have less choice and less access to, to these vaccines, or you're likely to have less, less choice and less access with regard to these vaccines than you did a week ago. We can get into some of the technicalities. Obviously it's, it's not like they have been, it's not like they're completely off of the table. They, you could make the argument, and we don't know exactly how this is gonna shake out, but one could note that if you are a pregnant mother, healthy pregnant mother, you still technically qualify under the FDA authorization from last week. But now the CDC has taken it off the schedule. So maybe you can still get the shot, but maybe your insurance won't cover the shot. That's all the stuff that needs to be kind of worked out in the days ahead here. But at a base level, there's just less access to these vaccines than there has been in the past. The other track on which this is sort of alarming and should, should alarm us like we should, we should see where this is going is that a lot of the arguments that, that, that RFK Jr. Is making here are not at all constrained to this shot. I mean, I think, I think what I wrote this morning was this is kind of low hanging fruit, Covid boosters, right? There's not enormous uptake for these shots already in the American population. About a quarter of the population is up to date on their Covid boosters. There's a wide kind of public perception that Covid is this thing that happened and over now and maybe you already had some shots, maybe you already had Covid, maybe you feel like you're basically covered. And so for RFK to start here is kind of like it's kind of, he's establishing a beachhead, right? But the arguments that he is making about this shot where he is saying it wasn't sufficiently tested, you know, we don't know what the harms are. We, we need to go back and do placebo testing on this stuff and, and you know, really kick the tires on these authorizations and make sure they're, they're legit. These are arguments that he has made for years about all vaccines, specifically lots of pediatric vaccines that are, that every kid gets today. You know, the, the MMR vaccine is, is the measles, mumps and rubella vaccine being a particular target of his, where he has made identical arguments basically saying, oh, it's never been placebo tested. It's never, you know, how could we know, how could we know how safe it truly is? And so there really isn't a limiting principle. I'm sorry, I'm talking for forever here, but I'll just end with this. There really is no limiting principle on what RFK is saying about vaccines and what he is likely to do with vaccines if he would do this for the COVID shots. There's really no limiting principle on him, against him taking similar action with regard to all kinds of other shots on the, on the childhood vaccination schedule, except for perhaps a perceived greater political cost. If RFK is saying, you know, here we're doing this with the, with the, the COVID vaccine for kids, I mean, that's, that's already really amazing that he's monkeying with the pediatric vaccine schedule here. But it is the latest shot to be added to the vaccine schedule. Right. It's only been, we've only been vaccinating kids against Covid for a few year. Few years. We've only had the COVID shots for a few years. So you can see in his mind, this being kind of like a trial balloon. Right. We'll see how they take this one. In theory, this one should go over a little smoother than other ones would. So let's see how we do here and then, and then proceed from there. But that, but, but again, that, that is really the only thing between us and where, where, where we're talking about these exact same kinds of decisions for a whole wide variety of shots that RFK has criticized in the same terms as he has used to criticize this shot that he is removing from the schedule today.