The global fallout of RFK Jr.'s vaccine policies

Summary

Podcast Summary: Short Wave (NPR)

Episode: The global fallout of RFK Jr's vaccine policies
Date: March 4, 2026
Hosts: Regina Barber, Gabriela Emanuel
Length: ~15 minutes

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Episode Overview

This episode explores the international consequences of policies and actions taken by Robert F. Kennedy, Jr. as the U.S. Secretary of Health and Human Services (HHS). The focus is on how his vaccine skepticism and policy changes are creating ripple effects in global health, causing funding disputes, ethical controversies, and potential risks to vulnerable communities. Science correspondent Gabriela Emanuel joins host Regina Barber to break down two major case studies:

1. The U.S. ultimatum to Gavi, the Vaccine Alliance, over the ingredient thimerosal.
2. The suspension of a hepatitis B vaccine research study in Guinea Bissau.

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Key Discussion Points & Insights

1. U.S. Ultimatum to Gavi Over Thimerosal

• Background: Gavi is a major global public health group that has helped vaccinate over 1.2 billion children (01:12).

• Recent U.S. Action: Under RFK Jr’s leadership, HHS threatened to withhold future funding unless Gavi removes thimerosal—a mercury-containing preservative—from its vaccines (01:26, 04:11).

  • The U.S. is traditionally one of Gavi’s largest donors.
  • Thimerosal is vital for preserving vaccines in multi-dose vials common in low-income countries (04:32–04:59).

• Why the Ultimatum?

  • Despite decades of research affirming its safety, RFK Jr. has spent 20 years campaigning against thimerosal (05:02).
  • Paul Offit, vaccine expert, highlighted the scale of accusation:

    “...to stop their programs of injecting mercury into more than 100 million black and brown babies in developing countries annually.” — Paul Offit [05:36]

  • Angela Rasmussen, virologist, clarifies:

    “The amount of mercury that you get...from a single thimerosal containing vaccine is less than you would get from eating a tuna fish sandwich.” — Angela Rasmussen [05:53]

• Consequences for Global Health:

  • There’s no clear alternative to thimerosal for low-income settings; removing it would be logistically and financially challenging (06:34).
  • Withholding U.S. funding could result in fewer vaccine doses, endangering children:

    “Children will no doubt die because those vaccines are unavailable.” — Paul Offit [07:40]

2. Controversial Hepatitis B Vaccine Study in Guinea Bissau

• Context: The country has high hepatitis B infection rates; vaccination at birth is globally recommended and extremely effective (08:09–08:10).

• U.S. Policy Shift:

  • In December, U.S. CDC advisors (selected by RFK Jr.) voted to stop universal newborn hepatitis B vaccination in favor of selective vaccination for high-risk babies (08:10).
  • No new research justifies this reversal; pushing back against decades of data (09:05).

• About the Study:

  • Danish researchers, partially funded by the U.S., planned a study of 14,000 newborns:
    • Half get hepatitis B vaccine at birth; half weeks later (per local policy).
    • Researchers monitor for side effects (10:07).

• Ethical Uproar:

  • Comparison to Tuskegee experiment is raised:
    “...doing it this way, you’re leaving like 7,000 newborns who would be unvaccinated and they could be exposed in those critical early weeks.” — Regina Barber [11:18]
  • The WHO called the study unethical, arguing it exploits local scarcity and withholds proven care (11:52).
  • Paul Offit adds:

    “To continue to do something that’s woefully ineffective is highly unethical and cruel and, frankly, dishonest.” — Paul Offit [12:19]

  • Christine Grady (bioethics expert) emphasizes:

    “The first and important consideration in making a study ethical is that it’s answering a valuable question.” — Christine Grady [12:48]

  • The hepatitis B vaccine’s safety and efficacy is already proven; running this study risks undermining local trust (13:08).

• Status:

  • Study is currently on hold pending an ethics review with international experts involved (14:31).

3. Broader Global Health Implications

• U.S. Reputation:
  • Gabriela Emanuel observes an increasing isolation of the U.S. in the global health scene:

    “The U.S. is getting more isolated when it comes to public health, being called out publicly as supporting things that are unethical or go against science.” — Gabriela Emanuel [15:00]

  • Possible shift in the global balance of public health leadership.

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Notable Quotes & Memorable Moments

• On RFK Jr.'s stance and its effects:

  "He [RFK Jr.] spent 20 years campaigning against thimerosal...he's made moves to ban this ingredient from US vaccines. He's urged Gavi to follow suit..." — Gabriela Emanuel [05:02]

• On the ethical stakes:

  "Children will no doubt die because those vaccines are unavailable." — Paul Offit [07:40]
  "Exploiting scarcity, exploiting the country's lack of resources is not a justification for withholding proven medical solutions for families that enroll in a research study." — Summary of WHO position [11:52]
  "Doing it this way, you're leaving like 7,000 newborns who would be unvaccinated and they could be exposed in those critical early weeks." — Regina Barber [11:18]

• On research ethics:

  "The first and important consideration in making a study ethical is that it's answering a valuable question." — Christine Grady [12:48]
  "...running this study risks creating resistance and hesitancy and suspicion of health care workers if people realize that they were part of an unnecessary and possibly unethical study." — Gabriela Emanuel [13:08]

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Important Timestamps

• 00:16 — Episode opens, theme/context set
• 01:12 — Gavi ultimatum introduced
• 04:32–04:59 — Thimerosal’s role and importance explained
• 05:02–05:44 — RFK Jr.'s skepticism and global implications
• 05:53 — Expert debunks thimerosal toxicity concern
• 07:03–07:40 — Gavi’s position and Paul Offit’s warning
• 08:09–09:29 — Hepatitis B vaccine context and U.S. policy shift
• 10:07–11:18 — Guinea Bissau study details
• 11:52–13:08 — Ethical arguments and risks of the study
• 14:31 — Study suspension and pending review
• 15:00–15:28 — Gabriela’s global health reflections

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Takeaways

• Policy decisions and skeptical attitudes at the top of U.S. health leadership have immediate and profound effects on vulnerable populations worldwide.
• Scientific consensus supports thimerosal’s safety and hepatitis B vaccination at birth, but U.S. pressure and funding threaten established global health practices.
• These cases highlight a growing ethical rift and potential leadership vacuum for the U.S. in global health, with outcomes that could shape vaccine access and trust for years ahead.

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For more in-depth exploration of RFK Jr.'s vaccine advisors or innovative vaccine trials, check out other Short Wave episodes.

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Produced by Richard Rachel Carlson; fact-checked by Gabriela Emanuel and Tyler Jones; edited by Gisele Grayson and Rebecca Ramirez; audio engineering by Kwesi Lee.

Transcript

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[Regina Barber]

You're listening to Short Wave from NPR. Hey, Short Wavers. Regina Barber here. So, if you've been listening to us this past year, we've done stories about all the big and small ways Robert F. Kennedy, Jr. Is changing how the United States approaches vaccines. And this is all in his role as the Secretary of Health and Human Services. But as Gabriela Emanuel will tell you in a sec, those changes aren't limited to the United States.

[Gabriela Emanuel]

Definitely not.

[Regina Barber]

So, Gabriela, as a global health correspondent at npr, you've been keeping tabs on how this new HHS approach is changing the conversation around the world.

[Gabriela Emanuel]

That's right. And right off the bat, there are two clear examples I can give you where changes in the US Are creating public health controversies elsewhere in the world. Okay, so the first one, RFK Jr. And his ultimatum to an international vaccine group called Gavi.

[Regina Barber]

I've heard of Gavi. They're a big player internationally. And looking at their site, they say they vaccinated over 1.2 billion children and prevented over 20 million deaths. The US is historically one of their biggest funders, right?

[Gabriela Emanuel]

Yeah. But last year, the Trump administration halted over a billion billion the US had previously promised to Gavi. And then earlier this year, HHS threatened to withhold future funding from Gavi, too, unless the organization removes a specific ingredient from its vaccines.

[Regina Barber]

Wow. Okay, so that's the first example, this ultimatum, which we'll talk about later. But what's the second?

[Gabriela Emanuel]

So that second example is a controversial vaccine research study that is partly funded by the US and it looks at hepatitis B and newborns in Guinea Bissau. So a West African country. Now, I have to say right up front, there are conflicting reports about the current status of the study. But Africa cdc, which is part of the African Union, says it's currently paused for review. And that is because some doctors, like Paul Offit, have called it unethical. Paul was a member of the Advisory Committee on Immunization Practices for the CDC from 98 to 2003. He also compared it to the notorious Tuskegee Experiment that started in the 1930s in the U.S. wow.

[Regina Barber]

This is. This is where black men who had syphilis were purposely not given treatment.

[Gabriela Emanuel]

Yeah, exactly.

[Paul Offit]

This was a very dark moment in American history.

[Regina Barber]

All right, this is a lot to dig into. So today on the show, how changes in US Vaccine priorities are making global waves. You're listening to Shortwave, the science podcast from npr.

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[Regina Barber]

okay, Gabriela, we started our conversation Talking about the US's ultimatum to Gavi, this international vaccine alliance, and now Congress has allocated money to them. But the Trump administration, specifically RFK Jr's team, has been trying to withhold money unless Gavi agrees to remove an ingredient from its vaccines. What is this ingredient?

[Gabriela Emanuel]

It is called thimerosal, and it helps make sure vaccines don't get contaminated with bacteria or fungi.

[Regina Barber]

This important?

[Gabriela Emanuel]

Yes, they want that. This is key if a vaccine comes in a vial that has many doses in it, so when you dip in that needle to fill it up, there's a risk of contamination. And thimerosol does a really good job at avoiding the contamination.

[Regina Barber]

Yeah. So why do people want to remove it then?

[Gabriela Emanuel]

Because it's partially made of a form of mercury, which on its face does sound scary. But thimerosal has been very well studied and deemed safe in medications and vaccines since the 1930s. However, RFK Jr. Is still skeptical, and that might actually be an understatement. He spent 20 years campaigning against thimerosal, including editing a book on the topic, and he's made moves to ban this ingredient from US vaccines. He's urged Gavi to follow suit and

[Paul Offit]

to stop their programs of injecting mercury into more than 100 million black and brown babies in developing countries annually.

[Regina Barber]

That is a big accusation. And you said it was safe.

[Gabriela Emanuel]

Well, here is Angela Rasmussen, a virologist at the University of Saskatchewan.

[Angela Rasmussen]

The amount of mercury that you get, dangerous mercury that you get, that could be toxic from a single thimerosal containing vaccine is like less than you would get from eating a tuna fish sandwich.

[Gabriela Emanuel]

In reality, she says the main type of mercury in thimerosal leaves the body very quickly and it does not accumulate and it isn't known to cause damage. And that's why the World health organization, the U.S. food and Drug Administration and the U.S. centers for Disease Control and Prevention have all deemed it safe.

[Regina Barber]

Okay, but now because of this ultimatum, can it happen? Is there a replacement or can it be like easily removed from vaccines?

[Gabriela Emanuel]

No, there's no obvious alternative. And actually in many lower income countries it cannot be removed easily. The single dose vials that are common in the US where thimerosal isn't needed are really too expensive. Instead, these lower income countries tend to use those multi dose vials to during these mass immunization days where lots of kids get vaccinated.

[Regina Barber]

But now that the US has given this ultimatum, do you think that Gavi will remove the Marisol from their vaccines?

[Gabriela Emanuel]

Well, in a statement to NPR, Gavi said it remains in contact with the U.S. on the subject and that any changes would be guided by scientific consensus and their board. But hhs in a statement to NPR put it more bluntly. It said Gavi has refused to develop a phase out plan and future funding will be withheld. But Congress did allocate funding to Gavi, so we'll see how it all plays out. I did speak with Paul Offit, as we mentioned earlier. He's the director of the Vaccine Education center at the Children's Hospital of Philadelphia. He says if Gavi agrees to the deal, the outcome is clear.

[Paul Offit]

Children will no doubt die because those vaccines are unavailable.

[Regina Barber]

That's really heavy. And I think it's time we turn to something else that seems just as heavy. That controversial study on Hepatitis B, which for anyone who doesn't know, it's a viral infection that attacks the liver, it's spread through blood or other bodily fluids, newborns can get this infection from their moms during delivery and there's no cure. But it is preventable with vaccines?

[Gabriela Emanuel]

Yes, exactly.

[Regina Barber]

Okay.

[Gabriela Emanuel]

If a vaccine is given right after birth, it is super effective at preventing infection, even if a kid is exposed through their mom during delivery. And so for 30 some years, newborns in the US have been given the Hepatitis B vaccine. And that's also the recommendation globally by the WHO. But here's a big but. On December 5th last year, CDC advisors voted to stop vaccinating all newborns against hepatitis B in the U.S. okay, so these Advisors who voted for the change were handpicked by RFK Jr. And they say they're worried it might cause harm to babies and that the vaccine should be limited to high risk babies after consulting with their doctors, not given kind of on a routine basis to every newborn.

[Regina Barber]

So is this harm? Is there research to back it up?

[Gabriela Emanuel]

In a word, no. And that's part of the pushback from doctors and vaccine experts about this change, the lack of research to support a shift in policy. And outside medical groups have pointed to studies showing the vaccine is very safe and that the rate of young kids getting hepatitis B has dropped by 99% since 1991 in the US largely because of this birth dose.

[Regina Barber]

Okay, so this is, this is all good context for the U.S. but the study we've been talking about is in Guinea Bissau. So what's the status of hepatitis B there, Gabriela?

[Gabriela Emanuel]

Yes, so this is a very poor country that we're talking about, and it has a very high hepatitis b rate. About 1 in 5 adults there have hepatitis B. So really high rates. And that means the chance a newborn gets exposed by their mom during delivery is pretty high.

[Regina Barber]

Yeah. So having the vaccine immediately after basically helps the baby fight off hep B if they've been exposed to it during that delivery.

[Gabriela Emanuel]

Exactly. It's a post exposure vaccine here, but it's very effective at preventing that infection from taking hold. The alternative is administering the vaccine a few weeks later, but at that point, the infection could have taken hold. This is the current policy in Guinea Bissau. However, the country is planning to start vaccinating at birth in 2028. But before then, researchers from Denmark want to do a study, and it's paid for in part by the US to the tune of $1.6 million. Okay. So the study was announced two weeks after the vote in the US to stop vaccinating every newborn and also after that pushback, saying there wasn't evidence to back up this change in U.S. vaccine policy. The plan is for the researchers to study over 14,000 newborns. Half would get the hepatitis B vaccine at birth, the other half would get it later, as is the country's current policy. And then the researchers would watch for side effects in the first few years, things like neurological problems or eczema.

[Regina Barber]

So the Tuskegee experiment comparison comes in right here, because doing it this way, you're leaving like 7,000 newborns who would be unvaccinated and they could be exposed in those critical early weeks.

[Gabriela Emanuel]

That's right. But since the current policy in Guinea Bissau is to wait several weeks. The researchers say, oh, no, no, we're not taking away vaccines from any babies who'd get them otherwise. In fact, they say half the time the babies will be getting treatment sooner, which is arguably better than the current policy.

[Regina Barber]

So that's the heart of the debate.

[Gabriela Emanuel]

Yes, and it has gotten heated. The WHO even called it unethical, but which is pretty extreme language for a very kind of subdued, careful group. They say exploiting scarcity, exploiting the country's lack of resources is not a justification for withholding proven medical solutions for families that enroll in a research study. Some doctors, like Paul Offit, have been even more blunt.

[Paul Offit]

The rebuttal is, we're just doing what has been done, even though you could argue that what has been done has been willfully ineffective. And to continue to do something that's woefully ineffective is highly unethical and cruel and, frankly, dishonest.

[Gabriela Emanuel]

Other experts, like Christine Grady, point out that there might be an even more fundamental question about this research. She's the former chief of the Department of Bioethics at the National Institutes of Health Clinical Center. The first and important consideration in making

[Christine Grady]

a study ethical is that it's answering a valuable question.

[Gabriela Emanuel]

The researchers behind this study say the goal is to see if newborns who do get the vaccine develop other illnesses and issues after vaccination.

[Regina Barber]

Yeah, but to Christine's point, you said earlier that the hepatitis B vaccine has been proven to be safe and effective.

[Gabriela Emanuel]

Exactly. And one of the risks of doing a study that is not asking a valuable question is that you are then asking the community to help and to trust you when it's not actually necessary. And later, that can then create resistance and hesitancy and suspicion of health care workers if people realize that they were part of an unnecessary and possibly unethical study.

[Regina Barber]

Okay, so what have the researchers said in response to all of this pushback?

[Gabriela Emanuel]

So I did reach out to the researchers in Denmark, and I didn't get a response despite many attempts. But it is worth noting the researchers are already controversial, and RFK Jr. Is a fan of their work and their somewhat unorthodox vaccine arguments, and he has cited them in the past. Many in the medical establishment say that after reviewing their published work, they've found big claims questioning vaccines where the data and the statistics often just don't back it up.

[Regina Barber]

So in the meantime, has the CDC responded to any of this?

[Gabriela Emanuel]

So, so far, they have defended the study. In a statement to npr, HHS called the study the gold standard and said it was based on the highest scientific and ethical standards.

[Regina Barber]

So will the study go on despite all of this pushback and controversy?

[Gabriela Emanuel]

Yeah, that that is the question. The authorities in Guinea Bissau, where there's been years of instability, they say it is currently suspended and it's kind of pending an ethics review. The head of Africa, cdc, said he's sending experts to help with the review. So that's where things seem to stand right now.

[Regina Barber]

After reporting on these two sort of case studies, what's your takeaway for the global public health landscape?

[Gabriela Emanuel]

Yeah, so I think I've noticed over the past year that the US Is getting more isolated when it comes to public health, being called out publicly as supporting things that are unethical or go against science. So we may be at the beginning of a kind of shift in the balance of power of who leads the world, at least from a public health perspective.

[Regina Barber]

Gabriela, thank you for sharing these stories with me. It sounds like neither one is quite resolved, so we'll see how this plays out.

[Gabriela Emanuel]

Absolutely. Thank you so much, Gina.

[Regina Barber]

If you like this show, share it with a friend. It really helps our show out. Also, consider checking out our episodes on RFK Jr. S new vaccine advisors and how an innovative HIV vaccine trial is pivoting after losing USAID funding. This episode was produced by Richard Rachel Carlson and edited by Gisele Grayson and our showrunner, Rebecca Ramirez. Gabriela Emanuel and Tyler Jones checked the facts and the audio engineer was Kwesi Lee. I'm Regina Barber. Thank you for listening to Short Wave from npr,

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