As Health and Human Services Secretary Robert F. Kennedy Jr. intensifies his drive to reverse decades of vaccine policy, the medical profession joins a growing list of fields and institutions facing unprecedented threats from the federal government under President Donald Trump. But this time the administration may have chosen an adversary with more capacity to fight back than the law firms, major universities and media organizations it has targeted so far.
To many medical professionals, Kennedy’s hostility toward vaccines represents the greatest threat to the nation’s public health system in memory. Medical groups fear that Kennedy’s wide-ranging actions — such as firing all the members of a prestigious advisory committee that advises the federal government on vaccine policy; narrowing access to the latest Covid vaccine; and pledging to soon release a study that will probably reexamine the widely debunked claim that childhood vaccines cause autism — will trigger a resurgence of deadly diseases, particularly among children.
“It’s overwhelming; it’s a complete frame shift,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “It’s not only that people are declaring their own scientific truths; it’s that science is losing its place as a source of truth. I could never imagine that something like this would ever happen. It’s a war on expertise.”
Medical groups are expressing increasing alarm that Kennedy’s rhetoric and actions will increase the already-growing number of parents demanding medical or religious exemptions from state vaccine mandates for school attendance and potentially encourage conservative states to repeal those mandates altogether. That concern became much more immediate last week after Florida’s Surgeon General Dr. Joseph Ladapo and Republican Gov. Ron DeSantis announced their intent to eliminate all state vaccine mandates, including those for school attendance. If implemented, that will make Florida the first state to do so.
Other institutions that Trump has targeted have struggled to mount an effective resistance to his efforts. But the medical profession may have more advantages than most.
Although confidence in medical professionals has declined since the Covid pandemic, particularly among Republicans, they still enter the debate over vaccine access with a much deeper well of credibility with the public than many of the other groups Trump has targeted, polls show. Surveys also consistently show that most Americans believe the major childhood vaccinations are safe and should remain a requirement for children to attend school. Taken together, those attitudes could make Kennedy’s crusade against vaccines riskier for Trump than the president’s actions against other constituencies.
“At the moment (Trump) seems to be enjoying it but … how important is it for him to keep the fringe part of his base happy?” said Drew Altman, president of KFF, a nonpartisan think tank focusing on health care issues. “Why does he care so much? At some point this (will) turn off a large segment of the American people, and he may decide this is no longer in his interest.”
The key question in how this debate unfolds may be whether the disparate and often fractious medical interests can unite effectively in common action.
“We need the organizations that represent America’s physicians to stand up, both for the sake of (influencing) policy and for the sake of giving guidance to their patients,” said Leslie Dach, chair of Protect Our Care, a liberal advocacy group that focuses on health care access. “This is no time to sit on the sidelines.”
Many of the institutions Trump has targeted most aggressively in his second term present a similar profile. Elite universities, such as Harvard and the University of Pennsylvania; media organizations such as ABC, CBS and the Wall Street Journal ; and law firms such as Covington & Burling are all wealthy, influential and accustomed to circulating through the elite circles of political power.
But all operate in sectors of the economy that face substantial skepticism from the general public and antagonism from the Republican base, which tends to view them as pillars of the liberal establishment. Polling by the Gallup Organization over the past few years captures those dynamics.
In an annual Gallup poll that tracks the public’s assessment of various professions, just 17% of adults last year said lawyers demonstrate high standards of honesty and ethics, and only 13% said the same about TV reporters. Even fewer Republicans expressed trust in those groups: just 12% for lawyers and 5% for TV reporters. College teachers performed better in a 2023 survey, with 42% of the public overall expressing trust in them. But the share of Republicans who expressed trust in them was only about half that, at 22%.
That backdrop may help explain the strategy adopted by institutions in the industries Trump has targeted for funding cuts or other sanctions. Several negotiated settlements with the administration. A few have fought him in court, with some law firms and Harvard University winning strongly worded lower court decisions invalidating Trump moves against them. But none of Trump’s early targets have launched a campaign to mobilize public opposition and pressure Congress to stop his moves altogether.
Medical professionals may be in a better position to try.
The share of Americans who view doctors as honest and trustworthy in Gallup polling has fallen since the Covid pandemic. Confidence in the overall “medical system” — a more expansive and amorphous concept — has also declined somewhat since Covid. But in the latest Gallup survey, 53% of all Americans still expressed trust specifically in doctors, including 44% of Republicans. Nurses received even higher grades for honesty.
The public is especially inclined to trust medical professionals on issues related to vaccination. In an April national poll, KFF found that about four-fifths of Americans trusted their own doctors as a “reliable source for information about vaccines.” Among parents, about four-fifths said they trusted their pediatricians for such information. By contrast, only about two-fifths of all Americans said they trusted either Kennedy or Trump for vaccine guidance.
KFF surveys have also found that the vast majority of Americans remain convinced that the major childhood vaccinations are safe, and about four-fifths of parents (including three-fourths of Republicans) continue to support the requirement that students receive vaccinations to attend schools.
Robert Blendon, an emeritus professor of health policy at the Harvard T.H. Chan School of Public Health, said the backlash among Republican voters against public health decisions during Covid, such as vaccine and mask mandates, created a constituency within the GOP for challenging federal vaccine policy — but that medical professionals still have standing to sway it.
“Republicans hold a belief (that) real mistakes were made by the CDC and public health authorities, and that has really opened up this opportunity for Kennedy,” Blendon said. But “when I was terribly sick (during the pandemic), who did I go to? It was my physician. It was the people running the units at my local hospitals.”
Blendon said the key for medical interests will be to focus their message on personalizing the potential impact of Kennedy’s policies — particularly for influencing voters in Trump’s electoral coalition.
“They are not going to be that influenced when scientists say it’s really bad for the world,” Blendon said. “But they could be interested in practicing physicians who say it could endanger the health of your own family.”
It remains uncertain, though, how forcefully medical groups will press those arguments. One reason universities, law firms, media organizations and even the clean energy industry failed to unite in robust opposition to Trump’s actions is that many preferred to stay quiet for fear the Trump administration could retaliate by threatening other federal funding, licenses or contracts.
Trump holds similar leverage over medical professionals with his ability to influence federal reimbursement rates, particularly for Medicare — which Kennedy has already signaled he hopes to reexamine. Pediatricians and other physicians “will be incredibly more trusted by parents than these various government people,” Blendon said. But the question remains “whether or not they are going to be nervous about threats to payment.”
Early in Trump’s presidency, the medical professions seemed to follow the same accommodating strategy as universities, law firms and media companies. The leading medical industry and professional associations mostly kept mum during Kennedy’s contentious confirmation hearings, Trump’s moves to slash federal funding for medical research, and even during congressional passage of the “One Big Beautiful Bill” that will revoke health insurance from more Americans than any single bill ever.
But medical groups are now issuing more urgent alarms about the flurry of anti-vaccine actions from Kennedy that culminated in last month’s dismissal of Dr. Susan Monarez, the recently confirmed director of the US Centers for Disease Control and Prevention, who has said she refused to rubber-stamp Kennedy decisions that could reduce vaccine access.
Probably the most aggressive group has been the nation’s pediatricians. When Trump dismissed Monarez and triggered the resignations of other top CDC officials, Dr. Susan Kressly, president of the American Academy of Pediatrics, issued a stark statement declaring, “This is a dangerous moment for our country and for the health of every family in every community.”
Together with other medical groups, including the organizations representing public health officers, the pediatricians sued in July to overturn Kennedy’s decision not to authorize the latest Covid booster for healthy people younger than 65. The pediatricians have also launched a website to rebut Kennedy vaccine claims and published their own recommendations for childhood vaccination, which continues to encourage the Covid vaccine for young people.
Other groups that have pushed back especially forcefully against Kennedy include organizations representing immunologists, public health professionals and nurses. The most important evolution has occurred at the most prominent of the medical groups, the American Medical Association. Its members are more vulnerable than pediatricians to possible changes in federal payment systems because pediatricians would not be directly affected by reimbursement rates for Medicare, which serves seniors. And early on, the AMA appeared especially leery of confrontation with Trump.
But, as documented in a recent Politico story, the group faced mounting dissent over its hands-off approach that culminated in an open rebellion at its June annual meeting from critics demanding more forceful pushback to an array of Trump policies. Since then, the tenor of the AMA’s statements has moved closer to those of the other major medical organizations; the AMA president called Monarez’s dismissal “highly alarming” and a threat to public health.
A senior executive at one of the leading medical professional trade associations, who asked not to be identified while discussing internal conversations, said that all the leading groups are trending in that direction.
Early in Trump’s term, the official said, “people were trying to find their footing” and “figure out how to play a constructive role in health policy and also stand up to the things that are really out of bounds.” In addition, the official added, groups were hesitant about engaging because “this administration has a history of punishing people that disagree with them.”
Now, though, the official said, “things are shifting” because Kennedy’s actions have grown so alarming. “Groups are going to feel … that they can’t sit it out anymore,” the official said. In a measure of the change, a coalition of medical groups on Thursday issued a joint call for Kennedy’s resignation, writing, “We are gravely concerned that American people will needlessly suffer and die as a result of (his) policies.”
Medical professionals may have retained more public trust than other experts, but all forms of expertise have lost ground with the public in recent years, noted Daniel Cox, director of the Survey Center on American Life at the conservative American Enterprise Institute. Young people, particularly men, are drawn to a kind of DIY ethos around decisions where they might once have deferred to credentialed experts, Cox said.
“This younger generation has grown up with access to all the information that they could ever want or need and that feels more natural and comfortable to them” than relying on experts, Cox said. “They feel: ‘I don’t need a college degree, I don’t need experts to tell me how to live or what to do. I can find what’s right for me online and … look for people who have a lifestyle that I aspire to. And those are the people I can put my faith in.’ ”
Those libertarian-ish attitudes have seeded the ground for Kennedy’s Make America Healthy Again movement and created the energetic constituency he brought into Trump’s electoral coalition. But as Offit pointed out, such attitudes directly collide with the core tenet of public health, which is collective action to protect the most vulnerable.
“The current zeitgeist is medical freedom: ‘I’m going to do my own research, I’m going to make a decision that is best for me and my child,’” said Offit, who was recently blocked from participating in a federal vaccine policy advisory committee. “That is in direct conflict with public health. In public health, you care about your neighbor.”
Those competing instincts are now colliding most consequentially in the nation’s classrooms and playgrounds. Public health experts say that to achieve herd immunity against the most dangerous childhood diseases, such as measles, about 95% of all schoolchildren must be vaccinated. But the share of newly enrolled kindergarten students who have received the MMR vaccine covering measles, mumps and rubella has fallen well below that level (to 92.5% in the school year that began in September 2024) as the share of parents requesting an exemption has steadily increased, according to CDC data.
These trends mean the vast majority of parents who continue to believe in vaccines cannot fully protect their children if enough people around them choose not to vaccinate their own. That threat will only rise if Kennedy takes further actions that encourage more parents not to vaccinate their children — or inspire more red states to consider rescinding their school mandates.
In that way, the risks that Kennedy’s decisions could impose on average families are far more tangible than the implications of most debates about Trump’s second-term priorities. Trump, mindful of the independent following that Kennedy has brought to him, appears extremely reluctant to curb him. But even at last week’s Finance Committee hearing, several GOP senators sharply challenged Kennedy’s direction — a rare moment of open Republican dissent to Trump.
And on Friday afternoon, Trump took a conspicuous step away from vaccine skepticism, telling reporters, “You have to be careful when you say people don’t need to be vaccinated. You have some vaccines that just work.” Trump was responding to a question about Florida’s move to rescind school vaccination mandates — but his language could easily apply to Kennedy as well.
With the medical profession stirring in opposition, cracks opening in Republican support and polls showing that most Americans don’t share Kennedy’s hostility to vaccinations, Trump eventually may view his lightning rod HHS secretary as too great a threat to his own political health. The political system’s antibodies against extremism have been gravely compromised in the Trump era — but they may be starting to coalesce against Kennedy.
