WASHINGTON — U.S. Health Secretary Robert F. Kennedy Jr. is aiming for quick wins on new health initiatives to help Republicans in November’s midterm elections, after the White House asked him to pivot from a widely criticized campaign to rewrite U.S. vaccine policy, senior administration officials told Reuters.
New efforts announced in the past few weeks were designed to appeal to Trump’s voter base, from an executive order bolstering research into psychedelics to approving a new gene therapy for children with a rare type of hearing loss, and the administration is looking for more.
Trump is keen to stress prescription drug price cuts negotiated by his appointees, while the health secretary and his team plan a slate of food policy initiatives and are exploring whether they can quickly approve other treatments for childhood disease, three people familiar with the matter told Reuters. It is not yet clear which of the possible moves under discussion will be chosen by the administration, they said.
Many of the details about efforts to align Kennedy’s strategy with the White House’s priorities for the midterms are reported here for the first time, based on interviews with more than a dozen current and former senior administration officials and outside advisers. The changes follow months of friction between the two camps over personnel and policies.
The stakes are high for Trump’s Republican party, which risks losing control of both chambers of Congress, polls show. Kennedy’s past moves, such as removing vaccines from the recommended U.S. childhood immunization schedule, are among the policies that could hurt the party’s candidates. As a result, the White House has insisted that he take no more steps against vaccines this year, ahead of the vote, four senior administration officials said.
At the same time, the White House views Kennedy’s celebrity status and appeal to Americans who may not otherwise vote for Republicans as an asset, according to three of the senior officials. The health secretary will join the campaign in competitive congressional districts over the next few months, they said.
Kennedy has “a good grasp” on the politics ahead of the elections, one senior administration official said. The health secretary can see a long list of policy options “that don’t cause consternation” between the health department and the White House.
Whit Ayres, a Republican pollster, warned that it remained to be seen if voters would put aside their views of Kennedy after he spent years sowing doubt about the safety and efficacy of vaccines, contrary to scientific evidence.
“The vast majority of Americans view effective vaccines as one of the great miracles of modern medicine. An anti-vaccine message is political poison,” Ayres said.
Kennedy “is trying to be a team player, but he is so widely associated with an anti-vaccine message that I don’t know that he can effectively pivot away from that,” he said.
In response to Reuters questions, Health and Human Services Department spokesperson Andrew Nixon said that Kennedy “remains focused on the priorities Americans consistently say matter most to them, including chronic disease prevention, food quality, and affordable health care.”
White House spokesperson Kush Desai described Kennedy as “an invaluable asset for President Trump since Day One.” Neither official commented on vaccine policies or the strategy ahead of the midterms.
Red hat, green hat
Kennedy plays a unique role in Trump’s orbit. He is the only Cabinet secretary with an agenda distinct from, and sometimes at odds with, the president’s “Make America Great Again” movement, according to Republican strategists and administration officials.
Several administration officials described that tension as a “red hat-green hat” divide. A so-called red hat staffer — referencing Trump’s cherry red Make America Great Again hats — signals loyalty to the president’s political agenda. A “green hat” staffer connotes allegiance and often fandom of Kennedy, whose “Make America Healthy Again” presidential campaign slogan was emblazoned on spruce green hats.
When Kennedy dropped out of the 2024 race to support Trump, his political base — a coalition of vaccine skeptics and opponents of pesticides and processed foods — was viewed by some Trump allies as a boost to the president’s reelection prospects. The health secretary received wide latitude to carry out his policies in the first year of the new administration.
The MAHA “green hats” cheered when Kennedy replaced a federal advisory board on immunization with new members who shared his views on vaccines. His appointees limited eligibility for COVID vaccines, dropped a universal recommendation for hepatitis B shots and promoted the view, not backed by science, that Tylenol taken by pregnant women may contribute to autism in their children.
But the White House eventually grew concerned about the potential political consequences, the current and former officials said.
In December, new survey results published by Tony Fabrizio, a pollster who works with Trump, showed strong bipartisan support for routine childhood vaccines, even among some of the MAHA voters who view Kennedy as their standard-bearer.
A Republican or Democratic candidate who opposed existing childhood vaccine recommendations would “pay a price in the election,” Fabrizio wrote in a published memo, concluding that “vaccine skepticism is bad politics.”
At the time, Kennedy and his top deputies were preparing to remove more vaccines from the recommended U.S. schedule, according to three people familiar with the discussions. Kennedy made the case to the White House to move forward, arguing that he needed to keep MAHA supporters on board, according to four senior administration officials.
Trump advisers, worried about Fabrizio’s findings, told Kennedy that would be his last big effort on vaccines ahead of the November midterms, the four officials said. On Jan. 5, the federal government scrapped recommendations for childhood immunizations against flu, rotavirus, meningococcal disease and hepatitis A, saying families should decide on their use with their doctors.
Public backlash was swift, including from major medical organizations that had already sued to stop Kennedy. The White House contrasted that criticism to a broadly positive response to Kennedy’s moves on nutrition, such as new dietary guidelines that recommend whole foods and protein over sugar and highly processed items, a senior administration official said.
The reaction in both the White House and health secretary’s office to the new food guidelines was “‘You know what? this is pretty cool,” the official said. “They thought, ‘Enough already with the negativity, let’s move forward with [food policy]. This is where the year begins.’”
A turning point?
Since January, the White House has taken a bigger role in staffing key positions at the health department to ensure Trump’s priorities are carried out and to avoid negative news coverage of controversial appointees and policies. Last week, Trump nominated a new surgeon general who has supported vaccines after it became clear that Kennedy ally Casey Means, a wellness influencer and non-practicing doctor, would not be confirmed by the Senate.
It has not all been smooth sailing. Top White House advisers sought to remove Kennedy’s chief of staff and longtime adviser, Stefanie Spear, and place her elsewhere in the administration, leading to a fight between the teams. In a White House confrontation — in which Trump was not present — Kennedy refused, according to three people familiar with the incident.
Spear remains a top adviser to the secretary, but her standing has been diminished, two senior administration officials said. Trump officials elevated Chris Klomp, former head of the U.S. Medicare program, in February to help enforce the president’s priorities at the agency as Kennedy’s No. 2. The change, at the behest of Trump officials to help bring order to the health department, has improved the working relationship with the White House, four officials said. Spear and Klomp did not respond to requests for comment.
Klomp has played a key role advancing more conventional health appointees, such as Erica Schwartz, the former deputy surgeon general tapped to lead the Centers for Disease Control and Prevention, three officials said.
A handful of close advisers to Kennedy helped convince him that Schwartz would not undermine his earlier work on vaccines, and White House advisers made clear they supported her nomination, one of the officials said.
Kennedy and his team have also aimed for greater cohesion with the White House in recent weeks as they put the finishing touches on new announcements unrelated to vaccines, four senior officials said, while warning it was too early to say whether core differences between MAHA and MAGA will create new tensions in the future.
Story by Yasmeen Abutaleb and Bo Erickson.
