Translating what Kennedy’s anti-vaccine allies hear in his response to the measles outbreak

PROVIDENCE, R.I. (AP) - When the nation's top health official, Robert F. Kennedy Jr., endorsed the measles vaccine this month after an outbreak in Texas claimed the life of a second child, his comments made waves because he has spent 20 years making false claims that vaccines are unsafe.

Many of Kennedy’s anti-vaccine allies stood by him anyway, trying to tamp down concerns from others who accused Kennedy of abandoning their movement.

That’s because, according to doctors, public health experts and propaganda researchers who know Kennedy's history well, the health and human services secretary is threading the needle between his agency’s role as a neutral arbiter of science and the rhetoric of anti-vaccine activists. They say his word choices reflect that he is working from the anti-vaccine playbook he has used for much of his career in public life.

Below, The Associated Press examines his comments about the measles outbreak that has infected more than 700 people nationwide and killed three, how his allies have interpreted them, and the facts according to scientists.

A Kennedy spokesperson said the health secretary is not anti-vaccine and had "responded to the measles outbreak with clear guidance that vaccines are the most effective way to prevent measles." He did not respond to questions about how Kennedy's comments were being interpreted by his allies in the anti-vaccine movement.

WHAT KENNEDY SAID: "The federal government's position, my position, is people should get the measles vaccine, but the government should not be mandating those," Kennedy told CBS this month after an unvaccinated child in Texas died of measles.

Later, in the same interview, Kennedy raised safety concerns about the measles vaccine, saying testing was inadequate. He also raised safety concerns about the vaccine for pertussis.

WHAT HIS ALLIES HEARD: Charlene Bollinger, who runs a business selling anti-vaccine videos and other products, highlighted in a Substack post how Kennedy had raised safety concerns.

In posts on X, she urged critics of his comments to "Trust him. Trust me. He's not walked through fire for years to abandon us now," then added, "Read what he said carefully and with a critical spirit … pay attention to the things he didn't say. There are clues.”

The group American Values, which was set up to support Kennedy's presidential run, posted a thread on X that amplified Kennedy's comments questioning vaccine safety.

THE FACTS, ACCORDING TO SCIENTISTS: The measles vaccine is safe and effective, and protecting people from outbreaks requires nearly everyone to be vaccinated. Public schools in the United States generally require children to be vaccinated against measles to attend, though a growing number of parents have been avoiding those mandates for their children, in some cases by getting exemptions. That has fueled low vaccination rates in communities around the U.S., which has left them vulnerable to measles and other infectious diseases. Just 92.7% of kindergartners got their required shots in 2023, below the 95% threshold for preventing outbreaks.

READING BETWEEN THE LINES: If Kennedy had truly changed his mind about the benefits of vaccines, he would have explained what he got wrong in the past, said Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security. He didn't do that and instead immediately questioned how vaccines are safety tested.

"If someone like RFK Jr. with his record were going to make an about-face on his position on the measles vaccine, you would expect an essay, an articulation of what he got wrong in the past. You're not seeing that," Adalja said. "The fact that he undercuts it almost immediately speaks to that."

WHAT KENNEDY SAID: Health authorities have said the two children who died were both unvaccinated, that they died as a result of measles and that neither had any reported underlying conditions. But Kennedy suggested those who died during the outbreak were "people who were already sick." He said the second child who died had various other health problems and asserted that " the thing that killed her was not the measles, but it was a bacteriological infection."

"Her death was caused by pneumonia," Kennedy told Fox News. "So, you know, her parents said that she was over measles two weeks before."

Kennedy's spokesperson did not respond to questions asking where he got his information about the child's medical history and to clarify why what he said conflicted with statements from health officials.

WHAT HIS ALLIES HEARD: The anti-vaccine group Kennedy led for years, Children's Health Defense, promoted his comments, posting a clip online and saying it shows that Kennedy "confirms the so-called 'measles deaths' are NOT actually measles deaths."

American Values wrote that his comments constituted a "bombshell" because the child "did not pass away from measles, despite what the media claimed."

THE FACTS, ACCORDING TO SCIENTISTS: Pneumonia is a complication of measles, and is the most common cause of death from measles in young children, according to the Centers for Disease Control and Prevention, a subsidiary of HHS.

READING BETWEEN THE LINES: Kennedy's comments suggesting measles didn't kill the child reflect longstanding tactics used to create doubt about vaccines, said Renee DiResta, a professor at Georgetown University who researches propaganda and has studied the anti-vaccine movement. She said Kennedy and Children's Health Defense have spent years telling people that measles is a routine and harmless childhood illness to justify the argument that a safe vaccine is somehow more risky than the disease.

"Reframing these deaths as something other than what they are - deaths from measles, which is not harmless at all - is necessary to prop up the dual pillars of anti-vaccine propaganda in play here," she said.

It reflects a similar narrative that emerged during the COVID-19 pandemic, when people who wanted to minimize its seriousness suggested people were dying "with COVID" rather than from COVID, said Richard Carpiano, a professor of public policy at the University of California, Riverside, who has closely followed Kennedy's anti-vaccine work. It's a way of minimizing the deadly nature of measles.

WHAT KENNEDY SAID: Kennedy attended the funeral of the 8-year-old girl who died, then posted online about meeting with her family and the family of a 6-year-old girl who died in February. In one post about the trip, he wrote that "The most effective way to prevent the spread of measles is the MMR vaccine." He also posted photos of himself with the families.

WHAT HIS ALLIES HEARD: Kennedy's positive comments about the measles vaccine prompted some criticism from his old group Children's Health Defense. CEO Mary Holland said in a video that Kennedy no longer speaks for the group, and said he had put out what she called "very partial information." She claimed that a vaccination for measles had caused her son's autism. But she went on to praise Kennedy's actions.

"People should not get lost in Bobby Kennedy saying that the vaccine can prevent measles," Holland said, adding, "Bobby went to stand with the unvaccinated. And he has said it's a personal choice."

Children's Health Defense and Bollinger have sued a number of news organizations, among them the AP, accusing them of violating antitrust laws by taking action to identify misinformation, including about the COVID-19 pandemic and vaccines.

THE FACTS, ACCORDING TO SCIENTISTS: Scientists have ruled out any link between vaccines and autism. Vaccines have saved an estimated 154 million lives in the past 50 years, according to the World Health Organization, which says immunization has been the greatest contribution to ensuring babies live until their first birthday.

READING BETWEEN THE LINES: Carpiano said Kennedy helped the anti-vaccine movement pivot to the idea that it is about personal rights, personal freedoms and medical freedom. While there is a libertarian bent to it, that framing leaves out an important piece.

"It's the freedom to do whatever you want. A libertarian would say, 'provided it doesn't hurt other people,'" he said. But when it comes to Kennedy and the anti-vaccine movement, the part about not hurting other people gets left out, Carpiano said. "And so basically becomes a tyranny of the minority," Carpiano said. "It's something that he helps to keep promoting and legitimating."