RFK Jr.'s partial vaccine legacy

Health Secretary Robert F. Kennedy Jr.'s vaccine agenda is one of the biggest political liabilities hanging over Republicans, but his suspicion of the medical system is likely to endure with the GOP base.

Why it matters: Kennedy will one day leave public life, whether it's after the midterms or later, and it is an open question who — if anyone — will pick up where he left off merging vaccine skepticism with official health policy.

Mistrust of the medical establishment and willingness to question foundations of public health like the childhood vaccine schedule are already baked into segments of the Republican faithful.

• Even without Kennedy — the nation's most prominent vaccine critic before entering the Trump administration — the GOP isn't likely to rewind the clock.
• "The medical leaders ... who are kind of hoping that Bobby Kennedy and this conversation goes away, think we're going to go back to normal where we just salute the ghouls at these institutions that are just telling us to shut the hell up and trust the science — that's never coming back," Health and Human Services adviser Calley Means recently said in a video he posted on social media.

The big picture: The "Make America Healthy Again" coalition has always been home to a big tent of health concerns.

• Polling has repeatedly indicated that its positions on healthier food and increased regulation of pesticides are much more popular than its vaccine skepticism.
• "We've seen partisanship creep into vaccine attitudes in a way that we haven't seen it before, but we still have majorities across partisan [lines] generally supportive of vaccines," said KFF senior vice president Liz Hamel.
• "I don't think the data supports the Republican Party as an anti-vax party, or Republicans as an overwhelmingly anti-vax group," she added.

Between the lines: Suspicion of public health institutions and pharmaceutical companies is widespread within the GOP. So, too, is the belief that federal agencies overseeing the drug industry have become captive to it.

• Kennedy's rise to power wasn't the precipitating event for a lot of this — COVID and the government's response was.
• "This predates RFK. GOP distrust of institutional authority has been developing for years, and everything that's come out with [Anthony] Fauci's diaries and all the conspiracy theories that have come true have not helped," said Republican pollster Chris Wilson, currently CEO of the public opinion firm EyesOver.
• "The durable attitude isn't, 'Vaccines are bad.' It's something closer to, 'Institutions shouldn't be trusted simply because they claim expertise.'"

Half of voters who identify as MAHA supporters say that reevaluating the safety of vaccines should be a top priority, and another 40% say it's important, according to KFF polling conducted in April.

• That's despite other polling that's found strong support even among MAHA voters for common childhood vaccines like MMR, TDAP and hepatitis B, and has warned of political costs to eliminating federal vaccine recommendations.
• Opposition to vaccine mandates is another defining goal of the movement, even though nearly two-thirds of Americans recently said in a YouGov survey that schools should require vaccines.

Reality check: Kennedy's policy wins haven't been as far-reaching as some critics had feared, leaving many of his goals as a candidate and anti-vaccine activist unrealized.

• But ideas like opening up vaccine manufacturers or the federal government to more injury claims could be revived after the midterms.
• And Kennedy continues to have sway over President Trump when it comes to matters like debunked theories about what causes autism, meaning he still can influence public opinion.
• "We certainly have seen the federal government questioning the safety of vaccines, and spokespeople like the president. That absolutely is going to affect how partisans respond to these questions," Hamel said.

By the numbers: Only 38% of voters surveyed by KFF said they approve of the Trump administration's handling of vaccine policy, though 79% of Republicans do.

• And only 40% of both MAHA supporters and non-MAHA supporters say they have confidence in the Centers for Disease Control and Prevention to act independently without interference from outside interests, according to KFF.
• Among MAHA supporters, 40% say they have confidence in the Food and Drug Administration, compared with only 33% of non-MAHA supporters.

Where it stands: The MAHA infrastructure has certainly beefed up over the last year and a half, embedding itself inside of Washington and developing relationships that could yield ongoing power.

• "We existed before RFK and we're going to be here after he's gone," Joseph Varon, president and chief medical officer of the Independent Medical Alliance, told Axios.
• "The health freedom movement — it just got started. I really think it's just getting started, and RFK was the one who helped us all start this, and I just hope whoever replaces him is willing to sit at the same table as us."
• Vaccine skepticism has also made its way into state policy around the country, revealing like-minded policymakers particularly in red states.

The bottom line: Kennedy may not have a successor lined up with his exact history or views, but his ideas are likely embedded within the GOP.

• "I don't think this is specific to RFK," Wilson said.
• "I think he is the political entrepreneur who owns it right now, but I think someone else will step forward in 2028 and have that same anti-sweeping trust of institutions."