US health policy reshaped in RFK Jr.’s first year at HHS

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Robert F. Kennedy Jr.’s first year leading the U.S. Department of Health and Human Services has brought sweeping changes to agencies that shape U.S. public health policy, according to an Associated Press review of the first year of President Donald Trump’s second term. Since Kennedy entered office in February, the department has moved quickly on staffing, scientific research priorities and public health guidance, actions that have drawn both praise from supporters and concern from medical and public health experts. The overhaul has also occurred as broader uncertainty in the U.S. health system has intensified, including congressional Medicaid cuts and expiring Affordable Care Act subsidies that place millions of Americans’ coverage at risk, the review said.

A central point of contention has been how the administration has approached vaccines. The review said Kennedy, who had spent years attacking vaccines publicly, sought during his confirmation process to reassure senators that he would not take a “wrecking ball” to vaccine science, but that less than a year into his tenure, HHS and its agencies moved to push what experts described as limits on those commitments. In May, Kennedy announced that the Centers for Disease Control and Prevention would no longer recommend COVID-19 vaccines for healthy children and pregnant women, a change that the review said public health experts questioned because they saw no new data to justify it.

In June, the review said Kennedy fired an entire 17-member CDC vaccine advisory committee and later installed replacements that included vaccine skeptics. The review said decisions made by that group shocked medical professionals, including declining to recommend COVID-19 shots for anyone, adding new restrictions on a combination shot for chickenpox, measles, mumps and rubella, and reversing the longstanding recommendation that all babies receive a hepatitis B shot at birth. In November, the review said Kennedy personally directed the CDC to abandon its position that vaccines do not cause autism, and while he left the older language on the CDC website to keep a promise he made to Republican Sen. Bill Cassidy, he added a disclaimer that the review said remained because of the agreement.

The Associated Press review said researchers and advocates strongly refuted what the updated website reflected and pointed to scientific research over decades that they say supports vaccines not causing autism. The review also said Kennedy had promised a broader effort to study environmental factors that might contribute to autism, and that in an Oval Office event with Trump in September, Kennedy promoted what the review described as unproven and, in some cases, discredited ties between Tylenol, vaccines and autism.

Alongside vaccine-related changes, the review described a rapid reconfiguration of HHS through restructuring and staffing reductions. The Associated Press said that within two months of taking office, Kennedy announced a sweeping plan to restructure the department, including shutting down entire agencies, consolidating others into a new entity focused on chronic disease, and laying off about 10,000 employees in addition to the roughly 10,000 others who had already taken buyouts. The review said that while parts of the effort were tied up in court, thousands of mass layoffs were allowed to stand and that the actions significantly thinned HHS, a department that oversees programs including food and hospital inspections, health insurance for roughly half of the country and vaccine recommendations.

The review said Kennedy also fired or forced out several HHS leaders, including four directors at the National Institutes of Health, the Food and Drug Administration’s former vaccine chief, and a CDC director whom Kennedy had hired less than a month earlier. Beyond staffing, the Associated Press review said Kennedy oversaw significant cuts to scientific research, including NIH slashing billions of dollars in research projects and termination of $500 million in contracts to develop vaccines using mRNA technology. The review said Kennedy proposed or funded some new research aligned with his MAHA goals, including work related to autism, Lyme disease and food additives.

The review said supporters of MAHA and Kennedy described the change as a long-awaited disruption to an agency they said was corrupt and untrustworthy, while also noting some actions had attracted praise across party lines. Both Democrats and Republicans, the review said, applauded some of the agency’s actions, including steps to encourage healthy eating and exercise and deals aimed at lowering the prices of costly drugs. But it also said doctors and public health experts raised “grave concerns” about the effect of the changes on the country’s scientific leadership.

Lawrence Gostin, a Georgetown University public health law professor who the review said was removed from a National Institutes of Health advisory board after a letter said he was no longer needed, warned of damage to U.S. scientific capacity. “At least in the immediate or intermediate future, the United States is going to be hobbled and hollowed out in its scientific leadership,” Gostin said, adding that the review said it would be “extraordinarily difficult to reverse all the damage.” In response, the review said HHS spokesperson Andrew Nixon rejected the idea that HHS was undermining scientific expertise and lauded the department’s work. Nixon said, “In 2025, the Department confronted long-standing public health challenges with transparency, courage, and gold-standard science,” and added that HHS would carry the effort into 2026 to strengthen accountability, put patients first, and protect public health, according to the statement described in the review.

The Associated Press review also described the growing role of MAHA, a campaign term Kennedy used publicly last year to describe a crusade against toxic exposures and childhood chronic disease. The review said 2025 became the year the “MAHA” label spread into the national lexicon, and that Kennedy made it the centerpiece of his work, using MAHA to push actions related to ultra-processed foods, artificial food dyes, fluoride in drinking water and banning junk food from a program that subsidizes grocery store purchases for low-income Americans. It said the concept has spread beyond Kennedy’s agency, with other cabinet officials appearing with him or promoting fitness and health-related initiatives under the MAHA umbrella.

At the same time, the review said MAHA has encountered setbacks and drawn criticism. It said HHS faced scrutiny in May for releasing a MAHA report that contained citations to studies that did not exist. And it said critics warned that to the extent the initiative urges distrust in vaccines or promotes raw milk, which the review said is more likely than pasteurized milk to lead to illness, it can be dangerous.