Trump somehow got worse on public health after covid
He's incapable of learning lessons and actively resists it.
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In the Trump administration’s latest assault on public health, HHS Secretary Robert F. Kennedy Jr.’s crankified FDA refused last week to review the first mRNA flu vaccine developed by Moderna.
The FDA’s official reason was that the trial of the vaccine had been inadequate. But since Moderna had already discussed trial design with officials, this is pretty obviously an excuse meant to provide cover for Kennedy’s longstanding gibbering anti-vax quackery.
This is bad news for Americans who would like to avoid the (sometimes deadly) flu virus. But the implications are much wider than that.
At the end of January, even before the latest RFK-engineered setback, Moderna’s CEO Stéphane Bancel said that the company was planning to pull back on crucial investments in late-stage mRNA vaccine trials.
“You cannot make a return on investment if you don’t have access to the US market,” he explained.
What this means is that RFK’s position as Trump’s chief snake-oil death dealer could affect global development of new vaccines for shingles, herpes, and the Epstein-Barr virus, the latter of which has been linked to some cancers.
The Trump administration is a disaster not just for public health in the US, but worldwide. There has been a great deal of discussion of the ways in which Trump’s reckless foreign policy has put global security at risk with his threats to Greenland, Canada, Europe, and general violent unpredictability.
But US abandonment of public health leadership may well be even more consequential. It will quite possibly lead to tens of millions of needless deaths over the next decades.
Trump 1.0 seems enlightened by comparison
The second Trump administrations assault on mRNA vaccines is especially bleak because the single unambiguous achievement of the first Trump administration was the mRNA covid vaccine.
Most traditional vaccines work by weakening a pathogen and injecting it into the body to trigger an immune response. By contrast, mRNA vaccines tell the body’s cells to make proteins that exist in the pathogens; it teaches the body to fight the disease without introducing it directly into the body.
The big advantage with mRNA is speed of development. Collecting, cultivating, and testing pathogens for each vaccine takes time. But mRNA vaccine proteins are designed with computers, which means the process is standardized and streamlined.
The technology for mRNA vaccines isn’t new — it was first developed in the 1960s. An mRNA vaccine was developed to fight ebola, but there had been limited funding for broader applications.
Then covid hit.
The Trump administration’s response was initially cavalier and reckless denial, followed by an attack on mitigation strategies like masking. Federal government failures led to some 58,000 excess American deaths.
But Trump did one thing right. Amid bipartisan pressure, his administration in May 2020 embraced Operation Warp Speed, a more than $12 billion investment in a public/private partnership to develop vaccines. It was a stunning success. Vaccines often take years or even decades to develop, but mRNA vaccines from Pfizer-BioNTech and Moderna were ready in December 2020, only eight months after Warp Speed began.
Other nations developed vaccines as well (and Pfizer was a joint German effort) but the US accomplishment was hugely important. America donated 800 million doses of vaccines globally, more than twice as much as any of its nearest rivals, China (284.5m), Germany (175m) and France (124m). Vaccines are believed to have prevented 19.8 million deaths worldwide, as well as uncountable amounts of illness, suffering, and chronic disability.
The bipartisan American investment, which the Trump administration led, was absolutely key to containing a horrific global pandemic which could have been exponentially worse without the stunning accelerated development of mRNA vaccines — one of the great public health triumphs in modern history. But this miracle cure was only the beginning. The massive investment in mRNA opened doors to numerous other medical advances.
As mentioned above, Moderna was planning to invest in development of herpes and shingles vaccines. There have been promising developments in a vaccine for pancreatic cancer. And scientists are working on mRNA vaccines for H5N1 avian influenza, a virus which uncontrolled could lead to a new pandemic.
The public health disaster that is Trump 2.0
These mRNA advances would obviously benefit people in the United States, who would be much less likely to die of cancer, flu, pandemics, and a range of other illnesses. But, as with the covid vaccines, the implications of the technology would be felt far beyond US borders.
Vaccine distribution to less affluent nations can be poor and maddeningly inegalitarian. But if the US could have a vaccine ready for the next pandemic before it starts, the number of lives saved could be incalculable.
Unfortunately, the skull’s head that is RFK Jr. and his team of crack conspiracy theorists loathe covid vaccines and mRNA technology, which they insist, sans evidence, pose dangerous risks to the public. Conspiracy theories range from fringe assertions that mRNA alters the human genome to Kennedy’s more straightforward but still utterly false insistence that they cause deaths in young people and don’t prevent infection.
Based on these malevolent delusions, Kennedy has launched a public health plan to play dice with worldwide suffering. Even before he blocked the Moderna flu vaccine, he had already slashed hundreds of millions of dollars in mRNA funding.
Funding cuts and administration hostility is likely to send researchers overseas, cutting the US out of leadership in what could be a $30 billion industry. Even worse, though, is that certain vaccines will simply be shelved for years, if not forever. And that is not even considering the calamity if, god forbid, there is another global pandemic while Trump 2.0 is in power.
The ongoing atrocity
The possible future harms of Trump and RFK Jr. on public health are terrifying. But in many ways the worst has already happened.
The US has been the largest supplier of humanitarian aid in the world — and indeed, in history. But when Elon Musk’s DOGE gutted USAID early in Trump’s second term, it unilaterally shut down vaccination, HIV, and food aid programs across the world. The result was mass suffering on an indescribable scale.
One estimate suggests that since the beginning of 2025, USAID cuts have led to 880,000 excess deaths, including almost 550,000 children. If cuts are not reversed by 2030, 14 million people could die — a number that rivals the death toll in World War I.
The DOGE cuts are easily the worst single atrocity of Trump’s term — and they are, by sheer numbers affected, arguably the worst atrocity committed by a single president in US history. They have not gotten as much coverage as many Trump horrors because they are concentrated overseas and over large swathes of the globe. But there is simply little precedent for this kind of mass murder through devastation of public health infrastructure.
The US in the post-war period built up resources, reach, and influence that dwarfs that of any other nation ever. Its central place in global health is difficult to calculate or imagine, even after the stunning illustration of Operation Warp Speed. Global human rights law and theory, to say nothing of US public opinion, lacks a good framework to respond to the moral crime of precipitating a genocide-level event by simply refusing to fund global lifesaving networks in the name of xenophobic hate budgeting.
Musk left government and DOGE has shut down. But Kennedy’s attack on mRNA vaccines — and on a range of other vaccines as well — carries on the same tradition of ghoulish mass murder. The worst measles outbreak in the US in 30 years, amidst a global measles resurgence, is only one indication of the potential horrors this administration is actively courting.
Trump has brought us fascism, he is threatening war and violence. But it is all too possible that his most lasting and horrific legacy, in his second term as in his first, will be plague.
That’s it for today
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Nothing says “I’m your public health secretary” quite like a man who looks like he personally rejected every vaccine ever invented and whose wellness routine apparently consists of raw milk, conspiracy theories, and whatever his brain worm recommends that morning.
His voice is clear warning for what not to do.
This is the guy blocking mRNA vaccines that could prevent cancer and the next pandemic. A man whose own body is a walking advertisement for why we need public health officials is now in charge of dismantling public health.
The measles outbreak making its greatest comeback in 30 years is the perfect metaphor: RFK Jr. didn’t just bring bad ideas to Washington, he brought the 1950s with him.
Dr. Oz is down the hall. The brain worm is in the office. And somehow this is the A-team for American healthcare.
Idiocracy turns out was a documentary with a 20-year delay. Brawndo’s got electrolytes.
—Johan
Excellent reporting on the threats of our science denying leadership. The FDA has been hijacked, important research funding has been canceled and millions of lives are threatened due to their policies. We must turn the tide to survive!