My wish list for Mr. Kennedy

Changes I'd love to see from the HHS!

Now that Robert F Kennedy Jr has been confirmed as the Director of HHS, and since a lot of other more famous MDs and PhDs that opposed The Narrative are giving all their thoughts, I’ll give mine!

In no particular order (since I keep modifying my draft every couple of days as things come to me…)

1. Returning to evidence-based public health

I’m ironically coining a phrase that Pro Narrative public health officials use a lot. The debate between Senators Cassidy and Paul during Mr. Kennedy’s hearing in the Senate Health Committee is emblematic of this.

Sen Cassidy argued that the HepB vaccine is critical for all children because it prevents HepB in 90+% of exposed children (I don’t remember the statistic, but it was high, and I can still make my point without it). The problem here is that a blanket “vaccinate them all” policy ignores the fact that mothers are tested for HepB prior to delivery… so why not just vaccinate the kids whose mothers are HepB+? The kids with HepB- moms won’t be at risk for HepB, like Sen Paul so accurately pointed out in that debate. Furthermore, the 90% whopping statistic is an example of relative risk as opposed to absolute risk (a distinction I have gained appreciation for the more I talk to

James Lyons-Weiler

).

A similar argument could be made for the COVID-19 vaccine being on the childhood schedule FOR BABIES… if the science demonstrates that the vaccine only (possibly – this is debatable) prevents hospitalization or death, and children aren’t at risk for either, then why push the vaccine on them?

2. Prioritize what diseases and aspects of pathogenesis matter for NIH funding

I’ve written on this before. As a standing member of study section, I see reviewers get all excited about, and advocate for, research on diseases that don’t affect a lot of people. Or, things that are going to very incremental. Or, research with zero potential for translation into human health (because yes, science for the sake of science is indeed fundable).

NIH needs to make very clear priorities. Currently, while the NIH budget across institutes (which are disease-specific-ish) sort of determines priorities, what gets funded is determined by what scores well in review and which applications actually come in. Obviously Mr Kennedy is very passionate about chronic disease and childhood diseases. Convey that priority to study section panelists.

I would also advocate (because yes, I do have a vested interest in non-chronic diseases) that we shouldn’t completely disregard infectious diseases. HOWEVER, prioritize the types of research, and maybe even the diseases, that get priority.

And maybe, consider revising the review scheme (yes, yet again) to appropriately weight this priority into grant priority score.

3. Vaccine mandates need to be weighed against risk

What has become abundantly clear is that there is risk associated with taking vaccines. There has been plenty of research even in mainstream medical journals demonstrating adverse effects of the COVID-19 vaccine. COVID-19 vaccines are not special in that way, but other vaccines have not gotten the research in this area that they deserve, and obviously that has to be a real priority.

President Trump has already called for removing federal funding from places that mandate the COVID-19 vaccine. This might be trampling on states rights a bit, but it needs to go further… schools can’t mandate other vaccines PERIOD. If there is a risk at all associated with something, it cannot be mandated. (Read back into my substack archives for a nice article about the ethics of vaccine mandates!)

It is highly likely that most parents blindly follow the vaccine schedule because otherwise their kid “can’t go to school”. Even though many states make exemptions available. Schools make that difficult sometimes, and sometimes states and public health departments flat-out lie about those exemptions. But maybe if they weren’t a “requirement”, parents would make an informed choice about what vaccines they want to give their children. Scared of the measles? Okay. But are you aware of what the vaccine lists as side effects? Fine then. Let’s follow truly informed consent and not coercion.

4. Do thorough research into vaccine adverse effects

This one goes hand in hand with #3. These studies have been suppressed, ignored, unfunded, disregarded, and un-rigorously done. That has to stop. Do the research, do it well, then educate medical professionals and the public on these things.

Again, if people want to weigh the risks vs benefits, that should be promoted not discouraged.

5. Meet with us that survived the persecution of medical professionals and academics

We have a lot to say. We are like-minded boots on the ground. And honestly, some of us might have some views on how to handle the finances of DHS better than “let’s cut indirect cost recovery to nothing” and “threaten to cut all research funding without warning”.

6. Update the NIH financial policies

And this one goes hand in hand with #5. I’ve been faculty for 20 years (and for the lay reader, that might not sound like much, but I’ve made it all the way to Full Professor rank, so I’m considered mid-late career stage!) and some policies have never changed in all those years. Two for example:

a) NIH capping R01 direct costs at $500k annually except with special permission from NIH. $500k does not pay for as much in 2025 as it did in 2005. Yet, we are expected to achieve the same level of science with less money. Yes, you can get more than $500k approved by NIH, but reviewers will then complain it is too much money (even though NIH approved it).

b) Grant reviewer reimbursement is also the same as it was before, at $200 per meeting day. However, you need to consider that grant reviews before the meeting take considerable amount of time (on the low end, 5 hours per review x 8 grant reviews for a two day 2 day meeting, not including reviewing 30+ other grants on the fly), plus sitting in a hotel conference room or zoom room for 2 full days, plus travel time if the meeting is in person. If you calculate the hourly rate, it’s pathetic.

7. Advocate for better medical education

What should be evident from some of the prior points is that many medical professionals have no idea what vaccines actually do and what their risks are. Calling patients “anti-vaxxers” and kicking them out of your practice is not practicing medicine. Learn the actual effectiveness of vaccines (in the population). Learn the risks. Learn what the vaccine actually prevents and what it doesn’t. And practice risk assessment.

Medical professionals are also under-educated on many chronic conditions. Not everyone needs a statin. Some have never even heard of perimenopause. There is a difference between bloodwork results “being within normal limits” and “being ideal”. Etc.

8. Restore transparency in published disease surveillance data

This is a rabbit trail I started going down recently… The CDC publishes data for annual numbers of infectious disease diagnoses and also tracks chronic disease through various indicators (non-infectious diseases are not reportable so CDC can’t get actual numbers). What I’ve realized recently is that the definitions for even infectious disease counts are loose. We all remember during COVID that a “COVID case” could be someone that tested positive on the antigen test but never showed a single symptom. Is that really a case? Or a “COVID death” was someone that tested positive for COVID even though they died in a farming accident. The truth is that various other loose definitions are applied to other infectious diseases as well (for example, take a look at tuberculosis – the CDC’s definition is clinical OR laboratory confirmed – it should be both). Similarly, chronic disease prevalence numbers are based on a laundry list of “indicators”, none of which are actual diagnoses. Are these underestimates, or overestimates, or not even in the right universe? At the very least, the places that publish these statistics should clearly explain where they actually come from. This is important for policy.

Readers, what would you like to add?