• Donald Trump has said he will give Robert F. Kennedy Jr., a notorious vaccine skeptic and conspiracy theorist, a major health role during his second term as president.
• Some health experts said elevating Kennedy, even in an informal Trump administration role, could potentially lead to severe consequences for patients, drugmakers and the nation's public health overall. 
• Experts said that could potentially look like lower vaccination rates, increases in preventable disease and greater distrust in federal health agencies.

Donald Trump has made one clear promise about who could help take up the government's health reins during his second term as president: notorious vaccine skeptic and conspiracy theorist Robert F. Kennedy Jr. 

Trump has been elected the 47th president of the U.S. in an extraordinary comeback for a former president who refused to accept his defeat just four years ago. Trump said last week that Kennedy, who ended his own independent White House campaign earlier this year and endorsed Trump, will have a "big role" in health care in his administration. Last month, Trump said he would let Kennedy "go wild" on health, food and drug regulation.

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It's unclear what exactly Kennedy's role would look like, but the possibility is already raising alarm bells in the broader health community. Some health experts said elevating Kennedy, even in an informal Trump administration position, could potentially lead to severe consequences for patients, drugmakers and the nation's public health overall. 

"I think it would be a world turned upside down," Dr. Paul Offit, a vaccine expert at Children's Hospital of Philadelphia who has been an open critic of Kennedy, told CNBC. "Things would not be grounded in scientific truth, just grounded in whatever he or his acolytes believe. It would be a free-for-all. It would be uncertainty and instability. It would be chaos." 

He said "chaos" could potentially look like lower vaccination rates, increases in preventable disease and greater distrust in federal health agencies, such as the Food and Drug Administration and the Centers for Disease Control and Prevention. 

That could exacerbate the nation's existing public health challenges, such as declining childhood vaccination rates for several preventable diseases, some experts say. The U.S. also has the lowest life expectancy at birth, the highest rate of people with multiple chronic diseases, and the highest maternal and infant death rate among other high-income nations, according to a 2023 report by the Commonwealth Fund, an independent research group. 

Kennedy, who does not have any medical or scientific credentials, believes drug companies and the federal health agencies that regulate them are making Americans less healthy. He has suggested that some vaccines should be taken off the market — a stance that Trump did not rule out Monday. 

The former environmental lawyer may also bring uncertainty to the pharmaceutical industry, which relies on federal health agencies to greenlight new products, keep old ones on the market, and, in some cases, fund research and development. It will likely be difficult for Kennedy to change the drug approval process, but experts said he could gain a new platform to politicize certain treatments he opposes and tout others that aren't proven to be safe and effective.

Top leadership roles, such as the FDA commissioner, require confirmation by the Senate, which some experts noted could pose a hurdle for Kennedy. But Kennedy has met with Trump transition officials and could take a broad White House "health czar" position that would not need Senate confirmation, The Washington Post reported Saturday. 

Regardless of what the position looks like, Kennedy will likely gain a "new podium to spread his views," said Drew Altman, president and CEO of health policy organization KFF. 

"It's giving one of the chief architects for health misinformation a national podium backed by the president," Altman told CNBC. "Many more people will hear what he has to say, believe it and act on it. That could pose a risk to their health."

Kennedy's team did not immediately respond to CNBC's request for comment.

Vaccine rhetoric and uptake

A second Trump term could allow Kennedy to elevate anti-vaccine rhetoric, regardless of whether he holds a major role at a federal health agency.

Health experts said that could deter more Americans from receiving Covid shots and routine immunizations against various diseases that have for decades saved millions of lives and prevented crippling illnesses.

"By elevating his message, it normalizes people, parents, opting out of the vaccination schedule," said Genevieve Kanter, associate professor of public policy at the University of Southern California. "I think we could reasonably predict that there would be a decline in vaccination rates among children, and perhaps vaccination overall." 

Real-world data from the CDC indicates that routine vaccination rates for kindergarten children ticked down during the pandemic and have yet to rebound. If Kennedy manages to push those rates even lower, vaccine-preventable diseases like polio and measles could potentially make a comeback, experts noted. 

For the companies that manufacture shots, an increase in anti-vaccine rhetoric could potentially translate to lower revenue. Drugmakers such as Pfizer and Moderna are still recovering from falling Covid vaccination rates in the U.S., which have dented their profits over the last two years. 

Kennedy may also affect the pharmaceutical industry's ability to respond to another pandemic if given the power to determine how much federal funding should go toward vaccine development, some experts say. He told NBC News last year that he wouldn't prioritize the research, manufacturing or distribution of shots if faced with another pandemic, falsely adding that "vaccines have probably caused more deaths than they've averted."

Kennedy's track record as a vaccine skeptic is extensive: He has long made misleading and false statements about the safety of shots, such as claiming that they are linked to autism despite numerous studies going back decades that debunk the association. Kennedy is the founder of the nonprofit Children's Health Defense, the most well-funded anti-vaccine organization in the country. 

"He misinforms to the point that children suffer or die, and also stands back and doesn't take any responsibility for it," Offit said.

He pointed to Kennedy's misinformation about the safety of the measles, mumps and rubella vaccine, which was linked to a severe measles outbreak in Samoa in 2019 that left dozens of children dead.

Regulatory process at the FDA, CDC

It would likely be harder for Kennedy to change how vaccines and other treatments are approved, recommended and regulated — even in a leadership role at the FDA, CDC or the Department of Health and Human Services, which oversees both agencies.

That could be good news for both patients and drugmakers. 

"Approval processes are very well specified and run by civil servants," USC's Kanter said. "I don't see, in terms of the day-to-day product approvals, that he would have a ton of influence because that's not the way the FDA is organized, and that's not the role of an FDA commissioner. And so this process, I think we can trust to stay constant." 

Recommendations for vaccine approval, use and coverage under certain federal health plans are made by advisory panels to the FDA and CDC, which are composed of outside public health and medical experts. The same applies to other treatments and medical devices. 

Kennedy could try to stack those committees with people who hold similar views on vaccination or other treatments to disrupt the "traditional regulatory oversight that protects us," Georges Benjamin, executive director of the American Public Health Association, told CNBC. 

But members of those panels have to undergo a rigorous nomination process. Many states that rely on advisory committee recommendations for vaccination schedules and mandates could also choose to ignore them if people sympathetic to Kennedy's views join the panels. 

Kennedy's other proposals for overhauling federal health agencies will likely be difficult to execute. He has proposed cutting funding or headcount at the FDA, but those changes could have to come from Congress. 

Last week, Kennedy warned in a post on X that the "FDA's war on public health is about to end" and hinted at plans to gut the agency of workers who don't agree with his views. 

He accused the agency of its "aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can't be patented by Pharma."

Kennedy has previously claimed that hydroxychloroquine and ivermectin work against Covid, even though several studies say they do not. Hydroxychloroquine is an immunosuppressive drug, while ivermectin is used to treat infections caused by parasites.

"He has embraced a lot of therapies that have been unproven for certain uses and some have been discredited," Kanter said. 

Chronic diseases

Both Kennedy and Trump have been vocal about tackling the root causes of chronic diseases rather than spending resources on treating those conditions with drugs from the pharmaceutical industry. There are few details on what that would look like and mean for drugmakers, but experts said Kennedy has pushed misleading claims about what factors drive chronic illnesses. 

The prevalence of chronic diseases, which last one year or more and require ongoing medical attention, is a real problem in the U.S. 

An increasing share of people in America are dealing with multiple chronic conditions, with roughly 42% having two or more, according to the CDC. More than 40% of school-aged children and adolescents have at least one. Chronic diseases such as heart disease, cancer, diabetes and obesity are also a major driver of health-care costs in the U.S., accounting for about 90% of the $4.1 trillion annual health-care expenditure, the CDC said. 

Kennedy could spearhead "Operation Warp Speed for childhood chronic disease" under a Trump administration, sources close to the former president's campaign told NBC News last week. That refers to the title of the Covid vaccine development and distribution project during Trump's first term. 

It's unclear what the new program or Kennedy's role would look like, but the focus on chronic illnesses aligns with his so-called Make America Healthy Again platform.

The initiative — a riff on Trump's Make America Great Again slogan — aims to remove chemicals from food production, combat the "root" causes of chronic diseases and eliminate conflicts of interest in medical research, among other priorities that largely have bipartisan support. Environmental factors such as air pollution and diet contribute to chronic health conditions, but Kennedy has pushed unfounded claims around certain food ingredients and minerals. 

Last week, Kennedy also proposed advising all U.S. water systems to remove fluoride from drinking water, falsely claiming that it is "an industrial waste" linked to several medical conditions, such as thyroid disease and and neurodevelopmental disorders. Trump has since said that idea sounds "OK to me."

But fluoride is a naturally occurring mineral found in soil, water and plants. Adding low levels of fluoride to drinking water is widely considered one of the greatest public health achievements of the 20th century for its role in preventing tooth decay. 

USC's Kanter also said "there is a danger of oversimplifying complicated health problems" and attributing them to a few "root causes," especially when they aren't backed by science. Chronic diseases are complex conditions that can be caused by multiple factors, such as a patient's genetics and socioeconomic status, according to Kanter. 

Kennedy's nonprofit falsely links vaccines to chronic diseases, citing misleading articles and studies that show unvaccinated populations have fewer chronic conditions than their vaccinated peers.