Department of Health and Human Services Secretary Robert F. Kennedy Jr. said this week that the U.S. government will no longer make financial contributions to Gavi, the leading global organization on vaccination.
In recorded remarks sent to a Gavi's global summit, RFK Jr. said he supports the organizations' broader efforts to address the affordability of healthcare but that it has "neglected the key issue of vaccine safety" and "ignored the science" on vaccines when it's inconvenient.
"When vaccine safety issues have come before Gavi, Gavi has treated them not as a patient health problem, but as a public relations problem," RFK Jr. said in the video, which was first made public by The New York Times.
RFK Jr. said the U.S. may resume financial contributions to Gavi if the organization can justify the $8 billion in funding the country has sent since 2001 and take steps to "re-earn the public's trust."
"I'll tell you how to start taking vaccine safety seriously: Consider the best science available, even when the science contradicts established paradigms," RFK Jr. said. "Until that happens, the United States won't contribute more to Gavi."
"Define success, not just in terms of the number of vaccines delivered, but on their rigorously measured overall impacts," he continued. "Business as usual is over, unaccountable and opaque policymaking is over. I invite all of you to join us in a new era of evidence-based medicine, gold-standard science and integrity."
In a response, Gavi said it "remains committed to continuing an evidence-based and scientific approach to its work and investment decisions, as it always has done." The organization said it agreed with RFK Jr. in the need for rigorous vaccine science.
Gavi also said that any decisions made around its vaccine portfolio are based on recommendations from the World Health Organization's Strategic Advisory Group of Experts on Immunization, which is made up of independent experts who review data on vaccines through a "rigorous, transparent, and independent process."
"This ensures Gavi investments are grounded in the best available science and public health priorities," the organization said.
In his remarks, RFK Jr. was especially critical of Gavi's continued support for a vaccine for diphtheria, tetanus and whole-cell pertussis. The inoculation is designed to protect against three diseases that primarily kill young children.
The traditional version of the vaccine is common in lower-income countries as it offers more long-lasting protection in regions with a higher burden of these diseases, Gavi said. The shot can cause side effects like fever and swelling at the injection site, according to the statement.
However, RFK Jr. cited a 2017 study published by Elsevier and conducted by "five internationally revered deities of vaccine research" that he claimed concluded the vaccine may "kill more children from other causes than it saves from diphtheria, tetanus or pertussis."
RFK Jr. instead supported the DTaP vaccine, which is more commonly provided in higher-income countries, according to Gavi. The DTaP vaccine causes fewer reactions but lasts for a shorter time, requiring booster shots that higher-income healthcare systems are better equipped to support.
Despite RFK Jr.'s assertions, Gavi said in the statement that it stands by its use of the vaccination.
"In places where access to hospitals is limited and disease risk is high, the stronger protection from DTPw against these life-threatening diseases far outweighs the temporary side-effects this vaccine may cause, such as fever or swelling at the injection site (which are signs the immune system is responding)," the organization said.
The spat with Gavi comes as RFK Jr. also works to remake the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. All 17 of the panel's existing members were removed earlier this month and replaced with individuals supported by RFK Jr., who is a known critic of vaccines.
The revamped organization hosted its first meeting this week and floated a new working group that would investigate childhood vaccine schedules.