In nearly three weeks as Health and Human Services secretary, Robert F. Kennedy Jr. certainly hasn't allayed concerns that he'll bring his vaccine criticism — most if not all of it unfounded — into his role as the nation's top health care official.

Why it matters: Several of Kennedy's vaccine-related actions have stoked fears that the anti-vaccine movement has gained a powerful foothold within the federal government in the midst of a worsening measles outbreak in Texas, one of the worst flu seasons in more than a decade and a circulating bird flu virus that has pandemic potential.

Driving the news: Kennedy drew attention last week during a Cabinet meeting, when he described measles outbreaks as "not unusual" after one now hitting west Texas and New Mexico resulted in the first U.S. death from the virus since 2015 and almost half of the cases seen last year.

• He then wrote in a Fox News op-ed over the weekend that vaccines protect individuals and communities from the disease but also that "all parents should consult with their healthcare providers to understand their options to get the MMR vaccine," and that "[t]he decision to vaccinate is a personal one."

The lukewarm support for measles vaccines came after a tumultuous few weeks in vaccine policy, including the Food and Drug Administration's cancellation of a March 13 meeting of a federal advisory panel to discuss the composition of next season's flu shot.

• Earlier this month, a Centers of Disease Control and Prevention advisory panel on vaccines was told that a February meeting on updating vaccination guidelines had been postponed indefinitely.
• The administration is also reviewing whether to pull $590 million in funding that Moderna received in the final days of the Biden administration to develop an mRNA vaccine for bird flu, reportedly as part of a bigger examination of spending on mRNA-based shots.
• "In isolation each of these actions have their own tolerable explanation, but taken collectively they raise the specter that RFK's trial-lawyer antipathy to any and all vaccinations continues to reign supreme," a person who worked on Kennedy's confirmation told Axios.

The big picture: Everything could still turn out fine, and the U.S. may resume business as usual when it comes to vaccines after a bumpy transition period. But it's hard to ignore the series of unusual vaccine-related decisions made over the last couple of weeks against the backdrop of Kennedy's decades of anti-vaccine activism prior to his government role.

• Kennedy said during his confirmation hearing that he wouldn't take away people's vaccines, but didn't disavow past anti-vaccine statements.
• The Trump administration clearly relishes disruptions to the status quo. It's plausible that these past few weeks are just the beginning of a brand-new, less transparent approach to vaccine policy under Kennedy's leadership — an approach that deeply alarms scientists and public health experts.

Kennedy's actions so far are "significant things, and I think it's just the tip of the iceberg," said Richard Hughes, a professor of vaccine law at George Washington University and a partner at Epstein, Becker & Green.

• "This is a man who was one of the most pivotal leaders in the anti-vaccine movement," he added. "It's not like he woke up one day and said, 'You know what, I feel different about vaccines.'"

The other side: "RFK has a mandate, under the MAHA movement, to allow for all of science to be critiqued and challenged," said David Mansdoerfer, a former senior HHS official in the first Trump administration.

• "These actions don't represent the rise of an anti-vaccine movement, they instead represent a return to science being able [to be] rigorously discussed in the public square," he said.

What they're saying: Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia and a member of the FDA's advisory committee, told Axios that the cancellation or postponement of meetings, combined with recent workforce reductions at health agencies, reflects "just a gradual sort of dismembering of the public health service."

• Offit said he didn't know the reasoning behind cancellation of the meeting on flu vaccine but that HHS officials said that they are going to make the decision about the vaccine internally within the FDA.
• "The irony to me is that Robert F Kennedy Jr. talks endlessly about transparency, and now you have meetings being canceled and decisions being made behind closed doors," Offit said.

Some advocacy groups were especially alarmed at the cancellation of the flu vaccine discussions, considering the severity of the current flu season and possibly delays formulating next year's shots.

• "Cancelling essential health advisory committee meetings without promptly rescheduling them is appalling," said Public Citizen Health Research Group director Robert Steinbrook.

Officials haven't said why the advisory panel's meeting on flu vaccines was canceled, but an HHS spokesperson said the FDA will "make public its recommendations to manufacturers in time for updated vaccines to be available for the 2025-2026 influenza season."

• HHS and CDC said in identical statements that the meeting on updating vaccination guidelines for infectious diseases was postponed "to accommodate public comment in advance of the meeting," adding that advisory working groups had met as scheduled.
• Addressing the review of federal funding of mRNA vaccines, an HHS spokesperson told Axios: "While it is crucial that the U.S. Department and Health and Human Services support pandemic preparedness, four years of the Biden administration's failed oversight have made it necessary to review agreements for vaccine production."

What to watch: Kennedy has considerable discretion to put his stamp on vaccine policy, drug approvals and any number of other issues.

• Some critics expect more requests for vaccine safety data and the appointment of like-minded individuals to advisory panels that could influence coverage of drugs, services and devices.
• His leadership could also result in a shift of federal health funding to chronic disease or unproven cures, and away from infectious diseases.

Tina Reed contributed to this story.

After watching 6-plus hours of Robert F. Kennedy Jr. testifying before two Senate committees, I have no idea whether he'll be confirmed as HHS secretary — I could see it going either way.

• Yes, but: It was still incredibly interesting to watch Kennedy reintroduce himself after decades in the public eye, hear more about how he'd govern and, in some cases, read between the lines of what he wasn't saying.

Here are some major takeaways from the hearings:

He's not declaring himself an entirely new man — on vaccines, on abortion or on many of his Democratic views.

Kennedy didn't deny several of his outlandish past statements, although he frequently tried to add context or explanation. He also began his testimony by saying that "news reports have claimed I am anti-vax or anti-industry. I am neither."

• But he refused to acknowledge that vaccines don't cause autism, saying only that he wouldn't take any preconceived notions into the office with him and would look at the data.
• The problem with that, as several senators pointed out, is that reams of studies have existed for years that find no link between vaccines and autism.

He also made no attempt to convince them he'd had a personal change of heart about abortion policies, saying repeatedly instead that he would implement President Trump's policies and that "every abortion is a tragedy."

• He didn't run away from other liberal positions, either, saying at one point that he and Trump have "agreed to disagree" on climate change.

Deference to Trump — both by Kennedy and GOP senators — may make none of that matter.

That's not to say Kennedy doesn't have any true fans, and he was vocally supported and praised by several GOP senators. Many on both sides of the aisle found points of agreement with him.

• But on abortion, one of his diciest issues, his repeated commitment to follow Trump's lead seemed to satisfy ardent anti-abortion members, although several Democrats did their best to remind those colleagues that Kennedy's personal values have been in stark contrast with their own.
• It's "great that my Republican colleagues are so open to voting for a pro-choice HHS secretary," Sen. Maggie Hassan, a New Hampshire Democrat, said at one point.

He's unfamiliar with the basics of how the federal health programs work.

This first became apparent during Louisiana Republican Sen. Bill Cassidy's first round of questioning on Wednesday, when he asked a series of Medicaid-related questions. Kennedy's answers contained factual errors about the program and suggested a lack of familiarity with federal health programs.

• Hassan then went in for the kill yesterday, asking him to explain what each of the four major parts of the Medicare program cover. Kennedy fumbled his responses.

If Kennedy is confirmed — or maybe even if he isn't — pharma is probably in trouble.

The hearings yielded very little information about what Kennedy would want to do as secretary outside of public health and vaccine policy. But he did have a few illuminating comments on drug pricing.

• In an exchange with Sen. Bernie Sanders (I-Vt.) about how much more the U.S. often pays for pharmaceuticals compared with other countries, Kennedy said that "we should end that disparity" and that he's spoken with Trump about it.
• He told Sen. John Hickenlooper (D-Colo.) that "I've spoken to President Trump about negotiations. He's absolutely committed to negotiating lower drug prices."
• And in a fiery back-and-forth with Sanders, Kennedy made clear his disdain for the pharmaceutical industry's influence in Washington.
• "Almost all the members of this panel — including yourself — are accepting millions of dollars from the pharmaceutical industry and protecting their interests," Kennedy said.

Where it stands: For the handful of senators truly on the fence about Kennedy's nomination, he may not have made the decision much easier for them. As a reminder, Kennedy can only lose three Republicans if every Democrat votes against him.

• At the end of yesterday's hearing, Cassidy told Kennedy that he is "struggling with your nomination."
• Does someone "who has spent decades criticizing vaccines and who is financially vested in finding fault with vaccines — can he change his attitudes and approach now that he'll have the most important position influencing vaccine policy in the United States?" Cassidy asked.
• "Will you continue what you have been, or will you overturn a new leaf at age 70?"

What the White House is saying: "After two days and over six hours of testimony in two Senate Committees, we are fully confident [Kennedy] will be confirmed by the U.S. Senate, 🇺🇸" confirmation spokesperson Katie Miller posted on X.

Almost everyone I talked to thinks this is ultimately going to be a nail-biter, including both Kennedy supporters and critics.

• If he is confirmed, it's also hard to predict which version of himself he'll bring to the job as the nation's top health official.

The success of Robert F. Kennedy Jr.'s first confirmation hearing Wednesday "kind of depends on which Bobby Kennedy shows up," as one Trump administration source working on his nomination put it.

Why it matters: Whether Kennedy becomes the next Health and Human Services secretary likely hinges on his ability to convince a handful of Republican senators that he's not the version of himself that was on public display only a few months ago — or at least that he can hold those instincts back once confirmed.

The big picture: The Kennedy who made his personal fame — and some of his fortune — around challenging the safety of vaccines and embracing other positions well outside the GOP mainstream has largely disappeared from public view since President Trump nominated him in mid-November, replaced by a more buttoned-down persona.

• The question is which version appears in potentially heated exchanges with senators from both parties. Kennedy can only afford to lose three Republican votes, assuming Democrats are united in opposition.
• "He's got to have a good hearing, address some of the concerns we all know, like vaccine, couple other things like that," Sen. Thom Tillis told reporters this week, Axios Pro's Peter Sullivan reported Tuesday.

Between the lines: Beyond being one of the nation's most prominent vaccine skeptics, Kennedy has also been a lifelong Democrat with liberal views on issues like the environment and abortion — until he teamed up with Trump late in the campaign.

• His personal life is littered with controversy and scandal, including new accusations by his cousin Caroline Kennedy in a letter to senators in which she called him a "predator." The letter was first reported by the Washington Post.
• "His basement, his garage, his dorm room were the centers of the action where drugs were available, and he enjoyed showing off how he put baby chickens and mice in the blender to feed his hawks. It was often a perverse scene of despair and violence," she wrote of Kennedy.

State of play: Kennedy's vulnerabilities haven't changed much in the months since his nomination was announced. A spokesperson didn't respond to a request for comment for this story.

• One tightrope Kennedy will have to walk is abortion, a subject that even lifelong foes of the procedure have struggled to navigate politically since the Supreme Court ended the federal right to abortion.
• "I think the challenge is his personal beliefs versus Trump's personal beliefs versus what GOP senators need to hear," said the source working on the confirmation.
• Treading that line "requires finesse and humility. Neither are characteristics he has in great abundance," the source added.

Although most anti-abortion groups have held their fire against Kennedy despite his prior pro-choice views, Advancing American Freedom — a group led by former Vice President Mike Pence — has voiced full-throated opposition to his nomination.

• A new ad from the group features a video of Trump himself from last year calling Kennedy a "radical left Democrat," and urging senators to vote against his nomination.

Where it stands: So far, he's not convincing major conservative editorial boards that he's moderated enough to be qualified for the position.

• "Senators would be wise to believe RFK Jr.'s career of spreading falsehoods rather than his confirmation conversions," the Wall Street Journal editorial board recently wrote.
• "[N]othing has changed about Kennedy from last spring. He's still a radical left lunatic who is anti-energy, a 'big time' taxer and completely incoherent about our nation's health," the NY Post editorial board wrote. "No Republican can vote for this guy. No senator should."

What we're watching: The only audience that matters, of course, are the 100 senators, half of whom Kennedy must convince to back him. The more Kennedy can stick to safe answers around topics like vaccines and abortion, the better off he'll be with members who are still on the fence.

• Some GOP lawmakers have said Kennedy's recent statements that he won't take away the polio vaccine are reassuring, but others are looking to this week's hearings, Peter reports.
• "I'm certainly concerned about it," Sen. Lisa Murkowski said when asked about his vaccine views. "I know others have other points of concerns that they want to drill down on and try to get some public commitments from him on."

Seed oils are being targeted by Robert F. Kennedy Jr. and influencers claiming they are linked to chronic illness and other health concerns, but many health experts say the oils are simply caught up in the real problem: Americans' diet and overconsumption.

Why it matters: The debate over seed oils ultimately ties back to Americans' over-reliance on processed foods and other, broader dietary habits that many people want the government to help address.

Driving the news: Online influencers and the RFK-led health movement alike share a skepticism of seed oils and their impact on people's health.

• Oils made from seeds including canola, soy and sunflower have been dubbed the "Hateful Eight."
• RFK has said Americans are being "unknowingly poisoned" by them and claimed beef tallow is a healthier option.
• "To turn the page on our chronic disease crisis, the new administration should initiate a thorough, science-based review of seed oil," author Nina Teicholz recently wrote in the Washington Examiner.

But many nutritionists say seed oil concerns are overblown, lack context or just aren't based in science. Studies have repeatedly found they are safe to consume and may even be associated with lower risks of cardiovascular disease, cancer and Type 2 diabetes, per the NYT.

• Nutritionists say they're also much healthier than other sources of fat, like butter and lard, the NYT reported last month.
• Seed oils are mainly made up of unsaturated fats, and are high in heart-healthy omega-6 fatty acids and low in omega-3 fatty acids.
• "Many ultra-processed foods are lower in nutrient density, but the oil itself has really been demonized," Judy Simon, a registered dietitian nutritionist at the University of Washington Medical Center, told Verywell Health.

The latest: A recent study found ultra-processed foods high in seed oils may increase the risk of developing colon cancer, which is rising among younger people.

• An excess amount of omega-6 fatty acids found in ultra-processed foods may be to blame, Scientific American reports. Seed oils are used in a lot of packaged and processed food.
• It's not that omega-6 is bad for you; it's that Americans tend to eat too much of it.
• "Omega-6 is an essential fatty acid. You've got to have it — but...it's like everything else: it should be in moderation," Timothy Yeatman, a co-author of the study and a professor of surgery at the University of South Florida, told Scientific American. "But the problem is we've massively overdone the amount of seed oil in foods."

What they're saying: Although seed oils themselves are typically processed, "even worse than that...is they're usually used to make ultra-processed foods — think fast food burgers and fries and anything you'd eat at a state fair or get in a package in the grocery store," the Cleveland Clinic writes in a blog post.

• "Outside of your own home, you're most likely to consume seed oils when you're eating something that's already pretty bad for your health — something that's also full of fat, sugar and sodium," the blog post adds.

The bottom line: Using seed oils — in moderation — to cook healthy meals at home is probably fine. The real takeaway is that eating fast food and heavily processed foods all the time isn't.

Unflattering stories about Robert F. Kennedy Jr.'s personal life and influential criticisms of his public health stances are already starting to pile up — more than a month and a half before President-elect Trump takes office and can even officially nominate him to lead Health and Human Services.

Why it matters: Kennedy can only afford to lose three Republican senators' votes, assuming all Senate Democrats vote against him. The question is how much the handful of wavering members will accept.

Driving the news: News stories published over the past few days highlight Kennedy's key vulnerabilities, including the wildcard presented by his colorful past.

• A deeply reported piece by the New York Times discusses his "drug addiction, compulsive sexual behavior and deep dives into conspiracy theories," including his arrest and conviction for heroin possession and a journal he kept documenting sexual encounters with more than three dozen women in one year.
• Kennedy was accused of sexual assault in the late 1990s by a woman who interned at his law clinic and babysat for his family. The woman has said she's willing to testify before the Senate, the Wall Street Journal reports. Kennedy didn't comment on the claims.

What they're saying: Trump's transition team is working to address concerns about Kennedy's abortion-related positions, CNN reports.

• A Trump transition spokesperson told CNN "this is President Trump's administration that Robert F. Kennedy has been asked to serve in and he will carry out the policies Americans overwhelmingly voted for in President Trump's historic victory."

Zoom in: Kennedy has in the past used the word "fascism" to describe the Centers for Disease Control and Prevention's vaccine division and compared an alleged widespread cover-up of vaccine harms — for which there is no evidence — to the Catholic Church's cover-up of child sexual abuse, NBC reports. Neither Kennedy nor the Trump transition team responded to requests for comment from NBC.

• Kennedy ally Del Bigtree, CEO of the MAHA Alliance PAC, suggested on X that Kennedy's opinions haven't changed: "Bobby didn't get dragged through the mud for over a decade just so he could compromise his values once he finally got inside the castle."

The intrigue: Although criticism is nothing new for Kennedy, a powerful voice has joined in: Trump's former FDA commissioner Scott Gottlieb, who is widely respected in GOP circles and beyond.

• Gottlieb said Friday on CNBC that he has "deep concerns" about Kennedy's intentions, especially related to childhood vaccines.
• "What I worry about is we're at a tipping point, that we're going to start seeing epidemics of diseases that have long been vanquished," Gottlieb said.
• "I think if RFK follows through on his intentions — and I believe he will, and I believe he can — it will cost lives in this country," he added.

President-elect Trump has selected vaccine skeptic Robert F. Kennedy Jr. to lead the nation's top health care agency, which would give him power over food and drug regulation, Medicare and Medicaid policy, the federal public health system and national health care research money.

Why it matters: We're now in the Wild West in a way we never were during Trump's first presidency, at least when it comes to health care.

• The pick is a radical departure from both mainstream science and Republican orthodoxy, and even before we know if Kennedy will be confirmed, the fallout is sending shockwaves through health care markets.
• "Kennedy likely will lead to significantly more volatility in health markets, making navigating policy risks far more challenging," Raymond James analyst and former Trump administration health official Chris Meekins wrote yesterday in an investor note.
• "If Kennedy is confirmed, it is hard to bookend risks for investors as his views are so outside the traditional Republican health policy orthodoxy."

What they're saying: "For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health," Trump posted on X, announcing the decision.

• "Mr. Kennedy will restore these Agencies to the traditions of Gold Standard Scientific Research, and beacons of Transparency, to end the Chronic Disease epidemic, and to Make America Great and Healthy Again!"

Between the lines: Kennedy's views on vaccines and the need to revamp health agencies are well-known at this point. But his views on more traditional health care topics — like Medicare Advantage or the Affordable Care Act subsidies — are much less clear.

• And on some topics, especially the value of the pharmaceutical industry, Kennedy has starkly different views than most Republicans — including those who may be staffing the administration in other health care roles.
• On the other hand, his appointment is likely to set the tone for other top health care appointees, like FDA commissioner or CMS administrator — and potentially scare away would-be contenders who don't share his views.
• Kennedy's appointment is likely to amplify fears of top government scientists fleeing health agencies.

Yes, but: Kennedy still probably has to get confirmed by the Senate, though there's been a lot of talk lately about Trump pushing for the use of recess appointments to skirt around the confirmation process. (Here's a good Semafor explainer of why that is easier said than done.)

• Regardless of how Senate Republicans react, a confirmation process would be brutal.
• "Mr. Kennedy's outlandish views on basic scientific facts are disturbing and should worry all parents who expect schools and other public spaces to be safe for their children," Senate Finance Committee Chair Ron Wyden said in a statement after the announcement.
• "When Mr. Kennedy comes before the Finance Committee, it's going to be very clear what Americans stand to lose under Trump and Republicans in Congress."

The big picture: By elevating Kennedy to such a position of power, Trump has lent credence to a messenger who distorts and misrepresents basic facts or concepts that have been rigorously proven.

• The post-pandemic years have shown how easy it is for seeds of doubt to translate into reduced vaccination rates and, in the case of measles, the outbreak of a disease that was declared eliminated in the U.S. in 2000.

Go deeper: What a Trump-empowered RFK Jr. could do on health care