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The vaccine tug of war inside the Trump administration, briefly explained

Who’s really in charge on health policy?

President Trump Signs Executive Order On “Fostering The Future”
President Trump Signs Executive Order On “Fostering The Future”
Donald Trump shakes hands with Health and Human Services Secretary Robert F. Kennedy Jr. in the East Room of the White House on November 13, 2025.
Heather Diehl/Getty Images

This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.

Welcome to The Logoff: The CDC is leaning into anti-vax rhetoric, suggesting in a recent change to its website that there is no fixed scientific consensus on whether vaccines cause autism (they do not).

What’s the context? The change, which has been met with dismay among career CDC staffers, cements the agency’s pivot away from evidence-based public health guidance under the Trump administration.

It also comes as a larger power struggle, centering on Health Secretary Robert F. Kennedy Jr. and FDA Commissioner Marty Makary, is unfolding over the administration’s health care agenda and vaccine policy. While Kennedy and Makary have been publicly aligned on most issues, news reports suggest that their battle for influence is heating up.

Why are they fighting? Part of the problem may be clashing management styles. But dig a little deeper, and this appears to be the dynamic: Kennedy, the outsider anti-institutionalist with no medical background, is pushing to go bigger and bolder and faster with changing public health policy, while Makary, a former Johns Hopkins surgeon, is moving more deliberatively.

What does Donald Trump think? This is the big question — and the hardest one to answer. Trump is inconsistent and has at times chided Kennedy for being overly anti-vaccine. But he also delivered an extended rant about aluminum in vaccines during a White House event. On top of that, the issue isn’t a top priority for him, which creates a power vacuum that both Kennedy and Makary are trying to fill.

Why does this matter? The Kennedy-Makary tug-of-war helps us make sense of the Trump vaccine agenda so far: They’re more anti-vaccine than any prior administration, but they have also hesitated to take bigger swings. They want to appease the Make America Healthy Again coalition without fully alienating more vaccine-friendly voters or the drug industry.

But if Kennedy wins out, he could hit the accelerator on overhauling vaccine policy in his anti-vax image.

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And with that, it’s time to log off…

NPR’s latest Tiny Desk Concert, featuring the Goo Goo Dolls, was such a treat, and you can listen to it here. I hope you enjoy, and as always, thanks for reading, have a great evening, and we’ll see you back here tomorrow!

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