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  • Michael Hiltzik: RFK Jr. is a Danger to Public Health

    Michael Hiltzik: RFK Jr. is a Danger to Public Health


    Michael Hiltzik, columnist for The Los Angeles Times, explains why Robert F. Kennedy Jr. is himself a danger to public health. Why did Trump pick him? RFK Jr. is neither a medical nor a scientific researcher. He has made his mark in public as a conspiracy theorist and a publicist for the idea that vaccines cause autism and other illnesses.

    Hiltzik writes:

    Americans have become woefully familiar with Health and Human Services Secretary Robert F. Kennedy Jr., the purveyor of flagrant misinformation about medical treatments. And with Robert F. Kennedy Jr., the minimizer of health crises such as the spreading measles outbreak. And with Robert F. Kennedy Jr., the antivaccine crusader.

    Now let’s meet Robert F. Kennedy Jr., the promoter of a costly, time-consuming and distinctly unethical order for testing vaccines. “All new vaccines will undergo safety testing in placebo-controlled trials prior to licensure — a radical departure from past practices,” HHS announced in a May 1 statement. What it didn’t say was that the “departure” is “radical” because it’s shunned by medical authorities as a bad thing.

    Just this week, Kennedy’s agency doubled down on this order with the appointment of Vinay Prasad, an oncologist at UC San Francisco, as head of the Center for Biologics Evaluation and Research, the division at the Food and Drug Administration that oversees vaccine testing.

    Prasad was a strident critic of the Biden administration’s approach to the COVID-19 pandemic, including the COVID vaccines. In a blog post in late April, he called for clinical testing of COVID boosters, along the lines of Kennedy’s order. Prasad succeeds Peter Marks, a widely respected expert who resigned from the FDA in March after clashing with Kennedy.

    “I was willing to work to address [Kennedy’s] concerns regarding vaccine safety and transparency,” Marks wrote in his resignation letter. “However, it has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.”

    The HHS announcement about Kennedy’s demand for placebo-controlled trials was unclear about how it defined “new vaccines.” But his previous claims about vaccine safety have made clear that he’s referring not only to first-generation vaccines for diseases, but also boosters and expanded formulations. That’s an important point, as I’ll cover in a moment.

    The antivaccine camp, of which Kennedy has long been a leader, has pushed the claim that most childhood vaccines haven’t been adequately tested for safety because they haven’t been subjected to placebo-controlled trials — and therefore may be unsafe.

    “Except for the COVID vaccine, none of the vaccines on the CDC’s childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products,” Kennedy’s spokesman at HHS, Andrew Nixon, asserted in connection with the order.

    Both components of that claim are misrepresentations.

    Let’s take a closer look, starting with some rudimentary points.

    The testing that Kennedy and Prasad advocate are randomized control trials. They’re correct in asserting that so-called RCTs are the gold standard in clinical testing of drugs and vaccines.

    RCTs typically involve at least two groups of subjects: One receives the medicine in question and another — a control group — receives something else, such as a placebo, a concoction that’s designed to resemble the medicine but is essentially inert, with no evident effect on the disease. The placebo may be an injectable saline solution, or water, or a sugar pill.

    Kennedy, like other antivaxxers, is deceptive in saying that the safety of vaccines should be questioned if it hasn’t been tested against an “inert placebo.”

    That brings us to the ethics of clinical testing, and why Kennedy’s policy is so dangerous.

    Testing a vaccine against a true placebo is ethical and proper when it’s the first treatment for a disease for which no other safe and effective treatment exists. That’s not the case, however, when a known treatment does exist — say after a vaccine has been shown to be safe and effective and has become the standard of care.

    As vaccine specialist Paul Offit of Children’s Hospital of Philadelphia has explained, subjecting new versions of those vaccines to placebo-controlled testing — giving some subjects the new vaccine and the control subjects no treatment, would be unethical, because it would require depriving the placebo group access to a known treatment. That was the conclusion of an expert panel assembled by the World Health Organization in 2014.

    Offit, in a 2023 rejoinder to Kennedy’s appearance on a Joe Rogan podcast, in which he claimed that drug companies “never do placebo-controlled trials,” pointed to what may be the most famous vaccine trial to illustrate this point.
    That was the nationwide trial of Jonas Salk’s polio vaccine. In 1954, 420,000 first- and second-graders were given the Salk shot, and 200,000 got a shot of salt water. Salk objected to the trial’s design. Smaller trials had established the safety and efficacy of his vaccine, so the plan meant depriving 200,000 children of immunity to a disease that was paralyzing 50,000 children a year and killing 1,500.


    As Offit noted, in the full trial 16 children died from polio; all were in the placebo group. So were 34 of the 36 children paralyzed in the course of the trial. “These are the gentle heroes we leave behind,” Offit wrote.


    Now let’s examine Kennedy’s order as it applies to modern vaccines. As the veteran pseudoscience debunker David Gorski has pointed out, contrary to the assertion by Kennedy’s spokesman, almost none of the vaccines on the current childhood vaccination list is a first-generation vaccine warranting placebo testing. (An exception is Gardasil, which safeguards against human papilloma virus.)

    They’re upgraded preparations of vaccines that themselves underwent placebo-controlled trials, or formulations aimed at new variants of the targeted disease, or shots that inoculate against several diseases all at once.

    To demand that every new formulation be tested against an inert placebo would mean turning back the clock to reproduce trials that may have taken place decades ago, but resulted in the licensing of the original vaccine after safety and efficacy were established.

    That means it would have been unethical to test the new version against a saline control, because the control group would be deprived of any effective treatment. “The bottom line,” Gorski writes, “is that, if you trace back the history of the vaccines developed for a disease like, say, measles, you will eventually find the RCT testing the first effective vaccine against it and that vaccine will have had a placebo control.”
    He’s right. In a tweet thread, vaccinologist Peter Hotez traced back the history of several vaccines to their initial RCTs.

    What makes Kennedy’s order especially cynical is that designing and implementing a clinical trial is an extraordinarily complex, costly and time-consuming process. As a team of Canadian researchers observed in a 2018 Nature article, a full-scale Phase 3 clinical trial — the level at which drugs and vaccines are studied for safety, efficacy and dosing — requires as many as 3,000 participants and can take as long as four years.

    In an online posting last month, Prasad ridiculed “the mainstream media” for being upset about the idea that COVID boosters should in effect receive full randomized clinical trials before approval. He took particular issue with an article by Helen Braswell of STAT asserting that such a requirement might well delay approval of a vaccine targeting a new COVID variant until it was too late to protect users from that variant. Prasad called the argument false because “the virus spreads year round.”

    Is that so? At the height of the pandemic, new COVID variants sometimes appeared within months of one another. The virulent Delta variant, for example, appeared in the spring of 2021 and was overtaken by the Omicron variant, which also caused severe disease, that November.

    Delays in rolling out vaccines to combat newly emergent disease strains and variants could cost millions of lives. Under existing vaccine approval protocols, the COVID vaccines prevented as many as 20 million deaths globally within a year after they were introduced early in 2021.

    Prasad’s new job will put him in charge of developing vaccine testing policies and overseeing the design and approval of clinical trials. I asked him via email what policies he would pursue, whether he was in alignment with Kennedy’s approach, and how he expected vaccine developers to reconcile the costs and time constraints of undertaking clinical trials on the scale he advocates with the imperatives of public health. I didn’t receive a reply.

    So far, the Kennedy regime at HHS has lived down to the worst expectations of his critics. His devotion to unnecessary testing of vaccines that have already shown their safety and efficacy is only one aspect of a comprehensive assault on public confidence in science-based medicine.

    In a recent appearance on Sean Hannity’s Fox News program, Kennedy dismissed the severity of the current measles outbreak and denigrated the effectiveness of the measles vaccine. The current outbreak of 935 cases is by far the worst in the U.S. since 2019, when 1,274 cases were recorded; at the current rate, we are on the path to nearly 3,000 this year.

    Kennedy has promoted almost useless nostrums against measles, such as vitamin A, while describing vaccination as a personal choice. That’s devastatingly wrongheaded. Kennedy confuses “medicine” and “public health.” The former concerns itself with the individual; the latter with the community. Vaccine policy belongs in the latter category because vaccines are most effective when the effort is communitywide.

    Measles is among the most contagious diseases known to humankind, which means that communal vaccination is crucial. Professionals have concluded that a 95% vaccination rate is the minimum required to protect the most vulnerable, such as infants, from infection; as of 2024, the U.S. vaccination rate among kindergartners had fallen from 95.2% in 2019-20 to 92.7%.

    The Centers for Disease Control and Prevention, which falls within Kennedy’s jurisdiction, says the decline in measles vaccinations leaves 280,000 kindergartners at risk. Two children in the U.S. already have died from a disease that was thought to have been eradicated in the U.S. in 2020; Kennedy doesn’t seem concerned that the toll on his watch is poised to get much worse.



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  • Michael Hiltzik: Trump’s Tariff War is Nonsensical

    Michael Hiltzik: Trump’s Tariff War is Nonsensical


    Michael Hiltzik is a Pulitzer-Prize winning columnist for the Los Angeles Times, who write about business and whatever else he wants. In this column, he tries to make sense of Trump’s tariff war. It’s hard to do because it doesn’t make sense. Trump claims to have made great deals with China and the United Kingdom, but on closer inspection, he didn’t. People assume that Trump was a successful businessman, but he wasn’t. He played one on TV. He declared bankruptcy six times, and he had no background in international economic policy.

    Hiltzik writes:

    Are you confused about Donald Trump’s tariff policy, including why he instigated a global trade war, what its impact will be on the U.S. economy and how hard it will hit your pocketbook?

    Join the club. So too are economists, trade experts, political prognosticators and Trump himself. Their bewilderment has only intensified with the White House’s recent announcement of trade “deals” with Britain and China. 

    Those quote marks are proper, because it’s unclear how much of a bargain Trump has struck with those countries despite his triumphalist rhetoric. 

    Running a trade deficit is nothing new for the United States. Indeed, it has run a persistent trade deficit since the 1970s—but it also did throughout most of the 19th century.

    — Brian Reinbold and Yi Wen, Federal Reserve Bank of St. Louis

    On Monday, for instance, Trump declared that he had achieved a “total reset” in trade relations with China. That doesn’t appear to be true, given that the thrust of the announcement was a 90-day pause in the recent round of U.S.-imposed tariffs on Chinese goods and retaliatory Chinese levies on goods imported from the U.S.

    Indeed, the announcement appears at least superficially to represent another climb-down by Trump of the stern tariff regime he claimed to be imposing. No one is even sure that the purported cease-fire will survive for the full 90 days. Even if it does, it means 90 days of continued uncertainty about the relations between the two largest economies on the planet.

    Praise for Trump’s tariff policy has been largely concentrated among his Cabinet members and other courtiers. Commerce Secretary Howard Lutnick, for one, was effusive about the British negotiations, even though they plainly achieved nothing concrete. “We started at 10% [tariffs] and we ended at 10%,” Lutnick told an Oval Office press gathering last week. “We got it done in 45 days, certainly because we work for Donald Trump.”

    Stock market investors have shown every sign of hanging on for dear life as the on-again-off-again tariffs have unfolded. 

    As of Monday’s market close, the Standard & Poor’s 500 index is down 3.39% since Trump’s inauguration. The tech-oriented Nasdaq index is down by more than 5.3% since the inauguration. Both indices are in the red year-to-date.

    Let’s try to clear away some of the confusion.

    On Feb. 4, Trump imposed a 10% tariff on all Chinese goods, then raised it to 20% on March 4. That meant that the effective rate on some imports from China rose to 45%, including a 25% levy on imported steel and aluminum. That rose by another 10% on April 5, reflecting global 10% “reciprocal” tariffs that Trump described as countering tariffs placed on U.S. goods by countries around the world. A few days later, Trump raised total China tariffs to at least 145%.

    Meanwhile, China was retaliating with its own tariffs on U.S.-made imports, ultimately set at 125%. Trade between the two countries virtually halted. Shipping traffic at West Coast ports, notably the ports of Long Beach and Los Angeles, plummeted amid proliferating predictions of empty shelves in the U.S. by September.

    Where are we today? According to the initial announcement, the “reciprocal” tariff on China will remain at 10%; according to Treasury Secretary Scott Bessent, who represented the U.S. at bilateral talks this weekend. Chinese goods will still be subject to an additional 20% levy Trump has described as punishment for China’s role in fentanyl exports to the U.S. 

    China, in return, cut its retaliatory tariffs to 10% from 125%, but left in place tariffs on U.S. farm goods — an additional 15% on chicken, wheat, corn and cotton and 10% on sorghum, soybeans, pork, beef, seafood, fruits, vegetables and dairy products. That’s bad news for U.S. farmers, for whom China had been a growing market, reaching a record $36.4 billion in 2022 before shrinking to $24.7 billion last year. 

    The deal Trump claimed to have reached last week with Britain was also murky. To begin with, the rationale for imposing “reciprocal” tariffs made no sense. Trump had justified those tariffs as countermoves to trade deficits the U.S. recorded with the target countries — but Britain is among the major trade partners that have consistently run a trade surplus with the U.S., meaning that it bought more from this country than it sold. 

    (Britain ranks only eighth among America’s trading partners; Canada, Mexico and China are the top three, respectively.) 

    As was the case with China, the agreement announced with Britain amounted to an agreement to keep talking, rather than a concrete deal. For all that Trump and British Prime Minister Keir Starmer congratulated themselves for their commitment to “deliver shared prosperity for American and British citizens alike,” the document they issued explicitly states that it “does not constitute a legally binding agreement” but only anticipates a “reasonable period of negotiation.”

    Even so, the terms the White House mentioned stoked concerns among U.S. automakers. That’s because they included cutting tariffs on imported British cars to 10% from the 25% imposed on cars and auto parts imported from other countries, chiefly Canada and Mexico under the United States-Mexico-Canada Agreement, which Trump negotiated in his first term.

    “It will now be cheaper to import a U.K. vehicle with very little U.S. content than a USMCA-compliant vehicle from Mexico or Canada that is half American parts,” complained the American Automotive Policy Council, a lobbying group for Ford, General Motors and Stellantis. Which British automakers would be its chief beneficiaries? Land Rover, Jaguar, Bentley, Rolls-Royce, Mini, McLaren and Aston Martin. About 103,000 vehicles from those brands came into the U.S. in 2024, auto market analyst Sam Fiorani told the Detroit Free Press.

    That brings us back to Trump’s reliance on tariffs as a weapon in trade negotiations. His core belief appears to be that every bilateral trade deficit suffered by the U.S. is harmful to its economy, or an attack on its national security or even its sovereignty. 

    Many economists find this notion bizarre. “Running a trade deficit is nothing new for the United States,” Brian Reinbold and Yi Wen of the Federal Reserve Bank of St. Louis have observed. “Indeed, it has run a persistent trade deficit since the 1970s — but it also did throughout most of the 19th century.”

    For the most part, they argue trade deficits have been good for the U.S. economy. They reflected the importation of capital goods that fed into America’s rapid industrialization a century ago. More recently, they’ve reflected America’s wealth, which enabled U.S. consumers to buy more from abroad.

    The truth is that the international trade regime in place for the last half-century or so has been a boon for American consumers and businesses. The U.S. outsourced the lowest-skilled work for the manufacture of products including electronics and baby clothes to countries with the lowest prevailing wage rates, while turning a blind eye to the abuses visited on those laborers — adults and children alike. Tariffs were low and, perhaps more importantly, stable.

    In return, sellers — such as Apple — of those manufactured goods purchased by American consumers became some of the most valuable public companies in the world. U.S. stock prices and the value of high-tech companies in Silicon Valley soared. A new class of billionaire plutocrats, their wealth based less on manufacturing than on services, emerged.

    Inexplicably, it was Trump, who blew this long-lasting arrangement to smithereens. Not because he thought the globalization of manufacturing was morally suspect, but because he saw it as damaging to the U.S. economy.

    It’s true that manufacturing employment has seen a precipitous drop from 2000 through the 2008-2009 recession. According to international trade expert Kyle Handley of UC San Diego, some 6 million manufacturing jobs were lost in that period. But international trade was only one of several factors in the decline; automation and “a broad shift toward service sector employment” also played a role, especially in sectors such as healthcare, business and professional services, and communications and transportation.

    “Many of the changes are irreversible,” Handley wrote last year. Nevertheless, “nostalgia for the past remains salient in national conversation.” 

    Trump’s inability, or disinclination, to look deeper into the roots of U.S. trade deficits, which he sees as invariably the result of illicit trade barriers blocking U.S. exports, may explain the bewildering course of White House tariff policy. 

    For the White House to “suggest that the trade deficit is somehow reflective of trade barriers, and the administration’s cherry-picking of the data (which excludes services where the United States has a surplus) further points to the arbitrary nature of its claims,” Inu Malak of the Council on Foreign Relations observes. 

    How Trump’s deal-making will proceed from here is anyone’s guess. One question concerns whether they’re even constitutional, since the Constitution vests trade policy in Congress. A lawsuit making that point filed by five small importers harmed by the tariffs will be heard Wednesday by the federal Court of International Trade. 

    Trump has misused the International Emergency Economic Powers Act, or IEEPA, to claim that authority for himself, the lawsuit asserts. “The government’s position,” Ilya Somin, a constitutional law expert at George Mason University who represents the plaintiffs, told me, “is that IEEPA gives the president the power to impose whatever tariffs he wants, against any country, for as long as he wants, so long as he first declares a ‘national emergency’ (which they argue he can do anytime he wants for any reason).” 

    But IEEPA doesn’t mention tariffs, the plaintiffs note, and has never been used to impose or increase them. Nor can trade deficits rise to the level of a “national emergency,” as Trump claims, given that the trade imbalances present when he took office had been in place for years, even decades, the plaintiffs say. 

    The question remaining is how lasting Trump’s disruption of international trade relations will be. His policies have already had one effect: Trust in the U.S. as a reliable trading partner has been profoundly shaken. 

    America profited from that trustworthiness for many decades. It may not be restored for years to come.



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