by Patricia Callahan

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Five months after taking over the federal agency responsible for the health of all Americans, Robert F. Kennedy Jr. wants to overhaul an obscure but vital program that underpins the nation’s childhood immunization system.

Depending on what he does, the results could be catastrophic.

In his crosshairs is the Vaccine Injury Compensation Program, a system designed to provide fair and quick payouts for people who suffer rare but serious side effects from shots — without having to prove that drugmakers were negligent. Congress created the program in the 1980s when lawsuits drove vaccine makers from the market. A special tax on immunizations funds the awards, and manufacturers benefit from legal protections that make it harder to win big-money verdicts against them in civil courts.

Kennedy, who founded an anti-vaccination group and previously accused the pharmaceutical industry of inflicting “unnecessary and risky vaccines” on children for profits, has long argued that the program removes any incentive for the industry to make safe products.

In a recent interview with Tucker Carlson, Kennedy condemned what he called corruption in the program and said he had assigned a team to overhaul it and expand who could seek compensation. He didn’t detail his plans but did repeat the long-debunked claim that vaccines cause autism and suggested, without citing any evidence, that shots could also be responsible for a litany of chronic ailments, from diabetes to narcolepsy.

There are a number of ways he could blow up the program and prompt vaccine makers to stop selling shots in the U.S., like they did in the 1980s. The trust fund that pays awards, for instance, could run out of money if the government made it easy for Kennedy’s laundry list of common health problems to qualify for payments from the fund.

Or he could pick away at the program one shot at a time. Right now, immunizations routinely recommended for children or pregnant women are covered by the program. Kennedy has the power to drop vaccines from the list, a move that would open up their manufacturers to the kinds of lawsuits that made them flee years ago.

Dr. Eddy Bresnitz, who served as New Jersey’s state epidemiologist and then spent a dozen years as a vaccine executive at Merck, is among those worried.

“If his unstated goal is to basically destroy the vaccine industry, that could do it,” said Bresnitz, who retired from Merck and has consulted for vaccine manufacturers. “I still believe, having worked in the industry, that they care about protecting American health, but they are also for-profit companies with shareholders, and anything that detracts from the bottom line that can be avoided, they will avoid.”

A spokesperson for PhRMA, a U.S. trade group for pharmaceutical companies, told ProPublica in a written statement that upending the Vaccine Injury Compensation Program “would threaten continued patient access to FDA approved vaccines.”

The spokesperson, Andrew Powaleny, said the program “has compensated thousands of claims while helping ensure the continued availability of a safe and effective vaccine supply. It remains a vital safeguard for public health and importantly doesn’t shield manufacturers from liability.”

Since its inception, the compensation fund has paid about $4.8 billion in awards for harm from serious side effects, such as life-threatening allergic reactions and Guillain-Barré syndrome, an autoimmune condition that can cause paralysis. The federal agency that oversees the program found that for every 1 million doses of vaccine distributed between 2006 and 2023, about one person was compensated for an injury.

Since becoming Health and Human Services secretary, Kennedy has turned the staid world of immunizations on its ear. He reneged on the U.S. government’s pledge to fund vaccinations for the world’s poorest kids. He fired every member of the federal advisory group that recommends which shots Americans get, and his new slate vowed to scrutinize the U.S. childhood immunization schedule. Measles, a vaccine-preventable disease eliminated here in 2000, roared back and hit a grim record — more cases than the U.S. has seen in 33 years, including three deaths. When a U.S. senator asked Kennedy if he recommended measles shots, Kennedy answered, “Senator, if I advised you to swim in a lake that I knew there to be alligators in, wouldn’t you want........

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