Robert F. Kennedy Jr. took office as Secretary of Health and Human Services on January 20 with an agenda centered on overhauling the federal vaccine program. Three months later, the three positions most critical to that overhaul remain unfilled. The director of the National Vaccine Program Office has not been nominated. The assistant secretary for health — the position that oversees the Advisory Committee on Immunization Practices — has a nominee awaiting Senate confirmation with no hearing scheduled. The FDA's Center for Biologics Evaluation and Research, which approves vaccines, is being run by an acting director who has been in the role since February 3 and has not been empowered to make policy changes. [1]

The ACIP, which recommends the childhood and adult vaccination schedules that drive insurance coverage and school entry requirements, has not convened since December. Four of its fifteen voting seats are vacant. It cannot form a quorum. The committee was scheduled to review updated RSV and pneumococcal vaccine recommendations in February. Those reviews are frozen. Pediatricians across the country are administering vaccines based on a schedule last updated in October 2025, and the guidance pipeline that produces updates has stopped. [1] [2]

Kennedy's office announced in February that it would conduct a "comprehensive review" of the childhood vaccination schedule — a process that would require the ACIP, which cannot meet. A federal judge in Maryland blocked a separate Kennedy initiative to remove the hepatitis B vaccine from the newborn schedule, ruling that the secretary had not followed the Administrative Procedure Act's notice-and-comment requirements. The ruling was procedural, not substantive, but it illustrated the gap between Kennedy's ambitions and his administrative capacity to execute them. [2]

The anti-vaccine agenda is not being defeated by political opposition. No congressional coalition has mobilized against it. No court has ruled on the merits of Kennedy's vaccine skepticism. The agenda is stalling because the machinery required to implement it — the nominations, the committee appointments, the regulatory processes — has not been assembled. You cannot overhaul a system you have not staffed. [1]

On X, public health accounts have shifted from alarm about Kennedy's agenda to something closer to grim relief. Dr. Peter Hotez, the vaccine advocate who has been Kennedy's most vocal critic, posted on Friday: "Governance by vacancy is not a strategy. But it might be the best outcome we could have hoped for." The comment captures the paradox: the system designed to protect public health is being protected, for now, by the incompetence of the people trying to dismantle it.

-- NORA WHITFIELD, Chicago