By Josh Nathan-Kazis

Robert F. Kennedy Jr., a prominent vaccine skeptic, is now in charge of the U.S. Department of Health and Human Services, the sprawling federal agency responsible for drug approvals, the Medicare and Medicaid programs, vaccination guidance, public-health emergencies, and pandemic preparedness.

The Senate confirmed President Donald Trump's nomination of Kennedy as Secretary of Health and Human Services in a 52 to 48 vote on Thursday morning. All but one Republican voted in favor of confirming the nomination, while all Democrats voted against.

Kennedy's confirmation has been essentially a sure thing since early February, when a prominent Republican who was seen as a possible "no" on Kennedy, Sen. Bill Cassidy, said he would back the confirmation. Drug stocks fell at the time.

As recently as January, Kennedy refused to rebuke the discredited theory that childhood vaccines cause autism.

Cassidy's announcement appeared to buckle Republican opposition. Rumored potential "no" votes like Sen. Susan Collins, a moderate Republican from Maine, and Sen. Lisa Murkowski of Alaska, voted in favor.

On Thursday, the only Republicans to vote against Kennedy was Sen. Mitch McConnell, the former majority leader, who survived polio as a toddler. The introduction of a polio vaccine in the 1950s resulted in the eradication of the disease from North and South America in the 1990s.

After President Donald Trump won the presidency in November, conventional wisdom in policy circles held that Kennedy would be too much for Senate Republicans to swallow, and his nomination would fail.

Democrats railed against Kennedy, but were unable to convince enough Republicans to join them.

"Every single Democrat will oppose Mr. Kennedy's nomination," Sen. Chuck Schumer, the minority leader, said on the floor of the Senate on Thursday morning. "If the Senate held a secret ballot today, I'll bet Mr. Kennedy would never come close to becoming confirmed, and that many, if not most, Republicans would vote against him."

The drug industry, for its part, made no visible effort to oppose the confirmation. "My stance is that you need to engage with him," Pfizer CEO Albert Bourla said of Kennedy in an interview with Barron's on Feb. 4. The stance is of a piece with the industry's broader strategy, which has been to avoid conflict with the Trump administration while trying to make progress on long-term industry priorities like pushing back against the pharmacy-benefit managers.

In a statement moments after the vote, the president and CEO of the drug industry lobbying group PhRMA, Stephen Ubl, said drugmakers were looking forward to working with Kennedy. "During his confirmation hearings, Secretary Kennedy discussed the need to reduce the burden of chronic disease, improve health outcomes and make healthcare more affordable for the American people," Ubl said. "Our industry is eager to work with the Trump administration to help address these urgent priorities."

Kennedy is now headed for HHS, which has the largest budget of any federal agency. There has been much speculation about what his leadership will mean for the Food and Drug Administration, the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services, among the other agencies that fall under HHS's purview.

On vaccines, Kennedy has presented a moderate face during the confirmation process. Cassidy said on the Senate floor in early February that Kennedy had promised him he wouldn't remove statements from the CDC website asserting that vaccines don't cause autism and would give the Senate notice 30 days before making any changes to federal vaccine-safety monitoring programs.

Cassidy also said Kennedy had promised to maintain the recommendations of the CDC's Advisory Committee on Immunization Practices, the influential outside body that sets vaccination schedules used in the U.S.

The rest of Kennedy's agenda remains an open question. In his hearing before two Senate committees, Kennedy displayed a tenuous grasp on the details of Medicare and Medicaid, which some observers took as an indication that the programs may not be an area of focus for him.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com

This content was created by Barron's, which is operated by Dow Jones & Co. Barron's is published independently from Dow Jones Newswires and The Wall Street Journal.

(END) Dow Jones Newswires

February 13, 2025 11:51 ET (16:51 GMT)

Copyright (c) 2025 Dow Jones & Company, Inc.