Government Goes Goop

Emory Law Scholarly Commons Emory Law Scholarly Commons

Emory Law Journal

3-26-2026

Government Goes Goop Government Goes Goop

Jennifer D. Oliva

Part of the Law Commons

Jennifer D. Oliva*

This Article argues that the appointment of prominent wellness and antivaccine figures to senior federal health positions marks the culmination of a long-running evolution in American health fraud—from nineteenth-century traveling medicine shows to the institutional capture of government health agencies. Drawing a direct lineage from patent medicine marketing to contemporary wellness conspiracism, this Article demonstrates how tactics perfected by early medicine show entrepreneurs—emotional manipulation, conspiratorial framing, anti-establishment positioning, and the exploitation of information asymmetries—have persisted across regulatory and technological shifts, ultimately achieving unprecedented political legitimacy.

This Article traces this evolution through the deregulated supplement marketplace created by the Dietary Supplement Health and Education Act of 1994, the amplification of health misinformation by social media platforms, and the COVID-19 pandemic’s destabilization of public trust in scientific authority. It then examines how these dynamics enabled the elevation of wellness-aligned figures to leadership roles at the Department of Health and Human Services, the National Institutes of Health, the Centers for Medicare and Medicaid Services, and the Food and Drug Administration. The resulting transformation of federal health agencies—from evidence-based institutions into platforms for wellness ideology—has produced immediate public health consequences, including mass resignations of career officials, preventable disease outbreaks, and erosion of America’s scientific credibility.

By situating contemporary wellness governance within a longer history of health fraud and regulatory arbitrage, this Article contends that the phenomenon of “government gone Goop”1 represents a broader crisis of

democratic governance: whether institutions tasked with protecting the public can maintain epistemic integrity in information environments that reward confusion, distrust, and commercially profitable misinformation.

INTRODUCTION ................................................................................................. 35

A SHORT HISTORY ................................................................................. 37 A. The Theatrical Roots of Modern Wellness Fraud .......................... 37 B. The Economics of Hope and Regulatory Capture ......................... 40 C. Mass Media Evolution and Information Warfare .......................... 44

ANTI-VACCINE EVOLUTION .................................................................. 47 A. Platform-Specific Wellness Fraud Innovation ............................... 47 B. The Wakefield Foundation and Celebrity Amplification ............... 49 C. COVID-19 and the Mainstreaming of Health Conspiracy ............ 51

INSTITUTIONALIZING HEALTH MISINFORMATION ................................. 53 A. Secretary Kennedy as Anti-Vaccine HHS Czar ............................. 53 B. Bhattacharya’s Lockdown Ideology at NIH .................................. 58 C. Oz’s Miracle Cure Administration at CMS ................................... 60 D. Makary’s Contrarian FDA and Vaccine

Skeptic Appointments ..................................................................... 63

GONE GOOP ........................................................................................... 67

A. Vaccine Hesitancy, Institutional Collapse, and

Preventable Disease Outbreaks ..................................................... 67 B. The Erosion of Scientific Authority in Health Policy .................... 74 CONCLUSION ..................................................................................................... 79

The theatrical medicine shows of the nineteenth century and today’s social media wellness influencers share more than historical curiosity might suggest. Both exploit identical psychological vulnerabilities, employ remarkably similar marketing tactics, and promise miraculous health transformations to audiences desperate for hope and control over their well-being.2 What has changed is not the fundamental nature of health fraud, but its scale, sophistication, and most alarmingly, its penetration into the highest levels of American government.3

The appointment of Robert F. Kennedy, Jr. as Secretary of the U.S. Department of Health and Human Services (HHS) represents the culmination of a century-long evolution from traveling medicine shows to institutionalized health misinformation.4 Kennedy’s confirmation, concomitant with the the Trump substantial representation of wellness-adjacent figures Administration—including former reality television star Dr. Mehmet Oz as Centers for Medicare and Medicaid Services (CMS) Administrator, COVID-19 contrarian Dr. Jay Bhattacharya as National Institutes of Health (NIH) Director, and vaccine mandate critic Dr. Martin Makary as Food and Drug Administration (FDA) Commissioner5—illustrates how tactics perfected by nineteenth-century patent medicine peddlers have achieved unprecedented political legitimacy. Makary’s subsequent appointments of vaccine skeptics Dr. Vinay Prasad and

Dr. Tracy Beth Høeg to lead the FDA’s biologics and drug evaluation centers further illustrate the systematic nature of this institutional capture.6

This transformation carries profound public health consequences. When government health agencies become platforms for the same misinformation tactics that drove profitable but dangerous patent medicine sales, the result extends beyond consumer fraud to the potential collapse of institutional safeguards protecting population health.7 The COVID-19 pandemic provided a preview of these dangers as wellness influencers and their political allies successfully redirected millions of Americans away from proven interventions and toward profitable but ineffective alternatives.8

Understanding how we arrived at this moment requires tracing the continuous thread connecting Clark Stanley’s snake oil performances9 to the Trump Administration’s anti-vaccine advocacy and Robert F. Kennedy, Jr.’s Make America Healthy Again (MAHA) platform.10 The story reveals that American health and wellness fraud has always been fundamentally about political and economic power—the power to shape public understanding of health and disease, to direct billions in healthcare spending, and to ultimately determine which voices are considered authoritative in matters of life and death.

This Article examines the direct lineage from nineteenth-century medicine shows through the deregulated supplement industry to today’s social media wellness empire, demonstrating how each era’s innovations in marketing and political influence set the stage for the next generation’s expanded reach and

harm. The stakes could not be higher. With wellness conspiracists now controlling federal health policy—and twelve former FDA commissioners warning that current leadership threatens to “upend core policies governing vaccine development”11—America faces the prospect of a return to prescientific approaches to public health, with consequences that will be measured not in dollars lost to wellness scams but in preventable disease and death.

This Article proceeds in four Parts. Part I traces the historical origins of wellness fraud. Part II examines the role of deregulation and mass media. Part III analyzes the social-media-driven anti-vaccine movement and Part IV documents the public health consequences of institutional capture.

This Part of the Article traces the historical foundations of modern wellness fraud from its theatrical origins to its contemporary regulatory environment. Section A examines how nineteenth-century medicine shows established the foundational template for health deception through entertainment, emotional manipulation, and performed authenticity. Section B explores how twentiethcentury pharmaceutical regulation evolved and the 1994 Dietary Supplement Health and Education Act created a deregulated marketplace that essentially legalized modern patent medicine marketing. Section C concludes this Part by following health fraud’s migration across mass media platforms—from radio to television each technological transition expanded the reach and sophistication of wellness misinformation while preserving its core manipulative techniques.

advertising—demonstrating

direct-response

how

to

A. The Theatrical Roots of Modern Wellness Fraud

The traveling medicine shows of the post-Civil War era established the foundational template for virtually every modern wellness scam through a sophisticated combination of entertainment, testimonials from planted audience members, scientific-sounding claims, and emotional manipulation.12 These elaborate productions created a framework instantly recognizable to anyone familiar with contemporary wellness marketing, from Dr. John R. Brinkley’s goat testicle transplant procedures to countless patent medicines promising to

restore natural vitality and optimize wellness.13 Patent medicines were commercial medicinal products sold directly to consumers by non-medicinetrained entrepreneurs as over-the-counter cure-all remedies in the eighteenth and nineteenth centuries.14 Despite their name, these products were never patented because manufacturers sought to keep their formulas secret.15

Medicine show entrepreneurs systematically engaged

in cultural appropriation: They constructed fictional narratives connecting their products to Indigenous healing traditions, Eastern mysticism, and “ancient secrets,” which exploited romanticized Western fantasies about non-Western medical knowledge.16 In so doing, they profited from cultural stereotypes and entirely fabricated connections to traditional healing practices.17 Medicine show performers also employed conscious and identifiable strategies of performed authenticity to cultivate audiences. These strategies demonstrated how authenticity functions as relational work that can be performed and negotiated between marketers and their audiences, enabling them to build trust and credibility while promoting health products and advice that may lack scientific support.

For example, Clark Stanley, the original “Rattlesnake King,” demonstrated the power of performative authenticity in health marketing through an elaborate backstory claiming he learned healing secrets from Hopi medicine men while working as a cowboy.18 This narrative created a compelling alternative to formal medical training, positioning Stanley as an authentic frontier healer rather than a trained physician. When federal investigators revealed that Stanley’s “snake oil” contained no snake oil whatsoever—just mineral oil, beef fat, and chili pepper—the revelation barely impacted sales because customers were purchasing Stanley’s story and identity as much as his purported miracle nostrum.19

The medicine show entrepreneurs understood that successful wellness grifting demanded more than dubious products—it required building movements and communities around shared skepticism of established authority.20 For instance, the Kickapoo Indian Medicine Company, founded by non-Native hucksters “Texas Charlie” Bigelow and John E. “Doc” Healey, featured frontier independence and self-reliance, values that made audiences more receptive to purchasing so-called Indian Sagwa elixirs from charismatic entertainers rather than seeking advice from trained physicians.21 This strategy of embedding health misinformation within broader cultural and political narratives would prove remarkably durable across technological and social changes.

elaborate Native-inspired performances

celebrating

Patent medicine manufacturers also pioneered the use of pseudoscientific language to lend credibility to dubious claims.22 Products like William Radam’s “Microbe Killer” and Lydia Pinkham’s “Vegetable Compound” employed medical-sounding terminology while making vague promises about restoring health and wellness.23 This approach allowed manufacturers to imply medical benefits without making specific claims that could be easily disproven—a strategy that remains central to modern supplement marketing and social media wellness promotion.

Perhaps most importantly, medicine show promoters mastered the art of exploiting information asymmetries. Most Americans in the late nineteenth century had limited access to medical care or scientific education, making them vulnerable to authoritative-sounding claims from charismatic performers.24 The

entrepreneurs positioned themselves as democratizers of health knowledge, offering ordinary people access to “secret” treatments supposedly being suppressed by the medical establishment for profit25—a conspiratorial framing that continues to drive contemporary wellness marketing.26

B. The Economics of Hope and Regulatory Capture

The federal government’s approach to pharmaceutical regulation underwent dramatic transformation during the twentieth century, establishing increasingly stringent oversight that would later contrast sharply with the supplement industry’s deregulated environment. The Pure Food and Drug Act of 1906, America’s first comprehensive consumer protection law, emerged from Progressive Era concerns about patent medicine dangers.27 It required accurate labeling of certain drug ingredients, while placing the burden of proving harm on government regulators rather than requiring manufacturers to demonstrate safety.28 The Food, Drug, and Cosmetic Act of 1938 (FDCA), enacted following the 1937 sulfanilamide tragedy that killed over one hundred people,29 fundamentally shifted this framework by requiring pharmaceutical companies to prove new drugs were safe before marketing them, transforming the FDA from a post-market enforcement agency to a pre-market gatekeeper.30 The 1962 Kefauver-Harris Amendments to the FDCA, fueled by the thalidomide crisis,31

completed this regulatory evolution by mandating that drugs demonstrate both safety and efficacy through “adequate and well-controlled investigations” before approval, establishing the modern pharmaceutical regulatory framework that emphasizes scientific rigor over market freedom.32 This progressive tightening of drug oversight created an increasingly stark regulatory divide between pharmaceuticals subject to rigorous pre-market testing and the emerging supplement industry, which would soon exploit this distinction through the Dietary Supplement Health and Education Act (DSHEA).33

DSHEA was enacted in 1994 in response to FDA efforts in the early 1990s to regulate dietary supplements as food additives or drugs, which would have required pre-market safety approval.34 The supplement industry launched an aggressive lobbying campaign, forming the Nutritional Health Alliance (NHA) in 1992 and generating unprecedented constituent contact with Congress, to “preserve the consumer’s freedom to choose dietary supplements.”35 The NHA even ran a “call-to-action” advertising campaign in support of DSHEA featuring camouflaged federal agents in full tactical gear arresting Hollywood actor Mel

Gibson for his purported use of Vitamin C supplements.36 The campaign was accompanied by an ominous voice-over warning that the FDA is “actually considering classifying most vitamins and other supplements as drugs. The FDA has already conducted raids on doctors’ offices and health food stores. Could raids on individuals be next?”37 Robust industry lobbying and over-dramatized, but effective, consumer scare tactics ensured the enactment of DSHEA, which essentially legalized modern patent medicine marketing by creating a regulatory environment where tactics perfected by nineteenth-century medicine shows could operate with minimal government oversight.38

DSHEA’s framework allows supplement manufacturers to make “structurefunction” claims about their products—such as “supports immune function” or “promotes heart health”—without receiving FDA approval for such claims before selling their products to consumers.39 DSHEA also established a burden of proof regime that requires the FDA to demonstrate supplement danger before market removal, rather than mandating that manufacturers prove product safety before sale.40 This regulatory scheme recreated the environment that allowed patent medicine manufacturers to promise miraculous health benefits while largely avoiding accountability for misleading marketing and harmful health outcomes.

The supplement industry’s response to DSHEA was swift and systematic. The number of available supplements exploded from approximately 4,000 in 1994 to over 80,000 today, creating a marketplace where consumers face the same information challenges that made nineteenth-century patent medicine customers vulnerable to health and wellness fraud.41 Modern supplement marketing employs virtually identical tactics to medicine show promotion:

testimonials from satisfied customers, scientific-sounding but unsubstantiated claims about “natural” and “holistic” healing, and positioning of products as viable—and often superior—alternatives to expensive or invasive conventional treatments.42

The economic incentives that propel the supplement industry mirror those that made patent medicine so profitable. Manufacturing costs remain marginal compared to pharmaceutical development, while marketing generates enormous returns through hope and desperation exploitation.43 More than 23,000 Americans seek emergency room treatment annually due to adverse dietary supplement reactions,44 yet the industry faces minimal economic consequences because DSHEA places the burden of proving danger on regulators rather than requiring manufacturers to prove safety and efficacy.45

The supplement industry perfected political strategies pioneered by patent medicine manufacturers, positioning themselves as champions of consumer choice and opponents of government paternalism.46 This rhetorical strategy proved remarkably effective at preventing meaningful regulatory reform while maintaining profitable information asymmetries driving sales.47 The industry’s political influence expanded through strategic campaign contributions and lobbying efforts that portrayed regulatory oversight as attacks on health freedom and natural healing.48

C. Mass Media Evolution and Information Warfare

The transition from medicine shows to mass media demonstrated the scalability of health fraud techniques across technological platforms. Radio personalities like John R. Brinkley (the “goat gland transplanter”) built media empires around dubious medical advice, demonstrating how entertainment platforms could distribute health misinformation to vast audiences while generating enormous profits through product sales.49 Brinkley’s KFKB station pioneered direct-response health marketing through a program called “Medical Question Box,” where he diagnosed listeners’ ailments over the airwaves and prescribed proprietary treatments to a nationwide audience.50 His border radio stations, operating from Mexico to avoid U.S. broadcast regulations, eventually broadcast at an unprecedented 1,000,000 watts—making XER (later renamed XERA) one of the most powerful radio stations in the world and enabling his signal to reach listeners across North America and as far as South America and Europe.51 These stations pioneered regulatory arbitrage strategies that modern wellness entrepreneurs employ through offshore hosting and international business structures, which resulted in the Communications Act of 1934’s (the “Brinkley Act”) prohibition on linking U.S. studios to Mexican transmitters.52

Television further refined these techniques by adding visual elements that enhanced emotional impact. The before-and-after transformations, expert testimonials, and scientific-looking demonstrations that became television health marketing staples were direct descendants of medicine show techniques adapted for broadcast.53 A 2002 Federal Trade Commission (FTC) analysis of weight-loss advertising found that more than half of the advertisements made claims that were “almost certainly false” or lacked adequate substantiation, while a subsequent FTC report identified weight-loss fraud as the most common

source of consumer complaints—affecting 7.6 million Americans in 2011 alone.54 Programs like The Dr. Oz Show demonstrated how entertainment formatting could make dubious health advice seem authoritative by employing production values and presentation styles associated with legitimate medical programming.55

Direct-response television advertising created new opportunities for supplement marketing that closely paralleled medicine show economics.56 Infomercials promoting miraculous weight loss, balding cures, teeth whiteners, and even “cellulite-reducing seaweed gel” could reach millions of viewers while maintaining the personal, testimonial-driven approach that made medicine shows effective.57 The FTC brought over 120 enforcement actions challenging health claims for supplements in the decade following DSHEA’s passage, yet the industry’s growth continued unabated—Americans spent an estimated $2.4 billion annually on weight-loss products by 2014, with supplement industry sales reaching $25 billion in 2009 alone.58 Television supplement programming often featured doctors or celebrities who lent credibility to product claims while carefully avoiding specific medical promises that might trigger regulatory scrutiny.59

As U.S. regulators note, health‑fraud schemes “have been around for hundreds of years,” and “[t]he snake-oil salesmen of old have morphed into the deceptive, high-tech marketers of today, preying on people’s desires for easy

solutions to difficult health problems.”60 What the digital environment changes is distribution: The internet and social media now allow such schemes to reach more people and at greater speed than ever before, effectively democratizing and accelerating long‑standing fraud techniques.61 Websites combined television’s visual appeal with medicine shows’ interactive community-building aspects, while email marketing and social media enabled more intimate, ongoing relationship development with potential customers.62

By the late 1990s, FTC “surf” days, where the FTC staff and law enforcement agencies search the internet for sites making dubious claims about specific diseases, discovered hundreds of websites promoting supplements with outrageous claims about treating cancer, AIDS, hepatitis B, and other serious diseases.63 Subsequently, government that supplement manufacturers continued making false and dangerously misleading claims faster than regulators could respond and twenty-eight percent of manufacturers failed even to register with the FDA as required by law.64 Most importantly, the internet’s global reach and minimal barriers to entry allowed anyone to establish themselves as an authority on health without the capital investments required for television production or medicine show touring. The internet set the stage for the social media influencer economy that would transform wellness fraud into a political movement.

reports

found

Part II examines how social media platforms and the anti-vaccine movement transformed wellness fraud from commercial enterprise into political force. Section A analyzes how platforms like Instagram, TikTok, and YouTube democratized health misinformation by enabling influencers to build global audiences while maintaining apparent authenticity. Section B traces the antivaccine movement from its origins in Andrew Wakefield’s fraudulent research to its modern form, examining how celebrity endorsement, particularly by figures such as Jenny McCarthy, amplified its reach. Section C demonstrates ideal conditions for wellness how misinformation to achieve mainstream political influence, revealing the “wellness to QAnon pipeline” that connected health skepticism to broader conspiracy thinking.

the COVID-19 pandemic created

A. Platform-Specific Wellness Fraud Innovation

that

Social media platforms fundamentally transformed health fraud by solving limited earlier generations of wellness the scalability problems entrepreneurs.65 Instagram became the platform of choice for wellness influencers because its visual nature enabled sophisticated authenticity performance that surpassed anything possible in earlier eras.66 The Belle Gibson saga illustrates how social media wellness fraud operates.67 Gibson cultivated a huge Instagram following by chronicling an invented recovery from terminal brain cancer, using polished images and intimate storytelling to project credibility and emotional resonance.68 She parlayed that trust into commercial

products—notably, The Whole Pantry app and a bestselling cookbook—and presented herself as a fundraiser and advocate, claims later proven false.69 Investigations by journalists and consumer agencies unraveled the story, revealing that she never had the cancers she described and that promised charitable donations and other claims were untrue.70 The exposure triggered intense public backlash and legal and financial consequences, including orders to refund customers and penalties, underscoring how quickly social media credibility can produce large-scale harm when built on deception.71

TikTok’s algorithm-driven content distribution created unprecedented opportunities for health misinformation to reach massive audiences within hours.72 The platform’s short-form video format proved ideal for the simplified, dramatic health claims that have always driven wellness fraud, and dangerous trends like “dry scooping” supplements could achieve viral status before health authorities could respond.73 YouTube also enabled the creation of wellness

content that mimicked educational programming while promoting unproven treatments, because the platform’s monetization system created financial incentives for sensational health content.74

The key innovation was democratizing the medicine show model.75 Where nineteenth-century entrepreneurs needed touring productions and radio personalities required broadcast licenses, social media influencers could build global audiences from home while maintaining personal, authentic communication that made product recommendations seem like advice from trusted friends.76 This apparent intimacy masked sophisticated marketing operations generating millions in wellness product sales and affiliate commissions.77

B. The Wakefield Foundation and Celebrity Amplification

The modern anti-vaccine movement’s origins in Andrew Wakefield’s fraudulent 1998 study published in—and later retracted by—The Lancet linking the measles/mumps/rubella (MMR) vaccine to autism78 demonstrates how wellness fraud techniques are applied to undermine established public health interventions. Wakefield’s approach claimed to reveal hidden MMR vaccine

dangers that medical authorities were concealing79 and employed the same conspiratorial framing that made medicine show audiences suspicious of conventional medical advice. His targeting of concerned parents seeking explanations for their children’s developmental challenges exploited emotional vulnerabilities that made patent medicine customers susceptible to miraculous cure claims.80 The British General Medical Council ultimately revoked Wakefield’s medical license due to his unethical research on child subjects, but that had little impact on Wakefield’s vocal anti-vaccine support network.81

Celebrity endorsement transformed Wakefield’s fraudulent research from a fringe theory into a mass movement. Former actress and model Jenny McCarthy’s promotion of anti-vaccine claims on television shows, in books, and through social media demonstrated how entertainment platforms could amplify medical misinformation while avoiding the oversight regulating medical advice.82 McCarthy’s approach—combining personal testimonials, emotional appeals, and attacks on medical authority—directly paralleled the techniques used by medicine show promoters to build audience trust and skepticism of conventional alternatives.83

The

celebrity-driven

anti-vaccine movement

identical psychological manipulation techniques perfected by patent medicine marketers: creating emotional identification between celebrity experiences and audience fears, positioning mainstream medicine as corrupt or incompetent, and offering hope through alternative approaches promising safer, more natural solutions.84

employed

Celebrity amplification proved crucial in transforming anti-vaccine sentiment from a fringe health theory into a mainstream cultural phenomenon.85

C. COVID-19 and the Mainstreaming of Health Conspiracy

ideal conditions

The COVID-19 pandemic created

for wellness misinformation to achieve mainstream political influence.86 Widespread anxiety, economic disruption, visible public health failures, and social isolation made large populations vulnerable to alternative health narratives promising simple solutions and easily identifiable villains.87 Wellness influencers who had built substantial audiences through supplement marketing and lifestyle advice found their platforms perfectly positioned to capitalize on pandemic fears while promoting profitable alternatives to public health measures.88

Celebrities used their COVID-19 experiences to market unproven treatments and conspiracy theories to millions of their followers.89 Gwyneth Paltrow’s promotion of “intuitive fasting” and expensive supplements as a COVID treatment, Joe Rogan’s advocacy for the anti-parasite medication Ivermectin, and numerous other celebrity endorsements of unproven interventions demonstrated how entertainment platforms could distribute dangerous medical misinformation while generating enormous engagement and profits.90

The pandemic also revealed how social media algorithms actively promoted dangerous health advice over accurate information. Studies found that antivaccine content received more engagement and algorithmic promotion than provaccine information, creating systematic bias toward misinformation in the health information content most Americans accessed.91 This algorithmic amplification created conditions enabling anti-vaccine activists to achieve unprecedented political influence.92

The “wellness to QAnon” pipeline demonstrates how health misinformation can serve as a gateway to broader conspiracy thinking and political extremism.93 QAnon—a decentralized far-right movement rooted in fabricated claims that a cabal of satanic pedophiles controls the government and that Donald Trump is waging a secret war against these elites—proved particularly attractive to those already predisposed to vaccine skepticism or enamored with natural health alternatives.94 For increasingly elaborate conspiracy theories about government control and elite manipulation became a natural progression.95 This trajectory followed predictable patterns: Wellness fraud has long relied on conspiratorial thinking—the belief that hidden truths are

individuals, embracing

these

being suppressed by corrupt authorities—to maintain audience engagement and product sales.96

Part III analyzes how wellness ideology achieved institutional capture of federal health agencies through key appointments in the Trump Administration. Section A examines Robert F. Kennedy, Jr.’s confirmation as HHS Secretary, documenting his anti-vaccine organization’s marketing techniques and the immediate policy changes—dismissing vaccine advisory committees and removing routine vaccine recommendations—that followed his appointment. Section B explores Jay Bhattacharya’s appointment as NIH Director and how his Great Barrington Declaration advocacy positioned anti-establishment wellness messaging within prestigious academic credentials, leading to fundamental changes in research funding priorities. Section C investigates Mehmet Oz’s role as CMS Administrator, tracing his transition from a television wellness entertainer to a federal health authority and examining the extensive conflicts of interest that accompany his leadership of Medicare and Medicaid. Section D examines FDA Commissioner Marty Makary’s appointments of vaccine skeptics Vinay Prasad and Tracy Beth Høeg to lead the agency’s biologics and drug evaluation centers, completing the systematic installation of wellness-aligned ideology across all major federal health regulatory bodies.

A. Secretary Kennedy as Anti-Vaccine HHS Czar

Robert F. Kennedy, Jr.’s February 13, 2025 confirmation as HHS Secretary represents the wellness fraud movement’s ultimate success in achieving

transformation

legitimacy.97 Secretary Kennedy’s

institutional from environmental attorney to anti-vaccine activist demonstrates how wellness conspiracy theories capture and redirect legitimate concerns about corporate power and government accountability.98 His anti-vaccine organization, Children’s Health Defense, employed marketing techniques virtually identical to those used by supplement companies and medicine show promoters: emotional testimonials, cherry-picked scientific studies, and conspiratorial narratives about hidden truths being suppressed by corrupt authorities.99

Secretary Kennedy’s anti-vaccine advocacy employs sophisticated rhetorical strategies that parallel patent medicine marketing. He positions vaccine skepticism within broader narratives about pharmaceutical industry corruption and government regulatory capture, making his anti-vaccine positions appear principled and scientifically informed rather than oppositional.100 This approach

proves particularly effective because it validates existing political and cultural grievances while providing medical-sounding justifications.101

Upon assuming the helm at HHS, Secretary Kennedy immediately began implementing policies reflecting wellness industry priorities rather than public health evidence.102 His sweeping changes included removing routine COVID19 vaccine recommendations for children and pregnant women, dismissing the entire Advisory Committee on Immunization Practices (ACIP), cancelling $500 million in funding for mRNA vaccine development, and appointing anti-vaccine activists to key positions.103 This makes clear that wellness conspiracy theories can be translated into government policy. Most significantly, Secretary Kennedy pursued these radical policy shifts during active measles outbreaks,104 highlighting the immediate public health consequences of elevating wellness ideology over epidemiological evidence.

The institutional chaos that followed his appointment was swift and severe. Secretary Kennedy laid off hundreds of Centers for Disease Control and

Prevention (CDC) career scientists and public health officials, creating an environment of unprecedented instability within the nation’s premier public health agency.105 The mass resignation of CDC leadership, who refused to implement policies contradicting established medical knowledge following Secretary Kennedy’s vaccine-related policy changes, created unprecedented institutional disruption.106 On August 27, 2025, Secretary Kennedy forced out CDC Director and infectious disease expert Susan Monarez, who had only served as the agency head for a month, over vaccine policy disputes.107

Monarez’s firing quickly provoked four additional high-ranking CDC health experts, including Immunizations Chief Dr. Demetre Daskalakis, to resign in protest.108 In his resignation letter, Dr. Daskalakis captured the Kennedy health administration’s fundamental conflict between scientific integrity and political ideology, writing: “I am unable to serve in an environment that treats [the] CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.”109 This significant brain drain from the CDC represents a fundamental threat to the institutional capacity necessary for effective public health responses to future crises. Physician Ashish Jha, former White House COVID-19 coordinator, described the events as a “total implosion” and “wholesale destruction of leadership at the CDC.”110 Michael Osterholm, a University of Minnesota infectious disease researcher, stated that “[t]he loss of experienced, world-class infectious disease experts at [the] CDC is directly related to the failed leadership

of extremists currently in charge of the Department of Health and Human Services.”111

The institutional turmoil created an environment that extended beyond policy disagreements to actual physical danger for public health workers. On August 8, 2025, amid the chaos at the CDC, agency staffers became victims of domestic terrorism when a lone gunman fired 180 rounds at the agency’s headquarters in Atlanta, pinning down employees and piercing blast-resistant windows, to express his “discontent with the COVID-19 vaccinations.”112 Famed former CDC Director Dr. William Foege publicly blamed the troubling event on Secretary Kennedy’s anti-vaccine rhetoric, offering a stark assessment of the consequences:

One would think Kennedy’s track record of nonsense would win no followers, yet there are people willing to accept drivel from those in positions of authority. Kennedy would be less hazardous if he decided to do cardiac surgery. Then he would kill people only one at a time rather than his current ability to kill by the thousands.113

Secretary Kennedy’s approach to vaccine policy employs the same techniques that made medicine shows effective: creating doubt about established medical authority while positioning alternative approaches as safer and more natural.114 His claims about vaccine dangers rely on the same selective use of evidence and emotional manipulation that characterized patent medicine marketing, while his dismissal of scientific consensus parallels the antiestablishment messaging that made audiences receptive to medicine show promotions.115

Secretary Kennedy’s actions as HHS Secretary have been so anti-scientific and unorthodox that they have been widely opposed by scientific and medical communities. In less than eight months on the job, Secretary Kennedy’s threats to public health instigated a scathing New York Times op-ed from a bipartisan

group of nine former CDC directors as well as an open letter calling for his resignation signed by more than one thousand current and former HHS employees.116 These overwhelming expressions of revolt demonstrate how completely Secretary Kennedy’s wellness ideology conflicts with evidence-based public health practice, yet they also illustrate how effectively his medicine show techniques have captured political authority despite significant scientific opposition.

institutional

B. Bhattacharya’s Lockdown Ideology at NIH

Dr. Jay Bhattacharya’s March 25, 2025, appointment as National Institutes of Health (NIH) Director represents another dimension of wellness ideology’s institutional penetration.117 Bhattacharya, a Stanford health economist and physician, has been popularly characterized as a “COVID contrarian.”118 This moniker is due to his prominent advocacy for ending COVID-19 public health measures through the Great Barrington Declaration, which advocated for permitting the virus to spread among younger populations to achieve “herd immunity” while supposedly protecting the elderly.119 As one health reporter explained it, the Declaration “called for people to ignore [COVID-19] and go about their business while protecting the old and vulnerable—without specifics about how.”120

The Great Barrington Declaration, which was organized by a libertarian think tank located in Great Barrington, Massachusetts—the American Institute for Economic Research—employed sophisticated techniques paralleling those used by wellness entrepreneurs to challenge established

rhetorical

medical authority.121 By framing disease mitigation policies as “lockdowns” and a form of government overreach rather than public health interventions, Bhattacharya positioned himself as a defender of freedom and economic prosperity against authoritarian medical bureaucrats.122 This approach proved particularly effective because it validated existing political and economic preferences while providing a scientific-sounding justification for policies many Americans wanted to support regardless of health evidence.123

Bhattacharya’s academic credentials provided crucial credibility for his “anti-lockdown” herd immunity arguments that might otherwise have been dismissed as fringe positions.124 His affiliation with Stanford facilitated national media appearances and policy debate influence unavailable to traditional wellness entrepreneurs.125 As the Bhattacharya case teaches, wellness industry, anti-establishment messaging can achieve mainstream political influence when promoted by individuals with prestigious academic credentials.

Bhattacharya’s approach to NIH research funding represents a fundamental retreat from traditional scientific merit review processes in favor of politically driven decision-making. Political appointees, rather than scientists, now ultimately decide who gets NIH grant money, with senior officials instructed not to routinely defer to recommendations from peer reviewers who have provided

the backbone of federal science funding for eight decades.126 Under Bhattacharya’s leadership, the agency has terminated thousands of grants and contracts totaling over $12 billion for research on COVID-19, health disparities, climate change, gender, and broadening the scientific workforce; though simultaneously, Bhattacharya has made funding decisions at odds with the peer review process, such as spending $500 million on a vaccine project without any apparent competition or review by experts.127 This systematic elevation of political considerations over scientific merit review exemplifies the broader transformation of federal health agencies under wellness industry influence and prioritizes ideological alignment over evidence-based research excellence.

C. Oz’s Miracle Cure Administration at CMS

Dr. Mehmet Oz’s April 3, 2025, appointment as the Centers for Medicare and Medicaid Services (CMS) Administrator represents the most direct translation of television wellness entertainment into federal health policy authority.128 Oz, a cardiothoracic surgeon turned daytime television host, built his public profile by promoting alternative health treatments and unproven medical interventions to millions of viewers on The Dr. Oz Show.129 His television program employed virtually identical techniques to those perfected by patent medicine promoters: dramatic before-and-after testimonials, scientificsounding but unsubstantiated health claims, and the positioning of expensive supplements and treatments as “miracle” solutions to common health problems.130 A 2014 study found that “roughly a third” of the medical claims

and recommendations that Oz advanced on his show were supported by “believable or somewhat believable” scientific evidence.131

A Federal Trade Commission (FTC) investigation of the company that manufactured green coffee bean extract—a product that Oz heavily promoted on his show—further revealed the extensive commercial connections between Oz’s television recommendations and supplement industry profits.132 In 2014, Senator Claire McCaskill called Oz before a Senate subcommittee to testify about his promotion of weight-loss supplements, during which she criticized him for giving “false hope” to viewers and noted that “[t]he scientific community is almost monolithic against you in terms of the efficacy of [a few] products you called ‘miracles.’”133 The FTC and Senate investigations demonstrate how television wellness entertainment operates as a sophisticated marketing platform for unproven treatments, with celebrity physician endorsement driving millions in supplement sales while avoiding the regulatory oversight applied to pharmaceutical marketing. During the hearings, Oz conceded that his claims often “don’t have the scientific muster to present as fact,” characterizing his role as being “a cheerleader for the audience.”134

Oz’s conflicts of interest, however, extend far beyond his television endorsements to encompass a vast web of financial entanglements that raise serious questions about his ability to make impartial decisions as CMS Administrator. According to the New York Times, Oz’s business and family ventures are valued between $90 million and $335 million, with financial interests spanning nearly every corner of healthcare.135 His ethics filings revealed holdings requiring divestiture in more than seventy companies, including up to $600,000 in UnitedHealth Group (the nation’s largest Medicare Advantage provider), up to $5 million in Inception Fertility Holdings, up to $100,000 in HCA Healthcare, and up to $26 million in Amazon (which operates One Medical, a primary care venture, and an online pharmacy).136 Perhaps most problematically, Oz became a licensed insurance broker in nearly every state for

TZ Insurance Solutions, a company that paid to be featured on his show while he promoted Medicare Advantage plans to viewers.137 Indeed, he told viewers “I’d be signing up” without disclosing his financial relationship with the company.138 As Senator Ron Wyden aptly put it, “[g]iven Dr. Oz’s history of basically acting as a salesman for Medicare Advantage, putting him in charge of regulating these middlemen is almost like letting the fox guard the proverbial henhouse.”139

Oz’s supplement industry connections present additional conflicts given CMS’s role in Medicare coverage decisions. His relationship with iHerb, an online supplement retailer, represents one of his largest financial holdings at $5 million to $25 million, and ethics experts noted that his agreement leaves open the possibility he might retain iHerb stock even while serving as CMS Administrator.140 Oz made “tens of millions of dollars hawking dietary supplements on his show and on social media, often without any mention of his financial interest,” including promoting iHerb products through social media posts featuring his mother with Alzheimer’s disease; he claimed that supplements he sent her had “probably slowed” her disease progression.141 Similarly, his previous relationship with supplement manufacturer Usana Health Sciences allegedly involved over $50 million in payments for product promotion on his show over five years.142

Oz, who stated during his confirmation hearing that “it is our patriotic duty to be healthy,” immediately made it clear that he would implement the MAHA wellness agenda at CMS.143 Oz’s leadership portends a qualitative departure from evidence-based healthcare administration toward entertainment-driven wellness policy. This transformation threatens the institutional integrity necessary for effective Medicare and Medicaid management, while illustrating

how wellness ideology has captured a federal agency responsible for administering healthcare to America’s most vulnerable populations.

D. Makary’s Contrarian FDA and Vaccine Skeptic Appointments

Dr. Martin Makary’s March 25, 2025, confirmation as FDA Commissioner completed the institutional capture of the FDA, America’s primary drug and biologics regulatory agency, by wellness-adjacent ideology.144 Makary, a Johns Hopkins surgical oncologist and prolific author, gained national prominence during the COVID-19 pandemic for his opposition to vaccine mandates, his criticism of FDA and CDC policies, and his advocacy for natural immunity— positions that aligned him with the broader MAHA movement before his nomination.145 While Makary’s academic credentials and surgical background initially led some observers to view him as a more moderate choice compared to other top Trump Administration health officials, his subsequent appointments have demonstrated a systematic preference for individuals who share his contrarian approach to public health orthodoxy.146

Makary’s most consequential appointment came in May 2025, when he named Dr. Vinay Prasad as Director of the Center for Biologics Evaluation and Research (CBER), the FDA division responsible for regulating vaccines, blood products, and gene therapies.147 Prasad, an oncologist, prolific social media commentator, and former professor of epidemiology at the University of California, San Francisco, built his public profile by criticizing the FDA’s COVID-19 response, opposing vaccine mandates, and, at one point, comparing pandemic restrictions to events in Nazi Germany.148 Prior to his appointment,

Prasad had characterized his CBER predecessor Peter Marks—who resigned after refusing to grant Secretary Kennedy access to the Vaccine Adverse Event Reporting System (VAERS) database—as “one of the most dangerous, propharma regulators of the 21st century” who could be “replace[d] . . . with a bobblehead doll that just stamps approval.”149

Prasad’s tenure at CBER has proven as disruptive as his rhetoric suggested. In late November 2025, he circulated an internal memo to CBER staff claiming that FDA review had determined “at least 10 children have died after and because of receiving COVID-19 vaccination”—an assertion he used to justify sweeping changes to vaccine regulatory policy.150 The memo proposed requiring large, randomized, placebo-controlled trials for all new vaccines—even updates to existing flu and COVID-19 shots—departing from long-standing standards that enabled rapid vaccine updates based on immune response data.151 Prasad concluded by instructing staff who disagreed with his “core principles” to resign.152

The response from the scientific community was swift and unprecedented. Twelve former FDA commissioners—appointed by both Republican and Democratic presidents and representing nearly every permanent commissioner since 1990—published a scathing rebuke in the New England Journal of Medicine on December 3, 2025.153 The former commissioners argued that Prasad’s proposed changes “will upend core policies governing vaccine development and updates” and would “impede the ability to update vaccines to keep up with the natural evolution of respiratory viruses.”154 Regarding Prasad’s

claims about pediatric vaccine deaths, the former commissioners noted that these cases had previously been “carefully reviewed by FDA staff, who drew different conclusions” and that Prasad’s memo “offered no explanation of the process and analyses that were used to reach the new retrospective judgment.”155

Makary further consolidated his inner circle by appointing Dr. Tracy Beth Høeg as Acting Director of the Center for Drug Evaluation and Research (CDER) on December 3, 2025—making her the fifth person to lead the FDA’s largest and most important division in a single year.156 Høeg, a physician and epidemiologist who coauthored a 2022 paper with Makary questioning COVID19 vaccine boosters for young adults, had previously published a blog post titled “FDA’s shortcomings: A list” and advocated for “stopping unnecessary vaccines” and reducing the childhood vaccination schedule.157 Before her CDER appointment, Høeg served as Senior Advisor for Clinical Sciences in Makary’s office, where she reportedly led the research underlying Prasad’s controversial claims about pediatric vaccine deaths and sought to change COVID-19 vaccine labels to indicate that risks outweighed benefits for young men.158

The rapid succession of departures that preceded Høeg’s appointment illustrates the institutional instability Makary’s leadership has created. Peter Marks resigned as CBER Director in March 2025 in lieu of being fired after refusing to implement Secretary Kennedy’s vaccine policies, writing that “truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.”159 George Tidmarsh

resigned as CDER Director in November 2025 amid an investigation into alleged misuse of regulatory authority.160 Richard Pazdur, a twenty-six-year FDA veteran who briefly assumed the CDER role, filed for retirement just weeks later, reportedly troubled by Makary’s politicization of nonpolitical positions.161 The biotech sector has responded to this leadership turmoil with significant market losses, with the XBI biotech index falling sharply following announcements of Prasad’s and Høeg’s appointments.162

The Administration’s pattern of health official appointments reveals a systematic effort to populate FDA leadership with officials who share a common ideological orientation toward vaccine skepticism and criticism of the regulatory status quo. All three figures—Makary, Prasad, and Høeg—opposed key aspects of the government’s COVID-19 response, questioned vaccine policies for children and young adults, and built public platforms criticizing the very agencies they now lead.163 The evolution of the FDA from a trusted scientific arbiter to a platform for wellness-aligned ideology represents the completion of institutional capture across all major federal health regulatory bodies.

This transformation began with Kennedy’s HHS confirmation. Within months, figures who had built public profiles by challenging vaccine science and regulatory orthodoxy now controlled the agencies responsible for protecting Americans from unsafe drugs, biologics, and medical devices. As explained in Part IV, the consequences of this transformation—measured not in stock prices or institutional departures but in preventable disease and death—are already boldly visible.

Part IV examines the tangible public health consequences that have emerged from the elevation of wellness ideology over evidence in federal health agencies. Section A documents the immediate and cascading effects of governmentendorsed vaccine skepticism, including record-setting measles outbreaks in Texas and beyond that place the United States at risk of losing its measles elimination status, a nationwide resurgence of whooping cough that has claimed multiple infant lives, and the CDC’s dramatic reversal of its position on the settled science regarding vaccines and autism. This section also traces the systematic dismantling of institutional safeguards, including Kennedy’s purge and reconstitution of the ACIP with his own appointees, the resulting chaos surrounding proposed changes to the childhood vaccine schedule, and the unprecedented decision by major medical organizations—including the American Academy of Pediatrics—to boycott federal advisory proceedings and issue independent vaccine recommendations. Section B analyzes the broader erosion of scientific authority in American health policy, examining how the systematic elevation of wellness ideology over scientific evidence has driven the flight of expertise from public service, complicated medical education and research funding, and damaged the international reputation of American health institutions.

A. Vaccine Hesitancy, Institutional Collapse, and Preventable Disease

Outbreaks

The elevation of anti-vaccine activists to positions of government authority created immediate consequences for American public health. A 2025 measles outbreak in West Texas became the largest the state has seen in thirty years, with 762 cases reported as of August 12, including ninety-nine hospitalizations and two deaths, both in unvaccinated children without underlying health conditions.164 As of April 2025, ninety-eight percent of cases occurred in individuals who were unvaccinated or whose vaccination status was unknown.165 The outbreak did not remain geographically contained: it seeded secondary outbreaks in New Mexico, Oklahoma, and Kansas, underscoring how official ambivalence toward vaccination—particularly when emanating from

senior health authorities—can rapidly translate into interstate spread of a highly contagious, vaccine-preventable disease.166

Rather than abating, this dynamic intensified in early 2026, as measles cases surged nationwide at levels not seen since the disease was declared eliminated in the United States in 2000.167 By late February 2026, federal and state health officials reported at least 982 confirmed measles cases across twenty-six states, with the overwhelming majority occurring among unvaccinated or under-immunized individuals.168 South Carolina soon emerged as the epicenter of a sustained outbreak that eclipsed even the 2025 Texas epidemic: By late February 2026, the state had confirmed more than 979 cases, prompting mass quarantines and emergency vaccination campaigns.169 Public health officials warned that the persistence and geographic spread of these outbreaks placed the United States’s measles elimination status at risk—a designation that depends on maintaining uninterrupted interruption of endemic transmission.170 Additional clusters linked to travel and congregate settings, including immigration detention facilities, further illustrated how weakened vaccination coverage and delayed public health response create conditions for

rapid amplification once the virus is reintroduced.171 Although vaccination demand increased in some effected jurisdictions as outbreaks worsened,172 the 2026 resurgence demonstrates how institutionalized vaccine skepticism— particularly when reinforced by government messaging—can convert isolated outbreaks into a national public health crisis.

The resurgence of vaccine-preventable diseases extends well beyond measles. Whooping cough (pertussis) cases are on track to exceed the already alarming 2024 statistics.173 The disease reached its highest levels in more than a decade with over 35,000 cases and ten deaths—six of infants under one year old.174 By May 2025, the Pan American Health Organization reported over 10,000 confirmed pertussis cases in the United States, including five deaths.175 Individual states have experienced devastating localized outbreaks: Louisiana recorded its first pertussis deaths since 2018 when two infants died in early 2025, while Kentucky reported three infant pertussis deaths—the state’s first since 2018—and alerted the public to the most pertussis activity since 2012.176 All five of these deaths occurred in unvaccinated infants, many of whom were too young to receive their first dose, highlighting the critical importance of herd immunity that population-wide vaccination provides.177 Louisiana health officials drew criticism for waiting two months after the infant deaths to issue

public communications about the outbreak, a delay that some public health experts believe contributed to subsequent case escalation.178

Beyond the immediate disease outbreaks, the administration’s systematic assault on vaccine science threatens to unravel decades of public health progress. In November 2025, the CDC revised its website to cast doubt on the long-settled scientific conclusion that vaccines do not cause autism—a dramatic reversal that shocked career scientists, drew rebukes from major medical organizations, and delighted anti-vaccine activists.179 The revised webpage states that “[t]he claim ‘vaccines do not cause autism’ is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism”180— language that the American Academy of Pediatrics called “false information” and the Autism Science Foundation described as “anti-vaccine rhetoric and outright lies.”181 The American Medical Association expressed deep concern that “perpetuating misleading claims on vaccines will lead to further confusion, distrust, and ultimately, dangerous consequences for individuals and public health.”182 Current CDC staffers, speaking anonymously out of fear for their jobs, told NPR that the updates are “a glaring red flag,” indicating that vaccine information on the agency website is no longer credible and is instead “antiscience.”183

The institutional mechanisms that have guided American vaccine policy for decades are simultaneously under direct attack. Secretary Kennedy’s reconstituted ACIP—purged of all seventeen previous members and replaced with Secretary Kennedy’s own appointees, including several who have promoted misleading information about COVID-19 vaccines—is now systematically reviewing the childhood immunization schedule that has

protected American children for generations.184 On December 5, 2025, following a day of contentious discussion that devolved into confusion and disarray, the committee voted 8-3 to recommend that parents delay the hepatitis B vaccine from birth until at least two months of age—overturning a thirty-year policy credited with reducing acute hepatitis B infections in children by ninetynine percent since 1991.185 A modeling study estimates that this delay could result in more than 1,400 babies becoming chronically infected with hepatitis B in the first year alone, and may lead to 304 cases of liver cancer and 482 hepatitis B-related deaths among those children as they age.186 José Romero, a former ACIP chair and member of the American Academy of Pediatrics’ infectious diseases committee, called the December ACIP meeting “a significant departure from the historic role ACIP has played in shaping vaccine policy in the United States, when we could expect science to inform decisions, experts to debate evidence, and consensus to drive shared, clear recommendations.”187 The committee’s new chair, pediatric cardiologist Kirk Milhoan, has a history of promoting treatments for COVID-19 that are not evidence-based and of making unfounded claims about COVID-19 vaccines.188

The erosion of ACIP’s credibility has prompted an unprecedented institutional response. The American Academy of Pediatrics (AAP) boycotted and publicly denounced ACIP meetings in 2025, with AAP President Susan Kressly stating, “it is no longer a credible process” and the organization would not “lend out [its] name to a system that is being politicized at the expense of

Integrity Project have begun

children’s health.”189 Major medical groups including the AAP, the American Academy of Family Physicians, and a newly formed University of Minnesota independent vaccine Vaccine recommendations that some states have started following instead of federal guidance.190 The Infectious Diseases Society of America characterized the policy changes as “politically motivated actions that are not based on science.”191

issuing

The economic costs of vaccine-preventable disease outbreaks far exceed any savings achieved through reduced vaccination programs.192 Each measles outbreak requires an extensive public health response, including, among other things, contact tracing, laboratory testing, quarantine measures, direct medical services, and emergency vaccination campaigns, that collectively cost millions of dollars.193 These costs are ultimately borne by taxpayers and healthcare systems rather than the wellness entrepreneurs and political figures whose promotion of vaccine hesitancy create the underlying conditions for disease transmission. The independent Vaccine Integrity Project estimated that the universal newborn hepatitis B vaccination policy has prevented more than six

million infections and nearly one million hospitalizations—benefits that could be jeopardized by changes to current recommendations.194

The psychological impact of government-endorsed vaccine skepticism extends beyond immediate disease outbreaks by creating long-term erosion of public trust in preventive medicine.195 Parents who might have followed routine vaccination schedules when recommended by health authorities become uncertain about vaccine safety when government officials promote competing narratives about vaccine risks.196 A January 2025 poll found declining trust in public health agencies amid rising Republican skepticism about vaccines.197 Such sentiments create ongoing vulnerability to future disease outbreaks while requiring increased public health expenditures for disease surveillance and outbreak response due to the higher risk of vaccine-preventable outbreaks and the significant costs of managing them.198

International recognition of the deteriorating American public health situation became evident when the World Health Organization received a report on the ongoing measles outbreak in the United States, treating the nation as a source of infectious disease risk rather than a global health leader.199 The reputational damage from allowing wellness conspiracy theories rather than epidemiological evidence to guide public health policy contributed to a significant downturn in international travel to the United States: In March 2025, overseas visits fell by 11.6% compared to the previous year, with notable

declines from Germany (28%), Spain (25%) and the United Kingdom (18%).200 This decline in confidence coincided with broader international concerns about American governance, as some European countries, as well as Canada, began warning their citizens who travel to the United States of increased health risks, reflecting a broader erosion of America’s traditional leadership role in global health.201

B. The Erosion of Scientific Authority in Health Policy

The systematic elevation of wellness ideology over scientific evidence in government health agencies creates broader consequences for institutional frameworks that guide American health policy.202 Career public health officials have been tasked with implementing policies that they believe contradict their professional training and scientific understanding, creating internal conflicts within government agencies and contributing to a flight of expertise from public service.203 The replacement of evidence-based decision-making with ideologydriven policy development threatens the institutional capacity necessary for effective public health responses to future crises.

The politicization of public health has contributed to a sustained partisan gap in trust toward scientific institutions, though recent data suggests a potential stabilization. According to a November 2024 Pew Research Center survey of 9,593 U.S. adults, 76% of Americans express a great deal (26%) or fair amount (51%) of confidence in scientists to act in the public’s best interests—up slightly from 73% in October 2023, marking a halt to the decline seen during the COVID-19 pandemic.204 Still, confidence remains lower than at the pandemic’s outset, when 87% expressed at least a fair amount of confidence in scientists in April 2020.205

The partisan gap in confidence toward scientists remains substantial but has shown recent movement. Roughly nine-in-ten Democrats (88%) express at least a fair amount of confidence in scientists, compared with two-thirds of Republicans (66%)—a twenty-two-percentage-point gap.206 While this gap remains sizable, Republican confidence has edged up five percentage points since October 2023, representing the first uptick in trust among Republicans since the start of the pandemic.207 This improvement, however, follows a dramatic decline: In April 2020, 85% of Republicans expressed a great deal or fair amount of confidence in scientists, compared with just 14% who expressed distrust; by 2024, 34% of Republicans expressed little or no confidence.208

Despite slight improvements in overall trust, perceptions of scientists’ characteristics have deteriorated along partisan lines. The share of Republicans who view research scientists as focused on solving real-world problems declined seventeen percentage points between 2019 and 2024, from 69% to 52%.209 A majority of Republicans (62%) believe that scientists’ judgments are just as likely to be biased as other people’s, and only 28% think scientists generally make better policy decisions than others on scientific issues.210 Americans are also divided over scientists’ role in policymaking: 51% say scientists should take an active role in public policy debates about scientific issues, while 48% say they should focus on establishing facts and stay out of policy debates—with 64% of Republicans favoring the latter position.211

The politicization of public health during and after the COVID-19 pandemic has produced a workforce crisis. A Health Affairs study using data from the Public Health Workforce Interests and Needs Survey found that 46% of all employees in state and local public health agencies left their jobs between 2017 and 2021—with the proportion rising to 75% for employees ages thirty-five and younger.212 Researchers speculated that pandemic-related challenges facing public health workers—including criticism, harassment, and personal threats— fueled the substantial job exodus.213 If separation trends continue, the study

estimated that more than 100,000 staff could leave government public health positions by 2025, representing as much as half of the state and local governmental public health workforce.214

A Johns Hopkins Bloomberg School of Public Health study documented 1,499 unique reports of harassment targeting local health department leadership or staff during the first eleven months of the pandemic.215 The study found that fifty-seven percent of local health departments had experienced harassment and that over one-third of the 222 public health officials who left their positions during this period had experienced some form of harassment, including personal threats.216 The researchers identified five categories of challenges that health officials under-resourced infrastructure, villainization, politicization, and disillusionment with their roles.217 Other studies found that fifty-three percent of public health workers reported at least one symptom of mental illness over a two week period during the pandemic and that the percentage of CDC officials considering leaving their jobs increased from forty-four percent before the pandemic to seventy-six percent after the crisis.218

underrecognized

experienced:

expertise,

The 2025 wave of federal health agency terminations, several of which are detailed above, accelerated the flight of expertise from government service. On April 1, 2025, HHS eliminated 3,500 FDA positions as part of a reduction in force that dismissed at least 121,000 federal workers across thirty agencies during the first one hundred days of the Trump Administration.219 Among those

terminated were Ph.D.-trained scientists conducting outbreak response, employees ensuring the safety of medical devices, and public health workers enforcing regulations at international airports.220 The FDA’s top food official, Deputy Commissioner Jim Jones, resigned citing the “indiscriminate firing” of eighty-nine staff members from the agency’s food program and explaining to HHS Secretary Kennedy that “[i]t has been increasingly clear that with the Trump Administration’s disdain for the very people necessary to implement your agenda . . . it would have been fruitless for me to continue in this role.”221 Between the time that President Trump assumed office in January 2025 and August 2025, approximately 3,000 CDC staffers had resigned or been fired.222

The federal health agency turmoil has accelerated concerns about a “reverse brain drain”—the departure of American scientific talent to institutions abroad. Dr. Francis Collins, who spent thirty-two years at NIH including twelve as director, warned that “[w]e may very well see, as a result of what’s happened in these dramatic few months, a reverse brain drain, where we start to lose some of our best and brightest young scientists because they think they will have a better chance in another part of the world.”223 A Nature analysis found that more than seventy-five percent of U.S. scientists were considering leaving the United States “following the disruptions prompted by Trump.”224

European nations have actively sought to capitalize on American scientific displacement. France launched a policy initiative “Choose Europe for Science,” with President Macron declaring, “[h]ere in France, research is a priority, innovation a culture, science a limitless horizon.”225 The European Commission

authorized additional funding of €566 million for 2025–2027 to make Europe “a magnet for researchers,” supplementing the European Research Council’s existing eighteen billion dollar budget with an additional $566 million.226 Belgium’s Vrije Universiteit Brussel created a dedicated office to welcome American researchers, with rector Jan Danckaert noting that “U.S. universities and their scholars are victims of political and ideological interference by the Trump [A]dministration.”227 France’s Aix-Marseille University reported receiving hundreds of applications for its “Safe Place for Science” program, observing that “Europe saw many scientists flee for the U.S. during World War II” but “it now appears that experts are starting to flow in the opposite direction.”228 A 2025 survey of over 300 scientists and institutional leaders found that ninety percent believed budget cuts would hinder research progress, seventy-five percent of research administrators reported low faculty morale, and eighty-one percent of non-principal investigator researchers reported plans to either leave academia altogether or move their careers abroad.229

Academic medical institutions face new challenges as government health agencies promote theories and treatments that contradict established medical knowledge. Medical schools and residency programs are now forced to navigate conflicts between government recommendations and evidence-based medical education, while federal research funding priorities increasingly favor studies aligned with wellness industry interests rather than scientific merit.230 These changes create systematic pressure to compromise scientific integrity in favor of political alignment.

A Lancet analysis found that trust in physicians and hospitals declined from 71.5% in 2020 to 40.1% in 2024, complicating the physician–patient

relationship that depends on mutual trust.231 Medical schools including the University of Minnesota and the University of Chicago have developed curricula to train students to identify and combat medical misinformation, though such programs remain limited in availability and reach.232 Estimates suggest only fourteen percent of the U.S. population has proficient health literacy, making it difficult for individuals to recognize medical misinformation.233

The international reputation of American medical institutions suffers as government health agencies promote policies that conflict with global scientific consensus.234 International collaborations in medical research and public health response are complicated by questions about whether American government positions reflect scientific evidence or political ideology.235 This reputational damage threatens the traditional leadership role that American health institutions have played in global health initiatives and emergency response coordination. 236

The transformation of wellness fraud from traveling entertainment to government policy represents one of the most consequential developments in American public health history. The techniques perfected by nineteenth-century medicine show promoters—emotional manipulation, conspiratorial messaging, anti-establishment positioning, and the exploitation of hope and desperation— have not only survived technological and social changes but have achieved unprecedented scale and political legitimacy through social media amplification and institutional capture.

The appointment of figures like Robert F. Kennedy, Jr., Jay Bhattacharya, Mehmet Oz, and Marty Makary to high-level government health positions

demonstrates how a century of evolution in health fraud techniques has culminated in the capture of the very institutions designed to protect public health from such misinformation. This development threatens the entire institutional framework that guides American health policy and protects population health.

The public health consequences of this transformation are already visible in preventable disease outbreaks that have claimed infant lives, erosion of vaccine confidence, and the systematic replacement of evidence-based policy with wellness ideology. The firing of CDC Director Susan Monarez in August 2025—after she refused to “rubber-stamp unscientific, reckless directives”— triggered an exodus of senior leadership and epitomized the institutional chaos now afflicting federal health agencies.237 The full implications of “government gone Goop,” however, will likely unfold over years or decades as institutional damage accumulates and public trust in scientific authority continues to erode. The economic costs of treating preventable diseases, responding to health misinformation campaigns, and rebuilding damaged public health infrastructure will ultimately be measured in billions of dollars and thousands of lives.

The history of wellness fraud reveals that the challenge facing American public health extends beyond correcting specific misinformation claims or improving individual health literacy. The fundamental issue is whether democratic societies can maintain institutions capable of distinguishing scientific evidence from commercial manipulation when powerful economic and political interests benefit from confusion and uncertainty. The medicine show that became government policy represents a test case for whether evidencebased governance can survive in information environments optimized for engagement rather than truth.

The path forward requires recognition that wellness fraud is not simply a consumer protection issue but a fundamental challenge to democratic governance and institutional legitimacy. Addressing this challenge will require not only enhanced regulation and education but structural reforms that strengthen the capacity of democratic institutions to resist capture by commercial and ideological interests that profit from public confusion about health and science. The alternative is the continued evolution of American health policy from evidence-based practice toward entertainment-driven wellness

ideology, with consequences that will be measured in preventable suffering and death.

--- FOOTNOTES ---

ABSTRACT

* Professor of Law and Val Nolan Faculty Fellow, Indiana University Maurer School of Law; Research Scholar, Addiction & Public Policy, O’Neill Institute for National and Global Health Law, Georgetown University Law Center; Senior Scholar, UCSF/UC Law Consortium on Law, Science & Health Policy, University of California College of the Law, San Francisco.

1 Goop is the name of former actress Gwyneth Paltrow’s “‘modern lifestyle brand’ that offers wellness advice . . . along with travel recommendations and an array of high-priced clean beauty, fashion, and home

products.” Daniella Genovese, What is Goop? All About Gwyneth Paltrow’s Controversial Shop, FOX BUS. (Mar. 28, 2023, at 14:21 ET), https://www.foxbusiness.com/lifestyle/goop-all-about-gwyneth-paltrowscontroversial-shop [https://perma.cc/2JF2-X8Q7]. Goop’s wellness advice has been roundly criticized by health experts, and the company has even been fined for disseminating false and misleading health and wellness claims. Id.

TABLE OF CONTENTS

I. PERFECTING THE ART OF HEALTH DECEPTION:

II. THE SOCIAL MEDIA TRANSFORMATION AND

III. THE TRUMP ADMINISTRATION’S WELLNESS CABINET:

IV. THE PUBLIC HEALTH CONSEQUENCES OF A GOVERNMENT

INTRODUCTION

2 Jaroslava Kaňkova, Alice Binder & Jörg Matthes, Helpful or Harmful? Navigating the Impact of Social Media Influencers’ Health Advice: Insights from Health Expert Content Creators, 24 BMC PUB. HEALTH 1, 2 (2024); ANN ANDERSON, SNAKE OIL, HUSTLERS AND HAMBONES: THE AMERICAN MEDICINE SHOW 20 (2000). 3 See, e.g., 6 Tip-Offs to Rip-Offs: Don’t Fall for Health Fraud Scams, U.S. FOOD & DRUG ADMIN. (Mar. 4, 2021), https://www.fda.gov/consumers/consumer-updates/6-tip-offs-rip-offs-dont-fall-health-fraud-scams [https://perma.cc/UQ5X-U7MA].

4 Chantelle Lee, “Terrifying”: Public Health Experts React to Senate’s Confirmation of RFK, Jr. To Lead HHS, TIME (Feb. 13, 2025, at 15:38 ET), https://time.com/7222309/rfk-jr-confirmed-hhs-public-health-react/ [https://perma.cc/9GX9-QFKL].

5 Mehmet Oz Confirmed by US Senate to Lead Medicare and Medicaid, GUARDIAN (Apr. 3, 2025, at 18:10 ET), https://www.theguardian.com/us-news/2025/apr/03/mehmet-oz-confirmation-medicare-medicaid [https://perma.cc/QF7M-WU3S]; News Release, Nat’l Insts. Health, Jay Bhattacharya Begins Tenure as 18th Director of the National Institutes of Health (Apr. 1, 2025), https://www.nih.gov/news-events/news-releases/jaybhattacharya-begins-tenure-18th-director-national-institutes-health [https://perma.cc/8WBR-8CPF]; Press Release, U.S. Food & Drug Admin., Martin A. Makary, M.D., M.P.H., Sworn in as FDA Commissioner (Apr. https://www.fda.gov/news-events/press-announcements/martin-makary-md-mph-sworn-fda1, commissioner [https://perma.cc/4X27-U9YJ].

6 Theresa Gaffney, New FDA Leadership, an ACIP Review, and Bipartisan Criticism Against Vinay Prasad, STAT NEWS (Dec. 4, 2025), https://www.statnews.com/2025/12/04/health-news-fda-tracy-beth-hoegpazdur/ [https://perma.cc/DN3D-KHB2].

7 Will Stone, RFK Jr.’s Vaccine Policy Sparks a Lawsuit from the American Academy of Pediatrics, NPR (July 8, 2025, at 05:00 ET), https://www.npr.org/sections/shots-health-news/2025/07/08/nx-s1-5459978/rfk-jrvaccine-pediatrics-public-health-lawsuit [https://perma.cc/KW26-SA65].

8 Laura Paddison, Wellness Influencers Fueled Pandemic Misinformation. Now They’re Targeting Another Crisis, CNN (Feb. 5, 2024, at 13:19 ET), https://www.cnn.com/2024/02/04/climate/wellnessinfluencers-conspiracy-climate-intl [https://perma.cc/H4Z3-AAUW].

9 Jordan Friedman, How Snake Oil Became a Symbol of Fraud and Deception, SMITHSONIAN MAG. (Oct. https://www.smithsonianmag.com/innovation/how-snake-oil-became-a-symbol-of-fraud-and-

2024),

21, deception-180985300/ [https://perma.cc/WJ6B-58H3].

10 Make America Healthy Again, U.S. DEP’T OF HEALTH & HUMAN SERVS. (last visited Jan. 25, 2026), https://www.hhs.gov/maha/index.html [https://perma.cc/XDW9-PNAY]; see also Isabel Vincent, RFK Jr.’s $100K Make American Healthy Again Grift: Supplements, Dog Bowls and Crypto Plans, N.Y. POST (Jan. 30, 2025, at 14:25 ET), https://nypost.com/2025/01/30/us-news/rfk-jr-in-cash-grab-to-market-maha-vitaminscrypto-t-shirts/ [https://perma.cc/E8PJ-6TTR] (discussing RFK Jr.’s registration, licensing, and marketing of the “MAHA” brand).

I. PERFECTING THE ART OF HEALTH DECEPTION: A SHORT HISTORY

11 Robert M. Califf, Andrew C. von Eschenbach, Michael A. Friedman, Brett P. Giroir, Scott Gottlieb et al., A Threat to Evidence-Based Vaccine Policy and Public Health Security at FDA, NEW ENGLAND J. MED. (Dec. 3, 2025), https://www.nejm.org/doi/full/10.1056/NEJMp2517497 [https://perma.cc/MSA8-MK9Q].

12 ANDERSON, supra note 2, at 48–49, 61–67.

13 Phillip C. Smith, John R. Brinkley: A Quintessential American Quack, 12 J. COMM. HOSP. INT. MED.

PERSPECTIVES 1, 1–2 (2022).

14 John Parascandola, Patent Medicines and the Public’s Health, 114 PUB. HEALTH RPTS. 318, 320 (1999); J. Worth Estes, The Pharmacology of Nineteenth-Century Patent Medicines, 30 PHARM. IN HISTORY 3, 3 (1988).

15 Id. 16 Sarah Dees, Before and Beyond the New Age: Historical Appropriation of Native American Medicine

and Spirituality, 4 AM. RELIGION 17, 21–22 (2023).

17 Id. 18 Lakshmi Gandhi, A History of “Snake Oil Salesmen”, NPR (Aug. 26, 2013, at 11:55 ET),

https://www.npr.org/sections/codeswitch/2013/08/26/215761377/a-history-of-snake-oil-salesmen [https://perma.cc/ZR4P-J4L7].

19 Friedman, supra note 9.

20 Judy Z. Segal, The Empowered Patient on a Historical-Rhetorical Model: 19th-Century Patent-

Medicine Ads and the 21st-Century Health Subject, 24 HEALTH 572, 580 (2020); Estes, supra note 14, at 7.

21 Joe Schwarcz, The Right Chemistry: Sordid Medicine Shows Exploited Indigenous Cures, MONTREAL GAZETTE (Apr. 6, 2024), https://montrealgazette.com/opinion/columnists/the-right-chemistry-sordid-medicineshows-exploited-indigenous-cures [https://perma.cc/GKD5-W484]; Peter Carlson, Sugar, A Mild Laxative, and a Dollop of Alcohol, HISTORYNET (Nov. 21, 2023), https://www.historynet.com/sugar-a-mild-laxative-and-adollop-of-alcohol/ [https://perma.cc/2VGQ-BS95]; Julie C. Larkin-Gilmore, “The Forest Is Their Laboratory”: Representations of Medicine and American Indians in Kickapoo Indian Medicine Company Advertisements 2, (Aug. University), https://irbe.library.vanderbilt.edu/server/api/core/bitstreams/c9f3997f-9cb6-42b8-8bf7-9f58921a11c4/content [https://perma.cc/7TN6-Q85F].

Vanderbilt

Thesis,

(M.A.

2016)

22 See generally ARTHUR J. CRAMP & GEORGE H. SIMMONS, NOSTRUMS AND QUACKERY AND PSEUDOMEDICINE (Vol. III 1936) (providing a detailed factual record concerning the gamut of non-scientific cure-all nostrums and other so-called remedies peddled by patent medicine manufacturers and marketers in the United States over the prior century).

23 JAMES HARVEY YOUNG, THE MEDICAL MESSIAHS: A SOCIAL HISTORY OF HEALTH QUACKERY IN

TWENTIETH-CENTURY AMERICA 26–27 (1967); ANDERSON, supra note 2, at 36.

24 YOUNG, supra note 23, at 21–30.

25 CRAMP & SIMMONS, supra note 22, at viii–ix. 26 Simon Williams, Gavin Yarney, Peter Van Heusden & Sarah Downs, The Far Right and Far Left Meet Over Wellness Conspiracy Theories, TIME (Nov. 28, 2023, at 11:57 ET), https://time.com/6340206/wellnessconspiracy-theories-pushed-by-left-and-right [https://perma.cc/WGH6-2T7L]; Paolo Demuru, Qanons, AntiVaxxers, and Alternative Health Influencers: A Cultural Semiotic Perspective on the Links Between Conspiracy Theories, Spirituality, and Wellness During the COVID-19 Pandemic, 32 SOC. SEMIOTICS 588, 588–605 (2022). 27 Kara W. Swanson, Food and Drug Law as Intellectual Property Law: Historical Reflections, 2011 WIS.

L. REV. 331, 334–35, 362–63 (2011).

28 The Pure Food and Drug Act of 1906, Pub. L. No. 59-384, 34 Stat. 768 (1906) (repealed by 21 U.S.C.

§ 329(a) (1938 .

29 In 1937, more than one hundred people—many of them children being treated for sore throats—died after taking Elixir Sulfanilamide, a liquid formulation that used diethylene glycol (a chemical normally used as antifreeze) as a solvent. Carol Ballentine, Taste of Raspberries, Taste of Death: The 1937 Elixir Sulfanilamide Incident, FDA CONSUMER MAG. (June 1981), https://www.fda.gov/files/about%20fda/published/TheSulfanilamide-Disaster.pdf [https://perma.cc/AW7K-ZV2C]. Because the 1906 Food and Drug Act did not require safety testing of new drugs, the company faced charges only for misbranding—calling the product an “elixir” when it contained no alcohol—and the tragedy hastened passage of the 1938 Federal Food, Drug, and Cosmetic Act. Id.

30 Federal Food, Drug, and Cosmetic Act, Pub. L. No. 75-717, ch. 675, 52 Stat. 1040 (1938); Katharine A. Van Tassel, Slaying the Hydra: The History of Quack Medicine, the Obesity Epidemic and the FDA’s Battle to Regulate Dietary Supplements Marketed as Weight Loss Aids, 6 IND. HEALTH L. REV. 203, 223–24 (2009).

31 Thalidomide, a sedative marketed in Germany beginning in 1957 and ultimately distributed in forty-six countries, was prescribed to pregnant women to ease morning sickness. Neil Vargesson, Thalidomide-Induced

Teratogenesis: History and Mechanisms, 105 BIRTH DEFECTS RSCH. 140, 140 (2015); Marilyn T. Miller, Thalidomide Embryopathy: A Model for the Study of Congenital Incomitant Horizontal Strabismus, 89 TRANS. AM. OPHTHAL. SOC’Y 623, 628 (1991). The drug caused severe birth defects—including hands and feet projecting directly from the shoulders and hips—in more than 10,000 babies worldwide, with approximately forty percent dying within a year of birth. Waqas Rehman, Lisa M. Afons & Hillard M. Lazarus, The Rise, Fall and Subsequent Triumph of Thalidomide: Lessons Learned in Drug Development, 2 THER ADV HEMATOL 291, 292 (2011). FDA medical reviewer Frances Kelsey prevented the drug’s approval in the United States by insisting on scientifically reliable safety evidence despite intense pressure from the manufacturer; the near disaster helped pass the 1962 Drug Amendments, which fundamentally changed drug regulation by requiring proof of both safety and efficacy before marketing. Jennifer D. Oliva, Reforming Clinical Trial Pregnancy Exclusions, 15 CONLLAWNOW 87, 95 (2024); Kefauver-Harris Amendments Revolutionized Drug Development, U.S. FOOD & DRUG ADMIN. 1–2 (Oct. 2012), https://www.gvsu.edu/cms4/asset/F51281F0-00AFE25A-5BF632E8D4A243C7/kefauver-harris_amendments.fda.thalidomide.pdf [https://perma.cc/P999-KCT9]; Frances Oldham Kelsey: Medical Reviewer Famous for Averting a Public Health Tragedy, U.S. FOOD & DRUG ADMIN. (last visited Jan. 25, 2026), https://www.fda.gov/about-fda/fda-history-exhibits/frances-oldham-kelseymedical-reviewer-famous-averting-public-health-tragedy [https://perma.cc/3WQG-47QU].

32 Drug Amendments of 1962, Pub. L. No. 87-781, 76 Stat. 780 (codified at 21 U.S.C. § 355(d) (2025 . 33 Dietary Supplement Health and Education Act of 1994, Pub. L. No. 103-417, 108 Stat. 4325 (codified

at 21 U.S.C. §§ 321, 331, 342, 343, 350b).

34 Stephen Barrett, How the Dietary Supplement Health and Education Act of 1994 Weakened the FDA, QUACKWATCH (Sep. 30, 2020), https://quackwatch.org/consumer-protection/dshea/ [https://perma.cc/HE5KGVNQ].

35 Id.; see also Bernd Wollschlaeger, The Dietary Supplement and Health Nutrition Act and Supplements: Dietary and Nutritional Supplements Need No More Regulations, 22 INT’L J. TOXICOLOGY 387, 387 (2003) (explaining that “DSHEA was enacted by Congress following public debate concerning the importance of dietary supplements in promoting health, the need for consumers to have access to current and accurate information about supplements, and controversy over the Food and Drug Administration’s (FDA) regulatory approach to this product category”).

36 James Gormley, What Does Mel Gibson Have to Do with DSHEA, CITIZENS FOR HEALTH (Aug. 7, 2009),

https://citizens.org/our-world-without-dshea/ [https://perma.cc/8G7H-YJH2].

37 Id.; see also BACKHOME PICTURES 1944, Mel Gibson Raid Vitamin Commercial HD 1994 (YOUTUBE,

Jan. 18, 2024), https://www.youtube.com/watch?v=J6bv92W4YnE [https://perma.cc/3JTF-59N5].

38 Barrett, supra note 34; see Roseann B. Termini & Vincent A. Sannuti, A Look Back at the DSHEA— Over 25 Years Later: The Dangers of a Reactionary Approach to Dietary Supplement Regulation, 22 QUINNIPIAC HEALTH L.J. 171, 180 (2019); Margaret Gilhooley, Herbal Remedies and Dietary Supplements: The Boundaries of Drug Claims and Freedom of Choice, 49 FLA. L. REV. 663, 678 (1997).

39 21 U.S.C. § 343(r)(6)(A); Structure/Function Claims, U.S. FOOD & DRUG ADMIN. (Mar. 28, 2024),

https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/structurefunction-claims [https://perma.cc/YT5D-39HB].

40 Rajani R. Starr, Too Little, Too Late: Ineffective Regulation of Dietary Supplements in the United States,

105 AM. J. PUB. HEALTH 478, 481 (2015).

41 Taylor C. Wallace & Igor Koturbash, DSHEA 1994–Celebrating 30 Years of Dietary Supplement

Regulation in the United States, 22 J. DIETARY SUPPS. 1, 2 (2025).

42 Michael

Specter, Miracle

a Bottle, NEW YORKER

2004),

https://www.michaelspecter.com/wp-content/uploads/miracle.pdf [https://perma.cc/AKZ8-S3NC].

43 See Stephanie Taylor, The Supplement Industry is Not Only Unregulated—It’s a Money Making Machine, DEARMEDIA (July 30, 2025), https://dearmedia.com/how-to-navigate-the-wellness-sector-and-theunregulated-supplements-industry/ [https://perma.cc/A7KN-E9NY].

44 Andrew I. Geller, Nadine Shehab, Nina J. Weidle, Maribeth C. Lovegrove, Beverly J. Wolpert et al., Emergency Department Visits for Adverse Events Related to Dietary Supplements, 373 NEW ENGLAND J. MED. 1531, 1533 (2015).

45 Victoria Hawekotte, FDA’s Minimal Authority over Dietary Supplements, REGUL. REV. (Jan. 10, 2024),

https://www.theregreview.org/2024/01/10/hawekotte-fdas-minimal-authority-over-dietary-supplements/ [https://perma.cc/2K27-AHHC]; Jessie L. Baker, Alex Flores & Michael S. Sinha, Re-Regulating Dietary Supplements, 19 J. FOOD L. & POL’Y 1, 4, 8–9 (2023).

46 Amanda Mull,

Everything

is

a Multivitamin, ATLANTIC

22,

2021),

https://www.theatlantic.com/health/archive/2021/11/dietary-supplements-mutlivitamins/620776/ [https://perma.cc/YR6A-UBZ5].

47 Specter, supra note 42, at 64. 48 Id. at 67, 69; Taylor, supra note 43.

49 Smith, supra note 13, at 2–3. 50 Id.; R. ALTON LEE, THE BIZARRE CAREERS OF JOHN R. BRINKLEY 76, 99, 101–02 (2002). 51 Sheryl Losser, Border Blasters: The Outlaw Stations that Changed Radio, MEX. DAILY NEWS (Oct. 3, 2024), https://mexiconewsdaily.com/culture/border-blasters-outlaw-stations-changed-radio/ [https://perma.cc/Q3YM-GSGU]; LEE, supra note 50, at 172–73; Smith, supra note 13, at 4; YOUNG, supra note 23, at 149–50.

52 47 U.S.C. § 325(c) (2024); Raymie Humbert, Making Sense of Section 325(c), MEDIUM (June 25, 2020), https://medium.com/en-frecuencia/making-sense-of-section-325-c-36d437ff99d [https://perma.cc/A7KMW5X8]; GENE FOWLER & BILL CRAWFORD, BORDER RADIO: QUACKS, YODELERS, PITCHMEN, PSYCHICS, AND OTHER AMAZING BROADCASTERS OF THE AMERICAN AIRWAVES 67–72 (2002).

53 See, e.g., RICHARD L. CLELAND, WALTER C. GROSS, LAURA D. KOSS, MATTHEW DAYNARD & KAREM M. MUOIO, WEIGHT-LOSS ADVERTISING: AN ANALYSIS OF CURRENT TRENDS 7–13 (Sep. 2002), https://www.ftc.gov/sites/default/files/documents/reports/weight-loss-advertisingan-analysis-currenttrends/weightloss_0.pdf [https://perma.cc/PRV6-2GNK].

54 Id. at 30. 55 Dani Blum, Emily Schmall & Nina Agrawal, Dr. Oz, Tapped to Run Medicare, Has a Record of Promoting Health Misinformation, N.Y. TIMES (Nov. 20, 2024), https://www.nytimes.com/2024/11/20/well/droz-health-medicare-record.html [https://perma.cc/CG6W-W24C]; Jon C. Tilburt, Megan Allyse & Frederic W. Hafferty, The Case of Dr. Oz: Ethics, Evidence and Does Professional Self-Regulation Work?, 19 AMA J. ETHICS 199, 199–202 (Feb. 2017); LAST WEEK TONIGHT WITH JOHN OLIVER: Dr. Oz (HBO, June 22, 2014).

56 W.H. Ramsay Lewis, Infomercials, Deceptive Advertising and the Federal Trade Commission, 19

FORDHAM URBAN L.J. 853, 853, 864–65 (1992).

57 Id. at 865–66. 58 Press Release, Fed. Trade Comm’n, FTC Testifies on the Marketing of Dietary Supplements (Oct. 28, 2003), https://www.ftc.gov/news-events/news/press-releases/2003/10/ftc-testifies-marketing-dietarysupplements [https://perma.cc/9TM8-TNAT] (noting that there were “more than 100 law enforcement actions” in the past decade and industry sales of $17.7 billion in 2001 for dietary supplements); Protecting Consumers from False and Deceptive Advertising of Weight-Loss Products: Hearing Before the Subcomm. on Consumer Prot., Prod. Safety, & Ins., 113th Cong. (June 17, 2014) (statement of Sen. Claire McCaskill) (citing $60 billion annual weight-loss product market); Health Claims, FED. TRADE COMM’N, (last visited Jan. 25, 2026), https://www.ftc.gov/news-events/topics/truth-advertising/health-claims [https://perma.cc/QD75-5NKL] (noting $25 billion supplement industry by 2009 with over 120 FTC enforcement actions in the prior decade).

59 Lewis, supra note 56, at 865–66.

60 U.S. Food & Drug Admin., supra note 3. 61 See, e.g., Ranijta Iyer, Scams in the Digital Era: How Technology is Changing Fraud, FORBES (Mar. 18, 2025, at 09:05 ET), https://www.forbes.com/sites/mastercard/2025/03/18/scams-in-the-digital-era-howtechnology-is-changing-fraud/ [https://perma.cc/2BUC-JB6X]; Steven Novella, The Menace of Wellness Influencers, SCI.-BASED MED. (Feb. 7, 2024), https://sciencebasedmedicine.org/the-menace-of-wellnessinfluencers/ [https://perma.cc/Z5PR-HANQ]; Emma Fletcher, Social Media: A Golden Goose for Scammers, FED. TRADE COMM’N https://www.ftc.gov/news-events/data-visualizations/dataspotlight/2023/10/social-media-golden-goose-scammers [https://perma.cc/732F-856W].

2023),

6,

62 Novella, supra note 61. 63 Sheila F. Anthony, Former Commissioner, Fed. Trade Comm’n, Remarks Before the Food and Drug Law Institute 45th Annual Educational Conference: Combating Deception in Dietary Supplement Advertising (Apr. 16, 2002), https://www.ftc.gov/news-events/news/speeches/combating-deception-dietary-supplementadvertising [https://perma.cc/Y69V-4DAH].

64 U.S. GOV’T ACCOUNTABILITY OFF., MEMORY SUPPLEMENTS: CLARIFYING FDA AND FTC ROLES COULD STRENGTHEN OVERSIGHT AND ENHANCE CONSUMER AWARENESS 26 (2017) (finding that “27 of the 28 [memory supplement advertisements assessed by the FDA] appeared to be disease claims—claims to treat, cure, or prevent a disease—which are generally prohibited in the labeling of dietary supplements and cause the product to be regulated as a drug”); OFF. OF INSPECTOR GEN., U.S. DEP’T OF HEALTH & HUM. SERVS., DIETARY SUPPLEMENTS: COMPANIES MAY BE DIFFICULT TO LOCATE IN AN EMERGENCY 7–8 (2012) (finding that twenty-eight percent of supplement manufacturers failed to register with the FDA); OFF. OF INSPECTOR GEN., U.S. DEP’T OF HEALTH & HUM. SERVS., DIETARY SUPPLEMENTS: STRUCTURE/FUNCTION CLAIMS FAIL TO MEET FEDERAL REQUIREMENTS 16 (2012) (finding twenty percent of supplements made prohibited disease claims on labels).

II. THE SOCIAL MEDIA TRANSFORMATION AND ANTI-VACCINE EVOLUTION

65 See Susie Khamis, Lawrence Ang & Raymond Welling, Self-Branding, “Micro-Celebrity” and the Rise of Social Media Influencers, 8 CELEBRITY STUD. 191, 198 (2017); see also Joshua J. Klein & Scott J. Schweikart, Does Regulating Dietary Supplements as Food in a World of Social Media Influencers Promote Public Safety?, 24 AMA J. ETHICS 396, E397–98 (May 2022) (noting that the proliferation of “influencer marketing” has made “it easier to use false or misleading claims about dietary supplements to promote their purchase,” which is difficult to regulate).

66 See Emily Lowe-Calverley & Rachel Grieve, Do the Metrics Matter? An Experimental Investigation of Instagram Influencer Effects on Mood and Body Dissatisfaction, 36 BODY IMAGE 1, 1 (2021); Zoe Brown & Marika Tiggeman, A Picture is Worth a Thousand Words: The Effect of Viewing Celebrity Instagram Images with Disclaimer and Body Positive Captions on Women’s Body Image, 33 BODY IMAGE 1, 1 (2020) (noting that research shows that “Instagram use is related to a variety of body image concerns”).

67 See generally BEAU DONELLY & NICK TOSCANO, THE WOMAN WHO FOOLED THE WORLD: THE TRUE STORY OF FAKE WELLNESS GURU BELLE GIBSON (2017) (explaining how Belle Gibson became a digital celebrity after deploying an elaborate and fabricated social media scheme contending that she beat terminal brain cancer by adopting a healthy diet and other alternative wellness interventions).

68 Stephanie Alice Baker, Apple Cider Vinegar: How Social Media Gave Rise to Fraudulent Wellness Influencers Like Belle Gibson, CONVERSATION (Feb. 14, 2025, at 11:26 ET), https://theconversation.com/apple-

cider-vinegar-how-social-media-gave-rise-to-fraudulent-wellness-influencers-like-belle-gibson-249432 [https://perma.cc/FH9C-FGRX]; Elaine Xu & Terence Lee, Illness Bloggers and Sickness Scams: Communication Ethics and the ‘Belle’ Gibson Saga, 14 ETHICAL SPACE 72, 77 (2017).

69 Sophie Corbett, What We Should Learn from the Belle Gibson Fraud, MENTAL HEALTH DIETITIANS (Feb. 20, 2025), https://www.mentalhealthdietitians.com/what-we-should-learn-from-the-belle-gibson-fraud/ [https://perma.cc/K6PC-T8J8]; Baker, supra note 68; Melanie McFarland, “Apple Cider Vinegar” May Explain How “The Whole Pantry” Fraud was a Step on the Path of RFK Jr., SALON (Feb. 7, 2025, at 12:01 ET), https://www.salon.com/2025/02/07/apple-cider-vinegar-may-explain-how-the-whole-pantry-fraud-was-a-stepon-the-path-of-rfk-jr/ [https://perma.cc/EKY5-LK7G].

70 Laura Martin, Apple Cider Vinegar: How Instagram Wellness Guru Belle Gibson Faked Cancer—and Caused a Scandal, BBC (Feb. 5, 2025), https://www.bbc.com/culture/article/20250204-apple-cider-vinegarhow-instagram-wellness-guru-belle-gibson-faked-cancer [https://perma.cc/2QNN-ZU8B]; Beau Donelly & Nick Toscano, Backlash Over App Developer Belle Gibson’s Missing Charity Money, AGE (Mar. 8, 2015, at https://www.theage.com.au/technology/backlash-over-app-developer-belle-gibsons-missing23:02 charity-money-20150309-13yzd4.html [https://perma.cc/TR2D-QX44].

ET),

71 Charlotte Graham-McLay, Wellness Blogger Belle Gibson Lied About Having Cancer. Years Later, Australia Is Still Chasing Her, ABC27 (Feb. 21, 2025, at 01:09 ET), https://www.abc27.com/news/health/aphealth/ap-wellness-blogger-belle-gibson-lied-about-having-cancer-years-later-australia-is-still-chasing-her/ [https://perma.cc/848C-CGY8]; Rosemary Counter, How Cancer Scammer Belle Gibson Became “One of the Most 2025), https://www.vanityfair.com/hollywood/story/cancer-scammer-belle-gibson-apple-cider-vinegar [https://perma.cc/3JGD-EZHS].

Australia”,

VANITY

Women

Hated

FAIR

5,

72 See Sergio Barta, Daniel Belanche, Ana Fernández & Marta Flavián, Influencer Marketing on TikTok: The Effectiveness of Humor and Followers’ Hedonic Experience, 70 J. OF RETAILING & CONSUMER SERVS. 1, 1–2 (2023) (noting that given TikTok’s “huge growth, its format and content characteristics, and its great ability to directly reach younger users with important potential as consumers, a real opportunity exists to exploit TikTok as a channel for influencer marketing campaigns”); A.W. Ohlheiser, How TikTok Profits Off Dangerous Health Trends, VOX (Oct. 5, 2023, at 07:30 ET), https://www.vox.com/technology/23902094/tiktok-shop-wellnesstrend-castor-oil [https://perma.cc/LA98-6QFC].

73 Erin Corbett, Whatever You Do, Don’t Try Dry Scooping, TikTok’s Latest “Wellness” Trend, REFINERY29 (June 4, 2021, at 13:20 ET), https://www.refinery29.com/en-us/2021/06/10507634/what-is-dry-

scooping-tiktok-trend-dangerous [https://perma.cc/C25V-E7QS]; see Daniel Davies, People on TikTok Are Dry Scooping Pre Workout. You Really Shouldn’t Do That, MEN’S HEALTH (May 12, 2021), https://www.menshealth.com/uk/health/a36404534/people-on-tiktok-are-dry-scooping-pre-workout/ [https://perma.cc/J3UX-E3KV].

74 Wael Osman, Fatma Mohamed, Mohamed Elhassan & Abdulhadi Shoufan, Is YouTube a Reliable Source of Health-Related Information? A Systematic Review, 19 BMC MED. EDUC. 1, 8–9 (2022); J. Qi, T. Trang, J. Doong, S. Kang & A.L. Chien, Misinformation is Prevalent in Psoriasis-Related YouTube Videos, 22 DERM. ONLINE J. (2016); Kapil Chalil Madathil, A. Joy Rivera-Rodriguez, Joel S. Greenstein & Anand K. Gramopadhye, Healthcare Information on YouTube: A Systematic Review, 21 HEALTH INFORMATICS J. 173, 190 (2015).

75 Gita Wirjawan, The Paradox of the Internet: The Democratization of Information versus The Democratization of Ideas and Economic Capital 1–2 (Shorenstein Asia-Pac. Rsch. Ctr., Working Paper) (Nov. 4, 2024), https://fsi.stanford.edu/publication/paradox-internet [https://perma.cc/7LS4-TCSC].

76 See, e.g., Delia Cristina Balaban, Julia Szambolics & Miahi Chirica, Parasocial Relations and Social Media Influencers’ Persuasive Power. Exploring the Moderating Role of Product Development, 230 ACTA PSYCHOLOGICA 1, 1–2 (2022).

77 Maximilian Beichert, Andreas Bayerl, Jacob Goldberg & Andreas Lanz, Revenue Generation Through

Influencer Marketing, 88 J. OF MARKETING 40, 40–41 (2024).

78 Julia Belluz, Research Fraud Catalyzed the Anti-Vaccination Movement. Let’s Not Repeat History, VOX (Mar. 5, 2019, at 12:06 ET), https://www.vox.com/2018/2/27/17057990/andrew-wakefield-vaccines-autismstudy [https://perma.cc/8WFF-C3WE]; Editors of The Lancet, Retraction—Ileal-lymphoid-nodular Hyperplasia, Non-specific Colitis, and Pervasive Developmental Disorder in Children, 375 THE LANCET 445, 445 (2010).

79 Sara Boseley, Andrew Wakefield Found “Irresponsible” by GMC Over MMR Vaccine Scare, GUARDIAN (Jan. 28, 2010, at 15:34 ET), https://www.theguardian.com/society/2010/jan/28/andrew-wakefield-mmr-vaccine [https://perma.cc/88RD-QLP9].

80 Id. 81 Sara Boseley, Andrew Wakefield Struck Off Register by General Medical Council, GUARDIAN (May 24, 2010, at 15:34 ET), https://www.theguardian.com/society/2010/may/24/andrew-wakefield-struck-off-gmc [https://perma.cc/5QP5-4BXG].

82 Samantha D. Gottlieb, Vaccine Resistances Reconsidered: Vaccine Skeptics and the Jenny McCarthy Effect, 11 BIOSOCIETIES 152, 154, 161–62 (2016); David Folkenflik, McCarthy’s Vaccination Stance Complicates ET), NPR https://www.npr.org/2013/07/16/202729420/jenny-mccarthy-a-controversial-choice-for-next-view-co-host [https://perma.cc/JA9A-L6YY].

View,”

16:53

2013,

“The

(July

Job

16,

on

83 Gottlieb, supra note 82, at 161–65; Jenny McCarthy: “We’re Not An Anti-Vaccine Movement . . . We’re Pro-Safe Vaccine”, FRONTLINE (Mar. 23, 2015), https://www.pbs.org/wgbh/frontline/article/jenny-mccarthywere-not-an-anti-vaccine-movement-were-pro-safe-vaccine/ [https://perma.cc/B3H3-C59A]; Folkenflik, supra note 82; ANDERSON, supra note 2, at 48–49, 61–67.

84 Aislinn Antrim, Anti-Vaccine Celebrities Have Inordinate Amount of Influence, PHARMACY TIMES (June 18, 2019), https://www.pharmacytimes.com/view/antivaccine-celebrities-have-inordinate-amount-of-influence [https://perma.cc/A78L-ZZG3]; ANDERSON, supra note 2, at 48–49, 61–67.

85 Antrim, supra note 84. 86 See, e.g., TARA KIRK SELL, DIVYA HOSANGADI, ELIZABETH SMITH, MARC TROTOCHAUD, PRARTHANA VASUDEVAN ET AL., NATIONAL PRIORITIES TO COMBAT MISINFORMATION AND DISINFORMATION FOR COVID19 AND FUTURE PUBLIC HEALTH THREATS: A CALL FOR A NATIONAL STRATEGY 1, 3 (2021), https://centerforhealthsecurity.org/sites/default/files/2023-02/210322-misinformation.pdf [https://perma.cc/5CH2-JPS9].

87 Daniel A. González-Padilla & Leonardo Tortolero-Blanco, Social Media Influence in the COVID-19 Pandemic, 46 INT’L BRAZ. J. UROL. 120–22 (2020); see also Erlene Roberta Riberiro dos Santos et al., Association Between COVID-19 and Anxiety During Social Isolation: A Systematic Review, 9 WORLD J. CLIN. CASES 7433, 7434–35 (2021) (explaining the association between COVID-19 social isolation and mental health conditions such as pathological anxiety and depression).

88 Arielle Pardes, Wellness Influencers Sell False Promises as Health Fears Soar, WIRED (Apr. 3, 2020, https://www.wired.com/story/coronavirus-anxieties-soar-wellness-influencers-step-in/

13:45

at [https://perma.cc/46Q4-X6N2].

ET),

89 Brianna M. White, Chad Melton, Parya Zareie, Robert L. Davis, Robert A Bednarczyk et al., Exploring Celebrity Influence on Public Attitude Towards the COVID-19 Pandemic: Social Media Shared Sentiment Analysis, BMJ HEALTH & CARE INFORMATICS Jan. 2023, at 1, 1, 3, 6.

90 E.J. Dickson, “A Menace to Public Health”: Doctors Demand Spotify Puts an End to COVID Lies on “Joe Rogan Experience”, ROLLING STONE (Jan. 12, 2022), https://www.rollingstone.com/culture/culturenews/covid-misinformation-joe-rogan-spotify-petition-1282240/ [https://perma.cc/892K-J2N9]; Soo Kim, Gwyneth Paltrow’s COVID Advice Not Supported by Evidence, Health Experts Warn, NEWSWEEK (Feb. 25, 2021, at 12:16 ET), https://www.newsweek.com/coronavirus-gwyneth-paltrow-regimen-covid-expertswarning-1572073 [https://perma.cc/SRM3-75W2]; see, e.g., Bryan Pietsch & Adela Suliman, Nicki Minaj

Tweets Coronavirus Vaccine Conspiracy Theory, Spotlighting Struggle Against Misinformation, WASH. POST (Sep. 14, 2021), https://www.washingtonpost.com/arts-entertainment/2021/09/14/nicki-minaj-covid-19vaccine-conspiracy/ [https://perma.cc/J8GY-ATFY]; see, e.g., Stephanie Mencimer, Steve Bannon: Wellness Warrior?, MOTHER JONES (Mar. 20, 2021), https://www.motherjones.com/politics/2021/03/steve-bannonwellness-warrior/ [https://perma.cc/LJN3-ZY2H].

91 An Nguyen & Daniel Catalan-Matamoros, Anti-Vaccine Discourse on Social Media: An Exploratory Audit of Negative Tweets about Vaccines and Their Posters, 10 VACCINES 1, 3–4 (2022); RENÉE DIRESTA, OF VIRALITY AND VIRUSES: THE ANTI-VACCINE MOVEMENT AND (2018), https://securityandtechnology.org/wp-content/uploads/2024/10/renee_diresta_virality_and_viruses_IST-12.pdf [https://perma.cc/836X-RVGA]. 92 DIRESTA, supra note 91. 93 Maintenance Phase, The Wellness

to QAnon Pipeline, SPOTIFY

(May 11, 2021),

SOCIAL MEDIA

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Science,

GUARDIAN

94 Sirin Kale, Chakras, Crystals and Conspiracy Theories: How the Wellness Industry Turned Its Back on ET),

COVID https://www.theguardian.com/world/2021/nov/11/injecting-poison-will-never-make-you-healthy-how-thewellness-industry-turned-its-back-on-covid-science [https://perma.cc/9E4F-NLWF]; Will Rahn & Dan Patterson, What is the QAnon Conspiracy Theory?, CBS NEWS (Mar. 29, 2021, at 15:36 ET), https://www.cbsnews.com/news/what-is-the-qanon-conspiracy-theory/ see Kaitlyn Tiffany, The Women Making Conspiracy Theories Beautiful, ATLANTIC (Aug. 18, 2020), https://www.theatlantic.com/technology/archive/2020/08/how-instagram-aesthetics-repackage-qanon/615364/ [https://perma.cc/A3UW-4MRY].

[https://perma.cc/32C5-VRTZ];

01:00

2021,

11,

95 Kale, supra note 94; Tiffany, supra note 94.

III. THE TRUMP ADMINISTRATION’S WELLNESS CABINET: INSTITUTIONALIZING HEALTH MISINFORMATION

17,

2021,

Theories,

GUARDIAN

Conspiracy

96 See, e.g., Eva Wiseman, The Dark Side of Wellness: The Overlap Between Spiritual Thinking and FarRight ET), https://www.theguardian.com/lifeandstyle/2021/oct/17/eva-wiseman-conspirituality-the-dark-side-of-wellnesshow-it-all-got-so-toxic [https://perma.cc/2FTJ-8M44] (noting that conspiracy theories and misinformation surrounding wellness has become “increasingly about ideology” where individuals who are “a part of [the wellness] community” are forced to embrace ideas like “Big Science is evil, supplements help . . . vaccines don’t work”). For example, Gwynneth Paltrow, whose wellness brand, Goop, is worth over $250 million alone, “curated a list of products recommended by her ‘functional medicine practitioner’ to help ease long Covid, including an $8,600 necklace, for ‘hiking in.’” Id.; Sarah Wilson, The Wellness Realm Has Fallen into Conspiritualism—I Have 13:30 ET), https://www.theguardian.com/books/2020/sep/15/the-wellness-realm-has-fallen-into-conspiritualism-i-have-asense-why [https://perma.cc/TTP9-KRBG]; Charlotte Ward & David Voas, The Emergence of Conspirituality, 26 J. CONTEMP. RELIGION 103, 104 (2011).

Sense Why, GUARDIAN

05:00

2020,

(Sep.

14,

a

97 See Selena Simmons-Duffin, RFK Jr. Confirmed as Trump’s Health Secretary, Over Democrats’ Loud Objection, NPR (Feb. 13, 2025, at 11:33 ET), https://www.npr.org/sections/shots-health-news/2025/02/13/nxs1-5294591/rfk-jr-trump-health-human-services-hhs-vaccines [https://perma.cc/MU7M-RTFZ].

98 Jonathan Jarry, The Anti-Vaccine Propaganda of Robert F. Kennedy, Jr., MCGILL OFF. SCI. & SOC’Y (Apr. 16, 2021), https://www.mcgill.ca/oss/article/covid-19-health-pseudoscience/anti-vaccine-propagandarobert-f-kennedy-jr [https://perma.cc/ZX4L-LMN4]. Secretary Kennedy first began his “public crusade” with an articled called “Deadly Immunity,” which was “riddled with mistakes, distorted quotes, and unsubstantiated fearmongering” that was later retracted. Id. Indeed, the article notes that Secretary Kennedy’s “idée fixe has snowballed and gained impressive momentum. He has propagated numerous falsehoods about the COVID-19 pandemic. He has been a mainstay at the AutismOne conference, which attracts fake experts convinced that vaccines cause autism.” Id.

4,

Feb.

2026),

visited

https://childrenshealthdefense.org/cdc-corruption-deceit-and-cover-up/

99 See, e.g., CDC: Corruption, Deceit and Cover-Up, CHILD.’S HEALTH DEF. FUND (last visited Jan. 25, 2026), [https://perma.cc/WWE2EW3A] (arguing that the CDC has become “a mouthpiece for industry and has protected the ‘all vaccines for all children’ policy despite peer-reviewed science to the contrary”); Agency Capture, CHILD.’S HEALTH DEF. FUND (last https://childrenshealthdefense.org/defender_category/agency-capture/ [https://perma.cc/FU94-CRKS] (last visited Jan. 25, 2026) (demonstrating that Children’s Health Defense dedicates substantial resources to publicizing allegations of agency capture by various industries); Craig Spencer, I’m a Physician Who Went to the Anti-Vaccine Movement’s Biggest Gathering. More of My Colleagues Should Too, STAT NEWS (Nov. 11, 2025), https://www.statnews.com/2025/11/11/childrens-health-defenseconference-pro-vaccine-doctor/ [https://perma.cc/KPN4-JAHL]; Shannon Bond, Inside RFK Jr.’s Nonprofit’s Legal Battles Over Vaccines and Public Health, NPR at 05:00 ET), https://www.npr.org/2024/12/03/nx-s1-5198506/rfk-jr-anti-vaccine-chd-lawsuits [https://perma.cc/95DK9FK8]; Children’s Heath Defense—Bias and Credibility, MEDIA BIAS/FACT CHECK (last visited Jan. 25, 2026), https://mediabiasfactcheck.com/childrens-health-defense/ [https://perma.cc/V4B4-MAH5].

(Dec. 4, 2024,

RFK,

Under

100 Lena H. Sun, Lauren Weber & Rachel Roubein, How Vaccine Policy, Including for Coronavirus, Has 2025), WASH.

Changed 24, https://www.washingtonpost.com/health/2025/07/24/vaccine-access-recommendations-covid-rfk/ [https://perma.cc/YP8N-B9CF]; Joseph Gedeon, RFK Jr Threatens Ban on Federal Scientists Publishing in Top Journals, GUARDIAN (May 28, 2025, at 11:41 ET), https://www.theguardian.com/us-news/2025/may/28/rfk-jrmedical-journals [https://perma.cc/NCB3-9DQS]; Lisa Desjardins, RFK Jr. Faces Questions Over Vaccine Skepticism, Medicaid Reform at Confirmation Hearing, PBS NEWS (Jan. 29, 2025, at 18:50 ET),

POST

(July

Jr.,

https://www.pbs.org/newshour/show/rfk-jr-faces-questions-over-vaccine-skepticism-medicaid-reform-atconfirmation-hearing [https://perma.cc/E9UP-LSE4]; CDC: Corruption, Deceit and Cover-Up, supra note 99; Agency Capture, supra note 99.

101 See, e.g., Elaine Godfrey, The Wellness Women are on the March, ATLANTIC (Dec. 13, 2024),

https://www.theatlantic.com/politics/archive/2024/12/wellness-rfk-washington/680977/ [https://perma.cc/5KEN-6FQP].

102 Ali Swenson, In a Tumultuous Year, U.S. Health Policy has been Dramatically Reshaped Under RFK Jr., L.A. TIMES (Dec. 30, 2025, at 21:19 ET), https://www.latimes.com/world-nation/story/2025-12-30/u-shealth-policy-has-been-dramatically-reshaped-under-rfk-jr [https://perma.cc/3BSY-V6MG]; Kylee Van Horn, Robert F. Kennedy Jr. Health: The Truth Behind His Wellness Movement and Policies, FLY NUTRITION (Feb. 26, 2025), https://flynutrition.org/robert-f-kennedy-jr-health-the-truth-behind-his-wellness-movement-andpolicies/ [https://perma.cc/AG7B-DV99]; Karen Feldscher, RFK Jr. Moves on Vaccines Could Have Broad Ramifications for Public Health, Says Expert, HARVARD T.H. CHAN SCH. OF PUB. HEALTH (June 18, 2025), https://hsph.harvard.edu/news/rfk-jr-moves-on-vaccines-could-have-broad-ramifications-for-public-healthsays-expert/ [https://perma.cc/TSQ2-JTKD].

103 Madeline Halpert, RFK Jr Cancels $500m in Funding for mRNA Vaccines for Diseases Like Covid, BBC (Aug. 5, 2025), https://www.bbc.com/news/articles/c74dzdddvmjo [https://perma.cc/36QP-WDU9]; Meredith Wadman, RFK Jr.’s Purge of CDC Vaccine Advisors Prompts Outrage, SCI. (June 10, 2025, at 15:30 ET), https://www.science.org/content/article/rfk-jr-s-purge-cdc-vaccine-advisers-prompts-outrage [https://perma.cc/53R9-2M88]; Will Stone, RFK Jr.’s Vaccine Policy Sparks a Lawsuit from the American Academy of Pediatrics, NPR (July 8, 2025, at 05:00 ET), https://www.npr.org/sections/shots-healthnews/2025/07/08/nx-s1-5459978/rfk-jr-vaccine-pediatrics-public-health-lawsuit [https://perma.cc/Y5R4X47V]; Lauren Weber, Unpacking RFK Jr.’s “Doublespeak” on Vaccines, WASH. POST (May 11, 2025), https://www.washingtonpost.com/health/2025/05/11/vaccines-measles-rfk-jr-health/ [https://perma.cc/M5NAB4G6].

104 See, e.g., Terri Langford, In Visit to Texas, RFK Jr. Said Autism, Diabetes Deserve More Attention than Measles, TEX. TRIB. (Apr. 29, 2025, at 18:21 ET), https://www.texastribune.org/2025/04/29/texas-measlesrobert-kennedy-autism/ [https://perma.cc/LXR7-G7L8].

105 Dave Muoio, CDC Finalizes Terminations of “Roughly 600” Employees After Court Narrows ET),

Preliminary https://www.fiercehealthcare.com/regulatory/cdc-finalizes-terminations-roughly-600-employees-after-courtnarrows-preliminary-hold [https://perma.cc/4Y5Z-4PBL].

HEALTHCARE

FIERCE

(Aug.

13:00

Hold,

21,

106 Sheryl Gay Stolberg & Megan Mineiro, A Defiant Kennedy Defends Vaccine Changes and C.D.C. Shake-Up, N.Y. TIMES (Sep. 4, 2025), https://www.nytimes.com/2025/09/04/us/politics/kennedy-senatehearing-vaccines-cdc.html [https://perma.cc/K2AK-85QN]; Selena Simmons-Duffin & Mary Louise Kelly, CDC Leaders Resign After RFK Jr. Moves to Fire Director Susan Monarez, NPR (Aug. 28, 2025, at 17:23 ET), https://www.npr.org/2025/08/28/nx-s1-5520718/cdc-leaders-resign-after-rfk-jr-moves-to-fire-director-susanmonarez [https://perma.cc/PPP9-DBKK].

Fired,

107 Sheryl Gay Stolberg, Apoorva Mandavilli & Christina Jewett, White House Says New C.D.C. Director (Aug. 2025), Leave, 27, [https://perma.cc/7H2Z-

is https://www.nytimes.com/2025/08/27/health/cdc-monarez-kennedy-vaccines.html NS6R].

Refuses

TIMES

N.Y.

She

but

to

108 Id. 109 Read the Resignation Letters of Top CDC Officials, MEDPAGE TODAY (Aug. 28, 2025),

https://www.medpagetoday.com/infectiousdisease/publichealth/117197 [https://perma.cc/V2AS-RT5G].

110 “Total Implosion”: How Trump Firing of CDC Chief Monarez Sparked an Exodus, AL JAZEERA (Aug. 28, 2025, at 20:13 ET), https://www.aljazeera.com/news/2025/8/28/total-implosion-how-trump-firing-of-cdcchief-monarez-sparked-an-exodus [https://perma.cc/2JLB-NKSM].

111 The Associated Press, CDC Director Is Out After Less Than a Month; Other Agency Leaders Resign, OR. PUB. BROAD. (Aug. 27, 2025, at 20:13 ET), https://www.opb.org/article/2025/08/27/cdc-director-susanmonarez-is-out-other-agency-leaders-resign/ [https://perma.cc/JL9V-67YE].

112 Charlotte Kramon & Jeff Martin, Shooter Attacked CDC Headquarters to Protest COVID-19 Vaccines, Authorities Say, PBS NEWS (Aug. 12, 2025, at 12:32 ET), https://www.pbs.org/newshour/nation/shooterattacked-cdc-headquarters-to-protest-covid-19-vaccines-authorities-say [https://perma.cc/U743-2L9U].

113 William Foege, Former CDC Director William Foege: How Public Health Can Fight Back in a Time of Dangerous Nonsense, STAT NEWS (Aug. 18, 2025), https://www.statnews.com/2025/08/18/rfk-jr-publichealth-threats-william-foege-smallpox/ [https://perma.cc/JAW6-99JP].

114 Jarry, supra note 98. 115 Id.

116 Joe Walsh, Over 1,000 HHS Staffers Call on Trump To Fire RFK Jr. for “Endangering the Nation’s Health”, CBS NEWS (Sep. 3, 2025, at 16:56 ET), https://www.cbsnews.com/news/hhs-staffers-call-on-trumpfire-rfk-jr/ [https://perma.cc/9P9Z-KAWF]; Kaia Hubbard, Former CDC Directors Slam RFK Jr. in Op-ed: “Endangering Every American’s Health”, CBS NEWS 20:39 ET), https://www.cbsnews.com/news/cdc-directors-oped-rfk-jr-endangering-every-americans-health/ [https://perma.cc/G7F8-JR47].

(Sep.

117 News Release, Nat’l Insts. of Health, Jay Bhattacharya Begins Tenure as 18th Director of the National Institutes of Health (Apr. 1, 2025), https://www.nih.gov/news-events/news-releases/jay-bhattacharya-beginstenure-18th-director-national-institutes-health [https://perma.cc/JP3D-7QZJ].

118 Id.; Arthur Allen, The Covid ‘Contrarians’ Are in Power. We Still Haven’t Hashed Out Whether They Were Right., KFF HEALTH NEWS (Feb. 19, 2025), https://kffhealthnews.org/news/article/covid-contrarians-jaybhattacharya-nih-stanford-pandemic-inquiry/ [https://perma.cc/NW7G-LGYF].

119 GREAT BARRINGTON DECLARATION, https://gbdeclaration.org/#read [https://perma.cc/H4V4-FNJL]

(last visited Jan. 25, 2026).

120 Allen, supra note 118.

121 Trish Greenhalgh, Martin McKee & Michelle Kelly-Irving, The Pursuit of Herd Immunity Is a Folly— 11:07 ET),

So Who’s Funding This Bad Science?, GUARDIAN https://www.theguardian.com/commentisfree/2020/oct/18/covid-herd-immunity-funding-bad-science-antilockdown [https://perma.cc/G7TE-ZSXQ]. See generally Why Was the Declaration Written, GREAT BARRINGTON DECLARATION ORG. (last visited Feb. 4, 2026), https://gbdeclaration.org/why-was-thedeclaration-written/ [https://perma.cc/9HXH-UTBD] (explaining that “[t]he Declaration was written and signed at the American Institute for Economic Research, located in Great Barrington, Massachusetts”).

2020,

18,

and

Environmental

122 Greenhalgh, McKee & Kelly-Irving, supra note 121. 123 Bob Ward, Organisers of Anti-Lockdown Declaration Have Track Record of Promoting Denial of 2020),

Health https://www.lse.ac.uk/granthaminstitute/news/organisers-of-anti-lockdown-declaration-have-track-record-ofpromoting-denial-of-health-and-environmental-risks/ [https://perma.cc/7EVF-R3PH]; Richard Murphy, The Great Barrington Declaration Has Nothing To Do with Epidemiology and a Great Deal To Do with Far Right Economics, FUNDING THE FUTURE (Oct. 7, 2020), https://www.taxresearch.org.uk/Blog/2020/10/07/the-greatbarrington-declaration-has-nothing-to-do-with-epidemiology-and-a-great-deal-to-do-with-far-right-economics/ [https://perma.cc/ZJ58-35QD].

LONDON

SCHOOL

ECON.

Risks,

20,

OF

124 Greenhalgh, McKee & Kelly-Irving, supra note 121 (explaining that “a strategy of pursuing ‘herd

immunity’ is nothing more than a fringe view”).

125 See, e.g., Eran Bendavid & Jay Bhattacharya, Is the Coronavirus as Deadly as They Say?, WALL ST. J. (Mar. 24, 2020, at 18:21 ET), https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say11585088464?ref=stanfordreview.org [https://perma.cc/C62A-BU9L].

126 Ryan Quinn, NIH Director Orders Review of All Current, Planned Research, INSIDE HIGHER ED (Aug. https://www.insidehighered.com/news/quick-takes/2025/08/19/nih-director-orders-review-all-

19, current-planned-research [https://perma.cc/DS22-UUW9].

127 Nicholas Jacobus, NIH Director Dr. Jay Bhattacharya Outlines New ‘Unified Strategy’ Aimed to Align the Agencies Priorities, PHARMEXEC.COM (Aug. 18, 2025), https://www.pharmexec.com/view/nih-director-jaybhattacharya-unified-strategy-align-agencies-priorities [https://perma.cc/5QTG-E64C]; Laurel Oldach, NIH Staff Break Ranks in Open Letter to Director Jay Bhattacharya, CHEM. & ENG’G NEWS (June 9, 2025), https://cen.acs.org/policy/research-funding/NIH-staff-break-ranks-open/103/web/2025/06 [https://perma.cc/5LPY-JWF2].

128 Amy Walker, TV’s Dr. Oz Confirmed to Lead Medicare and Medicaid, BBC (Apr. 4, 2025),

https://www.bbc.com/news/articles/c1k4em2yz9eo [https://perma.cc/82QG-P5UQ].

129 Reed Abelson & Susanne Craig, Dr. Oz: How His Millions Collide with Medicare, N.Y. TIMES (Feb. https://www.nytimes.com/2025/02/24/health/dr-oz-medicare-finances-conflicts.html

24, [https://perma.cc/7NAK-WBK3].

130 See Bahar Gholipour, Dr. Oz’s ‘Miracle’ Diet Pills: 5 Controversial Supplements, NBC NEWS (June 19,

2014, at 11:51 ET), https://www.nbcnews.com/id/wbna55453176 [https://perma.cc/LJ26-Q2G5].

131 Christina Korownyk, Michael R. Kolber, James McCormack, Vanessa Lam, Kate Overbo et al., Televised Medical Talk Shows—What They Recommend and the Evidence To Support Their Recommendations: A Prospective Observational Study, BMJ, Dec. 2014, at 1, 5.

132 Abelson & Craig, supra note 129; Jen Christensen & Jacque Wilson, Congressional Hearing (June 19, 2024, at 09:54 ET),

Investigates Dr. Oz https://www.cnn.com/2014/06/17/health/senate-grills-dr-oz [https://perma.cc/4FH9-G3RE].

‘Miracle’ Weight Loss Claims, CNN

133 Christensen & Wilson, supra note 132. 134 Abelson & Craig, supra note 129. 135 Id. 136 Id.

137 Id. 138 Id. 139 Id.; Selena Simmons-Duffin, 5 Things To Know as Dr. Oz Prepares To Lead Medicare and Medicaid, NPR (Apr. 3, 2025, 18:36 ET), https://www.npr.org/sections/shots-health-news/2025/03/25/g-s1-55766/drmehmet-oz-medicare-medicaid-cms-trump [https://perma.cc/3TFD-9JJZ].

of

Influencer Marketing

140 Abelson & Craig, supra note 129; Robert Weissman, Letter to FTC: Investigate Dr. Oz’s Potential 2024), Standards,

Violations https://www.citizen.org/article/letter-to-ftc-investigate-dr-ozs-potential-violations-of-influencer-marketingstandards/ [https://perma.cc/6GUS-A4A8]. 141 Abelson & Craig, supra note 129. 142 Id. 143 Simmons-Duffin, supra note 139; Dr. Mehmet Oz Shares Vision for CMS, CTRS. FOR MEDICARE & MEDICAID SERVS. (Apr. 10, 2025), https://www.cms.gov/newsroom/press-releases/dr-mehmet-oz-sharesvision-cms [https://perma.cc/9NB8-8CPC].

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PUB.

3,

144 Senate Confirms New FDA, NIH Leaders, AM. HOSP. ASS’N (Mar. 26, 2025, at 15:40 ET), https://www.aha.org/news/headline/2025-03-26-senate-confirms-new-fda-nih-leaders [https://perma.cc/UL97MDYC].

145 Phie Jacobs, Mixed Reactions Greet Trump’s Pick of Longtime FDA Critic to Head Agency, SCI. (Nov. 26, 2024, at 16:00 ET), https://www.science.org/content/article/mixed-reactions-greet-trump-s-pick-longtimefda-critic-head-agency [https://perma.cc/MBE9-PTG9].

146 Id. 147 Ben Fidler & Jonathan Gardner, Vinay Prasad, A Physician and FDA Critic, To Lead Agency Center Overseeing Vaccines, BIOPHARMADIVE (May 6, 2025), https://www.biopharmadive.com/news/fda-vinayprasad-cber-vaccines-cell-gene-therapy/747283/ [https://perma.cc/322H-WNCP].

148 Cyber-Iconoclast Vinay Prasad Named Head of FDA’s CBER, THE CANCER LETTER (May 9, 2025), https://cancerletter.com/regulatory-news/20250509_3/ [https://perma.cc/6WXH-BJSZ]; Chloe Courtney Bohl, Controversial Oncologist Dr. Vinay Prasad Disavowed by Dean, Lectures to GSBS, THE TUFTS DAILY (Mar. 8, 2022), https://www.tuftsdaily.com/article/2022/03/controversial-oncologist-dr-vinay-prasad-disavowed-bydean-lectures-to-gsbs [https://perma.cc/4GUP-CJGS]; Did Vinay Prasad Need To Mention the Nazis To Make a Point on the U.S. Pandemic Response, THE CANCER LETTER (Oct. 8, 2021), https://cancerletter.com/the-cancerletter/20211008_4/ [https://perma.cc/6HX6-PKEH].

149 Nyah Phengsitthy, Vaccines Face Uncertain Approval, Reviews with New FDA Official, BLOOMBERG L. (May 19, 2025, at 05:05 ET), https://news.bloomberglaw.com/health-law-and-business/vaccines-faceuncertain-approval-reviews-with-new-fda-official [https://perma.cc/XVH6-6UCS]; Cyber-Iconoclast Vinay Prasad Named Head of FDA’s CBER, supra note 148; Phil Taylor, Vinay Prasad Will Replace Marks as CBER Director, PHARMAPHORUM (May 7, 2025), https://pharmaphorum.com/news/vinay-prasad-will-replace-markscber-director [https://perma.cc/4UMB-NQ37].

150 12 Ex-FDA Leaders Criticize Claims Made by Agency’s Current Vaccine Chief, CBS NEWS (Dec. 3, 2025, at 21:49 ET), https://www.cbsnews.com/news/12-ex-fda-leaders-criticize-claims-made-by-agencycurrent-vaccine-chief-vinay-prasad/ [https://perma.cc/YT2Z-V3GN]; Marty Logan, FDA Claims 10 Child Deaths Caused by COVID-19 Vaccine, Vows To Tighten Vaccine Approvals, BMJ (Dec. 2, 2025), https://www.bmj.com/content/391/bmj.r2546.full [https://perma.cc/L7ZJ-5PDD].

151 Steve Usdin, FDA’s Vinay Prasad, In His Own Words, BIOCENTURY (Dec. 2, 2025, at 10:55 ET),

https://www.biocentury.com/article/657740 [https://perma.cc/Q3PH-TCHA].

152 Jessica McDonald, Unpacking the FDA’s Black Friday Vaccine Memo, FACTCHECK.ORG (Dec. 4, 2025), [https://perma.cc/3J4K-

https://www.factcheck.org/2025/12/unpacking-the-fdas-black-friday-vaccine-memo/ U438].

153 Califf et al., supra note 11. 154 Id.

155 Id. 156 Annabel Kartal Allen, FDA Appoints Tracy Beth Høeg as Fifth CDER Head this Year, CLIN. TRIALS ARENA (Dec. 4, 2025), https://www.clinicaltrialsarena.com/news/fda-appoints-tracy-beth-hoeg-head-of-cder/ [https://perma.cc/N6TE-YN9V]; Ryan Mancini, FDA Changes Heads of Drug Research and OTC Drugs in Latest Shakeup, THE HILL (Dec. 3, 2025, at 21:19 ET), https://thehill.com/policy/healthcare/5632812-fdaleadership-changes-vaccine-policy/ [https://perma.cc/CV6V-EZP7]; Nick Paul Taylor, FDA Names Tracey Beth Høeg, Fresh from Vaccine Safety Probe, as Acting Head of Drug Center, FIERCE BIOTECH (Dec. 4, 2025), https://www.fiercebiotech.com/biotech/fda-names-tracy-beth-hoeg-fresh-vaccine-safety-probe-acting-headdrug-center [https://perma.cc/3DEG-796C].

157 Mancini, supra note 156; Taylor, supra note 156; Tracy Beth Høeg, FDA’s Shortcomings: A List, BETTER THAN FICTION (Nov. 15, 2023), https://tracybethhoegmdphd.substack.com/p/fdas-shortcomings-a-list [https://perma.cc/XLF6-LJFX].

158 Annabel Kartal Allen, FDA Appoints Tracy Beth Høeg as Fifth CDER Head this Year, CLIN. TRIALS ARENA (Dec. 4, 2025), https://www.clinicaltrialsarena.com/news/fda-appoints-tracy-beth-hoeg-head-of-cder/ [https://perma.cc/N6TE-YN9V].

159 Matthew Herper, Helen Branswell, Usha Lee McFarling, Lizzy Lawrence & Jason Mast, Peter Marks, FDA’s NEWS 2025), 28, (Mar. [https://perma.cc/QS6Zhttps://www.statnews.com/2025/03/28/fda-peter-marks-cber-director-resigns-rfk-jr/ FKCV]; Ana Faguy, Top US Vaccine Official Forced To Resign, Reports Say, BBC (Mar. 28, 2025),

Regulator,

Vaccine

Forced

STAT

Out,

Top

https://www.bbc.com/news/articles/cn8r87z8vl0o [https://perma.cc/E7ZU-WSEM]; Rob Stein, The Top FDA Vaccine Official is Forced Out, Cites RFK Jr.’s ‘Misinformation and Lies’, NPR (Mar. 28, 2025, at 23:36 ET), https://www.npr.org/sections/shots-health-news/2025/03/28/nx-s1-5344010/fda-peter-marks-rfk-jr [https://perma.cc/A9VJ-M6SG].

160 Lizzy Lawrence & Adam Feuerstein, FDA’s Top Drug Regulator Resigns Amid Investigation, STAT (Nov. 2, 2025), https://www.statnews.com/2025/11/02/fda-george-tidmarsh-regulator-kevin-tang/

NEWS [https://perma.cc/H2VP-77VS].

161 Mancini, supra note 156. 162 Taylor, supra note 149; Heather McKenzie, Biotech Stocks Fall After FDA Names Vinay Prasad To Succeed Marks at CBER, BIOSPACE (May 6, 2025), https://www.biospace.com/fda/biotech-stocks-fall-after-fdanames-vinay-prasad-to-succeed-marks-at-cber [https://perma.cc/6KQX-UEFP]; Sarah Owermohle & Meg Tirrell, FDA Chooses Dr. Vinay Prasad To Lead Biologics, Vaccines Division, CNN (May 6, 2025, at 16:53 ET), https://www.cnn.com/2025/05/06/health/fda-vinay-prasad-vaccines [https://perma.cc/DR55-WXA2].

163 See, e.g., Cyber-Iconoclast Vinay Prasad Named Head of FDA’s CBER, supra note 148 (explaining that “Trump-allied appointees for the Department of Health and Human Services all seem to have this in common: a disdain for the agency which they have now been appointed to lead”).

IV. THE PUBLIC HEALTH CONSEQUENCES OF A GOVERNMENT GONE GOOP

164 Measles Outbreak—August 12, 2025, TEX. DEP’T HEALTH & HUMAN SERVS. (last visited Jan. 25, 2026),

https://www.dshs.texas.gov/news-alerts/measles-outbreak-2025 [https://perma.cc/6V2W-8RSA].

165 Jessica McDonald, No Sign of Texas Measles Outbreak Slowing, Contrary to RFK, Jr.’s Claims, FACTCHECK.ORG (Apr. 11, 2025), https://www.factcheck.org/2025/04/no-sign-of-texas-measles-outbreakslowing-contrary-to-rfk-jr-s-claims/ [https://perma.cc/7UM2-CNZS].

166 Jonathan Corum & Teddy Rosenbluth, Tracking U.S. Measles Outbreaks, N.Y. TIMES (Dec. 17, 2025), [https://perma.cc/YA9Q-

https://www.nytimes.com/interactive/2025/health/measles-outbreak-map.html WMA9]. 167

Maria Godoy, The U.S. Will Likely Lose Its Measles Elimination Status. Here’s What That Means, NPR (Jan. 31, 2026, at 07:00 ET), https://www.npr.org/2026/01/31/nx-s1-5694681/measles-elimination-status-southcarolina-texas-outbreak [https://perma.cc/9EZK-VH2T] (explaining that the Pan American Health Organization declared measles eliminated in the United States in 2000).

Measles Cases and Outbreaks, CTRS. FOR DISEASE CONTROL & PREVENTION (Feb. 20, 2026), 982 https://www.cdc.gov/measles/data-research/index.html confirmed measles cases across twenty-six jurisdictions as of February 20, 2026); Jim Wappes, US Measles Cases Soar to 588 So Far This Year as South Carolina Confirms 58 New Infections, UNIV. MINN.: CIDRAP (Jan. 30, 2026), https://www.cidrap.umn.edu/measles/us-measles-cases-soar-588-so-far-year-south-carolinaconfirms-58-new-infections [https://perma.cc/4NNE-XTW3] (confirming that ninety-three percent of those cases are classified as unvaccinated or unknown vaccination status, reflecting the disproportionate burden of the outbreak on under-immunized populations).

[https://perma.cc/UTR2-3GHG]

(reporting

After Major

See, e.g., 2025 Measles Outbreak, S.C. DEP’T OF PUB. HEALTH, https://dph.sc.gov/diseasesconditions/infectious-diseases/measles-rubeola/2025-measles-outbreak (last visited Feb. 25, 2026); Chad Terhune & Julie Steenhuysen, South Carolina Measles Vaccinations Jump in ET), REUTERS January https://www.reuters.com/business/healthcare-pharmaceuticals/south-carolina-measles-vaccinations-jumpjanuary-after-major-outbreak-2026-02-05 [https://perma.cc/4DSF-7LQD]; Lena H. Sun, What South Carolina’s Soaring Measles Outbreak Means (Jan. 31, 2026), https://www.washingtonpost.com/health/2026/01/31/south-carolina-measles/ [https://perma.cc/TGC3-LHKL] (reporting that local officials quarantined over 440 unvaccinated individuals and dozens of students across more than thirty schools).

[https://perma.cc/XFF8-7YE2]

the U.S., WASH. POST

the Rest of

Outbreak,

19:16

2026,

for

4,

Godoy, supra note 167.

2025 Measles Outbreak, supra note 169; Melody Schreiber, Calls To Shut Down Texas ICE Facility at 07:00 ET),

for Children Grow Amid Measles Outbreak, GUARDIAN https://www.theguardian.com/us-news/2026/feb/05/measles-outbreak-texas-ice-immigration-detention [https://perma.cc/7V6B-EK3Y].

(Feb. 5, 2026,

Terhune & Steenhuysen, supra note 169.

172 173 Neha Mukherjee, Two Infants Die of Whooping Cough in Louisiana as Cases Climb Nationally, CNN (Apr. 2, 2025, at 16:55 ET), https://www.cnn.com/2025/04/02/health/whooping-cough-pertussis-louisiana [https://perma.cc/2QZM-9CUY].

174 Id. 175 PAN AM. HEALTH ORG., EPIDEMIOLOGICAL ALERT: INCREASED PERTUSSIS (WHOOPING COUGH) IN THE AMERICAS REGION 4 (2025), https://www.paho.org/sites/default/files/2025-05/2025-05-31-epi-alert-pertussiswhooping-cough-final.pdf [https://perma.cc/KKK6-L832].

176 Stephanie Soucheray, Third Infant in Kentucky Dies of Whooping Cough as National Cases Stay High for Second Year in a Row, UNIV. MINN.: CIDRAP (Nov. 25, 2025), https://www.cidrap.umn.edu/pertussis/thirdinfant-kentucky-dies-whooping-cough-national-cases-stay-high-second-year-row [https://perma.cc/8KQL9XEP]; Mukherjee, supra note 174.

177 Third Unvaccinated Kentucky Baby Dies of Whooping Cough, KY. LANTERN (Nov. 25, 2025, at 10:26 ET), https://kentuckylantern.com/2025/11/25/third-unvaccinated-kentucky-baby-dies-of-whooping-cough/ [https://perma.cc/QVV6-V4C2]; Rosemary Westwood, Louisiana Officials Waited Months To Warn Public of Whooping Cough Outbreak, NPR (Oct. 28, 2025, at 05:00 ET), https://www.npr.org/sections/shots-healthnews/2025/10/28/nx-s1-5576494/louisiana-whooping-cough-pertussis-infant-deaths [https://perma.cc/3WPDDWSA]; Syra Madad & Boghuma K. Titanji, Whooping Cough is Surging in the U.S.: What You Need to Know, N.Y. ACAD. SCIS. (May 5, 2025), https://www.nyas.org/ideas-insights/blog/whooping-cough-is-surging-in-theu-s-what-you-need-to-know/ [https://perma.cc/N6C7-WP9B].

178 Westwood, supra note 177. 179 Rob Stein & Pien Huang, The CDC Revives Debunked “Link” Between Childhood Vaccines and Autism, NPR (Nov. 20, 2025, at 17:10 ET), https://www.npr.org/sections/shots-health-news/2025/11/20/nx-s15615040/cdc-rfk-childhood-vaccines-autism [https://perma.cc/UAV4-2L4E].

180 Autism and Vaccines, CTRS. FOR DISEASE CONTROL & PREVENTION https://www.cdc.gov/vaccine-safety/about/autism.html [https://perma.cc/E9RP-QEUZ].

(Nov. 19, 2025),

181 Stein & Huang, supra note 179; CDC’s New Autism Webpage Distorts Science and Rejects Decades of 2025),

Evidence https://autismsciencefoundation.org/press_releases/cdc-webpage/ [https://perma.cc/4XTB-PT6L].

Vaccine

AUTISM

FOUND.

Safety,

SCI.

20,

on

182 Sandra Adamson Fryhofer, AMA Statement on CDC Changes to Website on Autism and Vaccines, AM. MED. ASS’N (Nov. 20, 2025), https://www.ama-assn.org/press-center/ama-press-releases/ama-statement-cdcchanges-website-autism-and-vaccines [https://perma.cc/9AUR-KPQB].

183 Stein & Huang, supra note 179.

184 Rob Stein & Pien Huang, CDC’s Vaccine Advisers are Likely To Make a Controversial Change to Long(Dec. 4, 2025, at 11:44 ET), https://www.npr.org/sections/shots-health-

Used Vaccine, NPR news/2025/12/03/nx-s1-5630917/cdc-childhood-vaccine-schedule [https://perma.cc/F85Z-UH9B].

185 Helen Branswell, CDC Panel Recommends Delaying Birth Dose of Hepatitis B Vaccine, STAT NEWS (Dec. 5, 2025), https://www.statnews.com/2025/12/05/cdc-hepatitis-b-vaccination-acip-panel-overturns-30year-policy/ [https://perma.cc/WY4D-3P8T]; Lauren J. Young, CDC Vaccine Panel in Disarray over Hepatitis B Vote, SCI. AM. (Dec. 4, 2025), https://www.scientificamerican.com/article/cdc-vaccine-panel-in-disarrayover-hepatitis-b-vote/ [https://perma.cc/Q27C-9955]; Erika Edwards, CDC Advisors Could Reverse Newborn Hepatitis B Vaccine Recommendations, NBC NEWS 05:00 ET), https://www.nbcnews.com/health/health-news/cdc-advisers-reverse-newborn-hepatitis-b-vaccinerecommendations-rcna246812 [https://perma.cc/SN2U-4A7Y].

(Dec.

3,

186 Branswell, supra note 185. 187 Joshua Fitch, ACIP Delays Vote on Hepatitis B Virus Vaccine to December 5, CONTEMP. PEDIATRICS (Dec. 4, 2025), https://www.contemporarypediatrics.com/view/acip-delays-vote-on-hepatitis-b-virus-vaccineto-december-5 [https://perma.cc/9XC6-DH5K].

188 Stein & Huang, supra note 184; Mariam E. Sunny & Michael Erman, US HHS Names Pediatric (Dec. 1, 2025, at 18:20 ET),

Cardiologist Milhoan as Chair of Vaccine Panel, REUTERS https://www.reuters.com/business/healthcare-pharmaceuticals/us-hhs-names-pediatric-cardiologist-milhoanchair-vaccine-panel-2025-12-01/ [https://perma.cc/XB4G-G5CP].

189 Chris Dall, Vaccine, Public Health Advocates Warn of Fallout from ACIP Meeting, UNIV. MINN.: (June 27, 2025), https://www.cidrap.umn.edu/adult-non-flu-vaccines/vaccine-public-healthCIDRAP advocates-warn-fallout-acip-meeting [https://perma.cc/VU7L-MSKW]; Melissa Jenco, AAP Will Continue To Publish Its Own Vaccine Recommendations after CDC Advisors Sow Distrust, AAP NEWS (June 26, 2025), https://publications.aap.org/aapnews/news/32529/AAP-will-continue-to-publish-its-ownvaccine?autologincheck=redirected [https://perma.cc/NAM3-4CFZ].

190 See Dall, supra note 189; Anil Oza, National Pediatrics Group Splits with RFK Jr. on Covid Vaccinations, STAT NEWS (Aug. 19, 2025), https://www.statnews.com/2025/08/19/pediatrician-group-rebuffsrfk-issues-own-vaccine-recommendations/ [https://perma.cc/3LZF-CVG2]; Immunizations and Vaccines: Fall 2025–26 Immunization Recommendations, AM. ACAD. FAM. PHYSICIANS (last visited Jan. 25, 2026), https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines.html [https://perma.cc/5NB2-2VD5]; Vaccine Integrity Project, UNIV. MINN.: CIDRAP (last visited Jan. 25, 2026), https://www.cidrap.umn.edu/vaccine-integrity-project [https://perma.cc/72KB-77UC].

191 Dall, supra note 189. 192 See, e.g., The Economic Impact of the Ongoing Measles Outbreak, JOHNS HOPKINS BLOOMBERG SCH. PUB. HEALTH (Mar. 21, 2025), https://publichealth.jhu.edu/ivac/2025/economic-impact-of-the-ongoingmeasles-outbreak [https://perma.cc/6SGW-VV8Q] (noting that beyond the “direct medical costs of treating patients through both outpatient visits and hospitalizations significant resources are needed to respond to and control measles outbreaks with costs associated with identifying cases through diagnostic tests and performing contract tracing, among other expenses. Economic analyses must also account for costs to productivity such as lost wages for those quarantined with measles, their caregivers, and those who were exposed and lacked evidence of immunity”).

193 Id.; Jamison Pike, Alan Melnick, Paul A Gastañaduy, Meagan Kay, Jeff Harbison et al., Societal Costs

of a Measles Outbreak, PEDIATRICS Apr. 2021, at 1, 6.

194 Erika Edwards, CDC Advisors Could Reverse Newborn Hepatitis B Vaccine Recommendations, NBC NEWS (Dec. 4, 2025, at 09:47 ET), https://www.nbcnews.com/health/health-news/cdc-advisers-reversenewborn-hepatitis-b-vaccine-recommendations-rcna246812 [https://perma.cc/2QBU-8VAT].

195 Ari Nahum, Dimitri M. Drekonja & Jonathan D. Alpern, The Erosion of Public Trust and SARS-CoV-2

Vaccines—More Action is Needed, OPEN FORUM INFECTIOUS DISEASES Jan. 2021, at 1, 1–3.

196 Craig Palosky, Poll: Trust in Public Health Agencies and Vaccines Fall Amid Republican Skepticism, KFF HEALTH NEWS (Jan. 28, 2025), https://www.kff.org/health-information-trust/poll-trust-in-public-healthagencies-and-vaccines-falls-amid-republican-skepticism/ [https://perma.cc/QGY6-RSAF].

197 Kaitlin (Quick) Brumbaugh, Frances Gellert & Ali H. Mokdad, Understanding Vaccine Hesitancy:

Insights and Improvement Strategies Drawn from a Multi-Study Review, VACCINES Sep. 2025, at 1, 1–4, 10. 198 The Economic Impact of the Ongoing Measles Outbreak, supra note 192; Palosky, supra note 196. 199 See Measles—United States of America, WORLD HEALTH ORG.

(Mar. 27, 2025), https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON561 [https://perma.cc/VC8E-6VFP] (noting that the “public health risk in the Region of the Americas for measles is considered high due to the persistence of the circulation of the virus from imported cases, which have resulted in a limited number of outbreaks, with several generations of cases and the appearance of cases associated with pre-existing outbreaks in new geographical areas. Additionally, an increase in the susceptible population due to persistently low vaccination coverage related to factors such as the COVID-19 pandemic, increased vaccine hesitancy in some communities and sectors of the population, and limited access to health services, particularly for vulnerable populations”).

200 Samuel Cornell & Milad Haghani, Why Does the US Still Have a Level 1 Travel Advisory Warning 2025),

Despite https://www.unsw.edu.au/newsroom/news/2025/06/why-does-the-us-still-have-level-1-travel-advisorywarning-despite-chaos [https://perma.cc/WRA2-WME4].

NEWSROOM

Chaos?,

UNSW

(June

12,

the

201 Rachel Chang, The Full List of Countries That Have Updated Their US Travel Guidance, CONDÉ NAST TRAVELER (July 28, 2025), https://www.cntraveler.com/story/which-countries-have-issued-travel-advisoriesfor-the-us-2 [https://perma.cc/6KHD-J52F].

202 See Ross C. Bownson, Jamie F. Chriqui & Katherine A. Stamatakis, Understanding Evidence-Based

Public Health Policy, 99 AM. J. PUB. HEALTH 1576, 1576–81 (2009).

203 Walsh, supra note 116; Hubbard, supra note 116. 204 Alec Tyson & Brian Kennedy, Public Trust in Scientists and Views on Their Role in Policymaking, PEW RES. CTR. (Nov. 14, 2024), https://www.pewresearch.org/science/2024/11/14/public-trust-in-scientists-andviews-on-their-role-in-policymaking/ [https://perma.cc/Y9CL-3DKF].

205 Id.

206 Id. 207 Id. 208 Id. 209 Id. 210 Id. 211 Id. 212 Jonathon P. Leider, Brian C. Castrucci, Moriah Robins, Rachel Hare Bork, Michael R. Fraser et al., The Exodus of State and Local Public Health Employees: Separations Started Before and Continued Throughout COVID-19, 42 HEALTH AFFS. 338, 340, 344 (2023).

213 Id. at 338.

214 Id. 215 Harassment of Public Health Officials Widespread During the Initial Phase of the COVID-19 Pandemic, 2022),

Study Finds, https://publichealth.jhu.edu/2022/harassment-of-public-health-officials-widespread-during-the-initial-phaseof-the-covid-19-pandemic [https://perma.cc/MNT4-89MP].

JOHNS HOPKINS BLOOMBERG SCH. OF PUB. HEALTH

(Mar.

17,

216 Id.; Julie A. Ward, Elizabeth M. Stone, Paulani Mui & Beth Resnick, Pandemic-Related Workplace Violence and Its Impact on Public Health Officials, March 2020–January 2021, 112 AM. J. PUB. HEALTH 736, 736 (2022).

217 Ward et al., supra note 216, at 740. 218 See Rita V. Burke, Anna S. Distler, Timothy C. McCall, Emma Hunter, Shruti Dhapodkar et al., A Qualitative Analysis of Public Health Officials’ Experience in California During COVID-19: Priorities and 8, HEALTH Recommendations, https://pmc.ncbi.nlm.nih.gov/articles/PMC10525347/; see also PH WINS 2021: Rising Stress and Burnout in Public Health (2021), DE BEAUMONT FOUND., https://debeaumont.org/phwins/2021-findings/stress-andburnout/ [https://perma.cc/CHA2-RM4H].

FRONTIERS

2023,

PUB.

Sep.

1,

219 Jeremiah Genest, FDA Under Fire: The Troubling Impacts of Trump’s First 100 Days, INVESTIGATIONS QUALITY (May 5, 2025), https://investigationsquality.com/2025/05/05/fda-under-fire-the-troubling-impacts-oftrumps-first-100-days/ [https://perma.cc/KF5B-6GJ4]; Rob Stein, Sydney Lupkin, Selena Simmons-Duffin, Joseph Shapiro, Carnel Wroth et al., Widespread Firings Start at Federal Health Agencies Including Many in

Leadership, NPR (Apr. 1, 2025, at 13:25 ET), https://www.npr.org/sections/shots-health-news/2025/04/01/g-s157485/hhs-fda-layoffs-doge-cdc-nih [https://perma.cc/36NE-47Q9].

220 Will Stone & Pien Huang, Health Agencies Lose Staff Members in Key Areas as Trump Firings Set In, NPR (Feb. 17, 2025, at 20:18 ET), https://www.npr.org/sections/shots-health-news/2025/02/17/nx-s15300052/federal-employees-layoffs-cdc-nih-fda [https://perma.cc/D426-HD8Z].

221 Rachel Roubein, Lena H. Sun & Carolyn Y. Johnson, Trump’s Firings Strike the Nation’s Health Agencies, WASH. POST (Feb. 18, 2025), https://www.washingtonpost.com/health/2025/02/18/trump-healthfirings-fda-cdc/ [https://perma.cc/K6WA-EXYU].

222 Dave Lawler, Bonfire of Expertise: Trump Drives Scientists, Spies and Soldiers Out of Government, AXIOS (Aug. 30, 2025), https://www.axios.com/2025/08/30/trump-government-brain-drain-cdc-pentagon-intel [https://perma.cc/Z579-673R].

223 Brit McCandless Farmer, Medical Research Brain Drain: Why Scientists Could Flee the U.S., CBS NEWS (Apr. 27, 2025, at 19:44 ET), https://www.cbsnews.com/news/medical-research-brain-drain-whyscientists-could-flee-us-60-minutes/ [https://perma.cc/5GL3-R7VZ].

224 Alexandra Witze, 75% of US Scientists Who Answered Nature Poll Consider Leaving, NATURE (Mar.

27, 2025), https://www.nature.com/articles/d41586-025-00938-y [https://perma.cc/648A-RAAE].

225 Robert Hunziker, America’s Great Brain Drain, PORTSIDE (May 18, 2025), https://portside.org/202505-18/americas-great-brain-drain [https://perma.cc/Z4LZ-LXYE]; Catherine Gaschka & Lorne Cook, Europe

Launches a Drive To Attract Scientists and Researchers After Trump Freezes US Funding, AP NEWS (May 5, 2025, https://apnews.com/article/europe-us-science-funding-researchersET), 6a769e6d40c5127d59797e44a2470cfe [https://perma.cc/662X-CSDB].

20:51

226 Hunziker, supra note 225. 227 Misty Evans, U.S. Faces Growing Threat of Scientific ‘Brain Drain’ Amid Research Cuts and Political Pressure, INSIGHT INTO ACADEMIA (May 6, 2025), https://insightintoacademia.com/us-faces-brain-drain/ [https://perma.cc/VLH6-BA23].

228 Id. 229 BIORENDER,

2025 REPORT, https://www.biorender.com/2025-science-funding-report [https://perma.cc/3G9C-CE53].

OF U.S.

FUNDING

SCIENCE

STATE

7,

(2025),

230 See Jocelyn Kaiser, NIH Director Orders New Review of Grants in Outline of Top Research Priorities, SCI. (Aug. 15, 2025, at 18:20 ET), https://www.science.org/content/article/nih-director-orders-new-reviewgrants-outline-top-research-priorities [https://perma.cc/TWF6-MH6E].

CONCLUSION

231 Clara E. Tandar, John C. Lin & Fatima Cody Stanford, Combating Medical Misinformation and

Rebuilding Trust in the USA, 6 LANCET DIGITAL HEALTH e773, e773 (Nov. 2024).

232 Id.; Mitigating Health Misinformation Through Medical Education, ASS’N OF AM. MED. COLLS. (last visited Jan 25, 2026), https://www.aamc.org/about-us/mission-areas/medical-education/mitigating-healthmisinformation [https://perma.cc/WNE2-X2EX].

233 Jessica Ashby, The Effects of Medical Misinformation on the American Public, BALLARD BRIEF (Mar. 2024), https://ballardbrief.byu.edu/issue-briefs/the-effects-of-medical-misinformation-on-the-american-public [https://perma.cc/S6EV-PYB2].

234 See Lawrence O. Gostin & Eric A. Friedman, American Global Health Leadership in a Second Trump Administration, SCI. AM. (Jan. 8, 2025), https://www.scientificamerican.com/article/american-global-healthleadership-in-a-second-trump-administration/ [https://perma.cc/P3VM-ZLF6].

235 Id. 236 Id.

237 Stephanie Soucheray, CDC Director Fired After She ‘Refused To Rubber-Stamp’ Kennedy’s Vaccine Directives, UNIV. MINN.: CIDRAP (Aug. 28, 2025), https://www.cidrap.umn.edu/public-health/cdc-directorfired-after-she-refused-rubber-stamp-kennedys-vaccine-directives [https://perma.cc/WV2P-NJGL].