| Last week the Food and Drug Administration (FDA) approved COVID-19 vaccines that have been reformulated to better match the strains of the virus currently circulating. However, unlike in past years, this year’s approval came with an important caveat: it applies only for people between the ages of 6 months (for the Moderna vaccine only) and 18, over 65, and those in other age groups who are considered especially vulnerable due to pre-existing health conditions. An otherwise healthy adult who wishes to boost whatever remaining immunity they have from prior vaccinations or bouts of the disease will need to persuade a health care provider to prescribe the reformulated vaccine for off-label use. Doing so will be difficult in some places, as well as expensive. At a minimum, visits to see doctors may now be necessary for a great many people who previously could obtain vaccines simply by visiting a pharmacist. |
| Why has the FDA made access to COVID-19 vaccination more difficult? In a post on X, Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. claimed that he was aiming “to keep vaccines available to people who want them” and that they would be “available for all patients who choose them after consulting with their doctors.” But the limited approvals belie those claims. In fact, it will be difficult—and in some cases impossible—for people not defined as “at higher risk” to obtain the new vaccines. |
| The real explanation is actually contained in the RFK Jr. post: the FDA has demanded “placebo-controlled trials” to determine the safety and efficacy of the vaccines. Although that may sound scientific, it apparently stems from Kennedy’s longstanding vaccine skepticism. As a recent New York Times article noted, one of the required trials will examine “post-Covid-19 vaccination syndrome,” which is “a matter of pitched debate.” HHS under RFK Jr. appears to be overstating the risks and under-valuing the benefits of vaccines against COVID-19, bird flu, and other infectious diseases. |
| The limited approval of the new COVID-19 vaccines fits within a larger pattern of RFK Jr.’s administration of HHS by seeking to control what Americans put into their bodies—whether it is vaccines or food additives. Yet that approach is in marked contrast to the health libertarianism that has been central to the rhetoric of vaccine critics over the last half decade. |
| Are Vaccine Skeptics Genuine Medical Libertarians? Is Anybody? |
| Much of the opposition to COVID-19 vaccines and mandates during the pandemic’s height and since has had a libertarian cast. For example, Florida’s Republican Governor Ron DeSantis brags on an official state website both that his state was the first in the country to question the wisdom of vaccinating healthy children from ages 5 to 17 and that Florida is a “beacon of freedom in health care.” Likewise, in 2022, Virginia’s Republican Governor Glenn Youngkin encouraged Virginians to get vaccinated even as he voiced opposition to mandates, saying to his constituents, “I’ll never tell you what you must do.” |
| Yet many of the elected officials and voters who sound libertarian themes with respect to vaccines have also rejected medical libertarianism in other contexts. Red states that were the least likely to impose vaccine mandates are the most likely to have enacted legislation forbidding gender-affirming care for transgender minors. |
| Meanwhile, selective libertarianism is not exclusively a phenomenon of the political right. Some of the strongest advocates for vaccine mandates were liberals who support abortion rights. Is everybody a hypocrite? |
| Not necessarily. No sensible person is an absolute libertarian. For example, Governor Youngkin cannot have seriously meant that he would never tell Virginians what to do. Surely, he would and should tell them not to murder, rape, steal, or otherwise violate Virginia’s criminal law. Libertarianism should always be a defeasible stance. To be a libertarian is not to be an anarchist. It is to take the view that certain kinds of infringements on liberty require a strong justification. |
| But there’s the rub. People disagree about both what kinds of liberty are most valuable and what counts as a strong justification. For many liberals, a right to abortion is warranted by the fact that forcing a woman to carry a pregnancy for nine months and then give birth is an extraordinary bodily intrusion that cannot be justified until a fetus has developed key capacities of an infant. For those same liberals, a right against vaccination is unwarranted because a jab from a needle with relatively low medical risk imposes a slight burden compared to the benefit to the community from herd immunity. Conversely, many conservatives who oppose a right to abortion place much greater weight on the life of developing zygotes, embryos, and fetuses. Those same conservatives may be more skeptical of the safety and efficacy claims for particular vaccines. |
| Anti-Establishment Libertarianism |
| Nonetheless, it would be a mistake to pronounce libertarianism a completely empty vessel. In particular, it does play a substantial role in the policy decisions of RFK Jr. and the people who support him. The key to understanding that role is to recognize that the MAHA (“Make America Healthy Again”) brand of libertarianism is highly peculiar. Whereas libertarianism in general aims to free individuals from what its proponents regard as an overreaching state, MAHA libertarianism seeks freedom from the reign of scientific experts. |
| Vaccine skeptics and MAHA influencers who encourage their followers to “do their own research” are expressly questioning the scientific establishment. They argue that mainstream scientists are corrupted by ties to pharmaceutical companies and the food industry. In pointing to the potential for conflicts of interest, they are not entirely wrong. Powerful industries do fund research that they hope will bring them financial rewards. But the skeptics and influencers ignore the many safeguards in place to ensure that most research is reliable and that errors are detected and corrected. |
| Meanwhile, the skeptics and influencers tend to promote alternatives that are themselves unproven. For example, the only high-quality placebo-controlled studies reported in reputable medical journals (here and here) found no benefit from Ivermectin as a COVID-19 treatment. Yet prominent do-their-own-researchers continue to tout it. Just last week, RFK Jr. praised the Texas legislature for a new law that permits the sale of Ivermectin over the counter. “I think Americans should have the choice,” the HHS Secretary stated. |
| The juxtaposition between RFK Jr.’s stance on Ivermectin and his stance on vaccines is telling. He favors giving Americans the option to choose to treat COVID-19 with a medicine that the best science tells us is ineffective, while he uses his power as a Cabinet Secretary to limit access to vaccines that science shows to have saved millions of lives. RFK Jr.’s libertarianism is not only highly selective. It is also deadly. |
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