A top aide to Health Secretary Robert F. Kennedy Jr. is locked in a power struggle with his boss and the White House over vaccine policy and personnel, according to two senior administration officials.
For now, the head of the Food and Drug Administration, Marty Makary, still has his job, but the dispute — which centers on how the agency will examine vaccine side effects — is unresolved, the officials said. Both were granted anonymity to discuss confidential deliberations.
Tensions over Makary’s management of the FDA have simmered for months, but Kennedy is reluctant to be more forceful with his demands because it would contribute to a perception of chaos within his department, the officials said. Kennedy has already ousted two deputies in his office and the director of the Centers for Disease Control and Prevention this year.
In a statement, the spokesperson for the Department of Health and Human Services, Andrew Nixon, disputed the officials’ view that Kennedy and Makary are at loggerheads. “Secretary Kennedy has full confidence in Commissioner Makary,” Nixon said. “There has never been a time in history when an HHS secretary has been more aligned and had a closer working relationship with an FDA commissioner.”
An anti-vaccine activist before President Donald Trump named him health secretary, Kennedy has asked the FDA, which approves drugs and monitors them once they’re on the market, to quickly stand up additional vaccine‑safety studies.
Makary hasn’t yet moved on the request, believing that the agency first needs to develop a new system for examining vaccine side effects, the officials said, irritating Kennedy. A former Johns Hopkins surgeon, Makary was, like Kennedy, a prominent critic of Covid lockdowns.
Makary has been unable to promote policy adviser Sanjula Jain‑Nagpal to deputy chief of staff, according to the officials, because the White House, which wasn’t consulted on the promotion, hasn’t signed off. Jain-Nagpal nonetheless announced her appointment on a call with FDA stakeholders on November 12.
Amidst a separate kerfuffle over the dismissal of a Makary aide in early November — top drug regulator George Tidmarsh — White House officials had weighed scaling back Makary’s role by installing a day‑to‑day operations lead while keeping him as commissioner.
The idea was dropped after White House Chief of Staff Susie Wiles intervened, the officials said. Makary subsequently promoted longtime oncology chief Richard Pazdur to replace Tidmarsh, who resigned amid concerns about his personal conduct. Tidmarsh said he was quitting because of changes to the drug review process he objected to.
Makary, buoyed by Wiles’ backing, has increasingly routed sensitive questions to the White House rather than HHS, the officials said.
As POLITICO reported in August, Wiles intervened to reverse a White House decision to fire FDA vaccine chief Vinay Prasad, who is close to Makary, after pressure from MAGA influencer Laura Loomer and a drug company whose product Prasad had sought to pull from the market. Makary and Kennedy both argued Prasad was essential to Kennedy’s Make America Healthy Again agenda to fight chronic disease, but Prasad’s tendency to set a high bar for drug approvals has run afoul of conservatives who favor the “right-to-try” ethos that Trump endorsed when he signed legislation during his first administration.
HHS leadership is now closely monitoring every move inside the FDA, the officials said, including schedules and planned news statements, and has delayed announcements when necessary. Makary rarely uses email, complicating coordination as tensions rise, the officials said.
In the FDA directory, Jain-Nagpal is listed as a health informatics specialist.
The FDA and the White House didn’t respond immediately to requests for comment.
Lauren Gardner contributed to this story.
Comments
Post a Comment