Checking in on Make America Healthy Again: MAHA and vaccines

Back in December, we conducted something of a thought experiment. At the time, then-nominee Robert F. Kennedy, Jr.'s "Make America Healthy Again" (MAHA) was more slogan than blueprint. So we posed the question: what could such a blueprint look like in practice? What concrete actions could various federal agencies take to advance MAHA's goal of reducing chronic disease and reversing recent declines in U.S. longevity? Today, we're back with an update. Less than three months into the tenure of the new administration, the MAHA agenda is advancing quickly. In this post, we'll talk about where the focus has been thus far, and dive into the area that has seen both the most action—and the most scrutiny—to date: MAHA and vaccines.

(By the way: if you want to go back and read our predictions from December, you can find that post here.)

What does the MAHA agenda look like as of April 2025?

The rise of MAHA (and its core principles)

First, a quick refresher on the rise of MAHA, because it’s worth underscoring that MAHA has shifted the health policy landscape in some unusual ways—and at quite an astonishing pace. The healthcare issues that we’re focused on and talking about today as a result of MAHA are not the same ones that featured in any other election or administration in recent memory.

HHS Secretary RFK Jr. popularized MAHA during his challenge to President Biden for the 2024 Democratic presidential nomination (he eventually ran as an independent candidate). When he suspended his campaign and endorsed President Trump in October of last year, Trump adopted the slogan, promising RFK Jr. that he would have the opportunity to overhaul the U.S. public health system and "Make American Healthy Again."

Since the election, of course, RFK Jr. has been confirmed as HHS Secretary. And Republican leadership have rallied behind the MAHA blueprint—there’s now a MAHA caucus in the Senate and President Trump signed an executive order establishing a MAHA Commission within the executive branch.

At its core, MAHA is based around a few key principles, many of which reflect the current Trump administration’s approach to policy more generally; specifically:

• A focus on transparency

• An emphasis on corporate accountability

• A push to challenge conventional wisdom and institutional thinking

While some of these are long-standing Republican principles, others gained traction during the pandemic and are driving some of the differences in approach within the current Trump administration relative to the previous one. And while these core principles at times position the MAHA movement at odds with the traditional public health framework, in other cases they are being deployed in service of advancing long-standing goals within the public health community.

Specifically, the MAHA movement has generated substantial concern among public health experts regarding its potential impact on vaccination policy.

But the same principles that are driving growing vaccine skepticism are also behind an increased focus on preventive health and better nutrition and healthy food.

The MAHA agenda as of April 2025

The table below overviews the major goals of MAHA today—as described either on the 2024 campaign trail or in the early days of the new administration—and the potential role that each federal health department could play in advancing those goals. Some of these bullets have become reality across the past couple months, while others are still theoretical at this point.

For the remainder of this post, we'll talk about the first two ambitions on this list—the MAHA approach to medications generally, and vaccines specifically. We'll be back in a future post to delve into the others in more detail.

A closer look: MAHA and vaccines

What has the new administration done vis-a-vis vaccines to date?

This is the space that's probably seen the most concrete action thus far.

Unsurprisingly, President Trump followed through on his campaign promise to go after ongoing Covid-19 vaccine mandates. In February, the President signed an executive order aiming to ban such mandates in schools—although, it’s worth noting that the president alone doesn't have the power to do so barring additional legislative and/or regulatory action at the federal and state levels. But a signal along these lines was widely expected.

What was less clear in the immediate aftermath of the election is how federal regulatory bodies such as the CDC and FDA would approach the issue of vaccines. But we’re quickly starting to get a sense of what this will look like.

Following RFK Jr.'s confirmation (and at his direction), the CDC suspended its ongoing flu vaccination educational campaign. And the FDA cancelled its annual meeting to select flu strains for next year's vaccine. They did ultimately release recommendations on the date of the planned meeting, but the deviation from the usual process meant that the decision was less transparent and collaborative than it typically is.

This shift underscores a broader principle that we're seeing with this administration: its focus on transparency is a somewhat nuanced one. There's a clear emphasis on the need for consumer-facing transparency. But with the desire to also challenge conventional wisdom, this administration is at times taking a more closed-door approach to decision making, especially when it comes to consulting with experts who are considered to be a part of institutional thinking.

There has also been considerable focus on RFK Jr.'s response to the ongoing measles outbreak, which has fluctuated over time. He has at times challenged the importance of vaccinations while at other points underscoring their critical role. Again, this points to another theme within this administration: its leaders are very keenly aware of public opinion and reaction, and are continually modifying their approach as a result.

MAHA and vaccines: Where other players can (and can't) respond

Overall, though, we are seeing a more cautious approach to vaccines from this administration thus far. So how might other stakeholders respond if we continue to see the federal government pull back? Time for another thought experiment: where could—and might—other players step up to fill the gap, and where is the role of the federal government truly critical?

There was a lot of concern when the FDA initially cancelled that meeting about the development of next year's flu vaccine—but vaccine development and manufacturing are two places where private industry players such as drugmakers could scale up their efforts (and have the expertise/resources to do so) if the government pulls back.

Where things get stickier are tasks like distribution, tracking & monitoring, and of course, most critically, vaccine approval. Those are areas where either the scale or the authority of the federal government are essential.

Somewhere in the middle are things such as vaccine mandates, access/equity, education and awareness—those are all areas in which state and local governments play a huge role, and where we might begin to see more of a red/blue state divide in terms of the approach, with blue states potentially dialing up efforts while red states are more likely to follow the lead of the feds.

An open question: How will MAHA approach pharma more generally?

Outside of vaccines, there’s a larger question about how this administration will approach Big Pharma, as RFK Jr. has been a well-known and vocal critic of potential over-reliance on pharmaceutical interventions.

One of the first big tests will be related to GLP-1s.

RFK Jr. has, unsurprisingly, given his preference for lifestyle modification over pharmaceutical intervention, been somewhat critical of GLP-1s. But given their immense popularity, he has softened his stance over time,.

One of the last healthcare rules released in the final days of the Biden administration was the MA proposed rule—and in it, the previous administration proposed coverage of GLP-1s for obesity for Medicare Part D and Medicaid populations.

This proposal would come with a significant price tag, and the new administration is the now responsible for finalizing the rule—i.e. deciding whether to keep the provision to expand GLP-1s coverage or not.

One way or another, this will be an important signal of this administration's likely future approach to the pharmaceutical industry.

Want more on MAHA and the Trump administration's health policy agenda?

• Keep an eye out for additional blog posts in this series, where we'll delve into the MAHA approach to preventive care and nutrition policy (subscribe below to make sure you don't miss future posts!)

• Read our blog post about Trump's healthcare regulatory agenda

• Members can access ready-to-present versions of all of the above slides (and more) under the research tab