RFK Jr.'s Bully Pulpit Provides Path to Crimp Job Vax Mandates

Health-care companies and other employers that encourage or require their workers to get vaccinated will likely face headwinds if anti-vaccine activist Robert F. Kennedy Jr. wins Senate approval to lead the US Department of Health and Human Services, health law scholars said.

Kennedy would have few options to directly affect workplace vaccine mandates, which are governed by the at-will employment doctrine that’s in place in nearly every state. That doctrine gives companies broad latitude to fire workers for any legal reason, including failure to comply with an inoculation requirement.

But Kennedy could still influence vaccines in employment—first and foremost, by wielding the legitimacy and megaphone that comes with being the country’s top public health official and chief adviser to the president on health-related matters.

Kennedy, founder of the litigious anti-vaccine nonprofit Children’s Health Defense, has criticized inoculation mandates and challenged the safety of vaccines. Kennedy was named the “top superspreader” of vaccine misinformation on Twitter in 2021, based on a study of verified accounts on the social media platform now known as X.

“This man is the world’s most well-financed and influential anti-vaxxer,” said Lawrence Gostin, a law professor and director of Georgetown University’s O’Neill Institute for National and Global Health Law. “The disinformation about vaccines will be amplified under RFK Jr. as secretary of Health and Human Services, so there’s an air of distrust and even fear of vaccines.”

President-elect Donald Trump has signaled his own vaccine skepticism. When asked about Kennedy’s views during a Dec. 16 press conference, Trump said that “there are problems” with vaccines, adding that the US doesn’t “do as well as a lot of other nations and those nations use nothing.”

Kennedy fueling an anti-vaccine atmosphere may prompt workers to push back against their employers’ vaccine programs, which could reduce compliance rates, invite tension and conflict in the workplace, and even trigger lawsuits, health law scholars said.

“My biggest worry is that he’ll use the bully pulpit to increase vaccine skepticism,” said Robert Field, a professor of health administration, policy, and law at Drexel University. “If he’s pumping out headlines questioning the safety of vaccines, we might see a lot more people refusing.”

Children’s Health Defense didn’t respond to requests for comment.

Vaccine Litigation Landscape

Workers who refuse to get vaccinated for alleged health or religious reasons face a more favorable legal landscape than previous years.

The Covid-19 pandemic turbocharged the development of the law related to workplace vaccine mandates. Courts dealt with lawsuits contesting federal and state rules, as well as workers suing after their employers denied their requests for exemptions to vaccine requirements.

The US Supreme Court also watered down a pro-employer defense to legal claims contesting the refusal to provide religious accommodations in a case that wasn’t related to the pandemic.

The barriers for seeking religious exemptions are lower than for those driven by health concerns, in part because of the medical documentation that’s required for accommodations under the Americans with Disabilities Act.

Employers initially had success defending their denials of religious and health-related exemptions to Covid-related vaccine mandates in court, but workers have scored significant wins in recent months.

Federal juries awarded nearly $13 million to a former Blue Cross Blue Shield of Michigan employee and more than $7 million to six former San Francisco Bay Area Rapid Transit District workers who were fired after refusing to get vaccinated for religious reasons.

State Legislation

A Kennedy-inspired spike in anti-vaccine sentiments could motivate state lawmakers to create legislative obstacles to workplace inoculation requirements.

At least 19 Republican-led states passed restrictions on employers’ ability to require their workers to get vaccinated against Covid, according to a Bloomberg Law review of the National Conference on State Legislature’s database on state public health legislation.

No state went further than Montana, which barred companies from refusing employment based on a person’s vaccination status. The measure isn’t limited to Covid vaccines.

The US Court of Appeals for the Ninth Circuit blessed the law in an October ruling, throwing out a lower court’s order that had blocked its enforcement in health-care settings. The ruling signals that other state measures that protect unvaccinated workers could survive legal challenge.

Despite enthusiasm for state vaccine mandate restrictions receding since the height of the pandemic, Kansas lawmakers in 2024 proposed a Montana-style measure to protect unvaccinated workers from adverse employment actions.

Other Options

Kennedy could try to bring back an HHS rule from the first Trump administration on religious conscience protections in the medical field that was invalidated in court, said Dorit Reiss, a professor at the University of California College of the Law, San Francisco who specializes in vaccine policy.

“I could see RFK Jr. reviving it and forcing health-care employers to remove vaccine mandates,” Reiss said.

Kennedy might also try interfering with employer inoculation rules by making vaccines less available.

For example, he could pack the Advisory Committee on Immunization Practices with vaccine skeptics, which may result in some vaccines no longer being covered by insurers, health law scholars said.

But the potential negative consequences of Kennedy’s views on vaccines have less to do with employer mandates than childhood vaccination rates and access to shots more broadly, scholars said.

“It could be a rough four years,” Reiss said. “The big question is whether he will be confirmed.”