In the first week of January, the Health and Human Services Department, under Secretary Robert F. Kennedy Jr., released two arguably important public health announcements. The first was an overhaul of the childhood vaccine schedule. Going outside of the normal processes for such changes, Kennedy removed many vaccines from the list of those the Centers for Disease Control and Prevention recommends for kids, including shots to prevent hepatitis B, influenza, rotavirus, and several other illnesses.
The second announcement, just two days later, was a new set of dietary guidelines, which the government updates every five years. The new guidelines are much more concise than previous versions but largely provide similar advice. They focus on the importance of whole foods (“real food,” as Kennedy calls it), recommend consuming protein and vegetables, and urge limiting sugar and processed foods. There are some updates relative to prior editions, including more emphasis on full-fat dairy products and meat protein sources, and a higher level of recommended protein intake. The sugar restrictions are also tighter.
Based on existing scientific data, one of these announcements represents a dangerously wrong turn in public health, and the other is at least fine and arguably positive advice well worth following.
More specifically, the changes to the vaccine schedule are not based on scientific evidence. I’ve written on this elsewhere, so I won’t belabor the point, but there is no reason to remove these vaccines from the schedule. There are no new safety concerns, and no change in the evidence of their safety and effectiveness. And the vaccines are beneficial. The new guidelines remove the flu vaccine from being universally recommended for children. This is despite the fact that this vaccine is typically 70 percent to 90 percent protective against hospitalization, and the 2024-25 flu season marked the highest number of children’s deaths from the flu since 2004. Although the reduction in the number of recommended shots does not prohibit parents from having their kids get them, the changes made in the vaccine schedule will result in an erosion of trust in vaccines more broadly and more children dying of preventable diseases.
On the other hand, the new dietary guidelines largely reflect what we already know from the data about a healthy diet. They are, in fact, similar to the previous guidelines, which covered more than 150 pages and seemed aimed more at nutritionists than typical Americans, but are condensed into just nine pages. Shortening and simplifying those guidelines is a hugely positive change. A core issue with the dietary guidelines is that most people do not follow them. Americans consume far more sugar, for example, than guidelines suggest and far fewer vegetables. A food pyramid with frozen pizza and cookies at the top would be a more accurate depiction of how people eat. Making dietary recommendations simpler isn’t magic, but it might make it more likely that people change their behaviors.
To give an example: Both the old and new guidelines urge parents to introduce allergens to their babies early to lower the risk of developing food allergies. In the old guidelines, the details of this are buried on page 58; in the new ones, they are front and center, one of a small number of guidelines about baby feeding. This is better public health communication.
This isn’t to say there aren’t issues with the new guidelines—just as there were issues with the previous ones. A good example is milk. The old guidelines recommended low-fat or nonfat milk as being better for preventing obesity; however, the data overall doesn’t strongly support that. The new guidelines say full-fat milk is better; the data also doesn’t support that. Any milk is fine! The new guidelines focus on animal fats (beef tallow, anyone?) over seed oils like canola oil. There is no evidence to suggest animal fats are any healthier, and it’s just an opportunity for influencers to promote their niche products. The new guidelines’ protein recommendations are more than the average sedentary American requires.
But overall, based on a combination of adherence to reliable data and user-friendly design, I would argue the revamped guidelines are not just adequate but an improvement.
I’m not alone in seeing the difference between the vaccine schedule changes and the new dietary recommendations, and having the Trump administration announce them in close succession has raised a key question for people interested in communicating health information to the public. Many organizations and individuals believe this administration’s approach to vaccines is an existential threat to public health. As a result of Kennedy’s moves targeting vaccines, these groups and people—I count myself among them—spend a lot of time trying to counter anti-vaccine narratives. We try to give people information that will maintain or restore their trust in vaccination.
With this goal in mind, it’s easy to know how to react to the vaccination announcement: oppose it, and describe in detail why. It’s much harder to know how to respond to the dietary guidelines coming out of the same administration with the same leader in charge of public health. His vaccine skepticism, and the damage it has caused, somehow makes it harder to embrace his views on healthy eating. The core question: If I want people to listen when I say that you should ignore what RFK Jr. says about vaccines, what should I say about his department’s pretty reasonable advice on diet?
I could convey that these dietary guidelines are more of the same misinformation as the vaccine changes. I could focus on the new guidelines’ advice for consuming red meat (if you ate what they suggest, you’d be way over the saturated fat guidelines), on the oddly sized food pictures in the pyramid, or on the beef tallow (a fringe food fad). I could characterize it all as just more of the crazy RFK Jr. nonsense.
The upside of this approach is that it maintains the justifiable position that Kennedy’s views on public health are not to be trusted; the downside is that it isn’t the most honest take on the evidence.
The other option is to try to draw a clear distinction between the two announcements, suggesting that the dietary guidelines may be fine while maintaining that the changes to the vaccine schedule are not. The upside of this is that it is an honest take on the evidence. The downside is that it suggests a level of trust in some decisions by Kennedy and his advisers, which could be perceived as an endorsement.
In my own work, I choose the second option. When these dietary guidelines came out, I wrote largely favorably about them in the New York Times. And I came under criticism, largely from the left, for effectively “sanewashing” the administration. I believe this criticism is wrong. But it did reveal something fundamental about trust: It is very hard to build, and when you lose it, it is almost impossible to regain. When it comes to public health, the Trump administration’s actions have made it all too easy not to trust it.
