Photograph Source: Embajada de EEUU en Argentina – CC BY 2.0
During his confirmation hearings to serve as Secretary of Health and Human Services (HHS), Robert F. Kennedy Jr. emphatically pledged to prioritize tackling Long COVID, a debilitating chronic condition that develops after COVID-19 infections and leaves many patients with lasting symptoms, such as fatigue, brain fog, and respiratory problems. Sen. Todd Young (R-Indiana) asked Kennedy if he would commit to funding research into treatments and diagnostics for Long COVID. Kennedy’s response? “Absolutely, senator, with enthusiasm.”
Fast forward to August 2025, and Kennedy has dismantled not only federal COVID prevention programs but also much of the research infrastructure devoted to understanding and treating Long COVID. He closed the Office of Long COVID Research and Practice, a central coordinating body established in 2023 to unify agency efforts on Long COVID, and failed to meaningfully replace it. His sweeping reorganization of HHS eliminated or consolidated key centers essential for disease surveillance and chronic illness response, including the National Center for Chronic Disease Prevention and Health Promotion. Reckless funding cuts have dealt a significant blow to ongoing research, derailing NIH-funded clinical trials on antivirals and immunotherapies for Long COVID, halting large-scale cohort studies that track patient outcomes, and stalling the development of new diagnostics to improve detection and classification.
Long COVID is a chronic, multisystem condition that follows COVID‑19 infection. It can arise regardless of the severity of the initial illness and is characterized by symptoms that may persist or emerge weeks to months after the acute phase of infection. Researchers have drawn parallels between Long COVID’s impact and that of a stroke or Parkinson’s. Long COVID also shares similarities with other post-viral syndromes such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which similarly involve long-term fatigue and autonomic dysfunction. Studies have shown that both Long COVID and ME/CFS can lead to quality-of-life impairments that outstrip many advanced cancers.
Additional research suggests that Long COVID may be just the tip of the iceberg. Studies of large patient cohorts have found that COVID infection significantly increases the risk of cardiovascular complications, including myocarditis, arrhythmias, heart failure, and blood clots, even in people without prior heart disease. Other studies have documented a higher incidence of metabolic conditions such as new-onset diabetes. There are also neurological sequelae; COVID infections can cause or accelerate cognitive decline and dementia. Evidence suggests that repeated infection may accelerate cancer risk, in part due to inflammation and immune dysregulation. Taken together, these findings suggest that the long-term burden of COVID may extend far beyond what is captured by “Long COVID” alone.
Kennedy is not a solo actor in this. Closing the Long COVID office, for example, coincided with a Trump executive order to “reduce the federal bureaucracy.” The involvement of others does not absolve Kennedy — the head of HHS — of responsibility for what takes place in his agency on his watch. It does, however, suggest that this is not a one-man problem but something more systemic and entrenched. The issue is not limited to HHS; the Occupational Safety and Health Administration (OSHA), for example, is currently seeking to remove the few remaining emergency reporting requirements for hospitals.
Creating Barriers to COVID Vaccines
Of course, one of the best ways to avoid Long COVID is to avoid getting infected with COVID. Kennedy has spoken about wanting to address root causes, and the root cause of post-COVID complications is infection with COVID, making prevention efforts a key way to prevent new health problems. Unfortunately, Kennedy has approached COVID prevention the same way he has approached measles prevention. He has gone after COVID vaccines, both the currently available shots and promising research into improved versions.
As a form of protection from Long COVID, the current vaccines appear to be useful, albeit insufficient on their own. Most studies indicate that vaccination reduces the risk of Long COVID, and several find additional benefits from boosters, although this varies by timing and variant. One meta-analysis found that COVID vaccination reduces the risk of developing Long COVID by around 30 percent, depending on variant and timing of vaccination. A more recent study suggested that vaccination had played a major role in observed declines in new cases of Long COVID during later infection waves. Primary series vaccinations appear to be the most effective in reducing the risk of developing Long COVID following infection. Subsequent variant-specific shots appear largely helpful as a means of preventing infection (as imperfectly measured by symptomatic disease), which in turn lowers the downstream risk of Long COVID. However, such protection is limited and short-lived. Vaccine effectiveness against symptomatic disease peaks at 50 to 70 percent within a few weeks of administration and declines substantially over the following months. It often approached negligible levels within six months, particularly in the face of immune-evasive variants like XBB and its descendants. Taken together, the evidence suggests that vaccines, although far from a silver bullet, are a useful tool for reducing Long COVID. Cutting off access to vaccines will almost certainly mean more Long COVID cases and more people with lasting complications.
Unfortunately, Kennedy’s leadership thus far has culminated in new barriers to COVID vaccination that threaten to severely limit this year’s uptake (assuming new vaccines become available at all). The Food and Drug Administration (FDA) declined to approve COVID vaccines for those under age 65 without high-risk conditions, instead requiring randomized controlled trials in those groups before considering future approval. This includes both primary series vaccinations and additional variant-specific shots for those who have already received their primary series. The FDA also revoked the Emergency Use Authorization for Pfizer’s vaccinein children under the age of 5, leaving Moderna’s formulation as the only authorized option for high-risk children in this age group. For healthy children under 5, the only remaining path to vaccination is now through off-label use by a healthcare provider. The new framework imposes similar restrictions on adults: as of August 22, individuals under the age of 65 without high-risk conditions became ineligible to receive COVID vaccines through standard authorization channels.
The effort was touted as a cautious, evidence-driven approach, but its effect is to delay and potentially deny broad access to vaccines that were previously available (if not always affordable) to a much wider population. Limited access for children younger than 5 years old could be especially devastating. This age group has experienced some of the highest COVID-19 hospitalization rates of any pediatric cohort. Emerging data suggests that Long COVID may have overtaken asthma as the most common chronic illness affecting US children, with nearly 5.8 million affected by post-COVID conditions.
Kennedy has gone after public health officials who don’t share his approach to vaccination. Earlier this summer, Kennedy fired every member of the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP), a critical advisory body, replacing many of them with known vaccine skeptics. The ACIP’s role is to make recommendations within the boundaries of FDA approval; its personnel shake-up suggests that even within the FDA’s more restrictive framework, the CDC’s recommendations will be guided by an anti-vaccine political agenda rather than science. While ACIP had not always taken Long COVID seriously before, it did greenlight broad COVID vaccine eligibility in 2024, even if said vaccines remained financially out of reach for far too many.
Kennedy, CDC Firings, and Massive Research Cuts
And this past week, President Trump (at Kennedy’s behest) fired Susan Monarez, the director of the Centers for Disease Control and Prevention (CDC). A wave of protest resignations followed across senior leadership, including Chief Medical Officer Dr. Debra Houry, Director of the National Center for Immunization and Respiratory Diseases Dr. Demetre Daskalakis, and Director of the National Center for Emerging and Zoonotic Infectious Diseases Dr. Daniel Jernigan. In his resignation letter, Daskalakis opined, “Having worked in local and national public health for years, I have never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people.”
The insufficient protection afforded by current vaccines makes ongoing research into the next generation of prophylactics that much more crucial. But this month, Kennedy unilaterally slashed $500 million from mRNA-related research, which encompassed, among other things, vaccines targeting COVID, H5N1 bird flu, and RSV. Kennedy justified the cuts in part by suggesting that mRNA technology is inherently unsafe, an assertion not supported by scientific evidence. Earlier this year, Kennedy’s HHS issued a stop-work order to CastleVax for its development of an intranasal COVID vaccine. Intranasal vaccines have shown promise in inducing the mucosal immunity necessary to better prevent transmission. The Trump government, however, has declared COVID “over” (despite evidence to the contrary), and thus all further research related to it is considered expendable.
This month, Kennedy’s HHS also took aim at wastewater surveillance, a crucial tool for people trying to use real-world data to calibrate their preventive measures. Wastewater monitoring provides an early warning system for spikes in COVID and other infectious diseases, helping immunocompromised individuals — such as those recovering from cancer — decide when it may be safer to risk exposure from necessary activities like visiting the dentist. Kennedy’s HHS has doubled down on a favorite minimization tactic of the previous administration, and has changed the thresholds for transmission categories, such that virus levels that were previously categorized as “high” are now considered “very low.” More alarmingly, under Kennedy, the CDC has quietly stopped normalizing wastewater data (that is, adjusting for things like rainfall levels), a technical change that will significantly degrade its quality and comparability over time. Without normalization, raw viral counts are misleading, making it far harder for individuals, communities, and health systems to gauge real infection trends. This change threatens to undermine one of the most important and cost-effective surveillance tools still available.
Kennedy is clearly not interested in keeping the promise he made to the American people to tackle Long COVID. His behavior does, however, track with the ableist healthism that Julie Doubleday lucidly identifies as the beating heart of Kennedy’s “Make America Healthy Again” (MAHA) movement. Ableist healthism is an ideology that equates being healthy with virtue and reframes public health as an individual lifestyle project rather than a collective obligation. It also conflates “natural” with “good,” which explains why MAHA advocates seem so unfazed by preventable deaths from ‘natural’ diseases like measles. Given MAHA’s complacency in the face of preventable death and disability from measles, it’s unsurprising that they would shun interventions like vaccines and other preventative medical interventions for COVID.
To be sure, Kennedy has capitalized on the earned mistrust of his predecessors. That mistrust was fueled by a series of blunders, including but not limited to downplaying the threat of long-term COVID sequelae, failing to fully grapple with the reality of airborne transmission, and an unwillingness to meaningfully revisit the “vax and relax” strategy even as evidence increasingly failed to support that approach. Many but not all of these blunders appeared to originate from corporate pressure to return to a “normal” with a weaker social state and fewer protections for workers.
However, rather than building back trust based on sound science, Kennedy has doubled down on misinformation. Rather than leveling with people about both the benefits and limitations of existing COVID vaccines, for example, he has cast ill-founded aspersions on their safety profile (and the safety profile of other preventative medicine). He has also actively made it more difficult for those who want to use vaccines to protect themselves to do so. Where the agency once sowed confusion through poor messaging, Kennedy has actively weaponized that communications weakness to recast scientific uncertainty as evidence of conspiracy, replacing cautious half-truths with clear falsehoods.
It is abundantly evident that Kennedy does not intend to prioritize the well-being of Long COVID patients. Instead of using his immense power to expedite research to help current patients and prevent new cases, he has taken a hatchet to the limited systems of care that were already in place. But disabled lives are not expendable. Millions of people living with Long COVID and other post-viral and chronic conditions deserve dignity, care, and a government that values their survival and well-being. Investing in scientific research and robust public health infrastructure is not charity, but a commitment to a collective future that values and includes everyone in our community. The Trump government’s abandonment of Long COVID patients and disdain for prevention is not acceptable and should be recognized for what it is: a political choice to deepen suffering rather than relieve it.
This first appeared on CEPR.