Over 10 years ago, a Republican congressman named Bill Cassidy attended a ribbon-cutting at Westdale Middle School in East Baton Rouge Parish, Louisiana. The celebration was to honor the renovation of three local school-based health centers, made possible by a federal grant from the US Health and Human Services Administration, which had been secured with Cassidy’s assistance. At the ribbon-cutting, Cassidy talked about how he had helped to get hepatitis B and influenza vaccinations going in East Baton Rouge schools.

The head of a local nonprofit, Health Centers in Schools, talked fondly of the congressman’s enthusiasm for vaccines, saying: “I remember Bill [Cassidy] calling me from the floor of the Louisiana Senate when he was in the state legislature asking me if I knew about the flu immunization studies from a doctor in Texas—I had just read that same article myself. So, with Bill’s help, we launched the flu vaccinations in East Baton Rouge schools the same year.” Cassidy had worked in public hospitals in Louisiana for 30 years, and he was well aware of the power of immunization. His push for school-based vaccinations for HBV was motivated by his own clinical experience and, in particular, the near-death of a woman under his care due to liver failure associated with this preventable viral hepatitis.

Cassidy is now the senior senator from Louisiana and the chair of the powerful Senate Health, Education, Labor, and Pensions Committee. He’s more influential than ever, and he has presumably not forgotten about the importance of vaccinations. So when Donald Trump nominated longtime anti-vaxxer Robert F. Kennedy Jr. to the post of secretary of health and human services earlier this year, Cassidy was in a perfect position to push back.

We all know what he did instead. After expressing reservations about the nomination, Cassidy turned around and made an accommodation with Kennedy, securing “key commitments” on vaccine policy that Cassidy claimed had satisfied his concerns. He then offered up the crucial yes vote to RFK Jr., setting the vaccine denier up for full Senate approval.

It’s now June. Every promise Kennedy made to Senator Cassidy has been broken. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) has been purged and its members replaced with noted anti-vaxxers with obvious conflicts of interest. Meanwhile, a troika of fellow travelers, Vinay Prasad and Marty Makary at the US Food and Drug Administration, along with Jay Bhattacharya at the US National Institutes of Health, have unilaterally changed US Covid vaccination policymaking into an end-run around ACIP, mostly notably striking the recommendation for pregnant women and children to get the vaccine, which flies in the face of the scientific evidence and the clinical reality of the disease in these populations.

As Katherine Wu at The Atlantic has said, we’re now entering America’s anti-vaxx era. With measles and pertussis outbreaks happening across the country, this is a gasoline-on-a-fire moment. As colleagues of mine at Stanford have suggested, measles is likely to return to endemicity in the US, and should RFK Jr. and his “Mini-Me”s further erode vaccine coverage for other diseases, we risk other infections becoming more common as well.

We all knew who RFK Jr. was. So did Senator Cassidy. Yet he voted for him. Now, when questioned about what is happening,
Cassidy flees from reporters chasing him down the hallways of the Senate, and he has refused interviews on the subject since January.

RFK Jr.’s uncle once wrote a book called Profiles in Courage, consisting of short biographies of US senators who bucked their party to do the right thing and suffered the consequences. JFK’s book was popular—courage and integrity among politicians seemed to sell well back in 1956. But cowardice is all the rage in this next century.

If someone would like to write it, I’d suggest Bill Cassidy be Chapter One in Profiles in Cowardice. He can run from reporters, but he cannot hide from history. How does a lifelong advocate for vaccination capitulate so readily to the king of the anti-vaxxers? In the wake of his vote and after all that has happened in these short months, Bill can’t even rally himself to fight back for even a second. Does he even think of those children in East Baton Rouge? That young woman who almost lost her life to HBV? Of course he does—but he’s made a decision, which is to put his own political future ahead of the millions of children in this country who will now suffer the consequences of his cowardice.

This is a special kind of cravenness. The Susan Collinses and Lisa Murkowskis of this world will always express concern over bad things and then vote with their party. But Bill Cassidy has
a particular life of service that he has now trashed: In addition to setting up vaccination programs in his state, he served the poor and uninsured at Earl K. Long Medical Center for more than 20 years, and set up a makeshift hospital in an abandoned Baton Rouge K-Mart after Hurricane Katrina. Now he will be linked with RFK Jr. forever.

Cassidy opened the door and let RFK Jr. in. Now, he’s listlessly watching as RFK “goes wild” on health. Quite a precipitous fall for the good doctor. Sadly, we have not hit rock bottom yet in this new anti-vaxx era. Cassidy’s reputation still has further to fall, too.