As U.S. senators grill Robert F. Kennedy Jr. this week, President Trump’s pick to run the Department of Health and Human Services is expected to face sharp questions about his actions in an island nation half a world away.
Kennedy’s 2019 visit to Samoa has recently brought fresh attention to his history of activism focused on raising questions about the safety and effectiveness of the measles vaccine — because his trip came just months before a devastating measles outbreak that claimed 83 lives, many of them young children.
“It was very sad,” Dr. Take Naseri, Samoa’s health chief at the time, told CBS News. “It’s one of those things you don’t want to revisit.”
Kennedy has maintained that he had “nothing to do” with the people of Samoa resisting vaccines.
“I had nothing to do with people not vaccinating in Samoa,” he said in an interview with documentary producer Scott Hamilton Kennedy. “I never told anyone not to vaccinate.”
But some of Kennedy‘s critics assert he bears a measure of responsibility for the outbreak and that he leveraged the tragedy to promote false claims about the vaccine. Democrats have seized on the episode, even sponsoring advertising that calls out his visit.
What happened in Samoa?
Years before Kennedy trained his focus on vaccine issues in Samoa, the small Pacific island nation had been experiencing low vaccination rates. Medical professionals attributed this to a shortage of doctors and nurses as well as demographic shifts, with more people moving to cities and away from social structures that helped promote childhood vaccinations. By 2017, only about half of 1-year-old Samoan children were fully vaccinated — far below the 95% coverage needed to prevent community spread and a steep drop from earlier rates that had reportedly reached 90%.
The situation took a tragic turn in July 2018 when two nurses mistakenly combined an expired muscle relaxant with MMR vaccine doses instead of sterile water, leading to the deaths of two children. The nurses were charged with manslaughter, and the government responded by suspending the national vaccination program for 10 months. Vaccination rates for children dropped to 31%.
Naseri, the former Samoan health chief, told CBS News that the government had struggled to implement an effective vaccine program. He said the mishandling of the vaccine and its tragic consequences “was the last straw.”
“It created more hesitancy,” Naseri said.
Mistrust in vaccines spread across the island like a virus. At the time, even the prime minister issued a statement on Facebook alleging that his grandson had been injured by a vaccine. The temporary suspension of vaccinations corresponded with a growing distrust in modern medicine.
“I would rather treat them at home with old-fashioned herbal medicines than taking them to see a doctor,” one mother told local reporters at the time. “Since children died from these vaccines, I don’t trust any medication from the hospital.”
Patricia Stinchfield, a nurse practitioner and past president of the National Foundation for Infectious Diseases, said she had been monitoring the Samoan vaccine crisis even before the measles outbreak struck. She says the immunization rates had dropped so low the situation was “a ticking time bomb.”
It was in the midst of that “perfect storm,” Stinchfield said, that Kennedy arrived in Samoa in the summer of 2019. Kennedy has said the purpose of his visit was to pitch a health surveillance system, and that the vaccination pause in 2018 was an opportunity to naturally study an unvaccinated population. His trip was coordinated by a local anti-vaccine advocate known for spreading medical misinformation online.
Dr. Naseri told CBS News he met briefly with Kennedy but their conversation focused on environmental and vaccine safety issues.
In August 2019, two months after Kenendy’s visit, an infected traveler from New Zealand arrived in Samoa and the deadly measles virus began its spread. The government officially declared an outbreak on Oct. 16 and a month later declared a state of emergency.
It wasn’t until early December that the Samoan government conceded it had mishandled immunizations and launched an aggressive vaccination campaign, making the shots mandatory. Dr. Naseri said that delayed response may have contributed to the high infection and death rates. But finally, the country shut down for two days to allow health workers to vaccinate people at home, quickly achieving 90% coverage.
Hundreds of medical professionals from around the world responded and traveled to Samoa to help with the vaccination efforts.
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“The government needed the political will, and the international community backed us up,” Naseri said.
CBS News visited Samoa during that response and met one parent named Paulo Puelua, who said the measles outbreak took hold of his family in an instant, killing three of his five children. Their mother Fa’oso was so distraught that she had been sleeping on her children’s grave, set up in the family’s front yard according to Samoan tradition. She told CBS News she felt it was her only way to be close to them now.
Looking back, officials told CBS News they believe the outbreak’s high death toll resulted from multiple factors, including widespread malnutrition, reliance on traditional medicine, and an overwhelmed health care system. In rural Samoa, many families share a single sleeping space, making transmission easier, and nearly a quarter of the population lives in poverty, further complicating treatment.
Controversy about RFK Jr.’s role
Dr. Paul Offit is a vaccine specialist and co-inventor of the rotavirus vaccine. He’s also director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. He’s been a frequent critic of Kennedy’s and believes the nominee for health secretary deserves harsh judgment for how the outbreak unfolded.
Offit says Kennedy had been posting about the two deaths before it was understood what had happened, and blamed the MMR vaccine. When that turned out not to be the case, Kennedy did not correct that false assertion.
“If he was any kind of man, which he isn’t, he should go back to Samoa and apologize to every one of the families where a child died,” Offit said. “He’s a famous man who goes there and meets with anti-vaccine activists. He gives them credence by going there.”
CBS News reached out to Kennedy for comment through the organization he led until last month, Children’s Health Defense, and did not receive a reply. The group has previously denied his visit played any role in the outbreak.
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In interviews, Samoan health officials told CBS News they believe Kennedy’s actions were unlikely to have directly influenced what occurred.
“It is well documented that RFK Jnr’s visit to Samoa in 2019 coincided with increased anti-vaccine sentiment, particularly among certain groups,” the Samoan Health Ministry said in a statement. “However, there is no conclusive evidence that his visit directly contributed to the decline in vaccination rates or the subsequent measles outbreak.”
But in the midst of the island’s state of emergency, Kennedy sent a letter to the Samoan prime minister suggesting a defective vaccine may have been responsible for causing infections — a theory that has been debunked.
“It is critical that the Samoan Health Ministry determine, scientifically, if the outbreak was caused by inadequate vaccine coverage or alternatively, by a defective vaccine,” Kennedy wrote in the Nov. 19, 2019 letter. Kennedy’s letter partly leans on an idea that appears to have originated from misinformation widely spread on social media during a 2014-2015 measles outbreak at Disneyland that inaccurately said that measles originating from the vaccine had been identified.
Stinchfield says this is impossible based on the weakened nature of the virus in the vaccine. In very rare cases people may exhibit symptoms similar to those associated with measles but no cases have ever been documented of measles being spread as a result.
After the Samoan infections, critics say Kennedy downplayed the outbreak’s severity in blog posts and continued to suggest that the vaccine itself was responsible for the high death rate. He was joined by Del Bigtree, a prominent anti-vaccine activist and Kennedy ally, in pushing conspiracy theories surrounding the outbreak.
Stinchfield says the claims they pushed remained unsupported by evidence. And eventually, the Samoan government stopped listening.
Samoa has since achieved high vaccination rates and the World Health Organization says the country has reported no measles cases since 2020. However, vaccine hesitancy remains a challenge globally, with anti-vaccine activists continuing to spread fear and misinformation.
Samoa’s Health Ministry says it remains concerned about “the global spread of vaccine misinformation and the potential consequences of RFK Jnr.’s influence, particularly if he assumes a leadership role in public health policy. The spread of anti-vaccine narratives has already contributed to outbreaks of vaccine preventable diseases in multiple countries, reversing decades of progress in immunization efforts.”
Stinchfield said she believes misinformation spread by Kennedy and others — in Samoa, and during the years since — remains acutely dangerous.
“Their modus operandi is to take a little kernel of truth and spin it around and confuse people, spin it at a time where the fear is already so high,” she said. “That is disinformation, a weapon that will harm people, harm children.”
