David Wallace-Wells and Emily Oster argue that the effects of MAHA will be long-lasting.
“[Economist and CEO of ParentData Emily Oster] There’s two really core issues for the future. One is that this [mRNA vaccines] is the fastest technology we have to generate vaccines, full stop.
The difference in the amount of time it takes to make a vaccine in the traditional manner versus with this technology is very, very large. If you think about a future pandemic, having access to this technology is the difference between a vaccine and three months or four months or six months and a vaccine in two years.
The second thing that comes to mind is that there is real potential here to improve our protection against, for example, the flu, which kills many people every year. With a faster vaccine, you can generate a more well-matched vaccine to the current flu strain. And so the possibility in a world of mRNA vaccines is that we would all get a well-matched Covid booster and flu vaccine and maybe R.S.V. vaccine. Or at least the elderly would get that, and it would really protect them. So by taking away this funding, I think we’ve turned off that possibility, or at least made it somewhat less likely. [..]
[New York Times Opinion writer David Wallace-Wells] And maybe even more exciting in theory is this huge new application to cancer, which is not really a vaccine — it’s more a tool to use in immunotherapy. The basic idea is that we’re using the same platform to train someone with cancer’s ability to fight off the cancer in their body using their own immune system. So if we’re really backing away from mRNA entirely, then we’re putting ourselves really behind the eight ball when it comes to cutting-edge cancer research as well. [..]
[Oster]: [..] from my standpoint, what’s happened is the worst of both worlds: The changes on the food side are minor, performative and irrelevant, while the changes on the vaccine side are enormous and terrible. And so we’ve somehow landed in exactly the worst possible case. But is that how you see it? Or are you all more optimistic? [..]
[Wallace-Wells]: I would want to emphasize the particular role of the cohort I call the Covid contrarians, who are now empowered under R.F.K. Jr. in America’s health infrastructure. I’m thinking of people like Marty Makary, Jay Bhattacharya and Vinay Prasad. What’s really interesting to me about their story in this context is that in 2021, they were some of the most vocal people promoting vaccines. They were quite aggressive in saying: If you’ve got the shots, you really don’t have to worry about Covid anymore — you can move on with your life.
And now, when you see R.F.K. Jr. walking back from mRNA technology, what he’s emphasizing is that these vaccines don’t deliver long-lasting, sterilizing immunity against respiratory illness. And that’s true — it’s something I wrote about at the time. So I think the basic proposition R.F.K. Jr. is putting forward is correct: Covid mRNA vaccines did not truly end the pandemic in the way many people expected.
Yet many of the people who were — if not direct architects of this policy, then at least going along with it as part of the new public health regime — were just a few years ago the biggest boosters of these vaccines. I think that raises some really basic questions. What are we doing here? What’s the story that takes us from 2021 to 2025? And why is it that so many people who had so much faith in those shots are now part of a program to walk back from that technology in general?
[Oster]: On the first question of vaccine hesitancy, I think the end case scenario that I am most concerned about is one in which, in some way, this administration manages to make it quite difficult to get your kid vaccinated. And changing some aspect of what’s approved or what’s covered by Medicaid, that’s the really bad case scenario.
[..] I do lay some blame at the feet of some of the public health advice that postdated the early 2021 Covid vaccines. To play devil’s advocate or try to express what somebody like Jay Bhattacharya, the director of the N.I.H., would say here: These vaccines were an incredible breakthrough. They saved millions of lives. But when we started telling people that their 7-year-old needs a third booster in 2023, you lost a lot of people, and that is when a lot of this resistance — particularly among parents — became more extreme.
Perhaps if the sort of left-leaning public health establishment had talked a bit differently about how to think about vaccines in the period post-immediate vaccination, if there had been more nuance or understanding in that conversation, things might have gone differently. I don’t think that it’s insane to have a different position about the value of vaccination in February 2021 and the value of vaccination in August 2025 for Covid. I think that’s just what science would say, in my position, but we may not agree there.
[Wallace-Wells]: [..] I thought there was far too much confidence placed in long-term sterilizing immunity.
When we first started seeing breakthrough infections, the public health establishment didn’t really take that seriously as a scientific question. I think there was something irresponsible about that. They were basically overlooking signals from the population in order to meet the public where they were. And on that point, I do think there’s a political logic, as you lay out, that people got frustrated, exhausted and fed up with a lot of Covid mitigation messaging over the course of the pandemic. There’s a political logic to adjusting. But I also think we’re now in a period of what looks to me like a massive overcorrection.
We’ve so overlearned the lesson of Covid that people now want to navigate the landscape of risk entirely on their own. They don’t want to be told what to do. They don’t even want to interact with public health guidance. And that leaves us much more vulnerable going forward. [..]
Tell me your assessment of R.F.K. Jr.’s actions on food. What do you think about what he’s doing there and how it compares to the war on vaccines, on public health and the medicine side?
[Oster]: [..] taking red dye 40 out of Swedish Fish or Skittles is not likely to improve anyone’s health. What he’s achieved is that people are now more or less thinking about doing that. I’d say that’s about where we have landed. I do not think that the changes that have been promised — even if they happened — would matter very much or at all for health. And I don’t think they’re going to happen. So I would say, on those kinds of things, like, “I got this company to promise to do X” or “We’re going to make some Coke with sugar instead of high fructose corn syrup” — that’s not really improving people’s health.
There is one thing that has happened, though, which I think actually could improve health, although it’s ethically more complicated. He has allowed the U.S.D.A. to issue waivers to several states to remove soda from the approved items you can purchase with your E.B.T. or SNAP benefits — food stamps. I actually think there’s a reasonable chance that this may affect people’s soda consumption, and that could have some real health effects. This is like catnip for economists, so I’m sure in two years we’ll see some studies on whether it actually mattered. But everything else I can think of that he’s done on the food front is just useless.
[Wallace-Wells]: [..] I think that basically there are maybe some questions we want to ask about some of the vaccines we’re giving, maybe. But basically we know that they’re really effective and powerful. On the food side, the questions seem much larger and more consequential. And I’d be much more willing to follow a quasi-conspiratorial quest to get to the bottom of our ill health on that front than I would on vaccines.
When I think about the makeup of the MAHA movement, obviously, there are people who are focused on vaccination. But I think there’s a natural constituency that’s much larger arguing that we shouldn’t be eating the food that’s so bad for us. So how do we reform our agricultural practices? How do we change our eating practices, our diet? How do we change that at a large scale to make sure that the country is healthier?
It seems to me almost just at an intuitive level that would be a larger and more natural constituency. Why are we seeing so much more action on the vaccine side than we are on the food, diet and environmental health side? What’s that about?
[Oster]: [..] There’s maybe two things.
So one is this is running up against — much more directly — many of the political barriers that are put up by many people, but in particular by the right. So many of the changes that one would like to make are going to be vehemently opposed by lobbyists with enormous budgets, and ultimately some of these changes would need to be made through Congress, and that’s going to be an uphill battle. It’s much easier to get a company to stand up and say “We’ll think about taking dyes out of our Skittles” than to actually change some significant environmental or agricultural practices.
The second piece is that a lot of the changes that probably need to be made — real, meaningful change — involves getting people to change how they are eating. And that is very hard. It is very, very difficult to get people to change how they’re eating. Whereas changing out everybody on the Vaccine Advisory Committee and then changing your advice there is actually comparatively quite straightforward, and that is therefore an easier win. I think the wins here are really tough. [..]
[Wallace-Wells]: Do you see a possible hopeful future where MAHA makes more progress over the next couple of years on the food side? Or do you think it’s going to continue being empty and performative?
[Oster]: I’m not very optimistic. I think there’s an increasing set of evidence around ultraprocessed foods in particular, and so I could see some changes that might impact the share of our diet, which is in ultraprocessed foods, which has already gone down a bit. I think that would be interesting.
I have to be honest: If we’re looking to improve the metabolic health of the U.S., the answer is probably going to come from putting GLP-1s on the Medicaid and Medicare formularies rather than from this movement. And I realize that’s probably not a politically popular thing to say, but ——
[Wallace-Wells]: It could.
[Oster]: Probably going to have more impact. [..]
I would love to see a movement on improving the healthiness of food, especially around kids. I just think there’s so much potential to make school lunches fun and interesting, to get people to eat vegetables. I’ve occasionally talked to people who work in this space who I find incredibly inspiring. But for the most part, we haven’t really done it.
[Wallace-Wells]: I think the GLP-1 discussion is really illuminating because, at least as I understand the fractured lay of the land of the MAHA coalition, this is not a MAHA solution. The MAHA solution is diet, behavior, exercise.
That just illustrates something really profound to me: Much of what’s been gathered under this particular rubric, MAHA, is really a kind of public health libertarianism. It’s about bodily autonomy. It’s about how I can be more in charge of my own health and well-being, and therefore see my own healthiness as a reflection of some kind of behavioral virtue. And this whole category of things that counts as what the system is telling me to do, I’m going to just dismiss out of hand. Even though, like, what’s the difference between R.F.K. Jr. taking testosterone supplements versus some obese person getting on GLP-1s instead of going on a diet? There’s not really a categorical difference there.
But in the worldview of MAHA, these are very different ideas. One involves an individual seeking out a solution on their own, independent of official advice. The other is basically like, we imagine Americans opening their gullets and just getting drowned in Big Pharma sludge, and that is much more offensive. On the other hand, as you say, if we really want to get America’s obesity problem under control, we actually did invent a miracle drug to deal with obesity. If we were serious about literally making America healthy again, we have a tool to make an enormous difference.
And the culture that’s calling for exactly that — that has made that their slogan, their calling card — is resistant to it because their philosophy is really not about making America healthy again. I worry that we’re heading, because of that, into a much darker future. One where we are less aware of or focused on the opportunities we share, and instead pushed down paths where we are responsible for our own well-being as independent, autonomous units — without even being able to count on new meds like GLP-1s coming down the pike. For me, that’s the dark future of MAHA.
[Oster]: I think that’s a fair assessment. I would go back to what you said before, which is if your goal is really to make America healthy again, you should think about the full range of possible ways to do that. But to sort of say, well, we’re only going to consider the avenues that we’ve decided are associated with virtue, which always is how this feels to me — like, we’re going to focus on the avenues that are standing outside and drinking lemon water and intermittent fasting and whatever else it is. And we’re not going to think about some of the avenues that might help a much larger share of people. That feels like you’re not really doing the thing that you said. You’re not making America healthy again. [..]
[Wallace-Wells]: At a level of cultural discourse, we are in a much more distrustful place than we were five years ago. How do you see that playing out? Can we recover some of that on a relatively short timeline? What are our chances here?
[Oster]: I am not very optimistic about restoring trust in these broader public health institutions, in part because I feel that it was lost for some set of people, and it’s really hard to regain trust once you’ve lost it. And then we brought in a group which now another set of people distrust.
So we’re now in a place where no one trusts what the C.D.C. has up on their website, either because of before or because of now. We’ve made the problem twice as large as it was eight months ago. I will say that if you look at these same surveys of parents, people trust their pediatricians even if they don’t trust the C.D.C. That is an opportunity to keep people’s health supported, but maybe through a different kind of messaging, or maybe through a messaging that’s a little more tailored to individuals. The problem is that that takes more time, but that trust feels like it has not decayed in the same way.
[Wallace-Wells]: When I take the longer-term view, I think something like the decline in vaccination rates that we were seeing before the pandemic was the simple result of the fact that it had been a full generation since we had really seen the costs of non-vaccination. In the same way that people talk about the rise of populism veering into fascism, in part because people have forgotten the lessons of World War II, I think there’s a sort of parallel here with vaccination and with science.
So I wonder in a grotesque way if future public health challenges will push us back in the direction of trust, which is to say: If bird flu starts to spread through the human population, person to person, are we really going to say that we don’t trust the C.D.C.’s guidance? Are we really going to say that we don’t want a rapid development of the mRNA vaccine? What worries me is that it may take us to that crisis to really get to a place of renewed confidence.
The optimistic story I could tell is that we’re still living in the messy froth of that pandemic. And once those waves settle down, we can see things a little more clearly. But I worry it’s going to take another tidal wave to really push us into a place of renewed confidence and faith in science.”
Full interview, E Oster and D Wallace-Wells, New York Times, 2025.8.13