Health experts say a little-known form of science denial explains RFK Jr.'s views on vaccines and disease

'He believes that when those two children in Texas died of measles, it wasn't because of measles—it was because they were malnourished. He said they were
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Germ theory, formalized in the 19th century by Louis Pasteur, replaced the once-dominant 'miasma theory,' which held that disease stemmed from foul-smelling air or vapors from rotting organic matter. Pasteur's contemporary and rival, Antoine Béchamp, rejected germ theory in favor of 'terrain theory' — the idea that illness arises not from outside microbes but from internal imbalances in the body.
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Though discredited by modern science, terrain theory still finds adherents among germ theory denialists, including Kennedy, who in his 2021 book 'The Real Anthony Fauci' repeatedly attributes the 20th century's steep decline in infectious disease deaths to improvements in nutrition and sanitation rather than to vaccines.
Dr. Kristen Panthagani, a resident physician at Yale and public health communicator, said Kennedy does not deny the existence of microbes outright but reframes their role in illness.
'Instead of saying germs don't exist, they say germs exist but aren't necessarily harmful,' said Panthagani. 'They shift the blame to poor nutrition or other co-morbidities — saying that those are the real causes of disease.'
In his book, Kennedy calls for a 'marriage' between germ theory and his version of miasma theory, defined as 'preventing disease by fortifying the immune system through nutrition and by reducing exposures to environmental toxins and stresses.'
HHS did not respond to multiple requests for comment about Kennedy or the department's current views on miasma theory.
Panthagani said Kennedy creates a false dichotomy between germ theory and the idea that good nutrition and fitness play an important role in keeping people healthy.
'He painted germ theory as this belief that germs are the only cause of bad outcomes in infectious disease ... when there already is a nuanced understanding of how infections work in the medical community,' she said.
In his book, Kennedy repeatedly mischaracterizes mainstream medicine as downplaying both the importance of nutrition and physical fitness in whether or not one contracts or survives an infectious disease as well as the positive role that many microbes play in the human body — claims that Panthagani, who wrote her PhD thesis on the human microbiome, says are categorically false.
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'Yes, good nutrition and exercise are super important and will prevent a whole bunch of diseases,' said Panthagani. 'But they are not guaranteed to stop measles. We also need vaccination.'
While most medical professionals reject Kennedy's framing, terrain theory still maintains a foothold in alternative health circles — though not all who espouse it agree with the MAHA movement.
Sarah Southerton, a certified 'integrative health practitioner' (but not a medical doctor) and owner of the Minneapolis-based wellness business Healing Masters LLC, which sells coaching sessions and online courses, said, in her view, illness takes hold when the body is 'weakened' — by poor nutrition, environmental toxins, stress, and other internal imbalances — rather than by germs alone.
'Germ theory is just a little too simplistic,' she said, while acknowledging it still has value, in her view. 'It doesn't account for why some people get sick and others don't, even when they're exposed to the same thing.'
'For me, terrain theory includes your thoughts and feelings,' in tandem with biology, she said. 'If you're someone who's always resonating with criticism, judgment, self-pity, jealousy…you're not likely to have good health,' because it puts stress on the body, weakening both the immune system and physical resilience, in Southerton's view.
Southerton said her support for scientific research, environmental regulation, vaccine access, and public health infrastructure makes her concerned that MAHA's broad push for deregulation could leave vulnerable Americans more exposed and susceptible to illness — the opposite of the' individualized, informed, and supportive approach to health freedom' she advocates.
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To Offit, Kennedy's current mishandling of this year's measles outbreaks — which have infected more than 1,000 people in 33 states and resulted in the first U.S. pediatric measles death in more than 20 years — exemplifies the dangerous consequences of the HHS Secretary's germ theory denialism.
He has downplayed the importance of measles vaccination, Offit said, and repeatedly promoted vitamin A supplements and vitamin A-rich cod liver oil as measures to prevent and treat measles — a message that can be dangerously misleading in the U.S. context.
'The World Health Organization only recommends vitamin A in countries where there's vitamin A deficiency—which is not this country,' said Offit. 'He promoted this to the point that children were
'There's only two ways to develop specific immunity: to be naturally infected or to be vaccinated,' Offit said. 'Healthy people, no matter how healthy they are, can be killed by these viruses and bacteria unless they have specific immunity beforehand.'
Understanding Kennedy's germ theory denialism, Offit and Panthagani argue, helps illuminate many of his other beliefs. For example, Kennedy has long argued that vaccines pose greater risks than the diseases they are designed to prevent. After all, why expose oneself to a weakened virus — or trace amounts of heavy metals and other synthetic ingredients — if a properly maintained immune system should offer adequate protection on its own? In its most recent move, HHS
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With this novel strain of germ theory denialism as the basic, false premise of his scientific worldview, Kennedy has poisoned the well of public health discourse—potentially for decades to come, experts said.
'It's bad, and it's only going to get worse. I think the question is: when do we wake up? When do we say, 'This is too much—why should children suffer like this?'' said Offit.
Nathan Metcalf can be reached at

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