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One of the leading public health associations came out Monday against President-elect Trump's nomination of vaccine skeptic Robert F. Kennedy Jr. for HHS secretary.

Kennedy's selection, which would have to be either confirmed by the Senate or finalized temporarily in a recess appointment, "raises serious concerns for the health of the American people," Georges Benjamin, MD, executive director of the American Public Health Association (APHA), headlined, "America deserves better than RFK Jr."

"To effectively lead our nation's top health agency, a candidate should have the proper training, management skills, temperament, and the trust of the public," he wrote. "Unfortunately, Mr. Kennedy fails on all fronts."

"Kennedy's past statements and views on vaccines alone should disqualify him from consideration," Benjamin continued. "He has stated that 'there's no vaccine that is safe and effective' and touted misinformation claiming that vaccines cause autism. A serious candidate for this position would follow the decades of real-world evidence that shows that vaccines are safe and prevent as many as 5 million deaths each year."

"The American people deserve better than Mr. Kennedy," he noted. "We need an HHS secretary under the Trump administration who will listen to science, not discredit it ... We urge President-elect Trump to select a qualified health leader that is properly trained and has the management skills to be the nation's top health official. We look forward to working with the incoming administration to advance effective, evidence-based approaches to improve the health of the nation."

Kennedy's selection has been a controversial one largely because of his . He also has said he supports getting rid of fluoride in the drinking water supply.

The APHA's statement is in sharp contrast to the response from physician associations, which have remained mostly quiet about the nomination, possibly because, if confirmed, Kennedy would hold enormous sway over issues that physician groups care about. Several major physician organizations have not put out a statement at all, while others, such as the American Academy of Pediatrics (AAP), have put out statements in support of vaccination but mentioned the nomination obliquely or omitted it entirely.

"[This] nomination ... offers an important opportunity to share the settled science on vaccines with government leaders, policymakers, and the American public," AAP President Benjamin Hoffman, MD, said in that group's statement. "This is a conversation pediatricians have every day with families, and we welcome the chance to do the same with national leaders."

"Vaccines are the safest and most cost-effective way to protect children, families, and communities from disease, disability, and death," he continued. "Continuing national investment in vaccine access is absolutely essential to support healthy communities ... As pediatricians, we firmly believe the most effective way for HHS to ensure the future health of our nation is to protect and support the health of our children: by ensuring that science continues to underpin all decision-making, policies, and programs."

The American College of Physicians (ACP) did not comment directly on the nomination at all in its statement. "Vaccines are vital to our ability to prevent diseases that threaten public health," said ACP President Isaac Opole, MBChB, PhD. "The ACP remains concerned about the spread of disinformation and misinformation regarding vaccination ... It is critical that policymakers and government officials understand the importance of vaccines, evidence-based medicine, and other ways that our public health infrastructure protects all of us."

Doctors for America did not put out a statement but did post an "" asking members to write to their senators to urge them to oppose Kennedy's nomination. The group's mission statement says it "mobilizes doctors and medical students to be leaders in putting patients over politics on the pressing issues of the day to improve the health of our patients, communities, and nation."

"We oppose the nomination of Robert F. Kennedy Jr. as Secretary of Health and Human Services because he is unqualified and has a dangerous track record of spreading false information about health," the alert noted. "Our nation's health and healthcare system are in need of reform and improvement. The American public deserves to have full, unbiased information on how to protect their health. But the nomination of RFK Jr. leaves us deeply concerned that he will harm the nation's health by continuing to spread false health information."

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