An Empirical Analysis of Persons, Institutions and Factors held Responsible for the 2019 Samoa Measles Outbreak Over Time in the Peer Reviewed Literature and in the News Media: Was Robert F Kennedy Jr. Blamed Contemporaneously or only in Retrospect?

Background: In 2019 there was a tragic outbreak of measles in Samoa. Amidst discussion of Robert F Kennedy Jr’s nomination for the Secretary of the Department of Health and Human Services, there has been discussion of his role in this outbreak. We examined peer review publications and news reports over the last 6 years to see what factors were deemed responsible for the outbreak and analyze changes over time.

Methods: We systematically reviewed the peer-reviewed literature (PubMed, Web of Science, and Google Scholar), as well as Google News for reports on the Samoan measles outbreak (2018 through January 2025. We noted whether the article cited Robert F Kennedy or other notable people who may have had responsibility in the outbreak, as well as other factors, such as under-vaccination, suspension of the immunization program, mistrust, and/or misinformation/anti-vaccination efforts.

Results: Of 163 articles, under-vaccination (n=94; 57.7%), misinformation/anti-vax (n=44; 27.0%), public mistrust of the system and suspension of the immunization program (14.7%) were commonly mentioned as reasons for the Samoan measles outbreak. 115 articles (70.6%) did not name any particular person as having responsibility in the Samoa measles outbreak, and a higher percentage of articles not assigning personal blame came from scholarly articles (92.5% vs 55.2%; p<0.001). Comparing scholarly papers to the lay media, only Robert F Kennedy and the nurses improperly mixing vaccines were more commonly blamed.  Comparing the years 2019-23 vs 24-present, only Robert F Kennedy was blamed more often in recent articles than contemporaneously.

Conclusion: We find Robert F Kennedy was seldom held responsible for the Samoa measles outbreak between 2019 and 2023 (18.5%), but often held responsible between 2024-present (100%).  This pattern of attribution raises the question of whether Mr. Kennedy was actually thought responsible contemporaneously or rather whether he is being scapegoated on the eve of his confirmation.