When 12-year-old Braden Fahey collapsed during football practice and died, it was just the beginning of his parents’ nightmare.

Deep in their grief a few months later, Gina and Padrig Fahey received news that shocked them to their core: A favorite photo of their beloved son was plastered on the cover of a book that falsely argues COVID-19 vaccines caused a spike of sudden deaths among healthy young people.

The book, called “Cause Unknown,” was co-published by an anti-vaccine group led by Robert F. Kennedy Jr., President John F. Kennedy’s nephew, who is now running for president. Kennedy wrote the foreword and promoted the book, tweeting that it details data showing “ COVID shots are a crime against humanity.”

The Faheys couldn’t understand how Braden’s face appeared on the book’s cover, or why his name appeared inside it.

Braden never received the vaccine. His death in August 2022 was due to a malformed blood vessel in his brain. No one ever contacted them to ask about their son’s death, or for permission to use the photo. No one asked to confirm the date of his death — which the book misdated by a year. When the Faheys and residents of their town in California tried to contact the publisher and author to get Braden and his picture taken out of the book, no one responded.

“We reached out in every way possible,” Gina Fahey told The Associated Press in an emotional interview. “We waited months and months to hear back, and nothing.”

How could a member of one of the most influential political dynasties in American history be involved in such a shoddy, irresponsible project, the Faheys wondered?

Braden’s story is just one example of how Kennedy, son of the late Sen. Robert F. Kennedy, has used his famous name to disseminate false information about vaccines and other topics in a time when spreading conspiracy theories has become a powerful way to grow a constituency. An AP examination of his work and its impact found Kennedy has earned money, fame and political clout while leaving people like the Faheys suffering.

Now, Kennedy’s decision to drop his Democratic bid for president and run as an independent gives him a new spotlight in an election that’s currently heading toward a rematch between President Joe Biden and former President Donald Trump. There’s concern in both parties that he could emerge as a spoiler who could affect the outcome of the campaign in unexpected ways. And at a time when Republicans in the 2024 race also are sowing doubt about vaccine effectiveness, it threatens to further promote harmful misinformation that already has cost lives.

One mom told AP about how she had delayed important care for her child because she believed Kennedy’s vaccine falsehoods. A former elected leader described being harassed by Kennedy’s followers. Doctors and nurses recounted how his work has hurt people in the U.S. and abroad.

Kennedy’s campaign did not respond to several emails seeking comment for this article, but after AP contacted Kennedy and others involved in the book last week, the president of Skyhorse Publishing, which co-published it, texted the Faheys, offering to talk. Gina Fahey told AP she felt he reached out only after it became clear the situation could harm his reputation.

“There’s still that lack of compassion that was always there from the beginning,” she said, adding that she is hesitant to engage with them now because she doesn’t trust their intentions. “It’s only now that they’re reaching out, days prior to knowing this story is going to be released.”

Braden’s parents have read vicious comments from people who falsely blame vaccines for their son’s death. They say seeing Braden’s memory being misrepresented by Kennedy and others has been deeply painful.

“When you barely feel like you can even come up for air, you just get smacked back down again by this,” Gina Fahey said.

“It’s very manipulative. And you know, he’s making money off of our tragedies,” she said, adding, “How could you want somebody running our country that operates like that?”

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Many years before anti-vaccine activists exploited the pandemic to bring their ideas to the American mainstream, Kennedy, an environmental lawyer, was among the most influential spreaders of fear and distrust around vaccines. He has long advanced the debunked idea that vaccines cause autism. He has said vaccines had caused a “holocaust,” and has traveled the world spreading false information about the pandemic.

In recent years, Kennedy has used his name and rhetorical skills to build his anti-vaccine group, Children’s Health Defense, or CHD, into an influential force that spreads false and misleading information. An AP investigation previously revealed how Kennedy had capitalized on the pandemic to build CHD into a multimillion-dollar misinformation engine.

One of the ways Kennedy and CHD have made money is through the sale of books. Kennedy’s longtime publisher, Skyhorse, joined with CHD to create a book series that has published titles including “Vax-Unvax,” “Profiles of the Vaccine Injured,” and the book that included Braden Fahey, “Cause Unknown.”

Written by Edward Dowd, a former executive at BlackRock, that book is built on the false premise that sudden deaths of young, healthy people are spiking. Experts say these rare medical emergencies are not new and have not become more prevalent.

“We are just not seeing anything that suggests that,” said Dr. Matthew Martinez, of Atlantic Health System in Morristown Medical Center, who researches cardiac events among professional athletes.

The AP found dozens of individuals included in the book died of known causes not related to vaccines, including suicide, choking while intoxicated, overdose and allergic reaction. One person died in 2019.

AP asked Kennedy’s campaign, CHD, Dowd and Skyhorse president Tony Lyons several questions about the book, including why they chose to feature Braden, why they didn’t speak to his family first and what steps they took to fact check.

The only person to respond was Lyons, who also co-chairs the Kennedy Super PAC American Values 2024.

In emails, Lyons did not address why Braden specifically was chosen for the cover but defended his inclusion by saying that news stories and his obituary did not mention his cause of death.

Hundreds of deaths are cited in the book, though Lyons said it only attributes nine of them to the vaccine. Lyons said Braden’s death and others are never explicitly attributed to the vaccine, and that the book explores many possible reasons for deaths that have appeared in headlines since 2021.

Still, the book several times refers to its “thesis” that mass administration of COVID-19 vaccines caused a spike in deaths. Braden’s parents said his appearance in the context of the book implies he died of the vaccine, putting his death in a false light.

Lyons said he was unaware of the Faheys’ efforts to contact his company and asked AP to share with them his contact information. He said he would make some corrections in future editions, including to Braden’s date of death, but said they were studying whether to remove him from the book or the cover.

Lyons told the AP that Children’s Health Defense has a publishing deal with Skyhorse, though he would not say how much money CHD has received through it.

Kennedy also has a consulting deal with Skyhorse that personally paid him $125,000 since August 2022 for scouting out books for the company, according to a financial disclosure he filed. Lyons said that deal has so far resulted in 27 books of different genres including children’s books, mysteries and cookbooks, but declined to name them.

Lyons also praised Kennedy’s record of environmental work, such as protecting New York’s Hudson River, and other work he’s done to take on powerful corporate interests and what Kennedy sees as government corruption. Those are also topics Kennedy has focused on during his presidential campaign.

The platform Kennedy built for himself has an impact. In a study of verified Twitter accounts from 2021, researchers Francesco Pierri, Matthew DeVerna and others working with Indiana University’s Observatory on Social Media found Kennedy’s personal Twitter account was the top “superspreader” of vaccine misinformation on Twitter, responsible for 13 percent of all reshares of misinformation, more than three times the second most-retweeted account.

The messages Kennedy shares have convinced a significant slice of the public, some of whom attend his campaign events proudly wearing pins with crossed-out syringes or repeating Kennedy’s talking points about vaccine ingredients.

Kennedy’s anti-vaccine organization has a lawsuit pending against a number of news organizations, among them The Associated Press, accusing them of violating antitrust laws by taking action to identify misinformation, including about COVID-19 and COVID-19 vaccines. Kennedy took leave from the group when he announced his run for president but is listed as one of its attorneys in the lawsuit.

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Many people have staked their lives and the lives of their families on the views espoused by Kennedy and others who oppose vaccines.

The AP spoke to mothers who once identified as anti-vaccine and counted themselves among Kennedy’s most devoted followers.

“I thought he was heroic, because he was saying the things publicly that other people were too afraid to say,” said Lydia Greene.

Greene, who lives in the Canadian province of Alberta, declined all vaccines for her son after buying into the claims by Kennedy and other anti-vaccine “gurus” that vaccines cause autism. When her son started to show signs of autism, Greene discounted it out of hand.

“I couldn’t even see his autism because in the anti-vax movement, autism is the worst outcome that can happen to a child. And when they talk about their vaccinated autistic kids, it’s often with a tone of resentment and how they talk about how their life is ruined, their marriage is ruined, and it’s just this kid is damaged,” Greene said. “And so when my son was different, I couldn’t see that stuff about him.”

She said she did not recognize his condition until she “came out of the rabbit hole of anti-vax.”

“I realized I had wasted so much valuable time where he should have been in occupational therapy, speech therapy, evidence-based therapy for autism,” Greene said.

Kennedy’s Children’s Health Defense produces articles, newsletters, books, podcasts, even TV shows on its own CHD.TV. Greene said those articles often validate anxious parents’ fears – no matter how irrational – while making them feel like someone powerful is listening.

Today, Greene believes the group exploited her.

“That’s what CHD does,” Greene said. “They find parents when they’re vulnerable. And hack into that.”

Because of his national profile, Kennedy’s work has ripple effects beyond the most devoted anti-vaccine activists.

Medical professionals told the AP that vaccine disinformation spread by Kennedy and other influencers makes the patients they serve wary about lifesaving vaccinations.

Sharon Goldfarb, is a family nurse practitioner in Berkeley, California, who spent the worst of the pandemic caring for people on society’s margins: people with no homes; people who were living in the country illegally; people with serious mental health needs. She has seen firsthand the consequences of vaccine misinformation and refusal.

“It’s disturbing because he has a huge family name,” Goldfarb said. “When you’re a trusted public figure and you have a trusted family name, you have to answer to a higher authority. … I just don’t get it.”

Dr. Todd Wolynn, a Pittsburgh pediatrician who works to clarify the facts about vaccines on social media, said despite Kennedy’s lack of clinical experience, he has an outsized influence on his followers.

“He uses a very big platform to amplify disinformation that leads people down a path to make a decision that’s not evidence based,” Wolynn said. “And as a result, it puts their own lives, the lives of their children, the lives of their family, in harm’s way.”

Though Kennedy did not respond for this story, he has long said that he is not anti-vaccine, and only wants vaccines to be rigorously tested. The Centers for Disease Control and Prevention explains that vaccines undergo thorough testing before they are authorized or approved in the U.S. and they are monitored for safety after they are introduced to the public.

COVID-19 vaccines were initially developed under the Trump administration, through the program Operation Warp Speed. But what his Republican-led administration viewed at the time as a point of pride has since become a topic of criticism in Republican circles, including among GOP presidential candidates who have expressed skepticism about the immunizations.

The Republican candidate and biotech entrepreneur Vivek Ramaswamy said in a July podcast interview that if he’d had the facts he would not have gotten vaccinated against COVID-19. The administration of fellow GOP candidate Florida Gov. Ron DeSantis has broken with CDC guidance to advise Floridians under 65 not to get the latest COVID-19 booster.

That kind of rhetoric, along with the conspiracy beliefs that Kennedy has shared about other subjects, like 5G, “can impact the smooth running of societies,” said Daniel Jolley, a University of Nottingham social psychology professor, who has published several papers on conspiracy thinking and its impacts.

While skepticism is important, proper evaluation of the evidence is key, Jolley said. Anyone pushing conspiracy theories while running for president makes the theories seem normal.

“It’s that kind of rhetoric that I think is really damaging,” Jolley said. “You worry when you think about the next pandemic or the next event or the next issue that’s going to come our way.”

Jolley wonders: Will people listen to doctors or experts next time?

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Kennedy’s role in legitimizing anti-vaccine activism has not been limited to the U.S. Perhaps the most well-known example was in 2019 on the Pacific island nation of Samoa.

That year, dozens of children died of measles. Many factors led to the wave of deaths, including medical mistakes and poor decisions by government authorities. But people involved in the response who spoke to AP said Kennedy and the anti-vaccine activists he supported made things worse.

In June 2019, Kennedy and his wife, the actress Cheryl Hines, visited Samoa, a trip Kennedy later wrote was arranged by Edwin Tamasese, a Samoan local anti-vaccine influencer.

Vaccine rates had plummeted after two children died in 2018 from a measles vaccine that a nurse had incorrectly mixed with a muscle relaxant. The government suspended the vaccine program for months. By the time Kennedy arrived, health authorities were trying to get back on track.

He was treated as a distinguished guest, traveling in a government vehicle, meeting with the prime minister and, according to Kennedy, many health officials and the health minister.

He also met with anti-vaccine activists, including Tamasese and another well-known influencer, Taylor Winterstein, who posted a photograph of herself and Kennedy on her Instagram.

“The past few days have been profoundly monumental for me, my family and for this movement to date,” she wrote, adding hashtags including #investigatebeforeyouvaccinate.

A few months later, a measles epidemic broke out in Samoa, killing 83 people, mostly infants and children in a population of about 200,000.

Public health officials said at the time that anti-vaccine misinformation had made the nation vulnerable.

The crisis of low vaccination rates and skepticism created an environment that was “ripe for the picking for someone like RFK to come in and in assist with the promotion of those views,” said Helen Petousis-Harris, a vaccinologist from New Zealand who worked on the effort to build back trust in the measles vaccine in Samoa.

Petousis-Harris recalled that local and regional anti-vaccine activists took their cues from Kennedy, whom she said “sits at the top of the food chain as a disinformation source.”

“They amplified the fear and mistrust, which resulted in the amplification of the epidemic and an increased number of children dying. Children were being brought for care too late,” she said.

Kennedy’s campaign did not respond to emails seeking comment about Samoa, though he says on his campaign website that he had no role in the outbreak. He also said in an interview for a forthcoming documentary, “ Shot in the Arm,” that he bears no responsibility for the outcome.

“I had nothing to do with people not vaccinating in Samoa. I never told anybody not to vaccinate. I didn’t, you know, go there for any reason to do with that.”

But people who worked on the Samoan measles response told AP the credibility he gave to anti-vaccine forces when he met with them had an impact.

Moelagi Leilani Jackson, a Samoan nurse who worked on the vaccination campaign to stem the scourge of measles, said she remembered that after Kennedy’s visit, the anti-vaccine influencers “got louder.”

“I feel like they felt they had the support of Kennedy. But I also think that Kennedy was very – well, he came in and he left,” she recalled. “And other people picked up the pieces.”

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A few weeks after his trip to Samoa, Kennedy appeared in Sacramento, California, where lawmakers were debating a bill to make it more difficult to get a vaccine exemption. The bill was sponsored by Democratic state Sen. Richard Pan, a pediatrician.

As a crowd gathered outside the capitol, Kennedy stood to speak. Two large posters behind him featured Pan’s image, with the word “LIAR” stamped across his face in blood-red paint. Pan told AP he felt the staging was intended to incite the crowd against him.

“So he’s rallying to have people attack me, essentially, personally,” said Pan, who is no longer in office.

Within months, one anti-vaccine extremist assaulted Pan, streaming it live on Facebook. Another threw blood at Pan and other lawmakers.

Kennedy has repeatedly brought up the Holocaust when discussing vaccines and public health mandates, comparisons that Pan said amount to an “indirect call to violence” against health advocates.

“Who creates an atmosphere where they think what’s appropriate is to actually physically assault a legislator? It’s people like Robert F. Kennedy Jr.” Pan said.

Pan said it’s one of many instances when Kennedy has whipped people up against public health advocates. Kennedy also wrote a bestselling book attacking infectious disease expert and former top government scientist Dr. Anthony Fauci, who has received death threats.

Those attacks have prompted criticism from Kennedy’s sister Kerry Kennedy, who invoked the Kennedy family history of political violence – their father and uncle were both assassinated – when she told the AP in 2021: “Attacking doctors and scientists is irresponsible because many have received death threats. This can deter people from those professions. Our family knows that a death threat should be taken seriously.”

Kerry Kennedy and three other siblings on Oct. 9 issued a statement denouncing Kennedy’s independent candidacy, calling it “dangerous” and “perilous” to the country.

Pan said that Kennedy’s rhetoric, which often demonizes scientists and health care professionals, is part of a strategy to intimidate and silence them.

“When you call something a holocaust, it is incitement to violence,” Pan said.

“The real consequence of Robert F. Kennedy Jr. is we have dead children, and we have people who are in good faith doing their best to try to protect people, including children, who are basically being threatened and even assaulted because of his rhetoric and his lies,” said Pan, who is now running for mayor of Sacramento, a nonpartisan position. “That harms America.”

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Associated Press video journalist Terry Chea contributed to this report.

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