Health Secretary Robert F. Kennedy Jr. assured the lawmakers whose support secured his confirmation last year that his 2019 visit to Samoa, made shortly before a deadly measles outbreak, had "nothing to do with vaccines." Newly obtained documents reported by The Associated Press and The Guardian contradict that testimony.

The documents show that Kennedy — then a prominent anti-vaccine activist — wrote to the Samoan prime minister ahead of the trip requesting to study the Pacific island nation's measles, mumps and rubella (MMR) vaccines following the deaths of two children who had received them. In that letter, Kennedy used the words "vaccine" or "vaccination" eight times.

The correspondence, dated Jan. 20, 2019, and written on the letterhead of Children's Health Defense (CHD), the nonprofit Kennedy then led, raises questions about how truthful Kennedy was in testimony before Congress. During an arduous confirmation process in which he needed the support of skeptical Republican lawmakers to advance, Kennedy also pledged to maintain vaccine policies that, once in office, he moved to change.

"I am writing this letter to you in the hope that we might be helpful to the people of your great nation," Kennedy wrote, adding that he believed the deaths of the two children could have resulted from manufacturing issues.

"I would propose my team conduct detailed health informatics assessment in Samoa of what happened with your MMR vaccines," he continued.

In response to questions from the AP, the Department of Health and Human Services said the Samoa visit "was unrelated to vaccines."

"Any claim or insinuation based on these letters that Secretary Kennedy lied under oath or to Congress is not only false but outright defamatory," the department said in a written statement.

Kennedy was not under oath during his confirmation hearing. Knowingly giving materially false testimony to Congress is a crime that carries a possible prison sentence regardless of whether a person is under oath, though it is rarely prosecuted.

HHS did not make Kennedy available for an interview. The White House did not respond to a request for comment. The Samoan prime minister's office and the former prime minister who corresponded with Kennedy did not respond to requests for comment.

A Contentious Chapter

Kennedy's Samoa visit has become one of the most contentious events in his career. At the time, he was leading a nonprofit known for its anti-vaccine activism. Critics said the visit emboldened anti-vaccine activists in Samoa, which later experienced a measles outbreak that killed 83 people, mostly children under 5.

That history matters because the trip has become part of the broader record lawmakers have weighed in assessing Kennedy's credibility on vaccine policy, a central issue during his confirmation and now in his role overseeing the nation's health agency.

Lawyers with expertise in Senate procedure said that if lawmakers choose, they could use Kennedy's statements as grounds for hearings, an impeachment inquiry or creating other obstacles for him. But such action is unlikely under the current Republican-led Congress, which is aligned with President Donald Trump's administration.

The Confirmation Fight

At the start of Trump's second term, Kennedy — a leader in the anti-vaccine movement before entering politics — faced an uphill battle as he sought to become the nation's health secretary. Lawmakers from both parties had criticized his anti-vaccine rhetoric, and during his confirmation hearings he tried to assure them that he supported childhood vaccination.

The Samoa trip also came under scrutiny. Kennedy told senators that his visit did not influence people's decisions on whether to vaccinate, and several times he flatly denied that his reason for the trip had anything to do with vaccines.

When the subject came up during questioning by Sen. Ron Wyden, D-Ore., Kennedy replied: "I went there, nothing to do with vaccines. I went there to introduce a medical informatics system that would digitalize records in Samoa and make health delivery much more efficient."

The following day, when Sen. Edward Markey, D-Mass., asked, Kennedy said: "My purpose in going down there had nothing to do with vaccines."

Upon further questioning, Kennedy again denied the trip had anything to do with vaccines before adding: "My purpose in the trip was not to — I ended up having conversations with people, some of whom I never intended to meet."

Kennedy ultimately won crucial support from Republican Sen. Bill Cassidy, the Louisiana physician who leads the Senate Health, Education, Labor and Pensions Committee and has strongly advocated vaccination. The Senate confirmed Kennedy on a 52-48 vote.

Cassidy said he voted to confirm Kennedy because he received commitments that, as health secretary, Kennedy would not change certain vaccine policies and guidance. In a speech announcing his vote, Cassidy noted that Kennedy pledged to maintain a federal vaccine advisory committee "without changes." Once in office, Kennedy ousted all 17 members of the committee and named his own advisers.

Cassidy has acknowledged that his trust in Kennedy was broken.

"The commitments that were made to me have been violated," Cassidy said on CBS's "Face the Nation" in June.

Children's Health Defense and Samoa

Kennedy for years served as chair and chief legal counsel of Children's Health Defense, a nonprofit group known for its anti-vaccine activism. The group turned its attention to Samoa in July 2018, when two young children died after being given a tainted MMR vaccine that had been improperly prepared. The two nurses involved were criminally charged the month after the children died and ultimately pleaded guilty to manslaughter.

The Samoan government halted all vaccinations for 10 months, until April 2019. Vaccination rates plummeted, leaving public health officials with the added challenge of restoring confidence after a widely publicized tragedy.

During that time, CHD started contacting the Samoan government, according to emails previously obtained by the AP and The Guardian as the result of a lawsuit against the State Department brought with the aid of the Reporters Committee for Freedom of the Press.

The newly obtained Kennedy letter, also revealed through that lawsuit, was addressed to then-Prime Minister Tuilaepa Sailele Malielegaoi and described his desire to study Samoa's use of the MMR vaccine. Kennedy speculated that the deaths in Samoa may have been caused by issues with different vaccine lots, writing that his team wanted to evaluate whether that was the case through a "detailed health informatics assessment."

He expressed his belief that it is difficult and time-consuming in most of the world to investigate "adverse health events associated with vaccines," and said health information systems are rarely designed to quickly study links "between diagnoses and specific vaccination events." The letter did not specifically discuss anti-vaccine activism.

The prime minister responded a month later, saying Samoa could benefit from CHD's assessment of its MMR vaccines.

"It is certainly beneficial for Samoa to have the benefit of your Team's independent health assessment of our MMR Vaccines and I would welcome with much anticipation your Team's proposed visit to our islands," he wrote, including a representative from the U.S. Embassy on his communication.

CHD did not respond to a request for comment.

The Visit and Its Aftermath

Kennedy, his wife, actor Cheryl Hines, and Michael Graven, a CHD colleague, took their trip to Samoa in May and June of that year. By then, vaccinations had resumed, and Samoa's top health official had publicly announced that human error, not a vaccine issue, was responsible for the children's deaths.

While in Samoa, Kennedy met with anti-vaccine activists, including one who helped arrange the trip with a U.S. Embassy employee, the AP and The Guardian previously reported.

Months later, with vaccination rates still dangerously low, measles broke out, sickening thousands. Public health experts have said their efforts to address the outbreak were hampered by anti-vaccine activists, some of whom they claim were emboldened by Kennedy's visit.

The AP and The Guardian previously reported that officials with the State Department and UNICEF privately discussed that the trip was about vaccines. In response, some Democratic politicians, including Wyden and Markey, have said Kennedy lied or misled the Senate.

This story was originally featured on Fortune.com.