Plus, Trump isn’t trained in the biosciences, and as far as he probably knew going into the job those are “the good guys”. under that situation, he and all the prior office holders probably defer to advisors on the subject FAR more than for things like the economy or defense.
I’ve a feeling on the other side of this the shell of respectability deference that surrounds the medical/pharmaceutical and associated regulatory fields to excess will be well and truly munged up.
Q mentioned how bad the pharma companies were early on, that many vaxes were bad, that they had cures for conditions they were hiding, etc. So I think Trump was pretty much in the know about pharma companies and their nefariousness.