From KFF Health News (TNS), by Arthur Allen
In the 300-year history of vaccination, the development of safe and effective COVID vaccines less than a year into the pandemic was a high point that appeared to usher in an era of greater protection against infectious illnesses.
Infectious disease and public health experts and vaccine advocates say a combination of factors could lead to new, deadly outbreaks of measles, whooping cough, meningitis, or even polio. This comes after backlash against public health interventions culminated in President-elect Donald Trump’s nomination of Robert F. Kennedy Jr., the nation’s most well-known anti-vaccine activist, as its top health official.
The list of things that will begin to fall apart is substantial, according to James Hodge, a public health law specialist at the Sandra Day O’Connor College of Law at Arizona State University. The laws and policies around vaccines are about to undergo a significant shift.
According to Georgetown University public health law professor Lawrence Gostin, he will make America ill once more.
According to Northe Saunders, who monitors vaccine-related legislation for the SAFE Communities Coalition, an organization that supports pro-vaccine legislation and lawmakers, state lawmakers who have doubts about the safety of vaccines are prepared to introduce bills that would weaken or eliminate school-entry vaccination requirements.
Should Kennedy and former House member Dave Weldon be confirmed to head the Department of Health and Human Services and the Centers for Disease Control and Prevention, respectively, as well as a Republican-controlled Congress, even states that maintain current requirements will be at risk from their decisions.
Both individuals have supported disproven hypotheses linking vaccines to autism and other chronic diseases: Kennedy as an activist and Weldon as a physician and representative from 1995 to 2009. (Since leaving Congress, Weldon has appeared in anti-vaccine movies.) Despite dozens of credible scientific studies to the contrary, both have accused the CDC of hiding proof that this was the case.
Requests for comment from Kennedy’s team were not answered. Interviews with Kennedy and Weldon were not answered by Karoline Leavitt, the national press secretary for the Trump campaign.
Kennedy just stated to NPR that we will not deny anyone access to immunizations.
Although it’s unknown how far the administration will go to discourage vaccination, vaccine-preventable illnesses and fatalities could increase if immunization rates decline significantly enough.
Gregory Poland, co-director of the Atrium Academy of Science & Medicine, stated that it is unrealistic to believe that we can reduce vaccination rates and herd immunity in the United States and avoid return of these diseases. Children who contract measles have a one in 3,000 chance of dying. It doesn’t have a cure. They will perish.
Kennedy erroneously claimed in a letter to the prime minister of Samoa that the measles vaccine was likely to blame for the deaths of 80 children during a measles outbreak in November 2019. Trump’s first FDA commissioner, Scott Gottlieb, stated on CNBC on November 29 that if Kennedy undermines vaccination, it will cost lives in our nation.
According to Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, Kennedy’s nomination confirms and solidifies the public’s skepticism of government health initiatives.
According to Offit, the idea that he would even be given consideration for that role gives the impression that he is knowledgeable. He makes use of diminished trust and the notion that there are things you don’t see or information they don’t give you, but I’ll find out so you can make an informed choice.
Targets of Anti-Vaccine Groups
From disseminating false information to postponing FDA vaccine approvals to removing Department of Justice support for vaccine laws contested by organizations like Children’s Health Defense, which Kennedy founded and oversaw prior to his presidential campaign, Hodge has put together a list of 20 steps the administration could take to undermine national vaccination programs.
Kennedy might also destroy the National Vaccine Injury Compensation Program, which Congress established in 1986 to care for children who were thought to have been damaged by vaccines while shielding vaccine manufacturers from some legal action.
The number of firms producing vaccinations in the United States had decreased from 26 in 1967 to 17 in 1980 due to the prospect of lawsuits, and the remaining companies producing the pertussis vaccine were threatening to cease production before the law was passed. According to Poland, the vaccine injury program was crucial in retaining producers.
Through the 30-year-old Vaccines for Children program, which provides free vaccinations to over half of the children in the United States, Kennedy could eliminate the CDC’s Advisory Committee on Immunization Practices, whose recommendation for using a vaccine determines whether the government pays for it. As an alternative, Kennedy might appoint supporters of the anti-vaccine movement on the committee who are against new vaccines and, theoretically, remove recommendations for vaccines like the 53-year-old measles-mumps-rubella shot.
Threats from infectious diseases, meanwhile, are increasing or may soon do so. Unlike other new administrations, Kennedy has threatened to restructure the federal health agencies rather than prepare. At a Children’s Health Defense conference last month in Georgia, he stated that once in office, he will take a vacation from infectious diseases to concentrate on chronic illnesses.
Threats like mosquito-borne dengue fever are increasing in the United States, and the H5N1 virus, sometimes known as bird flu, which has infected at least 55 humans and spread via cattle herds, may start a new pandemic.
Neglected vaccination is contributing to the emergence of traditional childhood illnesses. The whooping cough epidemic is the worst since 2012, and there have been 16 measles outbreaks in the United States this year, with 89% of cases occurring among unvaccinated individuals.
According to Peter Hotez, a pediatrician and virologist at Baylor College of Medicine, that is how we are beginning. I am quite concerned when you consider that the head of HHS is one of the most vocal and well-known anti-vaccine activists.
Since Kennedy’s nomination, the stock values of pharmaceutical companies with sizable vaccine portfolios have fallen precipitously. Demand for more recent vaccines, such as GSK’s RSV and shingles doses, had already declined due to vaccine fatigue and mistrust before Trump’s election.
Kennedy has a number of options for reducing or halting the release of new vaccinations or the sales of already-approved ones. For instance, he may demand more post-market research or draw attention to dubious studies that raise concerns about safety.
Kennedy, who has subscribed to conspiracy theories like the idea that pesticides create gender dysphoria and that HIV does not cause AIDS, told NPR that vaccination safety research is severely lacking. “We will ensure that those scientific studies are completed so that people can make educated decisions,” he stated.
Stanley Plotkin, a consultant for the vaccine industry and the creator of the rubella vaccine in the 1960s, stated that Kennedy’s nomination was a bad sign for both the creation of new vaccinations and the usage of those that are already on the market. Millions of dollars are needed to create vaccines. Commercial businesses won’t do it until there is a chance for profit.
Vaccine proponents have a difficult fight to defend vaccination in courts, legislatures, and public spaces since they have less funding available than the more well-funded opponents. Even when vaccines are effective, they are difficult to promote since people are rarely inclined to rejoice when an ailment is eradicated.
“There hasn’t been an appetite from science-friendly people to give that kind of money to our side,” said Karen Ernst, director of Voices for Vaccines, “even though many wealthy people, including those who sell supplements and potions, have funded the anti-vaccine movement.”
He s Serious as Hell
Many people made fun of RFK Jr., but Ernst stated that he is really serious. He is wealthy, powerful, and has a large network of anti-vaccine parents who will appear at any time. Ernst stated that organizations such as hers had not experienced it.
There were no vaccination advocates present when an Idaho health board decided on October 22 to cease distributing COVID shots in six counties. Ernst said that we were unaware that it was on the agenda. On our end, mobilization consistently lags. I’m not giving up, though.
For Walter Orenstein, who led the CDC’s immunization division from 1988 to 2004 and convinced states to strengthen school regulations to combat measles outbreaks, the kaleidoscopic shift has been startling.
Orenstein, a CDC epidemiologist in India in the 1970s who saw some of the last cases of smallpox and regularly treated children with meningitis caused by the H. influenzae type B bacteria—a disease that has largely disappeared due to a vaccine introduced in 1987—said that people don’t understand the concept of community protection and that if they do, they don’t seem to care.
He said, “I was so naive.” I had assumed that COVID would increase vaccination acceptance, but the opposite was true.
According to Saunders, anti-vaccine lawmakers could propose legislation to eliminate school-entry requirements in almost all states. One bill to do this has been introduced in Texas, where what s known as the vaccine choice movement has been growing since 2015 and took off during the pandemic, fusing with parents rights and anti-government groups opposed to measures like mandatory shots and masking.
The genie is out of the bottle, and you can t put it back in, said Rekha Lakshmanan, chief strategy officer at the Immunization Partnership in Texas. It s become this multiheaded thing that we re having to reckon with.
In the last full school year, more than 100,000 Texas public school students were exempted from one or more vaccinations, she said, and many of the 600,000 homeschooled Texas kids are also thought to be unvaccinated.
In Louisiana, the state surgeon general distributed a form letter to hospitals exempting medical professionals from flu vaccination, claiming the vaccine is unlikely to work and has real and well established risks.Research on flu vaccination refutesboth claims.
The biggest threat to existing vaccination policies could be plans by the Trump administration to remove civil service protections for federal workers. That jeopardizes workers at federal health agencies whose day-to-day jobs are to prepare for and fight diseases and epidemics. If you overturn the administrative state, the impact on public health will be long-term and serious, said Dorit Reiss, a professor at the University of California s Hastings College of Law.
Billionaire Elon Musk, who has the ear of the incoming president, imagines cost-cutting plans that are also seen as a threat.
If you damage the core functions of the FDA, it s like killing the goose that laid the golden egg, both for our health and for the economy, said Jesse Goodman, the director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University and a former chief science officer at the FDA. It would be the exact opposite of what Kennedy is saying he wants, which is safe medical products. If we don t have independent skilled scientists and clinicians at the agency, there s an increased risk Americans will have unsafe foods and medicine.
Outbreaks of vaccine-preventable illness could be alarming, but would they be enough to boost vaccination again? Ernst of Voices for Vaccines isn t sure.
We re already having outbreaks. It would take years before enough children died before people said, I guess measles is a bad thing, she said. One kid won t be enough. The story they ll tell is, There was something wrong with that kid. It can t happen to my kid.
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