|Articles|January 13, 2017

Vaccine Experts Weigh in on Trump's Possible RFK Appointment

In light of recent news that reported “vaccine skeptic,” Robert F. Kennedy, may be appointed to lead president-elect Donald Trump’s panel on vaccine safety, Contagion spoke with vaccine experts to learn of any potential ramifications this may have.

Environmentalists, infectious disease specialists, and public health experts now share something in common—concerns over the views on widely accepted scientific findings on the part of officials within the incoming administration of president-elect Donald Trump.

While the role of so-called “climate-change deniers” in the new commander-in-chief’s cabinet has received significant coverage in the mainstream media, until now relatively little attention has been paid on the views of newly appointed—assuming they are confirmed by the Senate—officials to the administration’s healthcare team as they pertain to medical research. That all changed with Robert F. Kennedy, Jr.’s announcement on January 10th that he is under consideration by the president-elect to chair an as-yet-to-be-created committee on “vaccination safety and scientific integrity.”

Incoming White House press secretary Sean Spicer confirmed that Kennedy and Trump met to discuss, “issues pertaining to vaccines and immunizations.” However, the new administration has yet to make a formal announcement concerning what role, if any, Kennedy will have in the new cabinet.

Kennedy’s potential involvement in federal policy on vaccinations for vaccine-preventable diseases such as measles/mumps/rubella (MMR), tuberculosis, and pertussis is of concern to many experts on infectious diseases and public health because the son of the former attorney general and presidential candidate has been called a “vaccine skeptic.” Among other safety concerns, the former environmental activist has argued in the past that vaccines containing thimerosal may cause autism. This theory has since been debunked by the Centers for Disease Control and Prevention (CDC) and others.

Assuming it’s true about the appointment, the news about Kennedy is particularly alarming, given that president-elect Donald Trump has also reportedly met with former physician Andrew Wakefield, whose study linking the MMR vaccine to autism, which was published in The Lancet in the late 1990s, has since been declared fraudulent.

“I am very concerned about this appointment,” Davidson H. Hamer, MD, from the Center for Global Health and Development and Professor of Global Health and Medicine at Boston University Schools of Public Health and Medicine told Contagion. “Mr. Kennedy has a strong history of supporting anti-vaccine efforts. The evidence of an association between vaccines—specifically MMR—and autism has been refuted by multiple high quality population-based studies. I am very worried that he is going to strengthen anti-vaccine campaigns, potentially through incorrect, non-evidence-based information. Mr. Kennedy’s appointment may give legitimacy to the incorrect claims of the anti-vaccine advocates and thereby exacerbate an already concerning situation.”

Indeed, although medical science has since refuted the claims of Wakefield, Kennedy, and others, many would argue the damage has been done. Outbreaks of pertussis (in California in 2010), measles (222 cases in the US in 2011 alone), and multiple mumps outbreaks over the past 5 years have been linked with poor vaccine uptake, caused in many cases by parents’ refusal to allow their children to be vaccinated due to safety concerns, according to James D. Cherry MD, MSc, Distinguished Professor of Pediatrics at the University of California, Los Angeles David Geffen School of Medicine. Parents may also refuse vaccination for their children for religious and/or cultural reasons, Dr. Cherry added.

“We have been having sporadic outbreaks of measles and mumps in the United States over the past few years, and increasing rates of pertussis, which may relate more to the lower efficacy of the acellular vaccine than poor rates of Tdap or DTaP immunization,” Dr. Hamer explained. “His appointment could place the US population at even greater risk of morbidity and mortality from these vaccine-preventable diseases that we have been able to control over the past few decades.”

Dr. Cherry, who has published extensively on vaccine uptake and vaccine-preventable diseases, told Contagion that his concerns go beyond “giving legitimacy to the anti-vaccine crowd” and discouraging pediatric vaccination. “That’s always going to be there,” he said. Rather, he’s more concerned about the role Kennedy and others will have in setting national healthcare guidelines and establishing vaccination protocols in schools. He’s also expressed concerns that the new administration may decide to undo much of the work—and perhaps even defund future initiatives—of the CDC’s Advisory Committee on Immunization Practices (ACIP).

“[Professional societies] such as the American Academy of Pediatrics will be a voice of reason on this issue,” he said. “And the Infectious Disease Society of America and others have been vocal on this. But the money to run the CDC and the ACIP comes from the government. [The new administration] may decide to stop funding [these programs] And if they do that, the [professional societies] may be screaming into the wind.”

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.


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