Jason M. Goldman, MD, MACP, discusses the potentially damaging effects of the rhetoric coming from the presidential executive order, including downstream consequences and his concerns about the prospective findings of the HHS Task Force on Safer Childhood Vaccines associated with the order.
With this week’s presidential executive order on the childhood vaccine schedule, clinicians are again having to consider the potential consequences associated with it, including the idea that this will change vaccine guidance and the ability to deliver appropriate health care to patients.
“We do not make medical decisions because of someone's belief, opinion, or ability to just write on a piece of paper. We make medical decisions and recommendations based on research, evidence, and science, and it's a process,” said Jason M. Goldman, MD, MACP, immediate past president of the American College of Physicians. “We go through decades of data and information, hundreds of thousands of patients over the years, looking at vaccines, diseases, the effects of them, how they work, why they work, what we're preventing, and then we go through a very rigorous process on the evidence itself to even make a recommendation. And this can take months, years…to make sure we're getting it right. So to be able to just write an order and disregard all science because they think it's that way doesn't make it so.”
The order is part of a continued effort led by the current Advisory Committee on Immunization Practices and US Health and Human Services (HHS) Secretary Robert F. Kennedy Jr to decrease access to immunizations.
In addition to the potential to restrict access, Goldman mentioned concerns about insurance coverage for vaccines and whether insurers will not deem these necessary; therefore, the cost could be returned to families. “And the issue with this is that it can impact not only insurance reimbursement for patients [but also] health care coverage and access…that could prevent insurance companies from paying for those vaccines for patients because the Affordable Care Act mandates that CDC [Centers for Disease Control and Prevention]-recommended vaccines must be covered. [It] has nothing to do with executive order–recommended vaccines being covered.”
As part of the executive order, there is the HHS Task Force on Safer Childhood Vaccines that has 90 days to assess alternative adjuvants, schedule timing, and risk/benefit evaluations. This panel is chaired by National Institutes of Health Director Jay Bhattacharya.1 The panel also includes senior leadership and officials from the US Food and Drug Administration (FDA) and CDC.
According to an HHS press release announcing the panel nearly a year ago, “The Task Force will work closely with the Advisory Commission on Childhood Vaccines to produce regular recommendations focused on:
There is no mention in the press release about who from the CDC and the FDA will serve on the panel, aside from Bhattacharya, and this vagueness can create uncertainty, especially as it is also not known what data and information the panel will be reviewing.
Goldman is concerned about the potential findings.
“I have no confidence that this task force is going to do anything else but rubber-stamp Secretary Kennedy's antivaccine agenda for no reason based in science,” he said.
This is episode 1 of a 2-part series. In the second episode of the interview, Goldman talks about the legal aspects of the executive order.
