New executive order will cause more vaccine fear

In January, Health and Human Services Secretary Robert F. Kennedy, Jr., issued drastic changes to the widely endorsed Childhood Immunization Schedule. A district federal judge temporarily blocked Kennedy’s new recommendations, ruling that he likely violated federal procedures. The American Academy of Pediatrics, and other medical-professional organizations expressed outrage. The AAP filed suit.

On Aug. 10, President Donald Trump signed an executive order mirroring Kennedy’s new changes, implementing what the court blocked. Whether the order will withstand legal challenges is uncertain.

The order decreased 17 routine childhood vaccines to 11, recommending:

• All children receive measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae, pneumococcal disease, human papillomavirus, and varicella.
• High-risk children also receive hepatitis A, hepatitis B, meningococcal B, meningococcal ACYW, dengue, and respiratory syncytial virus (a non-vaccine antibody).
• After shared decision-making with a provider, children may receive hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19.

Part of the rationale for reducing the number of vaccinations is that the U.S. has recommended more immunizations than European countries – not a justified comparison. There are many differences in disease risks, population characteristics, and health-care systems. Millions of U.S. childhood infections have been prevented by administering vaccines not routinely recommended in Europe (CDC data).

Trump said, “Nothing bad can happen from what we’re doing.” But the new schedule is not grounded in evidence-based science. Changing vaccine recommendations should be based on rigorous reviews of new evidence rather than on personal agendas, disinformation, and pseudoscience.

The executive order also endorses splitting the MMR vaccine into three separate shots at separate visits (and all combination shots as feasible) and spreading the entire childhood schedule over an extended time. The president stated, without justification, that there are claims that the MMR vaccine is “quite lethal” and that dividing the MMR into separate vaccines would have a huge impact on autism. No evidence exists indicating that multiple vaccines given concurrently are dangerous or pose an autism risk, or that spreading out vaccines is safer.

Patients are more likely to complete the recommended vaccine series with combination vaccines, and fewer shots are involved. Trump called for separating all the vaccines given at age one into five separate visits. Seriously?

Trump astonishingly embarrassed himself, displaying incredible ignorance, foolishness, and recklessness. His claim that the volume of the immunizations given at one year of age equals a bottle of soda is beyond ridiculous.

The executive order signing was infused with repeated suggestions from Trump, Kennedy, and others that vaccines cause autism without offering evidence. The research to the contrary, conducted over decades involving millions of children, is overwhelming and is considered settled science.

When asked what his evidence was that vaccines cause autism, he replied, “What I’ve heard is that there are some people that say it is that way…” Huh?

The executive order has no mandatory effect. But given the president’s impact, especially in red states, the order may have considerable influence.

It will cause vaccine fear, confusion, hesitancy, and refusal; more doctor visits and medical costs; missed work; more injections; delayed or skipped immunizations; and doubt about the necessity of vaccines.

Kennedy spoke briefly, stating that HHS was comprehensively researching environmental factors that might explain autism, including vaccines. Kennedy and administration officials mostly parroted Trump’s comments.

Seek your physician’s advice. If your physician embraces the Trump/Kennedy nonsense, find a new physician.

We are experiencing the largest outbreak of measles in 35 years. Whooping cough is surging; expect new waves of vaccine-preventable diseases.

Children will die.

Richard D. Feldman, M.D. is an Indianapolis family physician and former Indiana State Health Commissioner who served in the administration of Governor Frank O’Bannon.