Republican candidates Ben Carson and Donald Trump during the CNN Republican presidential debate at the Ronald Reagan Presidential Library and Museum on Wednesday, Sept. 16, 2015,

Republican candidates Ben Carson and Donald Trump during the CNN Republican presidential debate at the Ronald Reagan Presidential Library and Museum on Wednesday, Sept. 16, 2015

I’ve been writing about vaccines and the antivaccine movement since the turn of the millennium, first in discussion forums on Usenet, then, beginning in 2004, on my first blog (a.k.a. the still existing not-so-super-secret other blog), and finally right here on Science-Based Medicine (SBM) since 2008. Vaccines are one of the most important, if not the most important, topics on a blog like this because (1) arguably no medical intervention has prevented more deaths and suffering throughout history than vaccines; (2) few medical interventions are as safe and effective as vaccines; and (3) there is a vocal and sometimes effective contingent of people who don’t believe (1) and (2), blaming vaccines for all sorts of diseases and conditions to which science, despite many years of study, has failed to link them. The most prominent condition falsely linked to vaccines is, of course, autism, but over the years I’ve written about a host of others, including sudden infant death syndrome, shaken baby syndrome, autoimmune diseases, and even cancer. In a similar vein, antivaccine activists will try to claim that vaccines are loaded with “toxins” or even tainted with fetal “parts” or cells because some vaccines’ manufacturing process involves growing virus in two cell lines that were derived from aborted fetuses many decades ago. Even the Catholic Church doesn’t say that Catholics shouldn’t use these vaccines, but that doesn’t prevent some antivaccine groups from portraying vaccines as virtually being made by scientists cackling evilly as they grind up aborted fetuses to make vaccines. (I exaggerate, but not by much.)

On a strictly scientific, medical level, antivaccine claims such as the ones described above are fringe, crank viewpoints. There is no serious scientific support for any of them and lots of scientific evidence against them, particularly the most persistent myth, namely that vaccines cause autism. It also used to be the case that, politically, antivaccine views tended to be those of the fringe. Unfortunately, in the current election cycle, those fringe views seem to be coming to the fore among prominent candidates for the Republican Presidential nomination. This was most evident at the second Republican Presidential debate last week, where Donald Trump spewed antivaccine tropes and neither of the two physicians also running for the Republican nomination mounted a vigorous defense of vaccines. Even candidates who have previously issued strong statements defending vaccines (Senator Marco Rubio and Louisiana Governor Bobby Jindal) remained silent.

(Video of the exchange can be found here.)

How did we get to this point? And why is it that antivaccine views, which in the past were stereotypically associated with crunchy lefties in the mind of the public, seem now to have found another comfortable home among small government conservatives, including the man who currently appears to be the frontrunner for the Republican nomination? In the days that followed the debate, there have been many discussions of Donald Trump’s antivaccine views, but none that take the long view. All seem to flow from the idea that it’s mainly just Donald Trump and his wacky views, rather than Trump being part of a more widespread phenomenon. I’ve frequently said that antivaccine beliefs tend to be the pseudoscience that knows no political boundaries, occurring with roughly equal frequency on the left and the right. However, it’s virtually inarguable that right now, in 2015, the loudest political voices expressing antivaccine views (or at least antivaccine-sympathetic views) are in the Republican Party. Yes, Robert F. Kennedy, Jr. is back in a big way, partying like it’s 1999 with Bill Maher over thimerosal-containing vaccines and autism, but neither he nor Bill Maher holds public office or is currently running for office. The über-liberal website The Huffington Post might have been promoting antivaccine propaganda since its inception, but its writers are not running for office, either, and of late it seems to be much less antivaccine than before.

Antivaccine politics over recent years

When I first started blogging, arguably the most prominent politician expressing strong antivaccine views (while claiming, of course, that he was for “vaccine safety”) was Representative Dan Burton (R-IN). Back in the day, as chair of the House Committee on Oversight and Government Reform, Burton regularly used to hold hearings designed to “investigate” links between vaccines and autism. Usually this involved dragging CDC officials in front of his committee to harangue them about what they were doing to investigate this nonexistent link. He interfered in other ways, as well. For instance, in 2000 he wrote a letter urging the director of the FDA to recall all thimerosal-containing vaccines. In 2007, he tried to insert himself into the Autism Omnibus hearings on the side of the “vaccine-injured,” using typically awful antivaccine studies as his “evidence.” Until his retirement at the end of 2012, Burton maintained on his official House website a page that was a veritable cornucopia of antivaccine fear-mongering disguised as autism advocacy, a common misrepresentation, along with a blunt statement to the effect that “Based upon my own research, I believe that the mercury-based preservative thimerosal – contained in 7 of the 9 vaccines that my grandson received in one day shortly before he was diagnosed with autism – may have been a contributing cause of his condition.”

Burton was a Republican, and a true believer that vaccines (particularly thimerosal-containing vaccines) caused an “autism epidemic.” He, at least, is somewhat understandable for the same reasons that antivaccine beliefs in some parents of children with autism are understandable. He has a grandson with autism, and he confused correlation with causation with respect to vaccination and the onset of his grandson’s first symptoms of autism. More frequently, politicians tend to pander. Indeed, in the 2008 Presidential election campaign, three major candidates did just that. First, responding to a question from the mother of a boy with autism at a town hall meeting, John McCain was quoted thusly:

McCain said, per ABC News’ Bret Hovell, that “It’s indisputable that (autism) is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.”

McCain said there’s “divided scientific opinion” on the matter, with “many on the other side that are credible scientists that are saying that’s not the cause of it.”

Yes, scientific opinion was about as “divided” on this issue as it is on whether creationism is a valid explanation for how the diversity of life on earth developed.

Sadly, it didn’t take long for both Hillary Clinton (who was still challenging Barack Obama for the Democratic nomination) and Barack Obama himself to issue statements that, while not as bad as McCain’s, were pretty bad. Both issued statements that were a mixture of vacuous politician-speak plus implicit agreement with for ideas that are pillars of the antivaccine movement, specifically claims that:

  • There is an autism “epidemic.” (Arguably, there is very likely not.)
  • There is a scientific controversy over whether vaccines cause autism. (There really isn’t; it’s a so-called manufactured controversy. There is no good evidence that vaccines cause autism. Multiple large epidemiological studies have failed to find even a hint of a convincing link.)
  • Vaccines are somehow unsafe or that children are “overvaccinated” and receive too many vaccines. (Again, there is no good evidence that either of these is the case.)

As antivaccine “journalist” David Kirby crowed at the time:

Senator Hillary Clinton, in response to a questionnaire from the autism activist group A-CHAMP, wrote that she was “Committed to make investments to find the causes of autism, including possible environmental causes like vaccines.” And when asked if she would support a study of vaccinated vs. unvaccinated children, she said: “Yes. We don’t know what, if any, kind of link there is between vaccines and autism – but we should find out.”

And now, yesterday, at a rally in Pennsylvania, Barack Obama had this rather surprising thing to say:

We’ve seen just a skyrocketing autism rate. Some people are suspicious that it’s connected to the vaccines. This person included. The science right now is inconclusive, but we have to research it.

(Note: The Washington Post reports that when Obama said “this person,” he pointed to someone who had asked an autism question).

So there you have it, our next President will share the views of such radical fringe crazies as, well, me, Democrat Robert Kennedy, Jr., Republican Joe Scarborough, former NIH and Red Cross chief Bernadine Healy, and several researchers at Harvard, Johns Hopkins, the Universities of California and Washington and elsewhere.

Of course, RFK, Jr. is a fringe crazy on the issue and has been ever since before he wrote his conspiracy-laden Deadly Immunity story for Salon.com and Rolling Stone. On the issue of vaccines, so was Bernardine Healy, her having served as NIH director in the 1990s notwithstanding. As I said at the time, I realize that Clinton and Obama are politicians and that they didn’t want to anger the group that sent them the questionnaire. I also realize that politicians will pander. The problem is that pandering to antivaccine groups like A-CHAMP can have serious consequences.

After the 2008 election, there appeared to be less pandering to antivaccine groups by major politicians. Certainly, I don’t recall anything major during the 2012 Presidential election campaigns or either the 2010 or 2014 midterm elections. I strongly suspect that this was largely due to the epic discrediting in 2010 of one of the architects of the MMR scare, Andrew Wakefield, who in rapid succession in the course of a year was stripped of his UK medical license, saw his 1998 Lancet paper that started the scare retracted, forced to resign his position as medical director of the quack clinic he helped found, and saw highly convincing evidence of his fraud published by investigative journalist Brian Deer, who pithily referred to it as “Piltdown medicine.” As much as I would prefer that rejection of antivaccine beliefs were based on science and evidence alone, it is undeniable that the public discrediting and humiliation of Andrew Wakefield provided a handy shorthand for rebutting antivaccine beliefs by referring to his fraudulent research. Today, except to committed antivaccine activists for whom he is “Nelson Mandela and Jesus Christ rolled up into one,” Andrew Wakefield is a joke, a punchline, a speaker on a “Conspira-Sea Cruise”—no, seriously, that’s what it’s really called!—so chock full of cranks, quacks, and conspiracy theorists that it must have taken considerable financial dispensation for Wakefield to swallow his pride and commingle with New World Order conspiracy theorists, crystal healers, HIV/AIDS denialists, and crop circle mavens.

Enter Donald Trump

If you were to peruse the front page of the antivaccine website Age of Autism, you’d rapidly find articles like the one written by AoA founder J.B. Handley entitled “Trump Stands with my Son, I Stand with Trump“, in which Handley declares “Donald Trump is the best thing that has happened to our kids in a very long time and I hope we can all lay down our issues and stand with him.” Other enthusiastic articles include ones by Dan Olmsted exulting how “Vaccine Injury Gets an Audience” and, as a “granola-cruncher,” praising Trump for “embracing our issues.” In fairness, not all AoA denizens were so impressed. For example, after attending a Trump rally in Dallas, Dan Burns expressed genuine and appropriate concern at Trump’s borderline fascistic “us versus them,” “winners versus losers” rhetoric.

The first time I learned of Donald Trump’s antivaccine proclivities was way back in 2007 after he spoke at an Autism Speaks fundraising event. What was he saying back then? This:

“When I was growing up, autism wasn’t really a factor,” Trump said. “And now all of a sudden, it’s an epidemic. Everybody has their theory. My theory, and I study it because I have young children, my theory is the shots. We’ve giving these massive injections at one time, and I really think it does something to the children.”

And:

“When a little baby that weighs 20 pounds and 30 pounds gets pumped with 10 and 20 shots at one time, with one injection that’s a giant injection, I personally think that has something to do with it. Now there’s a group that agrees with that and there’s a group that doesn’t agree with that.”

Referring to his and his wife Melania’s 22-month-old son Baron, Trump continued: “What we’ve done with Baron, we’ve taken him on a very slow process. He gets one shot at a time then we wait a few months and give him another shot, the old-fashioned way. But today they pump the children with so much at a very young age. We do it on a very, very conservative level.”

So, yes, back in 2007, Trump was already parroting the antivaccine pseudoscience that at that time I had been deconstructing for seven years and blogging about for nearly three. It was a performance—and, let’s face it, everything Trump does in public is performance art, if you can call it that—that was brilliantly parodied at Autism News Beat as “The art of the schlemiel“. In any case, I’m hard pressed to come up with any time when a baby gets 10 or 20 shots at a time, and that’s even assuming that Trump was ignorantly conflating the number of diseases vaccinated against in combination vaccines with “shots.” For example, the DTaP vaccinates against diphtheria, tetanus, and pertussis, or three “shots,” to use Trump’s apparent parlance, and MMR vaccinates against measles, mumps, and rubella, or three more “shots.” That’s six vaccines, six sets of antigens so far, but in only two real injections. You get the idea. Trump seems to think that each vaccine in combo vaccines is a single shot, or at least he talks as though that’s what he believes. I use the present tense because he’s still doing it, and this 2007 interview was just the first example of which I’m aware in which he did that.

Four years later, Trump was still at it. On Fox and Friends, he repeated once again that he had a “theory” about vaccines, and that was:

In a Monday interview on Fox News, the reality star explained that a series of casual observations had led him to the conclusion that “monster” vaccinations cause autism.

“I’ve gotten to be pretty familiar with the subject,” Trump said. “You know, I have a theory — and it’s a theory that some people believe in — and that’s the vaccinations. We never had anything like this. This is now an epidemic. It’s way, way up over the past 10 years. It’s way up over the past two years. And, you know, when you take a little baby that weighs like 12 pounds into a doctor’s office and they pump them with many, many simultaneous vaccinations — I’m all for vaccinations, but I think when you add all of these vaccinations together and then two months later the baby is so different then lots of different things have happened. I really — I’ve known cases.”

The video can still be viewed here.

Tellingly, when he was challenged on this by Gretchen Carlson, who noted that “the studies have said that there is no link” and that there hadn’t been any mercury in vaccines for years, Trump would have none of it:

“It happened to somebody that worked for me recently,” he added. “I mean, they had this beautiful child, not a problem in the world, and all of the sudden they go in and they get this monster shot. You ever see the size of it? It’s like they’re pumping in — you know, it’s terrible, the amount. And they pump this in to this little body and then all of the sudden the child is different a month later. I strongly believe that’s it.”

All because of what Donald Trump calls a “monster shot.” This is what those of us who pay attention to these things refer to as the “too many too soon” gambit. All spreading out vaccines accomplishes is to increase the period of time that a child is vulnerable to infectious diseases for no real benefit of reducing the chance of autism because there is no link between vaccines and autism.

More recently, Trump has become a Twitter sensation, with over 4 million followers, where he has expressed similar ideas. Here is but a sampling:

 

 

 

 

 

 


 

You get the idea.

Basically, like Robert F. Kennedy, Jr., Donald Trump subscribes to a notion that has been massively discredited from a scientific standpoint. Mercury in vaccines does not cause autism. I realize that criticizing Donald Trump for being an antiscience idiot is rather akin to criticizing water for being wet or Donald Trump’s hair for having a life of its own—particularly when he’s preoccupied with real science, but this time it’s different. This time, it matters a lot more.

In all the times before, Donald Trump was nothing more than a billionaire with a flair for reality TV and self-aggrandizement. True, in 2012 he did flirt with running for President but never actually went through with it to the extent that he has this time. Now, he’s been the top of the polls in the race for the Republican Presidential nomination for weeks. Now that he’s gotten this far, not surprisingly public health advocates are worried, given this sort of rhetoric Trump trotted out in response to a question by conservative radio talk show host Hugh Hewitt:

HH: If a group of scientists came to you and said look, The Donald, that’s just, that’s not right, you’re giving out misinformation, would you change your mind if presented with facts on that?

DT: Well, I’ve seen babies that were totally healthy that weren’t healthy, and I’m not asking for anything. All I’m doing is saying spread it out over a period of time. I’m not saying don’t get inoculated, don’t get the shots, don’t get the vaccines. I’m saying spread it out over a period of time. It doesn’t hurt anybody other than probably the pharmaceutical companies, because they probably make more money putting it into one shot. Maybe it hurts the doctors. I don’t know. But I can say this. Everybody would get the vaccines. They just, they wouldn’t be pumping these massive amounts of liquid into a child.

As you can see, although Trump has changed his positions on several issues over the years there is one issue about which he has been remarkably consistent, and that’s his belief that vaccines cause autism. He’s been just as consistent as characterizing vaccine shots as “monster shots” with a “massive shot of fluid” that do something to babies to cause autism. Of course, most vaccines are in 0.5 ml to 1.0 ml per dose (for comparison, one ounce is 30 ml), which is not a lot, even for a newborn, but Trump makes it sound as though babies receive gallons of toxic fluid with each round of vaccines, enough to overload them with…something.

Vaccines at the Republican debate

It’s almost unnecessary for me to quote what Trump said about vaccines in the second Republican debate last Wednesday because it was virtually identical to what he’s been saying about vaccines since at least 2007 if not before. Still, it’s useful to set up the context. The question that provoked The Donald’s repetition of his oft-repeated antivaccine tropes from the last eight years was not actually directed at him. After making a reference to the measles outbreak that started at Disneyland earlier this year, moderator Jake Tapper actually asked Ben Carson this question: “Dr. Carson, Donald Trump has publicly and repeatedly linked vaccines—childhood vaccines—to autism, which, as you know, the medical community adamantly disputes. You’re a pediatric neurosurgeon. Should Mr. Trump stop saying this?”

It was obvious that Tapper was trying to provoke an argument between Trump and Dr. Carson. Otherwise, he would have just asked Trump directly about his previous statements about vaccines and autism. It was a golden opportunity for Dr. Carson to defend vaccines, given that earlier this year, Dr. Carson had been quoted strongly defending school vaccine mandates:

“Although I strongly believe in individual rights and the rights of parents to raise their children as they see fit, I also recognize that public health and public safety are extremely important in our society,” Carson, a retired pediatric neurosurgeon, told The Hill in a statement.

“Certain communicable diseases have been largely eradicated by immunization policies in this country and we should not allow those diseases to return by foregoing safe immunization programs, for philosophical, religious or other reasons when we have the means to eradicate them,” he added.

That’s right. Back in February, Dr. Carson opposed religious and personal belief exemptions to vaccine mandates. Last winter, he published an extensive statement in which, while acknowledging the issue of personal freedom, nonetheless came down on the side of vaccine mandates, stating:

I am very much in favor of parental rights for certain types of things. I am in favor of you and I having the freedom to drive a car. But do we have a right to drive without wearing our seat belts? Do we have a right to text while we are driving? Studies have demonstrated that those are dangerous things to do, so it becomes a public safety issue. You have to be able to separate our rights versus the rights of the society in which we live, because we are all in this thing together. We have to be cognizant of other people around us and we must always bear in mind the safety of the population. That is key and that is one of the responsibilities of government.

I am a small-government person, and I greatly oppose government intrusion into everything. Still, it is essential that we distinguish between those things that are important and those things that are just intruding upon our basic privacy. Whether to participate in childhood immunizations would be an individual choice if individuals were the only ones affected, but as previously mentioned, our children are part of our larger community. None of us live in isolation. Your decision does not affect only you — it also affects your fellow Americans.

This was an eminently reasonable position, acknowledging the balance between individual rights and how they can be constrained when an individual’s choices affect other people. Perhaps that’s why it inspired this meme on an alternative medicine and antivaccine Facebook page called Thug Health:

Back in March 2015, antivaccine activists detested Ben Carson because he supported reasonable vaccine policies.

Back in March 2015, antivaccine activists detested Ben Carson because he supported reasonable vaccine policies.

How times have changed! Fast forward to September and Carson’s response to Tapper’s question:

Well, let me put it this way. There has — there have been numerous studies, and they have not demonstrated that there is any correlation between vaccinations and autism… This was something that was spread widely 15 or 20 years ago and it has not been adequately, you know, revealed to the public what’s actually going on…

This was technically correct. Tepid, but technically correct, although I don’t know what the heck Carson meant about “this” not having been “adequately revealed to the public what’s actually going on.” It’s not as though it hasn’t been widely publicized that science does not support the claim that vaccines cause autism and that Andrew Wakefield’s research was fraudulent. Then, whether it’s because he didn’t want to attack Trump or didn’t want to upset the Republican base (perhaps both) Carson went to undermine what he just said:

Vaccines are very important. Certain ones. The ones that would prevent death or crippling. There are others, there are a multitude of vaccines which probably don’t fit in that category, and there should be some discretion in those cases.

First of all, as Tara Haelle pointed out, all the vaccines on the current CDC schedule prevent death and severe morbidity. Which ones does Dr. Carson consider “discretionary”? I’d love to hear his answer. Later, after Trump once again channeled Jenny McCarthy and her “too many too soon” misinformation, in which it is claimed that children are receiving too many vaccines at too high a dose at too young an age (or, as Trump has put it, “monster shots”) and it is advocated that vaccines be delayed and spread out, Carson actually bought into this antivaccine gambit, saying, “But it is true that we are probably giving way too many in too short a period of time, and a lot of pediatricians now recognize that and, I think, are cutting down on the number and the proximity in which those are done.” The only pediatricians who “recognize that” are antivaccine pediatricians like “Dr. Bob” Sears and antivaccine-sympathetic pediatricians like Dr. Jay Gordon. Delaying and spreading out vaccines just prolongs the time when children are susceptible to vaccine-preventable diseases without any benefit.

Basically, Dr. Carson flubbed a chance to hit a home run defending vaccines. Whether it was his fear of Trump or his fear of his own base, he equivocated, parroted one antivaccine talking point (“too many too soon”) and in the end refused to tell Trump to his face to stop spewing antivaccine misinformation. It was an epic fail.

The Disneyland measles outbreak versus “parental rights”

Why did Ben Carson fail? Why did he flip-flop so blatantly, basically ignoring his strong past support for vaccines? From my perspective, the answer comes from one other statement Dr. Carson made during his response to Tapper:

But, you know, a lot of this is—is—is pushed by big government. And I think that’s one of the things that people so vehemently want to get rid of, big government.

Bingo! If you want to know why antivaccinationism has found another home among small government conservatives and why neither of the two physicians (Ben Carson and Rand Paul) standing on the stage with Donald Trump was willing to tell him in no uncertain terms that he should stop spreading misinformation about vaccines, there you have it in that statement. It’s distrust of government. Vaccine mandates come from government, and that’s why resistance to vaccine mandates resonates strongly among the Republican base. Antivaccine views are relatively uncommon, regardless of politics, but the concept of “health freedom” provides a banner that antivaccinationists can wave that will draw support from small government conservatives. Thus, freedom from vaccine mandates becomes conflated with “freedom.”

All of this might have remained fairly quiescent, lurking under the surface in Republican politics but not bubbling up, were it not for two factors: The Disneyland measles outbreak and, of course, Donald Trump. Given the concern over pockets of low vaccine uptake, mostly in affluent areas, California had been for years trying to tighten up its requirements for exemptions from school vaccine mandates. California Bill AB 2109, for example, was passed a couple of years ago and required parents seeking personal belief exemptions to school vaccine mandates to be counseled by a physician or certain other allied health professionals about the risks of leaving their child unvaccinated. The idea was to make it just a bit more difficult than signing a sheet of paper for parents to claim a personal belief exemption. Unfortunately, Governor Jerry Brown, no conservative he, neutered the law by adding a signing statement requiring the California Department of Public Health to allow parents claiming a religious exemption simply to sign the form without a physician’s signature.

Then came the Disneyland measles outbreak.

Alarmed at this outbreak, California Senators Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica) introduced SB 277, a bill designed to eliminate all non-medical exemptions. When it was first introduced, I didn’t think it had a prayer of passing. This was, after all, California, home to many antivaccine celebrities and pediatricians, not to mention entitled affluent elites who don’t think their children are vulnerable to vaccine-preventable diseases. Yet pass it did this summer. It is now law.

There’s no doubt that the Disneyland measles outbreak produced a seismic shift in attitudes toward vaccine mandates. Before, it was unimaginable that a bill like SB 277 would ever become law. Unfortunately, the SB 277 debate also had the unintended and potentially damaging consequence of recasting school vaccine mandates as an issue of “freedom” versus big government such that what happened in the Republican debate and what various Republicans have been saying about vaccine mandates have taken a disturbing turn. For instance, at the debate itself, Rand Paul was also asked to respond to Trump, and this is what he said:

…So I’m all for vaccines. But I’m also for freedom. I’m also a little concerned about how they’re bunched up. My kids had all of their vaccines, and even if the science doesn’t say bunching them up is a problem, I ought to have the right to spread out my vaccines out a little bit at the very least.

This is of a piece with earlier this year, when Rand Paul got into a rather testy exchange with an CNBC reporter (only the first 2:20 min are about vaccines):

Notice how sarcastically Paul started out, sneering, “I guess being for freedom would be really unusual.” Personally, I think Paul’s most telling remark came near the end of the vaccine segment, when, clearly irritated by the reporter’s insistence on pursuing questions about vaccine choice, Rand Paul replied with petulant annoyance, “The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” See what Rand Paul let slip? It’s an attitude that is all too common, namely that the parents own the children and that parental “rights” trump any rights children might have as autonomous beings. The right of the child and any public health considerations are subsumed to parental “freedom to choose” and “parental rights,” with children viewed, in essence, as their parents’ property, to do with as they will.

As for the rest of the interview, it contained much of the same old antivaccine nonsense. Paul repeated the antivaccine trope against the birth dose of hepatitis B vaccine as being not indicated because it’s a sexually transmitted disease, even though hepatitis B is transmitted by more than just sex. This trope was an obvious ploy to outrage parents by telling them that they’re being “forced” to have a vaccine for a sexually transmitted disease as though they were immoral. We also learned that Paul delayed vaccines for his children, thus leaving them vulnerable to childhood diseases longer than they needed to be, just like many of the vaccine averse. He even repeated his claim that vaccines cause neurologic injury, even though, as a physician, he should know damned well that this question has been studied time and time and time again, with the overwhelming scientific consensus being that vaccines do not cause autism, neurodevelopmental disorders, or “profound mental disorders.” And through it all, to Paul vaccine “choice” was all about “freedom.” It’s clear to me that Paul holds antivaccine views, maybe not to the same extent and depth (if you can call it that) as Donald Trump, but he definitely has antivaccine tendencies.

As a result of these sorts of attitudes among the Republican base, several of the candidates now express similar views on school vaccine mandates. New Jersey Governor Chris Christie, for instance, has sounded a lot like Ben Carson in advocating a “balanced” approach to vaccination in which “not every vaccine is created equal and “not every disease type is as great a public health threat as others.” He was forced to backpedal, but he did try to pander. He just got burned doing it.

Meanwhile, Carly Fiorina believes:

No, I don’t believe the federal government should mandate immunizations. But I think that state governments can allow public schools to say that a child who hasn’t been immunized against an infectious disease that poses a public health risk can’t come to school. And of course there’s some immunizations that don’t have anything to do with public health. Not all immunizations are the same. There’s a big difference between an immunization for measles and HPV.

She repeated similar sentiments as recently as last month, along with ignorance in general about vaccines on the CDC schedule.

Of course, the federal government does not “mandate” school immunizations. The CDC simply publishes recommendations; it is individual states that decide which vaccines are required for school. But note how she’s sounding like Ben Carson as well in equivocating about some vaccines without actually stating which ones she’d support not making mandatory.

Again, in fairness, several of the Republicans still come down strongly in support of school vaccine mandates, including Gov. Bobby Jindal, Sen. Marco Rubio, Sen. Ted Cruz, and Gov. Scott Walker. Unfortunately, the top two candidates at the time of the debate do not, and one of them (Trump) is a longtime antivaccine loon of the looniest variety.

The politicization of school vaccine mandates?

Support for vaccination used to be a solidly bipartisan affair, with politicians of all political stripes strongly supporting it. To a large extent, it still is a solidly bipartisan affair, and that’s a good thing. For instance, in my own state, there was generally solid bipartisan support for a rule change similar to California AB 2109 requiring counseling by a local health worker for parents seeking personal belief exemptions, particularly from our Republican Governor Rick Snyder. However, the conflation of “personal freedom” and “parental rights” with the “right” to refuse vaccinations for one’s children by the antivaccine movement has been one of the most effective rhetorical tools wielded thus far by antivaccinationists, so much so that it has percolated its way up from below to affect the statements and positions of Republican Presidential candidates. I even find that my very own state senator, Patrick Colbeck, panders to antivaccinationists.

Donald Trump is antivaccine. Of that there is no doubt. Given his current popularity, his presence makes it easier for other candidates to mouth less extreme variants of the same nonsense that he does and appear “reasonable” by comparison. Unfortunately, however, over the last several years antivaccinationism has found a home among conservatives and libertarians such that when Ronald Bailey of Reason.com wrote an article supporting vaccine mandates the backlash from his libertarian allies was swift and harsh. Meanwhile, antivaccine advocates like “Dr. Bob” Sears routinely invoke the same sort of language of “freedom” in opposing SB 277, even going so far as to liken vaccine mandates to Hitler’s fascism.

Partisan politics can never be eliminated completely from any issue of importance to society. It’s the nature of our government and society. However, certain issues have garnered a strong bipartisan consensus because of their extreme importance to society. Vaccination policy has traditionally been one of those issues. What worries me about the conflation of school vaccine mandates with “big government” and of personal belief exemptions to “freedom” and “parental rights” is that, in the current political climate, it threatens to undermine that bipartisan consensus by making support for vaccination mandates more a partisan issue than a public health one. If that happens, we’ll all suffer, starting with our children.

That‘s why the Republican debate scared me.
 
 

Posted by David Gorski

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