| So this might explain Trump’s use of insurrectionist language: He’s giving himself legal room, and he’s already made clear he loves using statutes from the 18th and 19th centuries, meant for times of war, to expand his own power. “The people who are causing the problems are bad people, they are insurrectionists,” the president told a group of reporters Monday. He added that Newsom, a vociferous critic of the administration’s actions, is “a nice guy” but also “grossly incompetent.”
Border czar Tom Homan has been making the TV rounds, promising arrests for anyone who obstructs Immigration and Customs Enforcement’s ability to do its job—hinting that even public officials might meet a sorry fate.
“Come and get me, tough guy,” Newsom had told Homan, antagonizing him a bit. “I’d do it if I were Tom,” said the president. But like so much of partisan politics right now, all that appears to have been bluster. “There’s no intention to arrest” California’s governor, Homan backtracked yesterday.
RFK Jr.’s big shakeup: Health and Human Services Secretary Robert F. Kennedy Jr. just fired the entire 17-member Advisory Committee for Immunization Practices (ACIP), which reports its findings to the Centers for Disease Control and Prevention, “to avoid conflicts of interest” and to “restore public trust in vaccines.”
“The U.S. faces a crisis of public trust,” writes Kennedy in The Wall Street Journal. “Whether toward health agencies, pharmaceutical companies or vaccines themselves, public confidence is waning. Some would try to explain this away by blaming misinformation or antiscience attitudes. To do so, however, ignores a history of conflicts of interest, persecution of dissidents, a lack of curiosity, and skewed science that has plagued the vaccine regulatory apparatus for decades.”
Kennedy cites the Rotashield incident as an example: “Committee members regularly participated in deliberations and advocated products in which they had a financial stake,” he argues in the Journal. “The CDC issued conflict-of-interest waivers to every committee member. Four out of eight ACIP members who voted in 1997 on guidelines for the Rotashield vaccine, subsequently withdrawn because of severe adverse events, had financial ties to pharmaceutical companies developing other rotavirus vaccines.” This was further confirmed by the HHS Inspector General’s report in 2009.
Some of these now-dismissed ACIP appointees had been selected by former President Joe Biden in January. The last-minute series of appointments seems to have been intended to preserve a pro-vaccine majority on ACIP heading into a potential shift like the one we’re seeing now. But Biden may not have taken into account the degree to which the Trump administration prefers to move fast and break things.
Like with so much of what RFK Jr. peddles, there’s a grain of truth within: The Rotashield incident was disturbing, and increased transparency into advisory committee actions would be good; but an incident from 30 years ago (that was subsequently investigated and rectified) doesn’t necessarily mean the whole advisory board should be thrown out or that all of their decision making is invalidated. And Kennedy relies on strange reasoning at times, objecting to the “exploding” immunization schedule. But the sheer number of doses recommended does not tell us very much about whether those vaccines are safe and valuable, and what types of risks are present.
It’s hard to say how much this actually changes things or how worried you should be: ACIP reviews new vaccines but is also tasked with evaluating existing vaccines. Lots of families already make the choice to deviate from the standard vaccination schedule, mostly in minor ways that don’t really cause significant issues with herd immunity (i.e. delaying a less-important vaccine—think rotavirus or PCV, not polio—by six months or 1 year, or spacing out the doses). The traditional childhood vaccines—polio, MMR, DTaP—still have rather high uptake rates (over 90 percent; higher for polio), and newer vaccines not generally required by public schools like HPV and COVID have high opt-out rates. Though skepticism toward the MMR vaccine has increased at times since the ’90s, uptake is still decently high.
It will probably take a long time for school immunization schedules to drastically change, and parents’ decisions will probably continue to roughly track those requirements; but it is also possible that a new ACIP could overhaul all of this, give parents worse recommendations for how to vaccinate their children that lead to cyclical outbreaks (like measles), or that a showdown could take place where school districts and the federal government are at odds as to what requirements ought to exist.
“I support vaccines,” RFK Jr. said in his confirmation hearings back in January. “I support the childhood [immunization] schedule.” Maybe so, but in his new posting, he has an awful lot of power to alter both requirements and recommendations. Turns out Cabinet appointments have real consequences. |
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