From less vaccinations to physician burn-out, doctors fear the worst under Trump and Kennedy‘s vision for health
Published November 26, 2024 5:15AM (EST)
Former Republican presidential candidate Robert F. Kennedy Jr. speaks ahead of a live interview with US commentator Tucker Carlson and former US President and Republican presidential candidate Donald Trump, during the finale of the Tucker Carlson Live Tour at Desert Diamond Arena in Glendale, Arizona, on October 31, 2024. (PATRICK T. FALLON/AFP via Getty Images)
Since Joseph Ladapo’s appointment as Florida’s surgeon general in September 2021, the vaccination rate for essential childhood immunizations among kindergartners has plummeted from 93.3 percent to a troubling low of 90.6 percent, marking the lowest level recorded in over a decade. Analysts attribute this significant decline, in part, to Ladapo’s controversial public health policies.
Amid a troubling measles outbreak in Florida, Ladapo boldly contradicted established medical guidance by neglecting to advise parents of unvaccinated children to seek vaccinations or keep their children at home. In a stark divergence from medical consensus, he publicly discouraged parents from vaccinating their children against COVID-19 in 2022, even calling for a moratorium on mRNA vaccines for all age groups.
Pediatricians across the nation are deeply concerned that current trends in vaccination rates, which are already declining, could worsen should Robert F. Kennedy Jr. secure the position of Secretary of Health and Human Services. Beyond the immediate implications for children’s health, there exists a broader concern about an erosion of trust in science and medicine that has the potential to inflict lasting damage on public health.
“Positions on vaccines represent a discounting of medicine and science,” stated Jeffrey Goldhagen, a professor of pediatrics at the University of Florida College of Medicine in Jacksonville, Florida, in a recent interview. “This discounting of medicine and science transcends vaccines, extending to, for instance, Kennedy’s support for hydroxychloroquine as a COVID treatment. The concern regarding RFK extends well beyond vaccines; they are merely the visible tip of an iceberg symbolizing a troubling nihilism or denial of both medicine and public health.”
Consequently, Kennedy symbolizes a potential “dismantling” of the public health infrastructure, which is an agenda seemingly endorsed by Trump. Recently, Trump remarked that Kennedy would work to “restore” public health “agencies” to adhere to the “traditions of Gold Standard Scientific Research” in an effort to “Make America Great and Healthy Again.” However, such a restoration could jeopardize crucial programs essential for protecting child health.
“Vaccines are the tip of the iceberg — an iceberg that represents a nihilism or denial of medicine and public health,” Goldhagen reiterated. “We witnessed the ramifications of this mindset with the crisis in Samoa.”
In 2018, the tragic events in Samoa serve as a stark warning regarding vaccine hesitancy and misinformation. Two infants died after nurses mistakenly mixed the MMR (measles, mumps, and rubella) vaccine with an expired muscle relaxant, prompting local authorities to temporarily halt the vaccination campaign. Concurrently, Kennedy’s organization, Children’s Health Defense, amplified false narratives regarding vaccinations throughout the island. A year later, the consequences were dire, as measles infections surged, affecting 57,000 Samoan individuals and resulting in 83 deaths, many of them children.
This situation marks a devastating regression to a time when measles deaths in the United States numbered in the thousands during the early 20th century. However, by the year 2000, effective vaccination efforts had led to the eradication of measles in the U.S., with no fatalities reported until a tragic incident in 2015 when a woman died due to complications from the disease. The contagious nature of measles cannot be understated; rapid transmission can occur through simple actions like coughing, talking, or even being present in the same room. It is estimated that the virus can infect up to 90 percent of unvaccinated individuals who come into contact with it.
Fortunately, this sequence of events can be altered. The MMR vaccine has proven to be exceedingly effective and safe. With two doses, nearly 99 percent of people gain immunity to the infection. Though the MMR vaccine was first introduced in 1963, it wasn’t until 1980 that all 50 states implemented laws mandating measles immunization for school attendance.
“Even a minor reduction in MMR vaccination rates can escalate the risk of community-level measles transmission, posing significant dangers not only to the unvaccinated but also to those who are vaccinated,” explained Dr. Dean Blumberg, chief of pediatric infectious diseases and associate professor in the Department of Pediatrics at the University of California, Davis, in a recent discussion. “Vaccines significantly lower the risk of infection; however, they are not infallible.”
Notably, childhood vaccination rates nationally are on a downward trajectory — encompassing diseases beyond measles.
“I, along with numerous colleagues, harbor significant concerns regarding the potential resurgence of polio in the U.S.,” Goldhagen remarked. “If we fail to maintain adequate vaccination levels essential for herd immunity, we risk exacerbating this public health issue.”
In light of Kennedy’s potential nomination, Benjamin Hoffman, president of the American Academy of Pediatrics, issued a statement emphasizing that “vaccines are the safest and most cost-effective way to protect children, families, and communities from disease, disability, and death.”
“Vaccinations prime children’s immune systems, enabling them to recognize and combat serious illnesses, thus safeguarding their health and promoting their ability to learn, grow, and flourish,” Hoffman commented. “Immunization sets the foundation for long-term health, well-being, and successful development into adulthood.”
Hoffman emphasized that a substantial national investment in vaccines is “absolutely essential to sustain healthy communities.”
Yet, as Goldhagen indicated, concerns about vaccines merely scratch the surface of a much larger problem. Blumberg elaborated that the proliferation of vaccine misinformation may erode trust not only in immunization but also in other routine childhood healthcare services. “As vaccine misinformation spreads, parents may begin to question the necessity of other essential care, such as the newborn vitamin K shot, which is not a vaccine,” he noted. “This skepticism can foster increasing tension in the parent-care provider relationship, potentially exacerbating physician burnout, thereby limiting access to care for children.”
Blumberg warned that growing distrust of public health initiatives and scientific consensus could ultimately result in elevated hospitalization rates among children, increased mortality, and heightened strain on an already overburdened healthcare system.
“This trend will necessitate greater public health resources to manage and contain outbreaks, ultimately creating unsafe environments for everyone in the community,” Blumberg concluded. “It’s heartbreaking to witness a decline in child health due to the promotion of fringe beliefs on prominent platforms that enable the spread of conspiracy theories.”
When approached regarding the reasons behind Kennedy’s resonance with segments of the public, Goldhagen pointed out that a majority of parents maintain a pro-vaccine stance.
“The challenge lies in understanding that the scientific foundation underlying vaccines necessitates maintaining high vaccination rates to ensure herd immunity,” Goldhagen explained. “When 10 percent of parents opt not to vaccinate their children, it places the entirety of children and those in their vicinity at elevated risk.”
How can public awareness and education be improved to restore confidence in vaccination programs?
Ation rates decline, the risk of outbreaks for vaccine-preventable diseases increases, which can have dire consequences for public health,” he said.
As discussions around Robert F. Kennedy Jr. potentially leading the Department of Health and Human Services gain momentum, experts worry that his views on vaccines may represent a more significant threat to established public health guidelines. Goldhagen and other pediatricians advocate for a recommitment to science and a return to immunization practices that have historically protected public health.
With the alarming downward trend in vaccination rates, pediatricians and public health officials are calling for increased public awareness and education about the importance of vaccines. They emphasize that restoring confidence in vaccination programs is essential to preventing outbreaks and ensuring the health of future generations.
decreasing vaccination rates in Florida and nationwide pose a considerable risk; experts like Goldhagen and Hoffman urge the public and policymakers to counter misinformation and emphasize the critical role vaccines play in protecting community health and preventing the spread of infectious diseases. As the debate continues, the importance of science-based public health policies has never been more urgent.
