U.S. president-elect Donald Trump’s meetings with anti-vaccination activists risks triggering a disease outbreak by lowering vaccination rates, an infectious disease expert warns.
“When someone takes a public policy position that weakens vaccine programs, they are threatening everybody’s health,” University of Toronto medical professor David Fisman charges. “They are threatening my health.”
Earlier this week, Trump met with vaccination skeptic Robert F. Kennedy Jr. to discuss naming him to a presidential panel on autism.
Kennedy, the son of the late U.S. attorney general and senator, has long argued that vaccines containing the preservative thimerosal may cause autism — a theory that mainstream scientists dismiss — and has advocated for parents to more easily opt out of childhood vaccinations.
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It’s not the first time Trump’s links to vaccine skeptics have been evident. During the campaign, he met for nearly an hour with an anti-vaccination group that included former British doctor Andrew Wakefield. Wakefield was stripped of his licence to practice medicine in 2010 when a British disciplinary panel found that research that he claimed proved a link between the measles, mumps and rubella (MMR) vaccine and autism was “dishonest” and “irresponsible.”
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“I found him to be extremely interested, genuinely interested, and open-minded on this issue, so that was enormously refreshing,” Wakefield told STAT, a medical news service.
In 2014, Trump tweeted his support for the vaccines-cause-autism theory:
But using a big platform like the White House to cast doubt on vaccines could lead to lower vaccination rates, which in turn raises the odds of a dangerous outbreak, Fisman warns.
“I think it’s extremely irresponsible,” Fisman says. “He bears the responsibility for outbreaks and epidemics that occur as a result of these signals, because he’s in a leadership position.”
Society’s resistance to infectious diseases like measles depends on “herd immunity” — having a critical mass of people vaccinated against a disease. The lower the vaccination rates, the more likely an outbreak becomes. The less vaccination is supported, the less common it is likely to be.
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“There is no doubt about what happens when a disease like measles, which is highly, highly infectious, and you decrease vaccine coverage for that disease,” Fisman says. “There is no mystery about what is going to happen next. What is going to happen next is that you’re going to have outbreaks and epidemics.”
A measles outbreak that started at Disneyland in 2014 was traced to the fact that a critical number of parents had refused to vaccinate their children.
Falling vaccination rates in California in that period were connected to a vocal anti-vaccine subculture led by celebrities such as Jenny McCarthy. In 2014, amid a pertussis outbreak in California, the Hollywood Reporter found that schools in affluent parts of Los Angeles had much lower vaccination rates than those elsewhere in the region. Some private preschools had a majority of children unvaccinated, “in line with immunization rates in developing countries like Chad and South Sudan.”
(In the wake of the epidemics, California tightened its vaccination exemption laws, and the state’s vaccination rates are now rising.)
“When anti-vaccinationists get credibility, and when they are actually able to influence policy, vaccination rates drop,” Fisman says. “What happens when vaccination rates drop is that diseases, especially highly infectious diseases like measles and mumps and rubella, resurge. What happens when those diseases resurge is that real children are sickened and real children are killed.”
Fisman predicts a cycle in which increased opposition to vaccination, caused in part by the success of vaccination in keeping dangerous diseases under control until they’ve faded from memory, leads to fresh disease outbreaks. The outbreaks will terrify people and lead to new support for vaccination, “but that comes at the cost of sick kids and potentially dead kids.”
— With files from The Associated Press
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