Under Trump, the anti-vaxxers might just win

Editor’s Note: Ford Vox is a physician specializing in rehabilitation medicine and a journalist. He is a medical analyst for NPR station WABE-FM 90.1 in Atlanta. He writes frequently for CNN Opinion. Follow him on Twitter @FordVox. The opinions expressed in this commentary are his.

Individuals on both the left and right in America share a common instinct – an opposition to vaccines. Vaccinations can be a costly imposition, and like taxes, the payoff isn’t always obvious.

Despite the imposition, those in the center have passionately and, until now, successfully advocated for the necessity of vaccinations. But can vaccine acceptance withstand the power of the Presidency?

On the campaign trail, Donald Trump, a real estate developer, entertained libertarians with his theory that spacing out vaccines makes more sense to him than what the carefully studied schedule that the Centers for Disease Control and Prevention and every other legitimate medical authority in our country recommends.

But Trump has joined in his vaccine skepticism with unexpected bedfellows like the Green Party’s Jill Stein. She lent credence to conspiracy theorists who see vaccination campaigns as a scheme invented by profit-hungry corporations.

And now the two ends of the anti-vaccine political spectrum are meeting. The liberal environmental crusader Robert F. Kennedy Jr., a well-known “anti-vaxxer,” informs us that Donald Trump will appoint him to lead a presidential commission on “vaccine safety and scientific integrity.” ( Trump’s team says there had been no decision on a commission or on a role for Kennedy.)

The unholy union of right and left against science has begun – and it threatens to undo years of important pro-vaccination advocacy.

But politicians aren’t the only ones attacking modern medicine. The director of the august Cleveland clinic’s Wellness Institute recently published a column on the news site Cleveland.com that recycled well-debunked theories about how vaccines might contribute to autism.

Facing an enormous backlash from the medical community, the clinic worked rapidly to distance itself from Dr. Daniel Neides, the author of the erroneous column, saying in a statement—misleadingly, it appears –that the doctor published the blog without the hospital’s authorization.

In an article subsequently published on Cleveland.com by Chris Quinn– the news site’s Vice President of Content–Quinn explained that communications staffers at the clinic are responsible for publishing posts on Dr. Neides’ behalf directly to the local news site as part of his wellness blog, which has appeared on Cleveland.com since 2014.

It is easy to see, as demonstrated by this slippery instance, how easily junk science can be introduced into mainstream thought, and blessed—even unintentionally—by officialdom.

It may be perfectly natural and even enticing to suspect vaccines might be a factor when children start to display some of the key behavioral changes associated with autism around the age they begin getting their vaccinations. The idea has a kind of commonsense wisdom about it, in the same way that people are apt to confuse short-term cold weather and long-term climate change.

But as President Obama said Tuesday night, “Without some common baseline of facts” and the belief that “science and reason matter, we’ll keep talking past each other.”

It’s crucial that a bastion of quality medicine like the Cleveland Clinic, with a reputation that people trust, consistently does its part in supporting important public health messages for people who aren’t scientists and doctors.

The same used to be true of the White House, which has a long history of establishing important presidential commissions that have positively influenced public policy. When President Obama established the Presidential Commission for the Study of Bioethical Issues, which published an influential report on ethics in neuroscience, he notably appointed respected scientists and scholars to the body, not a wayward Kennedy.

So what are the baseline facts about vaccines and autism? The latest research finds abnormal brain development associated with autism occurring early in gestation well before birth and the first vaccination. We know that autism isn’t purely a genetic condition, as it isn’t always shared by identical twins. Some aspect of the environment is probably at play, but numerous large analyses rule out vaccines as a factor.

Second-level analyses that eliminate even more variables, like one looking only at Japanese children in order to limit the influence of differing genetics as much as possible, continue to show no relationship between the most contested measles-mumps-rubella vaccination and autism.

Then there’s thimerosal, a mercury-containing preservative that’s used in trace amounts in some vaccines, and which draws much of the suspicion from anti-vaxxer parents. But thimerosal exposures bear no relation to autism onset either. Yet another Cleveland Clinic doctor wrote the foreword to Robert F. Kennedy Jr.’s scare-mongering book implicating thimerosal for a host of childhood problems.

Government ultimately holds quite limited authority over vaccinations. None of us is outright forced to vaccinate; diehards can find alternative schools and alternative careers. And when a state senator in California drafted a bill requiring vaccinations for schoolchildren, the anti-vaxxers attempted to recall him.

That said, Donald Trump’s candidacy and successful election lifted the lid on a whole array of deplorable, but surprisingly widely held beliefs in our country, ranging from white supremacy to denigration of the disabled. It now appears his nods to the fringe made during the campaign may well translate into official acts and policies.

Presidential commissions are serious affairs that address issues of major national importance. Creating such a panel on autism with a leading vaccine skeptic would do enormous damage, regardless of what the commission concludes.

If the fringe on vaccines becomes mainstream, our health will be in grave danger.