Dear Editor,
Dreaded diseases that we have forgotten about because vaccines have eliminated them are threatening to return.
Along with public health and sanitation efforts, vaccines are the single most lifesaving interventions in the history of medicine. Before vaccines, 10% of infants were dying of what are now preventable diseases; 30%-40% of children did not live to their 5th birthday, dying of preventable infectious diseases. Today the death rate is 95% lower. Walk through any cemetery in Vermont and look at the little headstones. Most are the graves of young children who died of preventable diseases.
I’ve been a pediatrician long enough to have cared for infants with pertussis, babies who cough so hard and frequently that they often stop breathing. They can’t eat, they can’t sleep and it lasts for weeks to months. It is heartbreaking because there is nothing we can do for them, except put them on a respirator as a last resort. I lost a patient to chicken pox in the ‘80s. My teachers told me about rubella-associated birth defects, deafness and sterility from mumps, and perhaps more than any other disease, the ravages of polio. Summer epidemics of polio left behind death, children in iron lungs to breathe for them, paralysis, a lifetime of disability.
Vaccines have largely relegated these diseases to the past. But political forces now threaten to resurrect them and their ravages for no good reason. President-elect Trump told Time magazine in an interview in late November that he would consider getting rid of some vaccines for children, “if I think it’s dangerous, if I think they are not beneficial.” He has repeated the disproved association of MMR vaccine (measles, mumps, rubella) with autism. The paper that speculated on this association in 1998 was retracted by the medical journal, The Lancet, and its author, Andrew Wakefield, who continues to promulgate this dangerous lie, has been stripped of his medical license.
Trump’s nominee to run the Dept. of Health and Human Services, RFK Jr., has suggested the polio vaccine might have caused a wave of cancers “that killed many, many, many, many, many more people than polio ever did.” And he has said the idea that the vaccine resulted in a drastic decline in polio cases is “a mythology” that is “just not true.”
These statements and conviction are demonstrably false and engender distrust of the medical profession and public health. And the lawyer who advises RFK Jr. is going to request that the FDA review the polio vaccine and suggest it be removed from the market.
While RFK Jr. recently said he wasn’t going to take away anybody’s vaccines, he also said, “People ought to have a choice, and that choice ought to be informed by the best information.”
In fact, Trump and RFK Jr. oppose school vaccine mandates, leaving parents to decide whether to vaccinate their children. But if even a small percentage of parents decide not to immunize their children, our herd immunity will fail, and these diseases will return. Leaving vaccine decisions up to each state’s health department will likewise guarantee the return of these diseases.
Consider the injected polio vaccine used in the U.S. It helps the immune system recognize the virus and fight it off before it gets to the nervous system and causes paralysis and death, but it doesn’t stop transmission of the virus. Vaccinated people can still carry and shed the virus in their stool. Though not ill with polio, they can be a reservoir of the polio virus that can easily infect the unvaccinated.
When a national immunization system breaks down, as it did when the Soviet Union collapsed in 1989, infectious diseases quickly surge back. Diseases as horrible as diphtheria killed thousands (more than 140,000 cases and more than 4,000 deaths).
We are always swimming in a microbial sea and vaccines are our lifeboats. We’re all in this together. Vaccine success depends on a social contract we have all adhered to for more than 70 years.
Without immunizations and robust public health measures, children will die. I worry about unvaccinated children spreading dangerous infectious disease to vulnerable populations: newborns before their routine first vaccines, children under the age of 1 before they receive their MMR vaccines, children and adults whose immune systems are compromised, the elderly.
Untoward reactions to vaccines rarely occur, and CDC officials monitor a large database where the public, doctors and vaccine makers report vaccine side effects. Surveillance is robust.
Although Trump is known for his frequent lying, I take him at his word about vaccines, and I worry. We all should worry. His policies are most likely to make America sick again.
Jack Mayer, Middlebury
Editor’s note: Mayer is a retired pediatrician and writer who has practiced in Vermont since 1976.
