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Saturday, January 21, 2017

Trump v. Science

Many posts have discussed Trump's support for the discredited notion that vaccines cause autism.  (He also has a bad record on disability issues more generally.) The story that Trump might appoint anti-vaccine activist Robert F. Kennedy Jr. to head a presidential commission -- whether on vaccines or autism -- has provoked widespread reactions.

 My position is firm: there is no link and I also believe there is no plausibility to such a link. My position is mostly based on the scientific literature, together with my perspective as an autism father witnessing first-hand the impact of this condition on Rachel and our family.
From his loose relationship with facts, to his denial of climate change, his low-opinion of the National Institutes of Health, and his meeting with an anti-vaccine leader, Trump has signaled that his administration will not just challenge proven scientific principles, but also undo the significant science policy progress of President Obama.
Enter the #USofScience hashtag. Researchers are using Inauguration Day to stand up for science, filling social media with celebratory comments about discoveries, debunking some of Trump’s anti-science claims, and reminding the public that many of our favorite inventions came from basic research. It’s the nerdiest hashtag to watch today.
At Respectful Insolence, Orac writes:
One of the retorts I heard when I wrote about Robert F. Kennedy Jr. meeting with Donald Trump a week and a half ago was that the commission on vaccine safety and/or autism that he might or might not have been asked to chair, was that this wouldn’t matter. That federal vaccine policy is based in law and regulations, and that unless Trump spends political capital changing those we don’t have any reason to be worried. Of course, that’s only partially true. Yes, Trump can’t just replace members of the Advisory Committee on Immunization Practices (ACIP) with Andrew Wakefield, Robert F. Kennedy, Jr., Barbara Loe Fisher, and a gaggle of other prominent antivaccine activists because there is a rigorous nominating process for membership, and vacancies are staggered, so that it takes several years to turn the membership over. It’s also true that school vaccine mandates are a matter of state, not federal, law; Trump can’t change 50 state laws. On the other hand, as was noted on STAT News, Trump can appoint a CDC director and agency staffers who have antivaccine proclivities, and such a director could change CDC priorities and policies. If he’s willing to spend political capital, he could conceivably work with Congress to change or eliminate the Vaccine Court. He could cut back funding for the Vaccines For Children program or Section 317, a CDC-administered federal program that pays for vaccines, epidemiology, science, surveillance, the management of outbreaks, and more and has been called the “backbone of the US Immunization Program.”
So, what Trump can do to vaccine policy is limited, at least initially. However, that doesn’t mean he can’t still do enormous damage. There’s a reason why public health officials were appalled at his having met with RFK Jr. and would have been appalled had they known about his meeting with Andrew Wakefield before the election, and it’s Presidential bully pulpit that Trump will have beginning this afternoon. As Olga Khazan wrote the other day in The Atlantic, there is a shadow network of doctors who encourage vaccine hesitancy who could be empowered by a President who openly questions vaccine safety based on no evidence.