Will 2017 be the antivaccine year?

]As hard as it is to believe, I’ve been dealing with the antivaccine movement since at least the early 2000s. Back then, I didn’t have a blog, either this one or my not-so-super-secret other blog, and most of my online activities were restricted to Usenet. For those of you who don’t remember Usenet, which has largely become the province of trolls and spam these days, it is a massive set of online discussion boards on literally thousands of topics. Indeed, I first encountered antivaccine advocates on Usenet and started to learn the sorts of pseudoscientific arguments they make, so that when I started my not-so-super-secret other blog at the end 2004 I was ready. Twelve years later, I keep seeing that everything old is new again, as antivaccine arguments never change. They just keep getting recycled covered in different wrappers.

The relentlessness of proponents of antivaccine pseudoscience has, not infrequently, led me to wonder every so often over the years whether antivaxers were “winning,” until I came to see that in this battle everything is cyclical. Some years the antivaxers would appear to be winning the PR war, while other years they would appear to be in retreat. I don’t have any hard data on this, but one huge victory I perceive is the much decreased use of the oft-maligned (and justifiably so) journalistic trope of false balance, in which editors seemed to think that every story about vaccines required input from the “other side.” Indeed, I cut my blogging teeth, so to speak, complaining about how often people like J.B. Handley, Jenny McCarthy, “Dr. Jay” Gordon, “Dr. Bob” Sears, and even Andrew Wakefield himself would show up on television and in news stories about vaccines to give the “other side” of the vaccine-autism manufactroversy. I call it false balance, because there is no “other side” to the “debate” over whether vaccines cause autism. The science has been convincingly settled for quite some time, and, barring new and extremely compelling evidence (which is highly unlikely to be unearthed), it’s far more concise to simply say that vaccines don’t cause autism. In any case, it could be confirmation bias, but over the last five years or more, I’ve noticed far more news outlets willing to state that vaccines don’t cause autism and to forego the once obligatory “other side” in articles and news reports.

Still, I never thought we’d nominate, much less elect, an antivaccine conspiracy monger as President. Donald Trump’s long, sordid history of antivaccine proclivities dating back at least to 2007 has been well documented many times. I never thought we’d see a future President meet with antivaccine activists like Andrew Wakefield on the campaign trail or, even worse, meet with Robert F. Kennedy, Jr. (who never met a bad study blaming vaccines for bad outcomes that he didn’t like) after elected to discuss vaccines. Now, antivaxers expect the Trump Administration to make changes in policy and law to suit their interests, such as abolishing the vaccine court and “draining the swamp” of the CDC. There’s a reason I fear for vaccine policy under President Trump, although, because vaccine requirements are set at the state level, there are limits to what he can do.

Given the election of Donald Trump as President, there’s no doubt that antivaxers feel emboldened, and, when combined with other trends, there is reason for concern. Even now, fake news stories are circulating claiming that the FBI raided the CDC in the middle of the night using the “CDC whistleblower’s” charges as a pretext and that President Trump ordered all vaccine-related information off the CDC website by February 18 and enacted a 90-day ban on childhood vaccines. Meanwhile, health organizations are urging Trump to back vaccine science. That’s something that’s never been seen before, to my knowledge: The need to petition a sitting President to accept the science of vaccines. There’s good reason why some are now openly asking whether antivaxers are winning.

I started thinking about this topic in response to an op-ed published earlier this month in the New York Times, by a pediatrician at Baylor College of Medicine and director of the Texas Children’s Hospital Center for Vaccine Development entitled “How the Anti-Vaxxers Are Winning.” Dr. Hotez, for those of you not familiar with him, is fast becoming the new Paul Offit in the eyes of the antivaccine movement. I mean that as a compliment, of course. If antivaxers view Paul Offit as Darth Vader, Lord Voldemort, and the Dark Lord Sauron all rolled up into one, they’re starting to view Dr. Hotez as Darth Vader, at least, thanks to his staunch advocacy for vaccines as the best means to protect children from deadly diseases. That’s a good thing, as is how much antivaccine activist J.B. Handley hates Dr. Hotez. I probably only qualify to them as one of Sauron’s orcs. (Meanwhile some antivaxers seem to think that Dr. Hotez is actually Dan Rather, something that amuses me to no end.) Dr. Hotez isn’t alone, either. Last month, Ford Vox wrote an editorial, “Under Trump, the anti-vaxxers might just win“, pointing to the antivaccine article published by the director of the Cleveland Clinic Wellness Institute as an example.

In his NYT op-ed, Dr. Hotez begins with this grim appraisal:

It’s looking as if 2017 could become the year when the anti-vaccination movement gains ascendancy in the United States and we begin to see a reversal of several decades in steady public health gains. The first blow will be measles outbreaks in America.

Measles is one of the most contagious and most lethal of all human diseases. A single person infected with the virus can infect more than a dozen unvaccinated people, typically infants too young to have received their first measles shot. Such high levels of transmissibility mean that when the percentage of children in a community who have received the measles vaccine falls below 90 percent to 95 percent, we can start to see major outbreaks, as in the 1950s when four million Americans a year were infected and 450 died. Worldwide, measles still kills around 100,000 children each year.

The myth that vaccines like the one that prevents measles are connected to autism has persisted despite rock-solid proof to the contrary. Donald Trump has given credence to such views in tweets and during a Republican debate, but as president he has said nothing to support vaccination opponents, so there is reason to hope that his views are changing.

Here’s where I’ll be more grim than Dr. Hotez. No, Donald Trump’s views are not changing. He’s been remarkably consistent in his view that vaccines cause autism at least since 2007, and, if there’s one thing we know about Donald Trump, once he’s latched on to a conspiracy theory, he doesn’t change his belief in it. My guess is that vaccine policy just isn’t a priority right now. We can only hope that his advisors manage to keep him distracted enough that he doesn’t turn his attention to it. Again, fortunately, vaccine policy is mostly made at the state level, with the CDC providing the recommendations that most states follow.

Dr. Hotez also notes a litany of other issues, such as Andrew Wakefield’s propaganda-film-disguised-as-a-documentary VAXXED and how President Trump might have proposed setting up a vaccine commission with RFK Jr. as the chair as reasons to be concerned, before launching into discussion of data concerning vaccine exemption rates in Texas that he wrote about in PLoS Medicine that was reported in December . In the past, Hotez has characterized Texas as the “center of the antivaxxer movement,” and his PLoS Medicine article shows why. I discussed the article in detail before under the title When the next big outbreaks happen, they’ll probably happen in Texas, and they quite possibly will. The reason is a massive 19-fold increase in the number of personal belief exemptions since 2003, a trend that shows no sign of stopping.

It’s a common misconception that antivaccine views and vaccine-hesitancy are primarily the provenance of crunchy coastal liberals. They’re not. As I point out frequently, antivaccine views are the pseudoscience that transcends political views. Unfortunately, we very well might be seeing evidence of that in Texas when the next measles outbreaks happen there. Donald Trump’s antivaccine views could well resonate in a bipartisan fashion, should he choose to indulge them.

Just as antivaccine views cross political boundaries, so, too, does support for vaccine mandates. That doesn’t mean, however, that there isn’t reason for concern, though, as the strength of support is weaker than I’d like to see, as Steve Novella pointed out. What most concerns me is that, with the election of Donald Trump, support for vaccine mandates, once a nonpartisan issue, is becoming increasingly politicized, with the right wing becoming the antivaccine political wing and representing school vaccine mandates as assaults on “freedom.” Worse, there’s a lot that Donald Trump can do to undermine support for vaccines.

Will 2017 be the year of the antivaxer?

Normally, when I see the antivaccine movement apparently in ascendancy, as I double down my efforts to defend science, I can also reassure myself that the antivaccine movement is a fringe group and that, contrary to the case a decade ago, the press has for the most part learned not to fall into the false equivalency trap and instead to state consensus science correctly when doing stories about autism or vaccines. With the discrediting of Andrew Wakefield as a fraud my perception has been that, overall, science is slowly winning the battle over vaccine hesitancy. Sure, there have been bumps along the way, but my perception has been that the overall trend has been in the right direction, particularly given laws like SB 277 in California, which bans nonmedical exemptions to school vaccine mandates and how others states have been considering similar legislation. Now we have a President who says the same sorts of things that antivaccine activists do and has met with their heroes. We’re in uncharted territory, as far as I’m concerned, and I don’t know what will happen next.

Here’s one other example I like to give of the change since my early days as a blogger. Several years ago, I used to dread April, which is Autism Awareness Month, because I could, usually beginning on March 30 or 31, count on seeing Jenny McCarthy, J.B. Handley, and the other usual antivaccine suspects in the media touting the pseudoscience blaming autism on vaccines, largely because media outlets would do stories on autism for the month and inevitably feel the need to cover that angle. Over the last few years, I’ve noticed that these sorts of Autism Awareness Month stories have become rare to nonexistent. I often no longer notice when March 31 or April 1 rolls around. Not this year. I don’t think it’s a coincidence that antivaccine activists have planned a March on Washington called Revolution for Truth on March 31, 2017.

Here’s its “call to action.” Predictably, the webpage invokes our Founding Fathers and the Declaration of Independence. (Antivaxers do love doing that.) On their Facebook page, the organizers declare:

On Friday, March 31, 2017, concerned individuals from across America will join with health care professionals in Washington D.C. to defend parental rights and civil liberties, including freedom of thought, speech and conscience. We are uniting to call out the corporatized mainstream media for manufacturing “fake news” that distorts the truth about environmental toxins, unsafe food and vaccine risks, which endangers our right to know and freedom to choose how we protect our health.

We are Taking a Stand for Truth and Freedom in Washington D.C.

To protest the corporatized mainstream media’s biased coverage and demonization of anyone who advocates for safer vaccines or defends the legal right to make informed, voluntary vaccine choices.

To protest the exploitation of the people by the chemical and pharmaceutical industries that have poisoned our environment and compromised our health for profit.

To protest the liability shield that Congress has given to drug companies to protect them from accountability in a court of law when government mandated vaccines injure or kill us or our children.

We are calling on our elected representatives in state legislatures and in Congress to protect our parental rights and civil liberties and to restore Truth, Integrity, and Transparency in Government agencies responsible for ensuring the public health and safety in America.

Join us IF you believe that you – not Big Pharma or the government – should decide what is best for you and your children’s health.

Join us IF you recognize that the corporatized mainstream media is ignoring and withholding the truth when it comes to the evidence that our environment and our food and vaccine supplies have been seriously compromised.

The speakers there will include a veritable rogues’ gallery of antivaccine pseudoscience supporters, including Trump’s new BFF RFK Jr. giving the keynote address. Joining him will be Barbara Loe Fisher, Minister Tony Muhammad, Del Bigtree, Brian Hooker, Paul Thomas, Judy Mikovits, Toni Bark, Marcella Piper-Terry, Kent Heckenlively, Diane Hennacy Powell, Sheila Lewis Ealey, Ty Bollinger, Diane Hennacy Powell, Jennifer Margulis, and Robert Moxley.

Now, I know what you’re thinking. Antivaccine activists did the same thing nearly nine years ago, then led by Jenny McCarthy and Jim Carrey, with a march called Green Our Vaccines. Nothing came of it, even though Jim Carrey was a big star then and Jenny McCarthy was a C- to B-list celebrity. This year the biggest celebrity at the march will apparently be RFK Jr. On the other hand, back in 2008 antivaccine activists didn’t have someone sympathetic to their views, someone who speaks their language, in the White House. Vaccine mandates hadn’t become a partisan issue, with libertarian-leaning Republicans like Rand Paul insisting on “health freedom” and “parental choice”. Congress was a lot less likely to be receptive. It could well be that this demonstration fizzles too, just like its predecessor in 2008, but the wild card remains the occupant of the White House, coupled with the sea change in our politics during the intervening nine years.

To be honest, I don’t know whether antivaxers are “winning” or not. That might be a cop-out, but in my defense I can only point out that, even taking the long view as I have before, circumstances have never been as they are now. There are certainly reasons to be pessimistic, not the least of which is our President. However, not all the news is bad, and I know that vaccine science will be one of the top issues that scientists and science advocates will defend. I also know that Trump can’t wave a magic wand and impose his will on 50 diverse states.

What I do know is that 2017 will be a time of peril, given how energized the antivaccine movement has been by the election of President Trump. I also know that science advocates have to do everything in our power to defend and strengthen vaccination programs. After all, if antivaxers are winning, our children are losing.