President Trump appears poised to betray the antivaccine movement again. Suckers.

As I mentioned yesterday, at NECSS I gave a talk, Whither the antivaccine movement in the Age of Trump? At the time, I only knew the identity of one of the most important public health figures appointed by President Donald Trump, and that’s Scott Gottlieb, the man appointed to be FDA Commissioner. As I noted when his name first came up as a candidate for this position, antivaxers weren’t going to like it. Why? One reason is because Gottlieb is the ultimate pharma shill, if such a thing exists. Another reason is that he is very pro-vaccine. This amuses me when I consider the high hopes antivaxers had for Trump’s election after his long, sordid history of antivaccine sentiments, his having met with antivaccine “hero” Andrew Wakefield during the presidential campaign, and his having met with another antivaccine “hero,” Robert F. Kennedy, Jr., during the transition period.

At the time I gave my talk on Friday morning, I didn’t yet know whom Trump had chosen for CDC Director. If I had, my talk would have been somewhat different (although not too much). It now amuses me to consider that it now appears that Trump has chosen his CDC Director (a post that does not require Senate confirmation). She does not appear to be the sort of person who would be willing to help Trump dismantle the public health system by supporting the idea that vaccines cause autism, supporting dismantling the Vaccine Court, or calling for more bogus antivaccine “research” designed to find nonexistent detrimental health effects due to vaccines. Her name is Dr. Brenda Fitzgerald, and she’s Georgia’s Commissioner of Public Health, a position she’s held since 2011. It’s not official yet, but news reports have indicated that Dr. Fitzgerald is deep in discussions to become the new CDC Director.

To give you an idea of the relief I’m feeling at the moment, you might recall that, when I heard that RFK Jr. was meeting with Donald Trump, I mentioned that the first thought that popped into my mind was that Trump was considering him for CDC Director or some other high profile public health position in the administration. Yet here we are, six months later, and nothing’s become of the “vaccine commission” that RFK Jr. claimed that Trump had offered him, while the FDA Commissioner is the ultimate pro-vaccine pharma shill. Now it appears that we will probably have a pro-vaccine, fairly boring, standard-issue CDC Director, the sort of CDC director that any Republican President might have been expected to appoint:

Fitzgerald is no newcomer to politics. She served as a health care policy advisor to House Speaker Newt Gingrich and U.S. Sen. Paul Coverdell, both Republicans. She twice ran unsuccessfully for Congress, in 1992 and 1994, both time as a Republican.

Gov. Zell Miller appointed her to the state Board of Education in 1996 when he remade the board in hopes it would get along with the state’s first Republican state school superintendent, Linda Schrenko. The chairman of that new board was Johnny Isakson, who is now Georgia’s senior U.S. senator.

Now here’s the interesting thing. She’s quite pro-vaccine. Indeed, as recently as April, she was touting not only her state’s improved vaccination rate, but urging parents to vaccinate their children:

During National Infant Immunization Week, April 22-29, the Georgia Department of Public Health and the Georgia Chapter of the American Academy of Pediatrics urge parents to check with their pediatrician to ensure their child is up-to-date on vaccinations.

“Immunizations are the best way to protect infants and children from childhood diseases, like whooping cough and measles that can be life-threatening at young ages,” said Brenda Fitzgerald, M.D., commissioner of the Georgia Department of Public Health. “It is critical for parents to talk to their child’s doctor to ensure they are up-to-date on immunizations, because no child should have to suffer a vaccine-preventable illness.”

She’s even written opinion pieces with titles like Babies Need Their Vaccines in 2014 (before the Disneyland measles outbreak), in which she rejects antivaccine pseudoscience explicitly:

I’ve heard all the arguments against vaccination. All have been debunked, including the infamous 1980s study in Europe about a similar vaccine for measles, mumps and rubella, and a supposed link – that we now know to be false – to autism, which shattered vaccine use in Europe. Outbreaks now plague the Continent, and here in the U.S., signs of trouble are building.

Pertussis outbreaks in Oregon and Texas and an ongoing outbreak in California should alarm us. In Georgia right now there are 83 confirmed cases of this disease.

And then makes an emotional appeal:

At the Georgia Department of Public Health, our team in immunizations has been preparing for National Infant Immunization Week, which begins today. The team will work to improve Georgia’s resilience to vaccine-preventable disease through increased immunization rates among siblings, caregivers, grandparents and infants. I want to reach our state’s mothers-to-be.

I am a mother. I am vaccinated. And I ask you to join me. Choose to vaccinate first yourself, and then your new baby. Follow the vaccine schedule, and guard against diseases like whooping cough that only you can prevent before baby is born.

As a board-certified obstetrician-gynecologist, I have seen the devastating and painful effects of whooping cough and other vaccine-preventable diseases. I’ve seen mothers who fear every gasp of air might be their babies’ last.

Get vaccinated. Help spread the truth on vaccines, not the diseases they prevent.

These are not the sort of things that someone who is antivaccine or antivaccine-sympathetic write. Nor do people who are antivaccine or antivaccine-sympathetic willingly enforce laws in which only nonmedical exemptions or religious exemptions are permitted, with a notarized state-issued form being the only accepted way of claiming a religious exemption. (Indeed, Dr. Fitzgerald was in charge when the Georgia Department of Public Health changed the rules to require a state-issued, notarized form to claim a religious exemption; presumably she had to sign off on such a major rule change—or at least not oppose it.) Nor would an antivaccine or antivaccine-sympathetic person allow a blog that promotes vaccination, including entries promoting the birth dose of the hepatitis B vaccine, tells parents how to catch their children up on their shots if they fall behind, and urges pregnant women to get their Tdap vaccine.

That sure sounds suitably pro-vaccine to me.

Of course, basically anyone who is involved in public health, especially at a leadership level (particularly at a state leadership level) is pro-vaccine. The reason is simple, and it has nothing to do with “dogma,” as antivaxers will claim. It has to do with science and the fact that vaccines work. They are the single most effective public health intervention conceived by the human mind and made by human hands. They do not cause autism. They do not cause all the horrible autoimmune and other diseases that antivaxers claim. They save lives, lots of lives. Sooner or later, anyone in public health who is intellectually honest, regardless of ideological bent, be it liberal or conservative, comes to that conclusion. The “ideological conformity” in public health officials’ belief in vaccines comes not from brainwashing, but from decades—no, hundreds of years—of evidence.

Interestingly, Dr. Fitzgerald shows characteristics unusual for a Republican politician:

Fitzgerald also drew headlines for a decision to rescind a job offer to a California physician initially offered a job as a north Georgia health director after reports surfaced about controversial sermons he made condemning gay rights and the theory of evolution.

I note that this action resulted in a lawsuit by Dr. Erick Walsh, the pastor fired after what he said in his sermons became known. This article mentions the lawsuit, calling it a violation of religious liberty while conveniently failing to note just what the sermons said, such as:

  • Oprah Winfrey is harboring the spirit of the anti-Christ;
  • The prophet Muhammad, founder of Islam, was influenced by Satan;
  • The devil set up Catholicism;
  • Acceptance of homosexuals is a satanic ploy to destroy America;
  • Rapper Jay Z is a disciple of Satan;
  • Single mothers are ruining their children;
  • Disney movies, which are loaded with violence, sex and magic, are a satanic ploy to split up families;
  • Darwin’s Theory of Evolution is a “satanic belief”;
  • The distribution of condoms to a public in need leads to higher AIDS rates;
  • The pope is the anti-Christ.

OK, I’ll have to give Dr. Walsh the first one. I can accept that Oprah might harbor the spirit of the Antichrist. But all the rest? Wow. In any case, Georgia ended up settling the lawsuit for $225,000. Pesonally, I’d think that these views are incompatible with doing a good job in public health, particularly the belief that condoms can lead to higher AIDS rates, which is just not supported by evidence, and the belief that homosexuality is a sin, but I can see how rescinding a job offer after finding out such information could give the appearance of making a job decision based on religion. Be that as it may, rare is the Republican who would have made such a decision.

I don’t know if Dr. Fitzgerald will be a good CDC Director or not. She seems to have the qualifications, and I can’t find anything egregiously disqualifying in her background. She is definitely pro-vaccine. She doesn’t seem to have the typical conservative Republican hangups about sex, gays, and evolution. Best of all, antivaxers who have bothered to say anything hate her. For instance, Ginger Taylor, who is the Dunning-Kruger Effect personified, posted this to Facebook:

What’s upset her? Dr. Fitzgerald’s’s Babies Need Their Vaccines article! Hilarity! The tears of betrayal following Taylor’s post are delicious. Then, a certain occasional commenter is also very, very unhappy.

So, am I happy with the appointment of Dr. Fitzgerald? “Relieved” is a better word to describe the feeling, although I must admit that it feels better than when Scott Gottlieb was appointed FDA Commissioner. He was basically the least bad of all the known candidates, but he is still a pharma shill who favors deregulation. Dr. Fitzgerald, in contrast, appears to be halfway decent in comparison.

Still, I have no illusions about Trump and vaccine policy. As Dr. Paul Offit wrote a couple of weeks ago, Trump’s budget takes aim at critical public health funding. If it passes, there will be less money for the CDC to do its job, less money to distribute vaccines, less money to intervene in the case of public health threats, and in general, less resources to do its critical job. Whether Dr. Fitzgerald can or would oppose such budget cuts, we have no way of knowing. Why anyone who is serious about public health would want to run the CDC under such circumstances, I don’t know.

Still, for a brief moment, I can’t resist feeling a bit of schadenfreude as I hear the wails of antivaxers who cry, “Betrayal!” Suckers. He conned you, too.