Scientific ignorance never lies very deep beneath the claims of the anti-vaccine movement. Many of its adherents still claim there's a connection between childhood vaccines and autism, even though the connection has been conclusively debunked and shown to have originated in an act of scientific fraud.
You can add Donald Trump and the august Cleveland Clinic to the list of abettors of vaccine denial. They've given a platform to some of the least credible corners of this discreditable movement. President-elect Trump's reputation may not be greatly affected, since as a climate change denier he doesn't have much scientific credibility to lose; but the Cleveland Clinic long has been one of the most respected medical institutions in the land. It will have to work hard to recover from its dalliance with anti-vaxxers.
Let's take the cases in order.
On Tuesday, the noted vaccine denier Robert F. Kennedy Jr., son of the late U.S. attorney general and presidential candidate, announced on emerging from a meeting with Trump that the President-elect had asked him to chair a commission "on vaccine safety and scientific integrity." The Trump team soon denied that the invitation had been issued, but acknowledged that Trump was "exploring the possibility" of such a commission and that he had "enjoyed his discussion with Robert Kennedy Jr. on a range of issues and .. .looks forward to continuing the discussion about all aspects of autism with many groups and individuals."
If you missed what happened there, the Trump team effectively reiterated the discredited claim of a link between autism and vaccination.
Trump has been playing footsie with the anti-vaccine lobby at least since 2012, frequently promoting the nonexistent vaccine-autism link in public statements and tweets. (See the tweet below, dated in March.) Trump doesn't appear ever to have cited a scientific basis for his belief in this link, because there isn't any. Then, in August, during the presidential campaign, he met with a small group of anti-vaccine activists including, amazingly, Andrew Wakefield.
Wakefield is the former British physician whose paper claiming a link between the MMR (measles, mumps and rubella) vaccine and autism has been shown to be fraudulent, costing Wakefield his medical license in Britain. Wakefield later moved to Austin, where he still promotes anti-vaccine claims. After meeting with Trump, Wakefield told Statnews.com that he found the candidate to be "extremely interested, genuinely interested, and open-minded on this issue…. For the first time in a long time, I feel very positive about this."
"The questions Donald Trump has about autism have been answered," says Paul Offit of Children's Hospital of Philadelphia, one of the nation's leading experts on the benefits of vaccination. "When Trump picks Andrew Wakefield and Robert Kennedy Jr. to educate himself, he's picking the wrong people."
Then there's the Cleveland Clinic affair. On Jan. 6, Dr. Daniel Neides, the medical director of the Cleveland Clinic Wellness Institute, published an anti-vaccine op-ed on Cleveland.com, casting doubts on the safety of the flu vaccine and others, implicitly raising the vaccine-autism link, and making other unsubstantiated claims.
Among other things, he questioned why newborns are vaccinated against hepatitis B, "a sexually transmitted disease," since "any exposure to this virus is unlikely to happen before our second decade of life." (The answer is that hepatitis B is not exclusively a sexually transmitted disease, and the most common mode of transmission is, in fact, from infected mother to newborn; the requirement that newborns be vaccinated before they leave the hospital was instituted in 1991 and has led to a significant reduction in the disease ever since.)
This anti-scientific rant by a physician affiliated with the Cleveland Clinic ignited a firestorm. The op-ed was temporarily removed from the website, which is affiliated with the Cleveland Plain Dealer. Neides issued a pro-forma apology in which he claimed, implausibly, to have intended to "be positive around the safety" of vaccines. That despite stating in his original piece: "Here we are, being lined up like cattle and injected with an unsafe product," and "I will stand up and scream … that newborns without intact immune systems and detoxification systems are being over-burdened with PRESERVATIVES AND ADJUVANTS IN THE VACCINES." (Emphasis in the original.) The clinic said Neides would be subjected to "appropriate discipline."
To many medical experts, the Neides episode reflects a disturbing trend in which big medical centers are dallying with "alternative medicine" nostrums because there's money to be made; in fact, these are growing profit centers. Neides' direct affiliation is with the clinic's Wellness Institute, which proffers such nontraditional — and often unproven — treatments as reiki, Chinese herbal therapy, and "holistic psychotherapy."
"Many institutions, including mine, cater to this market for alternative medicine," Offit says. He acknowledges that "there's a place for placebo medicine," but the promoters of alternative therapies often make claims that haven't been scientifically substantiated. When they go off and place their claims in the public record, as Neides did, it's the parent institution's reputation that gets shredded.
Even more important, the public's understanding of the great benefits and relatively meager risks of vaccination is undermined. Wakefield's fraud caused a long-term decline in measles vaccination in his native Britain, and a consequent increase in disease outbreaks. The measles outbreaks that partially originated at Disneyland in 2014-15 were the consequence of a reduction in vaccination rates in some areas of California, in part because state law had allowed too many exemptions from school-age vaccination requirements. (That flaw has since been rectified.)
Yet, entertainment and TV personalities — and politicians — persist in treating anti-vaccine activists merely as people with an alternative viewpoint that should stand shoulder to shoulder with extensively documented scientific studies, as though the jury is still out. It's not. The risk of Trump's science denialism, and the Cleveland Clinic's pursuit of easy dollars, is that they will lead to a costly crisis in public health.
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