An ongoing dialogue on HIV/AIDS, infectious diseases,
March 19th, 2017
What Health and Human Services Secretary Tom Price Should Be Saying About Required Immunizations
In case you missed it, Secretary of Health and Human Services Tom Price said this past week that the states should make decisions about mandatory vaccination policies.
Here’s the actual clip:
HHS Secretary Tom Price says it should be up to states to regulate whether immunizations are required https://t.co/soyH0YpO5E
— CNN Politics (@CNNPolitics) March 16, 2017
What’s notable here isn’t the content of what he says — the states already make immunization policies — but that he seems to be so carefully parsing his words.
Of course, his reticence might be the result of his belonging to the Association of American Physicians and Surgeons, a group with strong opposition to mandatory immunizations. Or perhaps it’s the well-known views of his boss, who has publicly expressed he’s not so sure about vaccine safety, especially regarding the link to autism.
So in that spirit, if Price is feeling hesitant about expressing his own views, I’m going to offer him some alternative responses to Wolf Blitzer’s queries (plus a few more questions I’ve made up).
Price is, after all, an orthopedic surgeon. Some input from an ID doctor might be welcome, akin to how we assist them in managing a septic hip.
Blitzer: So you believe in immunizations, you believe all children should get a shot for polio, and other diseases?
Neo-Price: Absolutely. We in the Department of Health and Human Services strongly support the state policies that require childhood immunizations. These policies have had a miraculous effect in reducing illness and death, particularly in children, and greatly improve public health for all. Some prevent cancer. They even save money! Talk about a win-win-win-win.
Blitzer: There are some people who argue that it should be up to the parent or parents to decide what’s best for their child. What do you say to them?
Neo-Price: When a policy is good for both the individual child and for society, we have to be firm that it’s enforced. And a critical component of vaccine effectiveness is herd immunity, especially with the most contagious infections such as measles. If we let immunity decline too much in the community, these infections will come roaring back. Let me show you this extraordinary short video:An excellent gif for visualising herd immunityhttps://t.co/OfTnj7HRcH pic.twitter.com/esJN2MKr30
— Educake Science (@educakescience) March 6, 2017
Blitzer: I hear there has been an increase in so called “nonmedical vaccine exemptions” in the United States. What are your thoughts on these?
Neo-Price: Frankly, each nonmedical vaccine exemption is essentially a misguided, selfish decision made by a parent at the expense of both the child’s health and public health. They should be more than strongly discouraged — they should be abolished.
Blitzer: Well said, Secretary! I assume, then, that you do not believe in the link between vaccines and childhood autism.
Neo-Price: Emphatically not. Vaccines are remarkably safe. After the fraudulent paper linking vaccines to autism was published, a torrent of scientific data subsequently found no such link. And the paper, as you know, was subsequently retracted by The Lancet. It’s garbage science.
Blitzer: One last thing before you go — there are some who say the vaccine policies are being set by individuals who have hidden agendas — conflicts of interest with the pharmaceutical industry, or with insurance companies, or are just ivory tower academics who don’t understand “real” people.
Neo-Price: The Advisory Committee on Immunization Practices (ACIP) — which is organized by the Centers for Disease Control, a wonderful government institution — is a prime example of how doctors, scientists, and public health officials can come together for the public good. They carefully review the vaccine safety and efficacy data, and then issue policies that are broadly endorsed. It’s about as good an example as you can find for your tax dollars well spent. Makes me tear up a bit with patriotism just thinking about it.
Blitzer: Thanks very much, Secretary. This has been most educational.
Neo-Price: Thank you for having me on. And let me know if you have any questions about your ACL repair. I am an orthopedic surgeon, after all.
My hunch is that Price will appreciate my articulating his position on vaccines more clearly. You’re welcome.
If not, I’d better watch out — orthopedists are much bigger than ID doctors.
Save
One of the problems I see with mandatory vaccinations is a lack of incentive for pharmaceutical companies to improve vaccines that don’t work very well. Cases in point are IM vaccinations for respiratory disorders. Why should a company spend any money on improving a product that is mandatory? They would have already achieved the holy grail. Any attempt to change a mandatory product is an admission of a less than optimum product pushed on the public. I believe in shared decision making, patient education and truth in advertising…. and I don’t think Tom Price was a good choice for HHS secretary and I did provide my child with childhood vaccinations, and I did offer recommended vaccinations to my geriatric patients when I was still practicing.
But, isn’t one of the cornerstones of capitalism competition? Why wouldn’t a pharmaceutical company try to create an improved vaccine, if it could mean stealing a huge and guaranteed market from a competitor. Is the potential profit not worth the difficulty? I suppose there could be some kind of collusion going on…a “we’ll keep our hands off of DTap if you stay away from MMR” kind of thing, but isn’t that what regulations are for?
I did not know that ‘mandatory’ was one of the cornerstones of capitalism.
The assumption than an improved vaccine (and by what standards?) would lead to a shift in the market for a mandatory vaccine has little precedence.
I still believe in shared decision making, patient education and truth in advertising.
This is an interesting perspective I hadn’t thought of before. I do think uptake of certain vaccines could be improved if the worked better.
Dr. Sax,
Ah, if only secretary (not lower case “s”) Price felt the way you articulated Neo-Price comments above. But alas, he seems to be very focused on garbage science and trading his personal brokerage account in advance of public information. I do think that it would be very valuable for Price to have a meeting with you and your colleagues so he could truly understand the science. How can we find a way to get you in front of him?
Every physician that believes in science should forward the above to Secretary Price. I have already e-mailed him my comments after I heard about his cowardlly statement. His e-mail address: Secretary@HHS.gov
Complaining about him on this website won’t change his attitude, and I doubt that he reads these sort of blogs. Take the two minutes right now and send him the above posting!
Great post!
For a simulation of how herd immunity works:
https://www.theguardian.com/society/ng-interactive/2015/feb/05/-sp-watch-how-measles-outbreak-spreads-when-kids-get-vaccinated