We all know by now that President Trump is what we can politely call an impetuous speaker. He speaks without thinking. He boasts. He insults. He speaks authoritatively on things he is factually challenged on. He tells outright lies, sometimes, it seems, to get an intended effect, sometimes out of ignorance. I wrote recently that it would be exhausting and pointless to try to keep up with his verbal offenses, far more productive to concentrate on what he actually does. But when his reckless words can have a real-world effect, we have to take notice. He has the world's biggest pulpit, and he needs to learn to use it responsibly. (Yes, I know, we're asking him to stop being Donald Trump.)
The CDC, Daniel Smith reminds us in The New York Times Review of Books, declared in 2000 that measles had been "eliminated," meaning "that it was no longer endemic to the United States. After that point, any cases that occurred were carried in from outside the country. Outbreaks still happened, but they were minor and restricted to small geographic areas. This changed in 2014."
What happened that year was a series of outbreaks, the most serious of which began in Disneyland and quickly radiated outward to six other states and Canada and Mexico. By the time it was over, 111 people had contracted the disease, half of them children.The Disneyland outbreak, epidemiologists think, originated in the Philippines.Smith again:
But source is different from transmission. When infectious-disease specialists at Emory University analyzed the records of US measles infections between 2000 and 2015, they found that the main reason the virus broke out was "vaccine refusal." To provide a bulwark against a measles epidemic—to establish what is known as "herd immunity"—90 to 95 percent of a population must be rendered immune. Of the nearly one thousand cases for which the researchers had good data, nearly six hundred were unvaccinated and more than four hundred had sought and received nonmedical exemptions from vaccination.
There have always been opponents and critics of vaccinations. But in recent years, the anti-vaccination movement has been getting stronger thanks mostly to the discredited claim that vaccinations are linked to an "epidemic" of autism., a claim happily and ignorantly spread by celebrities such as Jenny McCarthy and well-known names like Robert F. Kennedy Jr. (The number of cases of reported autism have increased dramatically in recent years, but mostly because of greater awareness and an expanded definition of what autism is.)
And now President Trump is getting into the act:
Among the conspiracy theories in regular rotation by President Trump is his insistence there is a connection between autism and vaccines.
He’s made this discredited link — a theory based and popularized on a now-debunked and retracted study by Andrew Wakefield, in which he falsified results — via speeches, tweets, even the Republican debate stage.
On Tuesday, in a conversation with educators and Secretary of Education Betsy DeVos, Trump reiterated these concerns. "So what’s going on with autism?" he asked a teacher in the audience. "When you look at the tremendous increase, it’s really — it’s such an incredible — it’s really a horrible thing to watch, the tremendous amount of increase."
In fact, he's been saying stuff like that for years, long before he decided to run for president. But it's one thing for citizen Trump, or even candidate Trump, to make reckless statements. It's quite another for President Trump to make them. His words from the White House have tremendous weight. He can not only affect where autism research goes, but how strongly people pursue an anti-vaccination crusade, and therefore how many disease outbreaks we have and how strong they are.
The successful vaccination attacks on infectious diseases is one of the great public health stories of our lifetime. That success is already being threatened by the growing number of "anti-vaxers" and the resulting unnecessary outbreaks of disease. And the president is just making it worse.
I grew up in the years before universal vaccination and in an area where people were not, to put it kindly, very health-minded, so I had just about every childhood disease there is, including a bad case of measles. That's a nasty little disease that's potentially fatal. Nobody should want to see its comeback.
(I can hear those little wheels turning out there. Why, this is just like climate change, isn't it, Leo? You have a "consensus of the scientific community" saying one thing and a bunch of deniers ignoring the facts and saying the opposite. Yes, there are similarities but the two situations are actually quite different, which is a subject for another time. Let's just say for now that the climate skeptics get one thing right and one thing wrong. No, there is no such thing as "settled science." But, yes, there is such a thing as "consensus" and it is a valid part of the scientific method.)