As a retired pediatrician, I am extremely concerned about what Robert F. Kennedy Jr., secretary of Health and Human Services, is doing in firing all 17 members of the Advisory Committee on Immunization Practices, which makes recommendations on immunizations.
Replacing them with vaccine skeptics worries me. If the ratio was eight skeptics and 17 traditional scientists, that might have made some sense. Obviously, science requires that we look at alternative points of view.
I don’t doubt that the pharmaceutical companies make an inordinate amount of money off the products that they sell, and maybe we should do something about their profits, but please don’t throw out the baby with the bathwater.
I believe that our immunization programs have been the most important thing in medicine. When I started in the 1970s, we would ask the patient if they had the usual childhood diseases when we did a history and physical. The UCHD were measles, mumps and chickenpox. and it was expected that most children would have those diseases by the time they got out of elementary school.
In my lifetime, tetanus has essentially disappeared due to the tetanus shot, but whooping cough is having a resurgence. We still never put signs on people’s house to quarantine them for whooping cough. This is due to the DTaP (diphtheria, tetanus, acellular pertussis vaccine). The acellular pertussis vaccine is a weakened pertussis vaccine that doesn’t give as robust immunity while giving an acceptable immune response with less severe side effects. We have been able to fine tune this vaccine due to the scientists at ACIP looking at the data year over year and adjusting our recommendations.
Polio has disappeared except in remote parts of the world where we can’t get the vaccines to the population, but I remember in the 1950s where we would have children put on an “iron lung” due to polio. Many died, but if they survived they were crippled to some degree. We still are treating adults my age who survived polio, now with “post-polio” syndrome from their crippling as children. We seldom use the oral (live) form of the vaccine in the U.S. due to rare occurrences of vaccine-associated polio, so we use the injection, which cannot transmit the disease. Another ACIP recommendation.
In my professional life, I have seen epiglottitis (an extremely dangerous/deadly) swelling of the airway due to a bacteria, H.influenzae, and the meningitis caused by the same organism disappear with the introduction of the HIB vaccine. I also remember the one-year pause on the rollout of the vaccine because one of the studies showed a possible problem.
We don’t see cases of pneumococcal meningitis in babies anymore with the use of the Prevnar vaccine, which also reduced the incidence of ear infections and pneumonias.
Rotavirus causes severe vomiting and diarrhea in babies, and the only treatment is rehydration, sometimes orally, sometimes only intravenously.
The first oral vaccine was noted to have rare problems with intussusception, (where the intestine folds in on itself) when it was first released.
No one in the U.S. died, but ACIP was able to recognize what was happening and put a pause on the vaccine, reworked it and adjusted the schedule, making it safe and effective.
I only know one family whose child died of chickenpox when he was given a high dose of steroids for his asthma while he was incubating chickenpox. When his mother found out there was a vaccine being used in Japan for 25 years at that time, she went to Congress and testified about her experience and her son’s death. This helped the vaccine’s release.
I felt the need to write this letter when I saw the wholesale dismemberment of the Advisory Committee on Immunization Practices. While it isn’t perfect, ACIP is a valuable resource for physicians and patients.
My recommendation is that patients ask their medical provider, whether a nurse practitioner, physician assistant, GP/FP, pediatrician, internal medicine or infectious disease specialist any questions they have about immunizations.
I want to maintain a robust scientific resource for the medical community, and I don’t believe this wholesale firing of all the institutional memory of the ACIP is helpful.
I have shared my thoughts with some of the pediatricians in Joplin and they believe pretty much the same as me.