President-Elect Donald Trump and Vaccines

Trump Tweet on vaccines

What does the United States president-elect have to say about vaccines?

Donald J. Trump has frequently stated that he believes that vaccines can cause autism, as in the Tweets shown here. In one of the primary debates, he dialed back his criticism a bit, stating, “I am totally in favor of vaccines, but I want smaller doses over a longer period of time.” But as Tara Healle, a blogger at Forbes.com wrote, “Vaccines are very precisely manufactured to include only what is absolutely necessary to induce enough of an immune response that the body can protect itself against those diseases. So a smaller dose wouldn’t protect a child. It would stick a child with a needle for no reason at all. And spreading out vaccines? That just increases the risks to the children, including leaving them more susceptible to the diseases for a longer period of time. Trump is not ‘totally in favor of vaccines’ if he doesn’t want children protected from the diseases above as early as possible.”

In contrast, in 2015, Hillary Clinton Tweeted, “The Science is clear: The earth is round, the sky is blue, and #vaccineswork. Let’s protect all our kids. #GrandmothersKnowBest.” Clinton, and President Obama, too, were not always so adamant in refuting a vaccines-autism link. This Mother Jones article notes that in 2008 both politicians, while acknowledging that no link had been demonstrated, called for more research into the question. Presumably, for them and for most of the medical and public health establishment, that question has been asked and successfully answered.

President-elect Trump has vowed to repeal and replace the Affordable Care Act as one of his first priorities, and he seems to have the support of the Republican-held Senate and Congress to do so. Mitch McConnell, Senate majority leader, said today that repealing the ACA “is a pretty high item on our agenda. I would be shocked if we didn’t move forward…” The ACA requires that marketplace insurance policies cover vaccinations, as a preventive health service, without a co-pay and without being subject to policy deductibles. We can’t know now whether the Trump administration will maintain this stipulation in their to-be-proposed replacement for the ACA, but, given Trump’s attitude to business regulations, it is possible to imagine a loosening of expectations regarding insurance practices about immunization.

The Vaccines for Children program, which provides free vaccines to Medicaid-eligible, uninsured, underinsured, and Native American children, is federally funded. Its budget has been somewhat reduced under the ACA, as more children have begun to be covered under insurance plans that provide vaccines. In fiscal year 2015, its budget was about $4 billion. Since its inception in 1994, funding VFC program has not been overtly politicized, and I don’t know that anyone expects it to become so.

President-elect Trump’s appointment to head the Department of Health and Human Services will play an important role in setting the policy agenda around immunization in his administration. Politico reports that names in the mix for this cabinet position include Florida Governor Rick Scott, Newt Gingrich, and Ben Carson, MD. Carson has gone on the record saying that he doesn’t think there is a connection between vaccines and autism, as in this statement at the second GOP debate in September 2015: “There have been numerous studies, and they have not demonstrated that there is any correlation between vaccinations and autism.”

However, he continued, “Vaccines are very important. Certain ones. The ones that would prevent death or crippling. There are others, there are a multitude of vaccines which probably don’t fit in that category, and there should be some discretion in those cases.” Carson has not articulated which of those vaccines, approved by the Advisory Committee on Immunization Practices, he thinks should be administered with more discretion.

Edited to add: Science reporter Zach Kopplin reported on November 18 that Mr. Trump met with anti-vaccine activists, including discredited doctor Andrew Wakefield, at an event in August 2016. 

Edited to add: On January 10, 2017, vaccine critic Robert F. Kennedy, Jr., met with the president elect and has told the press that Mr. Trump asked him to chair a committee on vaccine safety. Kennedy, an attorney and environmental activist with no scientific or public health training, is a vocal proponent of fringe and discredited ideas about vaccines.