Navigating vaccine misinformation with a pediatrician

0:00Health and Human Services Secretary Robert F. Kennedy Jr. has long been critical of vaccines and for years led an activist group opposing vaccines. There's no vaccine that is, you know, safe and effective. Although he's backtracked a bit on that comment he made at the Lex Friedman podcast in 2023, he repeatedly questions vaccine safety. I'll tell you how to start taking vaccine safety seriously. Consider the best science available, even when the science contradicts established paradigms. And now, as the country's top public health official, Kennedy is reshaping the federal government's official guidance on vaccines.

0:38RFK Jr. instructed the Centers for Disease Control and Prevention to update its websites to state that the link between vaccines and autism can't be ruled out. That's despite the fact that the connection between vaccines and autism has long been debunked by high-quality scientific research. Kennedy told the New York Times, quote, The whole thing about vaccines have been tested and there's been this determination made is just a lie. The move has stunned doctors and health experts. Republican Senator Bill Cassidy, a physician who did vote to confirm RFK Jr., had this to say on CNN Sunday. Anything that undermines the understanding, the correct understanding, the absolute scientifically based understanding that vaccines are safe and that if you don't take them, you're putting your child or yourself in greater danger.

1:29Anything that underlines that message is a problem. Some public health experts say that the once trusted CDC is now no longer credible. Dr. Paul Offit directs the Vaccine Education Center at the Children's Hospital of Philadelphia. I mean, Robert F. Kennedy Jr. has shredded the CDC and made it in his image, which is to say an anti-science, anti-vaccine image. The worry is that families who rely on the federal government for factual information will see the new guidance and will choose to not vaccinate their children. This is madness. That's Dr. Sean O 'Leary from the American Academy of Pediatrics.

2:03I'm so sorry that this is going to have an impact on, frankly, the health of children. I fear that it's going to lead to fewer children being vaccinated, children suffering from diseases they didn't need to suffer from. Consider this. Physicians often deal with misinformation. But the difference is that now it's coming from the federal government. Coming up, we speak with a pediatrician on how families should navigate the change in guidance.

2:34From NPR, I'm Scott Detrow.

2:45It's Consider This from NPR. The CDC, long one of the country's top, most trusted health authorities, now says a link between vaccines and autism cannot be ruled out. The guidance is also a break from the American Academy of Pediatrics, which publishes the Red Book on Pediatrics Guidance. Dr. James Campbell is a practicing pediatrician who helped write that guidance. He's also a professor at the University of Maryland School of Medicine and joins us now to talk about what this will all mean for the kind of information parents have access to. What do you make of this change from the CDC and what do you think it means?

3:19Yeah. So, I mean, over the last few months, what we've been seeing is essentially a dismantling of our public health guidance of our public health agency, the Centers for Disease Control and Prevention. As people probably know, it's the premier public health agency in the world. And the people that work there are the best public health officers, epidemiologists, statisticians, subject matter experts on everything having to do with my world, which is infectious diseases and prevention of those infections. And recently, they've not really been given the opportunity to continue to do that stellar job of providing evidence-based guidance.

4:10And essentially, website pages and others have been hijacked, if you will. And they're still stating that they're representing the CDC. But I think if you talk to the people that work in this field in the CDC, they're going to tell you they had no part in changing those guidelines. So it's confusing, I think, for the general public. It's confusing for practitioners and for parents to see guidance that is not aligned. But we believe that people, if they look into what the rationale is behind the guidance, they'll be able to see that the American Academy of Pediatrics continues to do science-based and data-based guidance.

4:54Are there ways that that conversation is going to look different now, given the changes that we've seen at the CDC over the past year? I think it is going to change because what makes it to the media, to the news, is that there is controversy between the different groups that make recommendations. And so in the past, pediatricians had maybe a difficult job sometimes in discussing recommendations about vaccines with families. But now trying to explain the different recommending bodies and why one body would choose one thing and another thing, I think, is going to make those conversations even more difficult.

5:37I mean, all of us want for parents to have the best evidence so that they can make the best decision with their providers. And we all have the best interests of children. And that's why we spend so much time reviewing these data and trying to make the best recommendations that we can. You've seen the trend lines on public views of vaccines over the decades. And, you know, I'm sure there's a lot of people listening right now who maybe in one way or another do have skepticism or worries about vaccines. What would you as a doctor say to that just kind of baseline concern or anxiety in a parent, especially at this moment now when there is multiple messages coming in from multiple authorities?

6:17Yeah, I mean, the first thing I would say is I'm a parent too, and I vaccinate and have vaccinated all of my children because after reviewing all of those data, I know just how much goes into checking on their safety, on their tolerability, on their efficacy. and I am in the unfortunate position, if you will, of being an infectious disease doctor who spends his time in the hospital caring for children who have very severe disease because they were not vaccinated. I see children with influenza who are on mechanical ventilators. I've seen children with COVID lose a lung. I've seen people die from hepatitis B after two liver transplants.

7:03All of those were preventable problems with simple vaccination. You've said a few times in this conversation that you see this latest change to the CDC website as one step in a broader trend line. And I'm wondering what you're most worried about when it comes to possible other changes that the CDC can make over the next few years. Well, the next thing's on the docket. There's a meeting in a few weeks, and one day we'll be spent talking about hepatitis B vaccine. and the other day on the pediatric schedule in general. Hepatitis B is a very serious problem. And before we had vaccination recommendations for babies and infants, about 18 ,000 to 20 ,000 babies and infants were infected with hepatitis B in the United States.

7:55And almost all of them go on to have chronic infection, and many of them go on to have cirrhosis, hardening of the liver, and some liver cancer requiring a transplant. We now have reduced that number from the 18 ,000 to 20 ,000 down to a few dozen every year. And the reason we've been able to do that is because moms get tested for hepatitis B during pregnancy, and their babies get vaccinated at birth and then in the first year of life. If we stop doing that, we will see more children with hepatitis B, and those children will suffer immensely. Looking at the pediatric schedule itself, the entire schedule, we have always looked at the schedule, and we do not add things to the schedule unless we find them to be safe and effective.

8:46And so a re-looking at the schedule without any additional data is worrisome to us, unless there are data that can be provided that would show that the schedule should be changed. So I think there's many new issues in vaccines, new vaccines coming down the pike and new versions of vaccines that need to be reviewed by the ACIP and by the CDC, rather than going backwards and looking at things that we've already proven or that are already added to pediatric recommendations. That is Dr. James Campbell, a professor at the University of Maryland School of Medicine. Thanks so much. Thank you. This episode was produced by Vincent Acavino and Karen Zamora.

9:30It was edited by Adam Rainey. Our executive producer is Sammy Yenigan. And before we go, a quick plug for our latest bonus episode for NPR Plus supporters. Mary Louise Kelly speaks with investigative reporters Carol Lenning and Aaron Davis of The Washington Post. their new book about the Justice Department, argues the agency has been, quote, vanquished by politics and fear. You can hear the conversation now if you're an NPR Plus supporter and learn more at plus.npr.org.

10:00It's Consider This from NPR. I'm Scott Detrow.