Trump Cares About Vaccines. Uh-Oh.

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1:30Julie Rovner: Julie Rovner, you're an esteemed health reporter for Kaiser Health News. Welcome back to the show. Thank you for having me. Can you explain what happened in the Oval Office on Monday? Probably not, but I can give it a try. The president issued an executive order, which does not have the force of law, but one of my colleagues rather ably said it's the equivalent to an all-staff memo sent out by the company's CEO. That's a good way to put it. Yeah, it was. I liked it. Dahlia Lithwick likes to call them letters to Santa, but I think that I think that's a little more actually on the nose. Yeah. And I think it I think it's actually more accurate because it's important as we go on to talk about what impact this is going to have.

2:13It doesn't have the force of law, but it certainly does have the force of directive to people who have the force of law. This executive order, it was all about vaccines. So we got on Monday the president making this big announcement of what he's calling gold standard science that would, if it all came to pass, dramatically change the childhood vaccine schedule. Would you call this gold standard science? Uh, no. That's, yeah, I would not.

2:46Julie Rovner: Maybe you're wondering what a Trump endorsed vaccine schedule even looks like. Julie can explain. In Trump world, they would reduce the number of childhood diseases that childhood vaccines prevent from 18 to 11. So in other words, you would no longer get vaccines to prevent against 18 different diseases. It would only be 11. So there's like seven other diseases. We just don't, we're not caring about them? Well, get to that. We care about them, but not as much. Basically, in Trump world, you'd only get certain vaccines if you were declared high risk. which of course means some vulnerable people would get left behind.

3:26Julie Rovner: This sounds a lot more complicated to me. It's really, it's complicated. One of the big pieces is that it would require much more time and effort and more appointments for pediatricians who are already slammed. Well, and parents. Like what? I think it's like five more appointments for parents. And parents. That's right. Trump wants to split up what's now the MMR vaccine, the measles, mumps, rubella vaccine, which has been the gold standard, forgive me for using that phrase, for many, many years. And he said, well, we should give those vaccines separately. So a separate shot for measles, a separate one for mumps, and a separate one for German measles, which pediatricians, you know, throw their hands up.

4:07It's like, first of all, it's more shots for kids. Why stick them, you know, more times if you don't have to? Well, and also those vaccines don't exist in the United States, Right now, we only have the combination vaccines approved in the United States. We don't have separate vaccines for these diseases. And the companies that make the vaccines, you know, they're hard pressed to make vaccines anyway. Vaccines are not the most profitable piece of the drug making industry. Vaccine making is more of a public service than it is a profitable enterprise. Just to be clear, this vaccine schedule is not required.

4:42Julie Rovner: But this order tells the rest of us maybe it should be. The CDC has already tried to change the schedule once. The courts blocked that temporarily. Many states actually refused to comply. Now Trump is saying not so fast. Can we just talk about the visuals of it for a second? Like at one point, Trump held up one of his truth social posts and basically implied American babies get tons of injections like it was a baby surrounded by needles. as opposed to European babies, which just had a few needles surrounding it. Like, is that even true? No, it's really not. He also talked about how vaccines were large, like you were getting injected with something the size of a bottle of soda, which like I'm a parent.

5:29Julie Rovner: I've been to these injections. It's just not true. It's just not true. It's more like, I think somebody said a half a teaspoon overall. Overall, I mean, yeah, it's just not. I don't know where he gets this idea. And frankly, I've seen a lot of people, you know, speculating as to whether Trump actually ever went to a pediatrician visit with any of his kids. I'm going to venture a no on that. But, you know, that's just editorializing and guessing on my part. You know what happens when you assume. Yes. He said he did. But if he did, he would probably know that there's not that much in these vaccines.

6:06Julie Rovner: Today on the show, we're beginning to learn just how much President Trump cares about vaccines. A lot, it turns out. But in a way that almost guarantees Americans are going to get sicker. I'm Mary Harris. You're listening to What Next. Stick around.

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8:19Julie Rovner: All of this took place at a really wild time. Because while Donald Trump is making these recommendations about vaccination, telling parents they have the freedom to ignore the vaccination recommendations that currently exist, vaccine preventable infection is actually on the rise, like specifically measles. I think this is the worst year for measles since 1991. It's dramatic, right? It is dramatic. And that is correct. And I actually went back and looked because the federal government created the Vaccines for Children program in 1993. And it's been going down ever since. And that's a program. That provides low-cost vaccines, right?

9:02Or no cost? Low-cost and no cost, basically, to make sure that vaccines, that childhood vaccines are available to every child, regardless of health insurance status. It was a bipartisan, you know, vaccines used to be a very bipartisan thing. Republicans celebrated vaccines, Democrats celebrated vaccines. Then one of the things that we had seen is we'd had for a long time herd immunity for measles, which is a super infectious disease. And we're about to lose that herd immunity status. I think it gets decided officially in November. But basically, you know, we are no longer a measles free country.

9:38Julie Rovner: I feel like we should say, too, measles is no joke in a lot of ways. It's not just the initial infection. There is good evidence that if you have a measles infection, it impacts your immune system potentially for years, makes you more vulnerable to other conditions that can make you incredibly sick later. So there's this idea that an infection can make you stronger, and that's not a crazy idea for a lot of infections. But for measles, it's just not the case. Measles is very, very different. And the fact that we have been preventing measles pretty effectively since the 1960s was an enormous achievement in medical science.

10:18Second, I would suggest only to polio in terms of, you know, improving the health of children nationwide and worldwide. And now it's over or ending. It's waning, let us say. I mean, it could come back. We still have measles vaccines. We could make measles, you know, a thing of the past again. We can do it, guys. It isn't that the vaccine doesn't work. It's that people aren't getting it.

10:46Julie Rovner: So this executive order, you've said it has little legal force, like all executive orders. Why does it worry you anyway? It's funny, at the beginning of this presidential term, I used to sort of shrug off executive orders. It's like, yeah, they don't have any force of law. But what we've seen is that what executive orders do is they order other executive agencies to do things that they can do. And what we've seen is that this is an administration where the people who work for President Trump tend to do what he says. One of the really sort of ominous things about this particular executive order is that it orders our new attorney general to go after states that don't allow parents to say, I don't want my kid to get this vaccine.

11:30Now, there are already exceptions in most states. There are religious exceptions. There are medical exceptions in every state. If your kid can't have the vaccine for some medical reason, you don't have to have the vaccine. But states have different laws on religious objections and sort of moral, just sort of this shared decision making parental, you know, vibes, if you will. And there's a question about whether or not the Justice Department is going to go after some of these states who don't change their laws. I was reading the exact wording of the executive order. It basically says to states, you know, states should consider changing their laws.

12:04You know, should carries a lot of weight here.

12:08Julie Rovner: Yeah. We'll just see how interested Todd Blanche is in putting the pedal to the metal here. Exactly. And from what we know, Todd Blanche has been pretty interested in doing what the president asks him to do. Can I cop to something? Sure. This executive order took me by surprise. And I say that because I was following other stuff. I hadn't read some of the Wall Street Journal reporting, which I think is very important. But I really thought this whole anti-vax thing was Bobby Kennedy's world. Like, I thought RFK Jr. kind of showed up on the scene and like Trump sort of allowed that to happen to capture a certain segment of voters who were Maha.

12:49Julie Rovner: Right. And this executive order is Trump himself full throatedly saying this is what I want. Right. Like, what did I miss here? You didn't miss anything. I mean, it caught me by surprise until I saw the Wall Street Journal report. So if you were if you're a regular listener to our podcast, What the Health, you would have known about this about three weeks ago when the Wall Street Journal first reported it. But yes, I mean, it was a great story about how the president was playing golf with RFK Jr. and told him he had the yips and he was basically talking about, you know, his pulling back on the vaccine stuff.

13:22You're too chicken, essentially. But yes, you're too chicken. But everybody had reported earlier, much earlier in the year, that there had been polling that found that, hey, vaccine, you know, vaccines are popular across the board politically. Vaccine resistance, not so much. And so Kennedy was given sort of like, why don't you back off on the vaccine stuff and work on some of these other things instead, which he has been doing. So now we do know that this is coming from the president as much as it's coming from RFK Jr.

13:54Julie Rovner: Yeah, and RFK went on CNN recently and Dana Bash really boxed him into a corner, basically pleaded with him to recommend vaccination for measles, given the state of measles in this country right now, which he eventually did. Are you willing to say to parents who have not vaccinated their kids that they should vaccinate their kids for measles because it is safe and it will help them save their children's lives? I tell people on my websites, my public right now that parents should get their children vaccinated for measles. To me, it felt like we were at this moment where it's like, OK, maybe we're getting to a shared reality here.

14:36Julie Rovner: Like maybe maybe just the facts on the ground are getting us where to a productive place. And then this executive order comes out and I'm like, well, I was wrong about that. Yeah. And, you know, politically, you wonder, you know, what the president's advisors are telling him about doing this, because, you know, as I point out, it is not particularly politically popular. And yet this clearly is something that the president himself feels strongly about. We certainly know this back when they, you know, last year when they were talking about Tylenol and pregnant women. He has some things he just believes.

15:12He has some things he just, I was going to say, when they ask him, you know, what proof do you have? He, you know, tends to fall back on, well, some people say. That's kind of his favorite kind of proof. Well, or well, I've heard or well, I've read, rather than pointing to things. But that is, he clearly, whoever he has heard and read and talked to, he seems to believe this. It's interesting.

15:35Julie Rovner: In this conversation, you've laid out why this executive order would maybe not be such a great idea for a lot of different constituencies of people, right? Parents like getting vaccines. Companies want to give the vaccines they've already made because they don't want to invest in more vaccine making because it's not exactly a profit leader for them, right? So the companies aren't so keen on changing the vaccine schedule. The parents maybe aren't as well. And I'm a person who doesn't want my parents or my kids to get sick. So who is this executive order for? Well, there's some thought that it might be, you know, aimed at the religious right, at people who, you know, don't who want parents to have more power over their kids, that this is part of the broader parental choice, you know, parental strength, that the government shouldn't be making choices that parents should.

16:35And we have already seen, you know, we used to, doctors, you say, oh my goodness, if people stop vaccinating their kids, then all these diseases are going to come back. Well, guess what? People have stopped vaccinating their kids and all these diseases are coming back. I mean, we're seeing, it's not just measles, we're seeing whooping cough. We're, you know, we're, we've seen cases of tetanus this year. You know, things that, that just didn't used to be controversial. It's like, guess what? If you don't get the vaccines that prevent these diseases, you're going to get these diseases. And that's exactly what's happening.

17:03Julie Rovner: And yet there is something durable about this idea that vaccines are somehow bad. Like if you look at the Gallup survey, you can see this massive divergence when it comes to vaccines, where Democrats basically feel the same way they've felt for a long time about vaccines, like vaccines generally good, Vaccines generally better than what they are preventing. But since about 2019, 2020, it's just been like the lines completely diverge with Republicans being much more likely to say that they don't like vaccines, even if that is not even if most Republicans still believe vaccines are important. certainly they are more likely than Democrats to say that vaccines are problematic in some way.

17:51It's become like a base belief. It has. Well, and it also goes back to the whole, you know, it's all about COVID and it was all about the COVID vaccine and has now spread from the COVID vaccine to we don't trust public health. And it was interesting that the two things that sort of tied together the interview that Dana Bash did with the secretary and that Margaret Brennan at Face the Nation did with Jay Bhattacharya, who was a prominent COVID denier, if you will. And he was now he's the head of the NIH and recently was the head of the CDC. Both of them, you know, go back to say it's because people don't trust public health and we're trying to restore the faith in public health.

18:26But basically, they're doubling down, exploiting the disagreements within public health. And of course, we've seen, you know, the CDC is down by a quarter. They're trying desperately to, you know, figure out what's getting cyclospora into the food supply and, you know, and what's going on with Ebola in Africa. I mean, there's an awful lot, you know, public health doesn't, we don't stop having public health emergencies because we cut our public health agencies. In fact, one could argue that we expand our public health emergencies when we cut our public health capacity.

18:57Julie Rovner: It's interesting. You say you say the covid thing tied those interviews together, but I see it as tying everyone together. If you look at that Dana Bash interview with RFK Jr., he does say vaccine skepticism goes back to covid. And then he cites Anthony Fauci's diaries and he says in Anthony Fauci's diaries, he writes, oh, this covid thing is going to make it really hard to vaccinate people. were going to get a lot more skepticism. I'm like, wow, you guys all agree on this one thing. That's really great. But what you want to do with it is really different. I think Anthony Fauci would be like, we need to robustly support public health and really make the case to people about why public health is important.

19:39Julie Rovner: RFK Jr., Jay Bhattacharya are just like, nah, let's pull back because people seem to be freaked out by it. So let's just make that go away. And we're politicizing the divide. I mean, there was a divide. There was going to be a divide. Nobody knew what to do during COVID. We'd never seen anything like that before. You know, public health didn't do a great job. I've spent an awful lot of time talking about all the failings of public health during COVID. But, you know, restoring trust in public health, I would argue, is not what is happening now. We'll be right back after a quick break.

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22:12Julie Rovner: I think the thing that bothered me most about this executive order announcement was the fact that you had the president and his aide, Stephen Miller, continuing to talk about this link, quote unquote, between measles vaccines, MMR vaccines and autism. And now I fully believe that you and I have to do this part of the show where we say this link has been investigated, despite the fact that people in the White House say it has not been investigated enough. It has been investigated and it is not a thing and it is impossible to prove a negative. And that is the space that these folks are walking into.

22:50Julie Rovner: But we just have to say it out loud. Right. We had another study just last week of two and a half million kids that showed there was no link between autism and childhood vaccines. And we know that the original study that raised this question was retracted and the doctor lost his license and was doing it for financial benefit. Everything that could go wrong in science went wrong with that. And it has now been disproved many, many, many times over. And yet we still see it. And yes, we have seen an increase in autism, partly because we're looking for it more, partly because we've redefined autism, which has really been a good thing.

23:41I mean, that there are people who are sort of less disabled by autism, but are on what we now call the autism spectrum. And we have found better ways to help them, but we still don't know what causes autism. And every time RFK Jr. says he's going to, you know, he's going to come out, you know, he's going to show us what causes autism. It keeps getting pushed out by months and months and months.

24:03Julie Rovner: I mean, Paul Krugman had a column today where he said, you know, it is linked to autism, air pollution. And we don't see this White House saying let's investigate air pollution at all. You know what else is linked to autism? Older parents, older fathers in particular. You know, there's a lot of things that are linked to autism that we actually do know and that lots of people are studying. But one of the things that we have studied relentlessly is the relationship between childhood vaccines and autism. And it is simply never panned out. I want to talk about a final thing about this executive order announcement.

24:44Julie Rovner: Who was there? Who is in the room for it? because I noted who was not in the room for it, which is the new head of the CDC. She was not there. Is that important? Is that notable to you? It was. I mean, she's being sworn in, I believe, as we are speaking today. So technically, she wasn't like official official? Right. Technically, she was not official official. She had been approved by the Senate, but she'd not been sworn in yet. And there's going to be a lot of watching. I mean, you know, at her, her name is Erica Schwartz. She comes with, you know, deep scientific credentials. She's been an officer in the Public Health Commission Corps.

25:20She was in the Surgeon General's office. I mean, she has come up through the ranks, literally and figuratively, and said at her confirmation hearing before the Senate Health Committee that she believes in vaccines. And when pressed on, well, what would you do if Secretary Kennedy tries to make you do things that are against science? And her response was basically, oh, he wouldn't do that. I mean, he literally did that to your predecessor and then she was gone. So. Right. She lasted a month. So and it was exactly a year ago that, you know, she was she was approved by the Senate, lasted a month.

25:55And, you know, Kennedy tried to say, I want you to approve these, you know, these experts' recommendations before they do them, no matter what they say. And she said, sorry, no. And she was basically shown the door. And many people, many higher ups at CDC followed her out the door saying, we can't deal. You know, we're scientists. We basically can't operate this way. So it will be a very quick test of what our new CDC director decides to do.

26:24Julie Rovner: It seems to me like it took a really long time to find this person to be at the CDC. It did. They went through several iterations of possible people. Is the Trump administration running out of doctors who will vouch for them? We'll see. And we'll see how long this next one lasts. Yeah. But there's been this continuing sort of rumors about how long RFK Jr. was going to last too. He's endured. He has endured. And I think, as you pointed out, I'm not sure at the beginning of the year that anybody saw this particular, you know, let's go after the childhood vaccine schedule again coming. And yet here we are.

27:04And I should point out that when RFK tried to do it, it was put on hold by a judge. So, I mean, the legality of it is, you know, is on hold. But that doesn't mean that things might not get escalated again. Do you expect this to be put on hold? I fully expect that some people are going to take some of that legal authority and try to do stuff. Is it going to get challenged? Absolutely. You know, the scientific community led, particularly in this case by the American Academy of Pediatrics, is not holding back from working on this. Although I would point out that Ken Paxton, the attorney general in Texas who's running for the Senate, has now said that he's going to investigate the American Academy of Pediatrics to see whether basically they have a financial incentive to push childhood vaccines, which, as I point out, makes people really, you know, throw their hands up because most doctors lose money on childhood vaccines.

27:57It is not profit-making for the vaccine makers, for the people who give it. It's one of the reasons why there is a federal program to help pay for childhood vaccines. It's just not something that people do for financial gain.

28:09Julie Rovner: You've noted this, that we're in the worst year for measles, but it's not just measles. There's whooping cough. There are more and more parents doing stuff like turning down vitamin K shots that prevent brain clotting during infancy. Like just people saying no to medical interventions that are proven. And then you combine all of that with like the cyclospora outbreak, even Ebola in Africa. Like I just feel like the last couple of years have there been a lot of outbreaks. But like, am I reading that right? Well, there's always a lot of outbreaks. But I mean, the thing about public health, it's sort of, you know, it's trite.

28:52It's like when public health is working, you don't notice it because nothing happens. It's when public health breaks down that things happen. And what we're seeing now is public health is breaking down and things are happening. I mean, it's perfectly predictable. Everybody predicted it. I mean, I have a segment in my podcast sometimes that I call, who could have seen this coming? Oh, yeah, everyone.

29:16Julie Rovner: Everyone, yeah. I mean, there's an anonymous CDC staffer who just wrote this op-ed basically saying Ebola is indicative of this problem that we have, which is we are not taking care of ourselves the way that we used to. And I think the implication is we're kind of lucky right now, but we're beginning to see our luck turn. Like whether you look at cyclospora, whether you look at Ebola, where it's like the outbreak is quite bad in Africa. But the question is, like, when does that outbreak get on a plane and go somewhere else? Right. That's right. And, you know, and also we we are nobody trusts anyone.

29:54I mean, this is the one thing that the social media sort of, you know, acceleration of all of this. We've always had some of it, but now we have everybody, you know, saying everything and no one knows what to believe. You know, I was interested during COVID. I went back and, you know, looked at what happened during the flu pandemic, you know, after World War I. And there was a lot of, we went through a lot of the same things. There was a lot of distrust. There was a lot of misinformation. What I have not been able to find is how long it took to recover, for the populace to basically recover from that.

30:29and go back to trusting medicine.

30:32Julie Rovner: Well, and what it required from people in charge, right? Like I think in some ways, what's notable isn't the outbreaks. Outbreaks do happen. Outbreaks are like part of being a person on this earth and ideally you prevent them, but sometimes you don't. What's notable is the lack of response to that from the administration. It is notable that there have been so many things that have gone on where there has been no like update from Donald Trump, no interest from Donald Trump or anyone else when, you know, the rest of the country is really worried about eating lettuce and getting explosive diarrhea.

31:10And no update to reporters. I mean, you know, as a health reporter, I used to spend so many hours on, you know, these phone updates from the CDC and the FDA. And, you know, you would get the daily briefings. I mean, they get really tiresome after a while. But that was a really important way to get information out. And we just haven't seen that. This administration doesn't believe in, you know, they don't like the media in general. They certainly don't like expert media who might know more than they do. So they basically, you know, everybody has to go sort of digging for themselves. There is not a clear message.

31:48And as I say, I really think that the biggest, you know, pandemic that we have right now is public health confusion.

31:55Julie Rovner: Julie, I'm so grateful for your time and your expertise. Thanks for coming on the show. Always a pleasure. Julie Rovner is the chief Washington correspondent at KFF Health News. She also hosts their weekly podcast. It's called What the Health. All right, that's our show. What Next is produced by Rob Gunther, Evan Campbell, Madeline Thames-Dusharm, and Patrick Fort. Paige Osborne is the senior supervising producer of What Next and What Next TVD. Mia LaBelle is the executive producer of podcasts here at Slate. Ben Richmond is our senior director of podcast operations. And I'm Mary Harris. Thanks for listening.

32:31Julie Rovner: I'll catch you back here next time.

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