Vaccine Issue Arises at Republican Debate, to Doctors’ Dismay
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| Donald J. Trump at the Republican debate on Wednesday night. Mr. Trump claimed that vaccines could be linked to autism, a contention disputed by scientists |
When
Dr. William Schaffner, an infectious disease specialist in Tennessee,
flicked on the television last night to catch the end of the Republican
debate, he watched a scene that felt unsettlingly familiar: A candidate
was talking about vaccines and autism.
Dr.
Schaffner has spent much of his career trying to debunk the contention
that childhood shots can cause serious medical conditions, but he had
hoped that national soul-searching this year after an outbreak of measles at Disneyland had moved the country past some of these old notions.
“I think it’s sad,” said Dr. Schaffner, a professor of preventive medicine at Vanderbilt University, who said he cringed through the autism
exchange at the end of the debate. “I would have hoped, since two of
the discussants were physicians, that there would have been a ringing
discussion about safety and value of vaccines, and an affirmation of the
schedule set out by the American Academy of Pediatrics.”
For
infectious disease doctors around the country watching the exchange, it
felt a little bit like “Groundhog Day.” In 2011, during the last
election cycle, Michele Bachmann, at the time a leading Republican
candidate, called the vaccine to prevent cervical cancer “dangerous,” setting off a controversy that damaged the image of vaccines and set back doctors working to promote them as safe.
This time, it was Donald J. Trump
who vigorously asserted a connection between vaccines and autism,
telling an emotional story of an employee whose “beautiful” baby fell
ill with a fever
after having a vaccine and, he said, became autistic. While the two
candidates who are doctors — Rand Paul, an ophthalmologist, and Ben
Carson, a retired neurosurgeon — said that childhood vaccines were safe
and important, even they shied away from the strict schedule set out by
the medical profession.
“We
have extremely well-documented proof that there’s no autism associated
with vaccination, but it is true that we are probably giving way too
many in too short a period of time,” Mr. Carson said. “I think a lot of
pediatricians now recognize that and are cutting down on the number and
the proximity in which those are done.”
Mr.
Paul agreed. “One of the greatest medical discoveries of all time were
vaccines,” he said. “I’m for vaccines, but I’m also for freedom. Even if
the science doesn’t say bunching them up is a problem, I ought to be
able to spread my vaccines out a little bit, at the very least.”
Doctors watching the debate were despairing.
“I was thinking: There’s a reason why we have a schedule,” said Dr. Saad Omer, an infectious diseases
expert at Emory University in Georgia. He watched the beginning of the
debate, then stopped to do work, but ran back in to turn it on again
when some vaccine expert friends started posting on Facebook about the
back-and-forth on the stage.
“I
had hoped was there would have been a stronger endorsement of the
schedule,” he said. “It’s not one person’s opinion. It’s not even just
the government’s opinion. It’s based on very broad scientific advice.”
Still,
the endorsement by Mr. Paul and Mr. Carson of delaying vaccines is in
keeping with what many pediatricians and family physicians reluctantly
do behind closed doors. If parents demand an alternative schedule,
physicians often agree to postpone one or more vaccinations.
A recent survey of a nationally representative sample of 534 primary
care doctors found that a third said they “often” or “always” allowed
parents to delay vaccinations or space them out.
The downside is that this leaves children vulnerable to potentially fatal infections like measles and whooping cough.
“When
you delay vaccines, you increase the period of time in which you are
susceptible to those diseases,” said Dr. Paul A. Offit, a pediatrician
specializing in infectious diseases
at the Children’s Hospital of Philadelphia. “We are seeing the effects
of that. The outbreak we saw this year in Southern California was among
parents who had chosen to delay or withheld vaccines for their
children.”
In
a bit of political jockeying, Mr. Carson suggested at the debate that
only vaccines that “prevent death or crippling” were very important.
“There are a multitude of vaccines which probably don’t fit in that
category, and there should be some discretion in those cases,” he said.
But
of the 14 preventable diseases that young children are vaccinated
against, Dr. Offit said, “the only one you could reasonably say does not
kill is mumps.” And mumps can cause permanent deafness and sterility in men after puberty, he said. The other 13 diseases can be deadly. “Tetanus kills, rubella kills unborn children, measles kills, hepatitis B virus kills,” Dr. Offit said.
He lamented, “Why is it that everyone on that stage got vaccines wrong last night?”
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