ACIP Chair Wonders Aloud If We Should Really Be Vaccinating For Polio These Days
from the wut? dept
The travesty that is RFK Jr. in charge of American health and what he’s done to the CDC’s ACIP committee for vaccines continues to be visited upon all of us. It’s really important to keep in mind that during his confirmation hearings, Kennedy lied repeatedly about his stance on vaccines. Supposedly serious senators, like Bill Cassidy, claimed they extracted promises from Kennedy that he wouldn’t screw with vaccination programs and the like. These were all lies, designed to get him past those hearings and into the post, where the GOP would close ranks and refuse to do anything so crazy like impeach a charlatan from a cabinet position.
This iteration of ACIP is a disaster. It is full of anti-vaxxers who have already altered the guidance on vaccines for COVID, Hep B, and childhood vaccines more generally. And this is all happening in the context of a measles outbreak that is now in month 13 and getting worse, despite that disease having been officially declared eliminated over two decades ago.
Well, as you know, retro and nostalgia are all the rage these days, so I guess it shouldn’t be a surprise that ACIP is pining for other eliminated diseases to come back. In this case we have the chair of ACIP wondering out loud on a podcast whether we should be vaccinating for polio any longer.
The conversation started off with this absolute banger.
Kirk Milhoan, who was named chair of the Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention in December, appeared on the aptly named podcast “Why Should I Trust You.” In the hour-long interview, Milhoan made a wide range of comments that have concerned medical experts and raised eyebrows.
Early into the discussion, Milhoan, a pediatric cardiologist, declared, “I don’t like established science,” and that “science is what I observe.” He lambasted the evidence-based methodology that previous ACIP panels used to carefully and transparently craft vaccine policy.
I barely know what to say. “I don’t like established science” is the kind of quote I would expect in The Onion, not on Ars Technica. As for the follow up line of “Science is what I observe,” that is a gross misrepresentation of the scientific process. Observation is certainly a part of the method. But you have to couple that observation with tedious and silly things like generating a hypothesis based on those observations, and then testing that hypothesis through rigorous and skeptical methodologies, typically experimentation.
To instead state his stance as he did on this podcast is lunacy. Milhoan went on to claim that vaccines had caused all kinds poor health outcomes, such as asthma, eczema, and deaths. Going even further, he claimed that measles and polio vaccines didn’t actually curtail the spread of those diseases, which flatly flies in the face of basic statistical analysis, before making the following jaw-dropping statement.
“I think also as you look at polio, we need to not be afraid to consider that we are in a different time now than we were then,” he said, referring to the time before the first polio vaccines were developed in the 1950s. “Our sanitation is different. Our risk of disease is different. And so those all play into the evaluation of whether this is worthwhile of taking a risk for a vaccine or not.”
Polio is no joke. While a large percentage of infections will present with little to no symptoms, it is an incredibly infectious virus. 6% of cases have more severe symptoms, including aseptic meningitis and paralysis. Infants infected can get encephalitis. It can result in horrific body deformations as well. The disease is so horrible that international health organizations created the Global Polio Eradication Initiative in the 80s.
And this assclown, hand-picked by RFK Jr., wants to use his position on ACIP to question the need to vaccinate against it?
In a statement, AMA Trustee Sandra Adamson Fryhofer blasted the question. “This is not a theoretical debate—it is a dangerous step backward,” she said. “Vaccines have saved millions of lives and virtually eliminated devastating diseases like polio in the United States. There is no cure for polio. When vaccination rates fall, paralysis, lifelong disability, and death return. The science on this is settled.”
Fryhofer also took aim at Milhoan’s repeated argument that the focus of vaccination policy should move from population-level health to individual autonomy. Moving away from routine immunizations, which include discussions between clinicians and patients, “does not increase freedom—it increases suffering,” she said, adding that the weakening of recommendations “will cost lives.”
Yes it will. Milhoan may not like established science, but that science is established for a reason. It’s also trivially easy to go look up case rates for polio and measles before and after mass vaccination programs were put in place and see the results.
Moving to curtail vaccinations of polio should be as clear a line in the sand as could possibly exist for those overseeing this fiasco in Congress. The anti-vaxxer stuff thus far has been bad enough to warrant impeachment hearings for Kennedy. This would be something completely different.
Filed Under: acip, anti-vaxxers, evidence, health & human services, kirk milhoan, polio, rfk jr., science, vaccines
Comments on “ACIP Chair Wonders Aloud If We Should Really Be Vaccinating For Polio These Days”
But there are only about 30 cases a year, in the world, which would be 1 or 2 people getting severe symptoms. So it seems reasonable to raise the question, especially when the vaccines can basically cause polio (“about three cases of vaccine-associated paralytic poliomyelitis per million doses given”—or apparently quite a bit less with newer vaccines).
Of course, I have my doubts this person is raising it as a legitimate question, and, in any case, the link above gives the answer:
Re: what do you even mean?
The same link you posted legit said that there are thirty cases per year because of global eradication efforts. Cases are few and far between because there’s a vaccine and people now do not get polio. Is there actually a large population of people out there who have polio not because they were not vaccinated but were? I do not understand where you’re coming from, nor the arguments you’re using to back whatever point you are trying to make. All medical interventions including vaccines come with risk. There is legit a government committee that reviews vaccine injury claims because of these documented risks.
Re: Re:
I don’t know about large, but that’s a quote from the “polio vaccine” Wikipedia page, and here’s one citation:
In that case, four people in the Philippines got polio—directly from the vaccine, or from contact with a recently-vaccinated person—despite the country being otherwise polio-free. Three were okay after 60 days.
The point is that it’s completely reasonable, in principle, to ask whether the risk of the vaccine is worth it. It looks like the answer is a clear “yes” (until polio’s gone like smallpox is gone, at which point it’ll likely be “no”), but Timothy shouldn’t be shitting on people just for asking the question. The statement described as “jaw-dropping” isn’t… in isolation; the “absolute banger”, though, suggests this specific person was full of shit and not asking seriously.
Re: Re: Re:
It’s always the same problem: population trust.
If doctors declare that Polio vaccines are unneeded, and in few years, many cases appears (which would certainly means a lot of deaths), how to explain to the population that theses unneeded vaccines are urgently needed again, without them thinking “I’m not vaccinated and I’m fine”?
But most doctors are not scientists (that read or make studies) but practitioners, that often give advises from decades of experience without knowing about recent science discoveries.
Re: Re: Re:2
What you’re describing as the problem doesn’t match what the World Health Organization is saying, though. They make a much simpler statement: forgetting about public perception and trust, polio’s just too damn virulent to stop vaccination until it’s fully eradicated. Despite the vaccine’s acknowledged risks.
Timothy said basically the same: “incredibly infectious virus”, and generally horrible. But the W.H.O. actually did the math, and predicted that stopping vaccination when we still have 20 cases per year could take us to 200,000 per year. Meaning we should keep vaccinating everyone until that number’s zero, and it’s been zero long enough that scientists—not politicians and their flunkies—are sure it’s really zero.
What really sucks is that the U.S. could fuck up the global eradication efforts when we’re so close to being done, much like our ancestors finished off smallpox. (Well, technically the U.S. could retroactively fuck up that: they still have it in a C.D.C. lab, and they’ve probably already replaced many of their good employees with supervillians.)
Re: Re: Re:
Okay but like why? What point are you trying to make here? You’re not wrong, but until recently the DHHS was staffed with medical professionals who asked these sorts of questions. Most people here don’t doubt that vaccines can come with certain risks or that all vaccines are equally effective. Like my own doctor legit told me the flu vaccine was about 40% effective this year. These types of questions are not original to Kennedy and his ilk, and that is what you’re making it sound like.
Re: Re: Re:2
That portraying questioning as wrong is a very anti-science view. There are scientists today legitimately questioning gravity, and there’s nothing wrong with that; if Einstein hadn’t done it, we might not have global navigation satellite systems (the clocks need to be corrected for relativistic effects).
The quoted person obviously doesn’t care about science, and probably doesn’t understand it; Trump’s people are using terms like “questioning” and “science” as mere pretexts for whatever bullshit they want to push. They might as well be throwing immigrants out of planes, saying they didn’t know how harmful it’d be because “gravity’s only a theory”.
But we shouldn’t become anti-science ourselves in pushing back against their false claims of “science”. Questioning would be a proper role of a competent person in this position, just as it was proper for the World Health Organization to ask the question (and actually accept the answer they got: that polio vaccination is still extremely important, so let’s not fuck this up near the finish line).
Re: Re: Re:3
Again, no one is arguing about questioning whether something is good for society anymore. I’m telling you that this was likely ALREADY DOING that, and you’re legit making it sound like these quacks are the first people to ask a legit question about society wide benefits and are therefore legit somehow. You’re also a humungous, smug butt head.
Re: Re: Re:4
Timothy wrote “And this assclown, hand-picked by RFK Jr., wants to use his position on ACIP to question the need to vaccinate against it?” (also see the headline)—as if there’s something wrong with mere questioning, when in fact that’s the ACIP’s job.
I don’t understand where you get that view, when there’s a link to an actually-credible health organization who asked and (reasonably) answered that question in 2018.
What these quacks are doing isn’t legit, and hardly deserves to be called “questioning” at all. They’re using the terminology of science to try to hide their quackery. Kind of like Monty Python’s “Argument Clinic”. (“An argument isn’t just contradiction. […] An argument is a connected series of statement intended to establish a proposition.” — “No it isn’t!”)
Re: Re: Re:
And given that polio has all but disappeared from the world save for incredibly rare instances, yes, the risk is worth keeping the vaccine around. You’re like a whole bunch of anti-vaxxers who think the diseases we vaccinate against can’t be “that bad” because you haven’t seen the kind of devastation those diseases can cause. Why haven’t you seen them? Because the vaccines fucking worked. We keep the vaccination programs going because there will always be a part of the population that can’t be vaccinated due to health risks, which necessarily means those who can be vaccinated should be to keep up herd immunity and thus lower infection risks for the unvaccinated.
Imagine thinking about any other safety measure in society this way: “Well, seatbelts have saved so many lives that we don’t need to make wearing them mandatory any more!” Do you really want to risk more lives because you can’t fathom how the risk is already lowered due to the safety measures already in place?
Re: Re: Re:2
How do you figure? Science is based on questioning things—though not pretextually like these Trump assholes—and accepting that the answer might not be what we want or expect. And how’s it anything like anti-vaxxers to note that, in this case, the answer remains a definite “yes, keep vaccinating everyone we can”? The vaccine has risks, but modelling suggests that it’d be a bigger risk to stop.
You could’ve posted the same reply about someone questioning the smallpox vaccine, although society did that long ago and came to the answer that it was time to stop (except in special cases, and so we still keep the vaccine around). Was that crazy just because smallbox caused devastation that we didn’t personally see? Well, I didn’t anyway; I don’t know how old you are.
Neither smallpox nor polio has any non-human host, so there is a point at which we can reasonably stop vaccinating. The only question is whether we’re there yet (see above).
Re: Re: Re:3
Anti-vaxxers see vaccines as an “unnecessary risk” compared to the risk of contracting a disease that fucks with immune systems. They only see things that way because they haven’t seen the kind of devastation to public health that measles, polio, and other such “practically eradicated” diseases can cause if left unchecked. Vaccines kept those diseases in check; their success in doing so has, ironically enough, led to people thinking “hey, those diseases can’t be that bad, can they” and saying shit like “we should let people get those diseases to test public health infrastructure”. I really hope you see why that’s a problem, especially given the reams of evidence that say “major side effects from vaccines are rare enough that vaccines are safe for most of the general population”. That’s not even getting into the “I’d rather have a dead kid than an autistic one” type of eugenics you see in some anti-vax circles, since the now-discredited Wakefield study is largely what popularized and mainstreamed the anti-vax movement.
Re: Re: Re:4
Well, they’re usually wrong, often deadly wrong, and that’s almost certainly the case with polio: the risk remains necessary. This is all a huge problem; your message is correct in its entirety.
But we need to push scientific understanding, and suggesting that it’s wrong to even question an accepted view very much works against that. It’d be taking one anti-science position to fight another.
Anything can be questioned, as long as it’s done in good faith. Some scientists, including Richard Feynman, were infamous for it. But they never made shit up to get the answers they wanted, and didn’t raise bogus questions to confuse the public; that’s what we need to push back on.
It’s literally the ACIP chair’s job to raise the question of which vaccines are necessary, and this person is abdicating their responsibility by not doing it seriously.
Perhaps the most unfortunate side effect of any vaccine is that they allow vaccine deniers to live longer lives and continue to infect the world with their stupidity.
Re:
And the results of the natural sciences more generally allow people to use advanced technology, like podcasts, to very effectively spread anti-science propaganda far and wide.
Now is a perfect time to invest your money in shares of Iron Lungs, Inc.
Suggesting getting rid of polio vaccines because we have better societal health is like suggesting getting rid of airbags because we have seatbelts.
Re: Air bags/Seat Belts... ooohh the irony
In my country, we made seatbelts mandatory in the 1970s.
A controversial Govt advert was: “Belt your wife and Save her life!!”
The seatbelts were very, very successful at reducing harm in impact situations.
Meanwhile, “freedom”-lovin’ USians were screaming “Seatbelt? Infringe my rights NO WAY!”
So, the carmakers turned to airbags to appease the big market.
And, since the complexity of build standards is a manufacturing nightmare, they made airbags standard in all markets, and tried to sell it as a “feature”.
[Aside: See “power steering” and “front-wheel drive” as another example of a need-turned-into-a-feature.]
So now, I have no choice but to drive with explosives controlled by a computer within 30-40cm of my face. Needless to say, I don’t trust car-embedded computers, and computer-controlled explosives, to keep me safe. (See “unintended acceleration” for more grist for the mill.)
cheers, tryptich
Re: Re: Airbags
I’ve had an airbag recall because of a ‘manufacturing defect’ the explosion could spread metal shrapnel…
And airbags seem to work better when seatbelts are worn.
Re: Re:
Malfunctioning airbags have caused a few dozen deaths over the years, mainly due to a single manufacturer that shipped defective airbags.
On the other hand, airbags have saved hundreds of thousands lives, when operating as designed.
Throwing them out because of those few death is making the wrong risk-calculations.
Similar statistics exist for seat-belts, and yes, also for vaccines. You accept the risk, because the gain is so much bigger, it borders on lunacy not to do so.
Re: Re:
I generally agree with you on seatbelts, but what you say there is simply not true: Wikipedia on the relevant laws
Re: Re: Re:
Are seat belts good for safety? Yes.
Am I pleased by seatbelt laws? Yes.
Would I have ever worn a seatbelt without a law? No.
Re: Re: Re:
I find nothing in the Wikipedia article to contradict the quoted post.
If the alleged idea is that “Americans have rejected seat belt use, and car makers have used airbags instead” then some incorrect inferences have been made.
Americans did reject voluntary seat belt use, but I reckon that they usually obey the law. With no law, seatbelt use was at about 10% if I remember correctly.
Re: Re: Re:2
I had interpreted tryptich’s post as implying or assuming that there are no seatbelt laws in the USA because of right-wing influences, and that that was what led to the introduction of airbags. I apologize if that was a misinterpretation.
Quoting from your other reply so that I don’t have to write two separate replies:
Speaking only for myself, in my case, I think I’ve worn seatbelts since before I was old enough to understand the concept of a “law”. By the time I was old enough to know about the legal requirement, I don’t think it mattered much, because I had gotten so used to seatbelts that I felt, and still feel, kind of “naked” sitting in a moving car without a seatbelt.
Re: Re: Re:3
“Seatbelt law” is an ambiguous term, because there are many: some mandating that seatbelts be included in new cars, some extending that to all seating positions, some mandating that people use seatbelts where available, and some forbidding people to sit in places without belts (perhaps excepting old cars). Also some setting quality standards, probably some mandating they be retro-fitted (like when taking paying passengers in old cars), and others.
Would you have gotten used to seatbelts if no such laws existed? Maybe only if your parents had fitted them as after-market accessories.
Re: Re: Re:4
Good question. Dunno about the answer.
Misunderstanding
Milhoan appearently wasn’t properly briefed and he thought the podcast was titled “Why should I NOT trust you”.
I wondered when they would push this
And, now is that time. Anecdote, browsing The Onion the other day, and came across one of their “Headlines” in 1955. One of their hilarious satire stiletto offerings.
I focused instead of a smaller headline. First KinderGarten kids get free Polio Vaccine
I missed by three years. I won’t take up more of your time/space here, but do at least look into Post Polio Syndrome
It might well mean their ignorance is going to flood the US with disabled people who were the children of those who got scammed by these people. The same crew that is gutting Social Security, Medicare, Medicaid ’cause no slackers allowed
FFS
I remember my sugarcube
I’m old enough to remember standing in a long line to get my sugar cube of polio vaccine. I don’t know how old I was, 3 maybe, but it’s one of my first memories. Who knows if I’m remembering it correctly after all these years, but I remember it being extremely quiet. That’s so strange for a large group of parents and children. I think everyone was frightened by the reality of polio then and relieved there was something that could finally be done. Everyone knew someone who died or had to live their lives with braces on their legs. Of course, most of the parents remember President Roosevelt. They knew the reality of the disease. We’ve lost that. I tell everyone I can that I’m partially deaf because I got measles before there was a vaccine. I don’t know if that’s persuaded anyone to get their children vaccinated, but I hope it has.
Science
The critical aspect of science, especially under this regime, is that you also allow other scientists in the field to test your hypothesis and to accept their results, even if they disprove your position, and being willing to change your propositions when proven wrong (or prove their method wrong).
One scientist is fallible, the method adjusts for this with the process of critical examination by opposing scientists. When a consensus is reached, the scientific method has worked.
Obviously, this Kirk Milhoan is not practicing science.
Let the iron lung production lines get that nice cleaning and maintenance, they’ll be needed soon.
Maybe after reviving the horrors of polio people will become less inclined to question vaccines?
Re: It's a religion
How many of them changed their minds because their own kids got measles? I bet fewer than you’d think.
Faith’s not about evidence or reasoning. Reality can stare them in the face and they’ll deny it.
The antivax (& flerfs & etc) just want to think they’re super-special god-chosen geniuses who have the “secret truth” all us “sheeple” don’t,
AND THEY DON’T CARE IF PEOPLE HAVE TO SUFFER AND DIE FOR THEIR DELUSIONS
Y’know. Like religion.
Re: Re:
Mostly a matter of pride, I guess. For a lot of people, their pride is more important than almost everything else. If they’re wrong on vaccines and don’t admit it, it might cost them their lives. If they’re wrong on vaccines and do admit it, it will hurt their pride.
“[…] Milhoan’s repeated argument that the focus of vaccination policy should move from population-level health to individual autonomy.”
They should test his theory with traffic lights. In the city he lives, remove all those traffic lights that infringes on people’s freedom of driving how they want and let’s see what happen. I’m sure individual autonomy will be way, way better. 🙂
MAGA's full of holes
We need a vaccine against the spread of the brain worms…
Re:
Ironically enough, that’s the one thing Ivermectin is good for.
Dude, if you hate established science, don’t appear on podcasts. Without the past couple centuries of established science, there would be no such thing as a podcast today.
And if you say that science is what you observe, then explain how the ridiculous things you say are based on what you’ve observed.
An anti-vaxxer's "freedom" to subject everyone to the rainstorm that never stopped.
In the voting rights case Shelby County v. Holder, Justice Ginsburg pointed out in her (continually vindicated) dissent that:
Ginsburg’s analogy is too charitable toward the willful ignorance of the Supreme Court justices in the majority, but applies to contexts beyond voter suppression. The umbrella is not merely something each individual chooses to throw away. The umbrella represents the initially absent, hard-won, continually necessary rights, freedoms, and safety that a coalition of malicious and ignorant people rips back out of other people’s hands. Often (as in the case of anti-vaxxers), the ones who throw away other people’s umbrellas often throw away their own as well.
Re:
Aargh. What fool accidentally writes “often” twice in the same sentence?
Re: Re:
If it’s any consolation, it could have been worse. You could have written the word “often” often in the same sentence.
If a person doesn’t “like science” then how do they earn a postgraduate degree in a scientific field? I was a liberal arts major and I was required to learn the rigors of the scientific method and to take an upper-level course in statistics. I graduated with a firm understanding of scientific inquiry and the principle of the standard distribution. How did Tom Cotton get admitted to Harvard? How did he graduate? The man is a dunce. I understand that no system is perfect. But I expect borderline cases to slip through the cracks, not idiots earning Ivy League doctorates. Yes, these are anecdotal evidence. It’s just frustrating when gatekeepers fail.
Re:
I guess that’s a “You can lead a horse to water…”-thing.
Some people get taught stuff by people whom they can’t stand, and end up hating the stuff they got taught because of that.
One of the most surreal moments in my life was when a professor who was a respected authority in a different field of natural science seriously recommended homeopathy to me for a medical problem I had told him about.
Re:
You don’t have to like or agree with the scientific method in order to employ it.
And this ongoing playacting that these people are just “dunces” who don’t understand what they’re doing is getting really tiring. He understands perfectly well what he is doing. He understands the scientific method and statistical distributions just as well as you do. He didn’t trick Harvard into graduating when he didn’t know the material, he knows the material. He’s doing this with full knowledge and intention of the consequences because it gives him personal power.
Re: Re:
In the case of Cotton, I agree.
In the case of this Milhoan, you might be right, but I don’t think it’s guaranteed.
Contrary to common belief, being smart and being dumb are by no means mutually exclusive. And I say that as an IMO reasonably smart guy who has sure done his share of stupid things in life.
Among other things, there are ways in which otherwise smart people can make themselves kind of artificially stupid. Some of these are stubbornness, ego gratification, and a complete refusal to admit mistakes. For instance, I once got treated by a doctor who apparently had a god complex and therefore, when I told him about the side effects of some medication he had prescribed to me, couldn’t imagine that a decision he had made might have been a wrong decision, and insisted that the side effects had to be something I had been born with.
When someone is really strongly psychologically invested in believing something stupid, they’ll often believe it even though, in theory, they should be too smart for that.
Re:
I’ve had a few classmates that passed their tests even though they didn’t actually understand the subject, they just learned what was needed to pass the tests and they couldn’t later apply that knowledge practically in real life situations.
How many people have you run across that brags about their degree but are so inept they couldn’t find their ass with both hands, a flashlight and a map?
Re: Re:
Yes, exactly. Keep in mind that the Donald himself has a degree from an Ivy League school. Yes, one of the “lesser” Ivies, but still.
Perhaps formal academic credentials are a bit like restaurant recommendations: they can give you some first idea of which places might be worth checking out, but you shouldn’t trust them over what your own taste buds are telling you.