Doctors raise alarm over Trump’s push to scale back US childhood vaccinations

Doctors raise alarm over Trump’s push to scale back US childhood vaccinations The Trump administration says its overhaul of childhood vaccine recommendations will provide “gold-standard” protection, but doctors warn the changes could increase the risk of preventable diseases. WASHINGTON: Doctors have warned that United States President Donald Trump’s overhaul of childhood vaccination recommendations could leave more kids vulnerable to preventable diseases. Health experts also cautioned the changes could impose logistical and financial challenges for parents and healthcare providers. Trump signed an executive order last Monday (Aug 10) calling for fewer childhood vaccinations, recommending immunisation against 11 diseases, down from 18 previously. The order also backed splitting the measles, mumps and rubella (MMR) vaccine into three separate shots and administering them – and other vaccinations – during separate appointments. The order advances a long-standing goal of Health Secretary Robert F Kennedy Jr, an anti-vaccine activist who has promoted a link between vaccines and autism – a claim that scientists have repeatedly debunked. Trump said the changes would provide American children with “gold-standard” protection and bring the US in line with peer nations that recommend fewer shots. But doctors have pushed back against the order, saying fewer routine vaccinations could lead to more children becoming seriously ill from diseases that are largely preventable. “Some per cent of those (children) are going to end up in the intensive care unit, and some per cent of them are going to die,” said Andrew Racine, president of the American Academy of Pediatrics (AAP). “There’s nothing more terrifying for a family and nothing more tragic.” CONCERNS OVER SPLITTING MMR VACCINE The MMR vaccine has been administered as a combined shot since the 1970s. Doctors say Trump’s plan to split the vaccine would require more visits to clinics, potentially forcing parents to take more time off work and increasing the chances of children missing their vaccination appointments.. Measles, a highly contagious disease, can cause complications including pneumonia and encephalitis, an inflammation of the brain that can be life threatening in some cases. "A vaccine ecosystem that is in disarray, which had functioned very, very well for decades, but which is (now) in utter disarray," said Steve Morrison, director of the Global Health Policy Center at Washington-based think tank Center for Strategic and International Studies (CSIS). "What are the costs going to be for parents and for children?" Drugmakers would also need to resume production of individual vaccines that have not been widely used in the US for decades, requiring new manufacturing capacities. Morrison said the upheaval had prompted states and medical societies to seek alternative sources of guidance. The AAP has opposed the changes and continues to recommend routine immunisation against 18 diseases. STATES STILL HOLD KEY POWERS There are limits, however, to what the federal government can do. Vaccination requirements for children attending school, for example, are determined by individual states. But the Trump administration can encourage states to change their rules, meaning the impact of the federal overhaul could ultimately depend on how many states follow Washington’s lead. IMPACT BEYOND US Public health experts say that Washington’s changing approach to vaccines could have consequences beyond the US. Changes to US vaccine policy could risk sending mixed messages overseas and fuel vaccine hesitancy, even as Washington continues to support vaccination against some of the world’s deadliest diseases. “Those who are out to spread misinformation about vaccines will (be) encouraged,” said CSIS’ Morrison. At the same time, he noted that the US remained heavily involved in global vaccination efforts targeting diseases including measles, polio, malaria and Ebola. Walter Orenstein, former director of the National Immunization Program at the Centers for Disease Control and Prevention (CDC) said vaccination efforts abroad can also help protect public health in the US. "It would be very important for the US, for its own domestic health security, to help global programmes improve their immunisation status,” he said. . “That's a win-win situation. It helps those countries, but it also enhances our domestic health security."