What Trump, Kennedy can and can’t do to change U.S. vaccine policy


President-elect Donald Trump might use his bully pulpit to spread doubt about vaccines. Photo by Lucy Nicholson/Reuters

Robert F. Kennedy, Jr., a prominent doubter of the safety of vaccines, told reporters on Tuesday that he will chair a commission on vaccine safety and scientific integrity as part of Donald Trump’s administration.

It’s not clear yet exactly what this panel will aim to do. But the news is already raising concern about what Trump, who has a long history of questioning vaccine safety, could do to undercut childhood vaccines.

For now, it’s worth taking a look at what’s possible for Trump to change — and what’s not.

Trump does not have direct authority over vaccine schedules

The recommendations about which vaccines children should receive and when they should get them are developed by an advisory panel of scientists, called the Advisory Committee on Immunization Practices, under the Centers for Disease Control and Prevention. This is different from the panel Robert F. Kennedy will chair. Trump has no power to order the ACIP to make recommendations that are not based in evidence.

Trump can appoint agency staffers who doubt vaccines

Trump certainly can fill his administration will like-minded staffers who could steer agencies like the CDC in a new direction. But keep in mind: He can’t just fill ACIP with vaccine doubters. Members are chosen through a rigorous nomination process. And the makeup of the scientific advisory committee on vaccines doesn’t turn over with the start of a new administration; vacancies are staggered, as they are in the US Senate.

Trump does not have direct authority over vaccine requirements

Requirements about which vaccines children must receive to enroll in school also don’t fall under the president’s purview. That’s the domain of the states. Consider, for instance, a new law enacted last year in California, which made it much harder for parents to get out of vaccinating their children before enrolling them in school.

Trump can use his bully pulpit to spread doubt about vaccines

Experts interviewed late last year told STAT this is perhaps the most powerful way Trump could influence childhood vaccination rates. Fanning uncertainty among wavering parents could go a long way in turning doubt into abstention from vaccines. And that could be dangerous for everyone, as it would increase the likelihood of outbreaks of communicable diseases such as measles.

This article is reproduced with permission from STAT. It was first published on Jan. 10, 2017. Find the original story here.

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