The current measles outbreak in Texas, the ascension of Robert F. Kennedy, Jr. to the post of Secretary of Health and Human Services and broad societal trends have prompted widespread debate over the wisdom and future of vaccinating children for preventable infectious diseases with meaningful, even major, morbidity and mortality.

 

Against this background, I believe CMDA’s 2021 Position Paper on Vaccines and Immunizations (accessible here), though nuanced in some ways, is a strong endorsement of vaccinating children, which deserves affirmation with considerable vigor by CMDA as an organization and by its members.

 

The current outbreak is not historic—yet. The New York City outbreak in 2019 was greater, and it was eventually controlled. Still, the nationwide trend is clearly up from a low of 85 cases in 2000, which in turn represented a nadir from the large number of cases last seen in the late 1980s and early 1990s. The nationwide vaccination rate for measles has declined from 95.2 percent in 2019-2020 to 92.7 percent in 2023-2024, with 13 states showing rates lower than 90 percent, down to Idaho at 79.6 percent. The lowest rates appear to fall below the herd immunity threshold for measles, potentially auguring a resurgence of the disease in the U.S. The U.S. Center for Disease Control and Prevention (CDC) further reports that reduced rates similar to those for MMR have been seen for DTaP, polio and varicella vaccines.

 

Because policy often begins with leadership, it is vital to examine the past vaccination views of Secretary Kennedy, a historic skeptic of vaccination. While he recently expressed “support” for the measles vaccine, he stopped short of urging parents to have their children vaccinated, saying only that parents “should consult with their healthcare providers to understand their options to get the MMR vaccine.” He also touted Vitamin A to reduce measles mortality, citing a report that also affirms the efficacy of vaccination consistent with the currently recommended schedule. The Wall Street Journal commented (subscription required) that in 2019, Mr. Kennedy claimed that “the cure for most infectious measles…is Vitamin A.” The Journal added, “In [a recent] interview, [Mr. Kennedy] promoted treatment [with] steroids and cod-liver oil as producing ‘almost instant and miraculous recovery [from measles].’” It is concerning that Secretary Kennedy appears to be overstating Vitamin A’s efficacy while understating the measles vaccine’s efficacy in preventing measles.

 

Arguments for challenging childhood vaccinations include personal choice and parental rights, the concern that at least some vaccines were developed using fetal cells derived from aborted babies and the notion the current vaccines are ineffective. Then there is what we might call the “pincushion argument,” that the current recommended vaccine schedule goes beyond the “core 7” of polio, MMR, DTaP, pneumococcal conjugate (PCV15, PCV20), H. flu type b (Hib), Hepatitis B and varicella. Of course, vaccination is medically contraindicated in some cases. Arguments can be made for the benefit/risk ratio of specific individual vaccines when not contraindicated. I do not intend to take those up here, but would note I would be reluctant to argue against recommendations for rotavirus or meningococcus, for example. Some vaccines (Mpox, Dengue) clearly apply to specific situations. Recently, a Christian nursing PhD/bioethicist told me she is convinced that heavy vaccination induced severe eczema in her daughter. Perhaps data exists for such an “immune overstimulation” model; if so, I confess I don’t know the data.

 

Particularly pernicious, in my opinion, is the persistent canard that measles vaccine, or vaccination in general, causes autism. I still occasionally encounter people who believe the thoroughly-discredited Wakefield report from The Lancet in 1998. The claim is refuted by substantial information; an extensive review discussion is available here (subscription required, however), and I believe the burden of proof lies with anyone asserting an association of vaccines and autism. CDC is reportedly planning a new large study of the potential link. We should monitor the design of that study carefully. If it is of the quality of the WordPress blog report Secretary Kennedy advanced in his confirmation hearings—a report based on billing codes that appears to suffer from, to name a few issues, selection bias, poor case definition and failure to account for confounders—I would worry the CDC study would be more designed to support future tort claims than medical/scientific recommendations.

 

CMDA’s 2021 Position Statement:

• Affirms the Christian’s duty to care for children, selves, our neighbors and the vulnerable;
• Cites the safety and efficacy of vaccination for preventable diseases such as smallpox, polio, measels, mumps, rubella, diphtheria, tetanus, pertussis, pneumococcal disease, influenza, hepatitis A and B and rotavirus;
• Warns that healthcare professionals should be alert for, and counter, “misinformation” and “encourage vaccine usage within their communities and churches:”
• Says that “healthcare professionals should not recommend an alternative vaccine schedule;”
• States that vaccination rates greater than 90 percent support herd immunity and are important to support community health;
• Says that “No credible scientific study has proved causation of developmental disorders, such as autism, by an immunization product;” and,
• Recommends a replacement rubella vaccine be developed that does not use fetal cells.

 

Separately, CMDA has addressed questions of moral complicity with evil (relevant to vaccines developed from fetal cells), parental choice and its limits and shared decision-making.

 

Finally, we might consider that HPV vaccination is a special case, and much current vaccine hesitancy may have arisen out of concerns—that I share—about how the COVID pandemic was handled.

 

Still, I urge robust re-assertion of the 2021 CMDA Position Paper on Vaccines and Immunizations.

 

Full-disclosure: I am not an epidemiologist, pediatrician or infectious disease expert. In fact, I’m not even a practicing physician. I am a medical oncologist by training, retired from a career in industry drug development, who also has an master of arts in bioethics from Trinity International University. I am on the review board for Dignitas, a publication of the Center for Bioethics and Human Dignity (CBHD). I was an online, general-public signatory to the Great Barrington Designation.