Create an independent FDA, CDC – new COVID-19 vaccines required it

independent CDC FDA

The COVID-19 pandemic and the subsequent rush for treatments and vaccines for the virus have renewed calls for a more independent FDA and CDC. Professor Dorit Rubinstein Reiss, who is a frequent contributor to this space, has written two powerful articles arguing for an independent CDC and FDA.

If you have followed the progression of the COVID-19 pandemic in the USA, the Centers for Disease Control and Prevention (CDC) and the United States Food and Drug Administration (FDA) responses have been politicized to the point that even those of us who have strongly supported those two agencies are appalled. 

The CDC has been pushed to scrub information and data to make the Trump administration look good. Recently, it was reported that one of Trump’s minions tried to pressure CDC regarding the transmission of the virus to kids to get it in line with the nonsense being pushed during Trump’s failed presidential campaign.

And then the FDA gave Emergency Use Authorizations (EUA) to hydroxychloroquine and remdesivir for treatment of COVID-19. Unfortunately, the data showed that hydroxychloroquine does not work and remdesivir has only a marginal effect on outcomes. In each case, it appears that the FDA was more interested in promoting these drugs to support President Trump’s wild claims that he was “doing something” about the pandemic, rather than relying upon robust science.

Professor Reiss has written two articles about how we might create a more powerful and independent FDA and CDC by utilizing the types of structures of actual independent agencies within the Federal Government. I want to quickly review what she proposes because I think it’s a conversation that we hope that President-elect Joe Biden might embrace during the next few years.

The problem is that 

Continue reading “Create an independent FDA, CDC – new COVID-19 vaccines required it”

Public health and vaccines commentaries – employment repercussions

public health and vaccines

When employees speak up on matters of public health and vaccines in their free time, those who do not like the speech may retaliate by complaining to their employers, who may be tempted – or feel forced – to act against the employee. But employers should not, and some types of employers – public employers – are likely barred from doing so.

This post considers mostly employees in public institutions – department of health, teaching hospitals, or universities – because these employees have legal protection against sanctions – an employer is likely legally prohibited from acting against them because of speech on matters of public health and vaccines in their free time.

However, the points made about defamation and the policy considerations also apply to private employers, those who can fire employees at will, at least when the employees provide mostly accurate, fact-based information.

These issues can come up in a variety of contexts, some of which the employer may appreciate more than others. One situation is when an employee working for a public institution spends part of his personal time commenting on public health and vaccines issues and informing the public through a personal blog, on which his position is mentioned, or by commenting on social media, Facebook or Twitter.

The employee provides information, corrects misconceptions, and criticizes those offering bad advice or factually inaccurate information, sometimes with strong language. A person so criticized contacts the public institution and threatens to sue for defamation if the blogging does not stop and the statements are not retracted, or if the employee is not otherwise dealt with.

Or, for example, an employee makes a joke about a public health issue – in good or bad taste – in her personal time. People offended complain to the employer, either just criticizing the employee or threatening legal action. In both cases, employers should not take measures against the employee.

First, in most circumstances, there would almost certainly be no defamation case here. Second, limits created by the First Amendment on the ability of public employers (though not private ones) to fire an employee for their speech likely apply here. Finally, there are public benefits from allowing the employee to speak in this manner. Continue reading “Public health and vaccines commentaries – employment repercussions”

Gun control and vaccines – the deniers use the same twisted logic

Because of the lack of willpower to implement serious gun control, thirty-one children, brothers, sisters, grandparents, mothers, and fathers died this past weekend. But another week will pass, and there will probably be another week of horrible killings by hate-filled mostly white, mostly men.  

  • Dayton, 10
  • El Paso, 20
  • Gilroy, CA, 4
  • Virginia Beach, 12
  • Aurora, IL, 5
  • Thousand Oaks, CA 12
  • Pittsburgh, 11
  • Annapolis, 5
  • Santa Fe, TX, 10
  • Parkland, FL, 17
  • Sutherland Springs, TX, 26
  • Las Vegas, 58
  • Orlando, 5
  • Ft. Lauderdale, 5
  • Burlington, Wash., 5
  • Sandy Hook, 26

The dates and locations change, but the will to make substantive changes to our gun control laws evaporates after each mass murder. The Republican Party, which effectively controls our government, knows that it really doesn’t have to do anything. After a few weeks pass, we’ll forget about it, and they don’t have to do anything. It’s cynical, but that’s what happens when a political party is beholden to racism and the gun lobby.

So you’re probably asking, “what the hell does this have to do with vaccines?” 

Two days ago, I would have shrugged. Then, while getting coffee from my local venti Americano shop, I overheard two older (and lily-white) men discussing the shooting. Setting aside their overt racism, they thought that killing a few “illegals” is “heroic,” they said that “just because a handful of people died out of 300 million Americans, that’s not a reason to take our guns.”

In other words, they’re saying that the risk of dying from a gun is so small, it’s not a consideration for gun control. I’ve heard this logic before, and it’s from the anti-vaccine religion. They argue that because only a few children will die of measles (or any vaccine-preventable disease), vaccines should not be mandated. 

Yes, the chances of dying from measles are rare (thanks to vaccines). Yes, the chances of one person dying in a mass murder are small. The problem with the logic of the anti-vaccine and anti-gun control nutjobs are the same – we have the power to prevent both. And we should prevent both. 

The old racist white guys talking too loud in my local coffee establishment probably thought they were immune (sorry, had to go there) from being killed in a mass killing because only brown people were targeted (which wasn’t true about either El Paso or Dayton this past weekend). The murders were indiscriminate. And all of those murdered did not deserve to have their lives cut short. Continue reading “Gun control and vaccines – the deniers use the same twisted logic”

WHO’s top 10 public health threats – vaccine deniers included in the list

public health threats

The World Health Organization (WHO) recently published their top 10 world public health threats in 2019. It includes all of the public health threats that you can imagine, plus what they call “vaccine hesitancy,” or what I call the anti-vaccine religion’s ignorance, misinformation, and lies.

Yes, the anti-vaccine fiction and deception are one of the greatest dangers to the world’s public health. Their tropes, memes, and falsehoods are convincing enough people to delay or avoid vaccinating their children that diseases we thought weren’t a threat anymore are coming back. Europe and the USA are experiencing an unprecedented measles outbreak because of slightly lower measles immunization rates.

I want to review the WHO public health threats list because it’s interesting to those of us who fight the good fight for science. Of course, I’m going to focus on the vaccine deniers because that’s what we do here. Continue reading “WHO’s top 10 public health threats – vaccine deniers included in the list”

H1N1 flu vaccine – Peter Doshi invents a myth about GSK Pandemrix

H1N1 flu vaccine

During the 2009-10 flu season, public health officials across the world were concerned about a flu pandemic caused by the H1N1 influenza virus. In response to the dangerous new flu, these same public health officials made certain to protect their citizens with new a new H1N1 flu vaccine that would protect individuals from the pandemic H1N1 flu virus.

There have been two H1N1 flu pandemics in recent history. The first, the 1918 pandemic, also called the Spanish Flu, infected over 500 million people worldwide (when the planet only had about 2.5 billion humans) and killed between 50-100 million. And no, it didn’t target babies and the elderly, it killed everyone targeting healthy young adults.

In the USA alone, the US Centers for Disease Control and Prevention estimated that the 2009 pandemic resulted in over 43-89 million cases, 195-403 thousand hospitalizations and between 8,870 and 18,300 deaths. The CDC also estimated that over 300,000 people died worldwide from the 2009 H1N1 flu.

No wonder the world’s public health authorities made sure the H1N1 flu vaccine was widely available. I cannot imagine what those numbers would have been without it – possibly millions of deaths worldwide.

Recently, anti-vaccine hawker, Peter Doshi, continues with his perverse, pseudoscientific assaults on flu vaccines by now using a ridiculously amateurish conspiracy to invent safety concerns about the 2009 H1N1 flu vaccine. I’m not one to let this nonsense pass, so here goes. Continue reading “H1N1 flu vaccine – Peter Doshi invents a myth about GSK Pandemrix”

Measles epidemic in Europe is killing children – blame anti-vaccine religion

measles epidemic

Maybe some of you haven’t been following the reports about the European measles epidemic, but it’s scary news. The BBC News reported that more than 41,000 people have contracted measles in the first six months of 2018. Worse yet, 37 of those people have died of that virus.

Let me be blunt – nearly every one of those 41,000 cases and 37 deaths could have been prevented by the MMR vaccine (for measles, mumps, and rubella). Period. Full stop. End of story.

In case I wasn’t clear, let me repeat myself – indulge me, we’re talking about children dying of an entirely preventable disease. Every single case of measles could have been prevented. Every single death could have been prevented. This isn’t a complicated story.

Maybe you think that Europe is a big area with over a half billion people, so this might be expected. That would be incorrect. Measles was almost extinct in much of the developed world. In 2016, there were just 5,273 measles cases for the whole year. In 2008, there were only 3,575 cases and one death. Measles was almost eliminated.

Let’s take a look at how this happened, and place blame right where it belongs – in the misinformation, pseudoscience, and outright lies of the anti-vaccine religionContinue reading “Measles epidemic in Europe is killing children – blame anti-vaccine religion”

Robert Redfield named CDC director – what does this mean for vaccines?

robert redfield

The Centers for Disease Control and Prevention (CDC) is America’s national public health institute – it is one of the most respected scientific institutions in the world. And the CDC Director, a presidentially appointed position, usually sets policy for public health in the USA, while they have considerable influence over public health worldwide. After the resignation of Dr. Brenda Fitzgerald in January 2018, President Donald Trump appointed Dr. Robert Redfield as the new CDC Director.

Despite the fantasies of the anti-vaccine religion and other science deniers, the CDC is staffed by highly educated and trained scientists, public health experts, physicians, and nurses, many of them are officers in the United States Public Health Service. These people are dedicated to the public health of Americans and often spend their lives keep all of us safe from harm from diseases.

The CDC’s main goal is to protect public health and safety through the prevention of disease, injury, and disability not only in the USA but also internationally. The CDC is an independent Federal agency whose dedicated staff stand at the front lines of infectious diseases throughout the world. The agency also focuses on non-infectious diseases, such as diabetes and obesity. Finally, they provide educational activities designed to improve health.

Of course, the CDC matters to me because they are the primary source of information about vaccines and vaccine-preventable diseases in the USA and the world. Though the CDC does not control vaccinations, they only set recommendations that states and certain parts of the Federal government (like the military and foreign service officers) generally follow. The CDC follows logical and scientific procedures to make these recommendations.

And now we have a new CDC Director, Dr. Robert Redfield, who at first blush appears to be a reasonable choice for the position. However, I am a scientific skeptic, so I never stop at the first blush. Continue reading “Robert Redfield named CDC director – what does this mean for vaccines?”

CDC Director Brenda Fitzgerald resigns – impacts on vaccines, public health

Brenda Fitzgerald

If I asked the general public about the CDC director, or who that person is (Brenda Fitzgerald), I’d get a blank look. It’s not exactly the most prestigious position in the Federal Government, but if you care about vaccines, cancer, infectious diseases, and public health, the Centers for Disease Control and Prevention is probably one of the more important Federal agencies, unless you buy into thoroughly debunked CDC whistleblower conspiracy theories.

Because most Donald Trump appointees to Federal government department and agencies were filled with incompetent, ethically-challenged, science-denying individuals, his appointment of Brenda Fitzgerald as CDC Director was, more or less, taken by the science and medical community with a sigh of relief. She wasn’t anti-vaccine. She seemed to understand the role of public health in the USA. And she was a doctor. Trump could have done much worse, as we’ve seen in other departments.

The anti-vaccine religion has been bigly supportive of Trump because he had shown some proclivity towards the vaccine denier beliefs. But they ended up crying vaccine tears when Trump did the “right thing” (probably the only time I will write that comment with respect to Trump) regarding several public health posts, including the CDC Director and Surgeon General.

Then it all blew up.

Continue reading “CDC Director Brenda Fitzgerald resigns – impacts on vaccines, public health”

Gun control regulations and firearms mortality – UPDATED

Gun control regulations and public health.

Firearms mortality, either murder, accidental or suicide, has always been a public health issue in the USA. There have been several good epidemiological studies that have examined whether gun control regulations and firearms mortality risk are related – and the results are surprisingly vigorous.

From recent epidemiological research, there is some convincing evidence that establishes a correlation between state-level gun control regulations and firearms mortality rates. However, the link is not as black and white as one might wish – the relationship between firearms regulations and mortality depends on the quality of the law.

The nation’s leading public health organization, the Centers for Disease Control and Prevention (CDC), is essentially prevented from analyzing and publishing any epidemiological research that would help us understand what, if any, links there are between gun control and firearms mortality. The Republican dominated congress have done everything they can to prevent the CDC from using any funds to study the issue.

Furthermore, because the CDC cannot (or will not) fund research into gun control, it has lead to a chilling effect on gun control research in academia. According to the Washington Post, “young academics were warned that joining the field was a good way to kill their careers. And the odd gun study that got published went through linguistic gymnastics to hide any connection to firearms.”

But maybe because this public health menace can no longer be ignored, a smattering of well done epidemiological research is being published in very high quality medical journals. Let’s look at one.

Continue reading “Gun control regulations and firearms mortality – UPDATED”

Trump appointed Surgeon General and CDC director – good for vaccines

Trump appointed Surgeon General

Donald Trump’s record on appointments for science and medical positions has been horrific, at best. His choice of Tom Price for Health and Human Services was terrible for healthcare. Anti-science individuals were also appointed to serve as EPA Director and Secretary of Energy. But recently, Trump appointed Surgeon General and will appoint a CDC director, both of whom appear to be good, though not perfect picks.

From a purely non-political standpoint, those of us on the science side wanted a few basics in the new Surgeon General and CDC director:

  1. Have a respectable medical and/or public health background.
  2. Provide full-throated support for immunization programs
  3. Don’t belong to the right wing Association of American Physicians and Surgeons (AAPS), which has radical ideas about health care, Medicaid, Medicare and just about any modern healthcare strategy.
  4. Don’t have unscientific ideas about HIV/AIDS, Ebola, Zika virus, and many other contemporary issues in public health.

Sure, it would be nice for our national public health advocates to remind the country that accidental gun deaths is a public health issue, but that’s never going to happen in the current political environment.

Let’s take a look at who President Trump appointed Surgeon General and who he will probably appoint CDC director. Continue reading “Trump appointed Surgeon General and CDC director – good for vaccines”