Are Doctors Dumb and the CDC Evil?

Last week, I wrote about Dr. Toni Bark’s testimony in front of the Minnesota Senate Health and Human Services Committee concerning a vaccine bill that would have made it more difficult to opt out of school entry vaccine requirements. I touched briefly on her assertion that the CDC is not transparent, hides information, plays games, and is bad in all possible ways.

Today, I wanted to revisit some of these assertions because they are common to the anti-vaccine movement. In fact, in order to believe that vaccines are bad for children, a person must believe that either the CDC is evil and wants to purposely harm them, or doctors are bumbling fools who don’t know what they are doing.

You cannot be anti-vaccine without believing that someone is hiding something from you or that you are smarter than the experts in the field since nearly every single expert in the field agrees that vaccines are safe and effective. In fact, the anti-vaxxers like to trot out their list of doctors who believe that vaccines are bad, which is quaint because there are so few of these doctors that they fit on a list. The number of doctors who want you to vaccinate your children and yourself is so large that we cannot list them. It’s easier just to say, “Pretty much all of them, except the ones on your list (who usually have online stores).”

But let’s address some of the questions this either-or anti-vaccine assumption posits.

Do doctors know anything about vaccines? Or do anti-vaccine parents who use the internet find themselves better informed than their doctors?

For this answer, I would like to quote the reply given by Dr. Dawn Martin, pediatrician at the Hennepin County Medical Center in Minneapolis. She was asked this question directly by Minnesota Senator Eaton in response to Toni Bark’s testimony in front of the MN HHS committee. Here is what Dr. Martin said:

One of the centerpieces of what we do in pediatrics is preventative care, and one of the centerpieces of preventative care is vaccines. We take it very seriously. I’m actually a faculty member of Hennepin County Medical Center, where I am involved in teaching medical students [and] residents. We have in this state, I think cutting edge information through our health department and through original research that has been done here in this state on vaccines. We have several members who have testified here before you that are on the Advisory Committee for Immunization Practice for the CDC. We have, I believe, a wealth of solid immunization information here, and it is centerpiece in our medical school curriculum.

I can speak for what we do in pediatric resident training. It is something, that I know for a fact, that our pediatric trainees are well-versed and well-educated in solid immunization information. . . . So, yes, we are familiar with that research, we are familiar with the vaccines, I think most pediatricians take this very seriously. And it’s a very big part of our ongoing continuing medical education.

If you look at CMEs that most pediatricians engage in, immunization information, how are the schedules changing, wanting to be up-to-date, that is very important in pediatrics. And I am not a family doctor, but I would also venture to say it is a central part of their education as well as nurse practitioners and physicians assistants. So I don’t know, Madam Chairman, if I have answered your question or if there is other information that you want. It really pains me to hear individuals say that physicians, and pediatricians in particular, don’t take this seriously or do the research or get the background that they need to come themselves informed and up-to-date. I will admit that it is a changing field and that it does take some very deliberate effort to stay up-to-date, but we do take that very seriously.

Is there a lack of transparency at the CDC? 

Whenever a large, bureaucratic government agency exists, we will naturally wonder if, in an attempt at self-preservation, will close their shutters to all scrutiny. However, when it comes to immunization, it is very important to note that the schedule is not made from within the Ivory Towers of the CDC. It is suggested, debated, and voted upon by doctors who are current practitioners working in communities around the country and outside the CDC.These researchers, doctors, nurses, and public health officials sitting on the Advisory Committee on Immunization Practices (ACIP) rely on research done from many different sources when deciding if and how to change the recommended vaccine schedule. And all of this is done as transparently as possible – in fact, you can watch the meetings on the internet as they take place.

Does the CDC waive Conflicts of Interest (COIs) in order to remain in cahoots with Big Pharma?

Part of the anti-vaccine trope about ACIP, however, is that those on it bring their Big Pharma love there without anyone ever being able to learn about their ties. Is this true? Is it possible that I could own  Big Pharma stock and sit on ACIP in secret hopes of becoming rich by getting vaccines added to the schedule? I asked Patsy Stinchfield CPNP, the first nurse to sit on ACIP, about this question. Here’s what she said:

To become an ACIP voting member I had to provide the CDC detailed statements of my and my husband’s investments. (I have no conflicts). At the beginning of every day of every ACIP you must declare if you have any conflict of interest and if you do you cannot vote on that issue.

So not only does someone have to declare COIs in order to be a member of ACIP, one also must declare before voting and abstain from votes where a conflict might exist.

The CDC probably wants to prevent disease and doctors probably know more than their patients.

Even I have had the exceedingly rare moment when I was right and the doctor was wrong. (A doctor once performed a strep test to humor me, and it came back positive.) But for the most part, those of us who never went to medical school know less about medicine than those who went. And while government agencies can feel like something faceless from a science fiction movie, when it comes to vaccines, it’s pretty easy to watch, in real time, what the CDC is doing.

Remember that in order to be anti-vaccine, you have to believe that either the experts are evil or the experts don’t know what they are doing. If you want to help a friend or family member overcome vaccine hesitancy, help them see the follies of this belief, first.

A special thank you to Dr. Dawn Martin and Patsy Stinchfield for their advocacy and their all-around awesomeness.