Dave Weldon was President Trump’s pick to run the Centers for Disease Control and Prevention. But just 12 hours before his Senate confirmation hearing, he was told that the nomination was being pulled. There was bipartisan opposition to his candidacy based on his vaccine-skeptic views. And so, the White House believed Weldon didn’t have sufficient votes to be confirmed.
Weldon’s position on vaccines aligns more or less with Secretary of Health and Human Services Robert F. Kennedy, who appears to be readying the CDC for changes in vaccine policies. Long considered a vaccine-skeptic, Weldon is a practicing medical doctor and a former Congressman. He has repeatedly raised questions about the safety of measles, mumps, rubella and human papillomavirus vaccines. It’s this ongoing controversy that appears to have nixed Weldon’s hopes to be nominated the next head of the CDC, but somehow did not undo Kennedy’s confirmation.
The CDC does a lot more than just vaccine policies. But its issuance of recommended scheduling of immunizations is perhaps more visible to the public than its other work. Specifically, the CDC is responsible for providing recommendations to the public about when and how to use vaccines approved by the Food and Drug Administration. This includes issuing the United States adult and childhood immunization schedules that provide guidance on the age(s) when vaccines should be given, the number of doses recommended, timing of doses and other information.
Together with the secretary of HHS, the CDC director has considerable influence with respect to vaccine policies. The director makes decisions regarding whether a vaccine should be recommended to the public. Advice disseminated by the agency is not binding on states and local jurisdictions which establish vaccination requirements for school children and in some cases healthcare workers and patients or residents of healthcare facilities. But negative guidance from the CDC may affect insurance coverage because insurers are only obligated to cover vaccines that have been recommended by the agency.
Weldon has said he’s just interested in “vaccine safety.” On the face of it, some of his statements do seem strictly aimed at addressing perceived safety issues while not necessarily undermining vaccines. Introducing the Vaccine Safety and Public Confidence Act in 2007 as a representative in Congress, he stated: “I’m a physician. I understand the importance of immunizations in protecting children and the public at large from infectious disease. As a society we benefit from vaccines and as such it is important that we guard carefully vaccine safety research to ensure its objectivity.” And in a public statement on the withdrawn nomination, Weldon writes that he “gives hundreds of vaccines every year in my medical practice.”
The bill which Weldon sponsored in 2007 sought to undo what he saw as a conflict of interest entailed by CDC being both a promoter of vaccines and an evaluator of their safety. In Weldon’s view at the time, vaccine safety research ought to be under the auspices of an independent division or agency within the Department of HHS.
He also introduced a piece of legislation that same year which would have limited who can receive vaccines containing thimerosal, a preservative used to prevent germ contamination. Theoretically, thimerosal’s ethyl-mercury base could lead to mercury poisoning in high doses. However, the additive hasn’t been used in vaccines since 1999.
But what may have tipped the scales against Weldon’s potential confirmation is his continued staunch defense of the (former) gastroenterologist Andrew Wakefield. Weldon has stirred controversy repeatedly by insinuating a link between the MMR shot and autism, citing Wakefield’s debunked theories. As such, Weldon’s views have been a cause for concern in the public health community.
The overwhelmingly positive effectiveness of vaccines is not in doubt in mainstream medicine. The World Health Organization estimates that worldwide immunization efforts have saved at least 154 million lives over the past 50 plus years.
Despite an abundance of evidence to the contrary, Weldon holds fast to the belief that vaccines cause autism. In his three-and-a-half page public statement on the withdrawal of his nomination he devotes more than a page to defending Wakefield and colleagues.
Even though Weldon claims to be merely interested in determining and communicating vaccine safety risks, amplifying the very small risks at the expense of the known benefits would come at a time of a widening measles outbreak that began in Texas. Emphasizing the need to further examine vaccine safety could raise doubts in the minds of parents considering vaccinating their children, leading to more vaccine hesitancy.
Curiously, Weldon (and other vaccine skeptics) also pins the blame on “Big Pharma,” using the term in a negative light seven times in his written statement yesterday. Yet historically vaccines have represented a mere 2% of overall drug industry revenues, with only a handful of large pharmaceutical firms dominating the market. Vaccine development and manufacturing have relatively high costs of market entry and generally yield lower profits compared to other pharmaceuticals.
Whether the withdrawal of Weldon’s nomination is a win for vaccines depends on who Trump nominates next and how much influence Kennedy exerts as the CDC director’s boss.
