As I mentioned yesterday, at NECSS I gave a talk, Whither the antivaccine movement in the Age of Trump? At the time, I only knew the identity of one of the most important public health figures appointed by President Donald Trump, and that’s Scott Gottleib, the man appointed to be FDA Commissioner. As I noted when his name first came up as a candidate for this position, antivaxers weren’t going to like it. Why? One reason is because Gottlieb is the ultimate pharma shill, if such a thing exists. Another reason is that he is very pro-vaccine. This amuses me when I consider the high hopes antivaxers had for Trump’s election after his long, sordid history of antivaccine sentiments, his having met with antivaccine “hero” Andrew Wakefield during the presidential campaign, and his having met with another antivaccine “hero,” Robert F. Kennedy, Jr., during the transition period.

At the time I gave my talk on Friday morning, I didn’t yet know whom Trump had chosen for CDC Director. If I had, my talk would have been somewhat different (although not too much). It now amuses me to consider that it now appears that Trump has chosen his CDC Director (a post that does not require Senate confirmation). She does not appear to be the sort of person who would be willing to help Trump dismantle the public health system by supporting the idea that vaccines cause autism, supporting dismantling the Vaccine Court, or calling for more bogus antivaccine “research” designed to find nonexistent detrimental health effects due to vaccines. Her name is Dr. Brenda Fitzgerald, and she’s Georgia’s Commissioner of Public Health, a position she’s held since 2011. It’s not official yet, but news reports have indicated that Dr. Fitzgerald is deep in discussions to become the new CDC Director.

To give you an idea of the relief I’m feeling at the moment, you might recall that, when I heard that RFK Jr. was meeting with Donald Trump, I mentioned that the first thought that popped into my mind was that Trump was considering him for CDC Director or some other high profile public health position in the administration. Yet here we are, six months later, and nothing’s become of the “vaccine commission” that RFK Jr. claimed that Trump had offered him, while the FDA Commissioner is the ultimate pro-vaccine pharma shill. Now it appears that we will probably have a pro-vaccine, fairly boring, standard-issue CDC Director, the sort of CDC director that any Republican President might have been expected to appoint:

Fitzgerald is no newcomer to politics. She served as a health care policy advisor to House Speaker Newt Gingrich and U.S. Sen. Paul Coverdell, both Republicans. She twice ran unsuccessfully for Congress, in 1992 and 1994, both time as a Republican.

Gov. Zell Miller appointed her to the state Board of Education in 1996 when he remade the board in hopes it would get along with the state’s first Republican state school superintendent, Linda Schrenko. The chairman of that new board was Johnny Isakson, who is now Georgia’s senior U.S. senator.

Now here’s the interesting thing. She’s quite pro-vaccine. Indeed, as recently as April, she was touting not only her state’s improved vaccination rate, but urging parents to vaccinate their children:

During National Infant Immunization Week, April 22-29, the Georgia Department of Public Health and the Georgia Chapter of the American Academy of Pediatrics urge parents to check with their pediatrician to ensure their child is up-to-date on vaccinations.

“Immunizations are the best way to protect infants and children from childhood diseases, like whooping cough and measles that can be life-threatening at young ages,” said Brenda Fitzgerald, M.D., commissioner of the Georgia Department of Public Health. “It is critical for parents to talk to their child’s doctor to ensure they are up-to-date on immunizations, because no child should have to suffer a vaccine-preventable illness.”

She’s even written opinion pieces with titles like Babies Need Their Vaccines in 2014 (before the Disneyland measles outbreak), in which she rejects antivaccine pseudoscience explicitly:

I’ve heard all the arguments against vaccination. All have been debunked, including the infamous 1980s study in Europe about a similar vaccine for measles, mumps and rubella, and a supposed link – that we now know to be false – to autism, which shattered vaccine use in Europe. Outbreaks now plague the Continent, and here in the U.S., signs of trouble are building.

Pertussis outbreaks in Oregon and Texas and an ongoing outbreak in California should alarm us. In Georgia right now there are 83 confirmed cases of this disease.

And then makes an emotional appeal:

At the Georgia Department of Public Health, our team in immunizations has been preparing for National Infant Immunization Week, which begins today. The team will work to improve Georgia’s resilience to vaccine-preventable disease through increased immunization rates among siblings, caregivers, grandparents and infants. I want to reach our state’s mothers-to-be.

I am a mother. I am vaccinated. And I ask you to join me. Choose to vaccinate first yourself, and then your new baby. Follow the vaccine schedule, and guard against diseases like whooping cough that only you can prevent before baby is born.

As a board-certified obstetrician-gynecologist, I have seen the devastating and painful effects of whooping cough and other vaccine-preventable diseases. I’ve seen mothers who fear every gasp of air might be their babies’ last.

Get vaccinated. Help spread the truth on vaccines, not the diseases they prevent.

These are not the sort of things that someone who is antivaccine or antivaccine-sympathetic write. Nor do people who are antivaccine or antivaccine-sympathetic willingly enforce laws in which only nonmedical exemptions or religious exemptions are permitted, with a notarized state-issued form being the only accepted way of claiming a religious exemption. (Indeed, Dr. Fitzgerald was in charge when the Georgia Department of Public Health changed the rules to require a state-issued, notarized form to claim a religious exemption; presumably she had to sign off on such a major rule change—or at least not oppose it.) Nor would an antivaccine or antivaccine-sympathetic person allow a blog that promotes vaccination, including entries promoting the birth dose of the hepatitis B vaccine, tells parents how to catch their children up on their shots if they fall behind, and urges pregnant women to get their Tdap vaccine.

That sure sounds suitably pro-vaccine to me.

Of course, basically anyone who is involved in public health, especially at a leadership level (particularly at a state leadership level) is pro-vaccine. The reason is simple, and it has nothing to do with “dogma,” as antivaxers will claim. It has to do with science and the fact that vaccines work. They are the single most effective public health intervention conceived by the human mind and made by human hands. They do not cause autism. They do not cause all the horrible autoimmune and other diseases that antivaxers claim. They save lives, lots of lives. Sooner or later, anyone in public health who is intellectually honest, regardless of ideological bent, be it liberal or conservative, comes to that conclusion. The “ideological conformity” in public health officials’ belief in vaccines comes not from brainwashing, but from decades—no, hundreds of years—of evidence.

Interestingly, Dr. Fitzgerald shows characteristics unusual for a Republican politician:

Fitzgerald also drew headlines for a decision to rescind a job offer to a California physician initially offered a job as a north Georgia health director after reports surfaced about controversial sermons he made condemning gay rights and the theory of evolution.

I note that this action resulted in a lawsuit by Dr. Erick Walsh, the pastor fired after what he said in his sermons became known. This CNSNews.com article mentions the lawsuit, calling it a violation of religious liberty while conveniently failing to note just what the sermons said, such as:

  • Oprah Winfrey is harboring the spirit of the anti-Christ;
  • The prophet Muhammad, founder of Islam, was influenced by Satan;
  • The devil set up Catholicism;
  • Acceptance of homosexuals is a satanic ploy to destroy America;
  • Rapper Jay Z is a disciple of Satan;
  • Single mothers are ruining their children;
  • Disney movies, which are loaded with violence, sex and magic, are a satanic ploy to split up families;
  • Darwin’s Theory of Evolution is a “satanic belief”;
  • The distribution of condoms to a public in need leads to higher AIDS rates;
  • The pope is the anti-Christ.

OK, I’ll have to give Dr. Walsh the first one. I can accept that Oprah might harbor the spirit of the Antichrist. But all the rest? Wow. In any case, Georgia ended up settling the lawsuit for $225,000. Pesonally, I’d think that these views are incompatible with doing a good job in public health, particularly the belief that condoms can lead to higher AIDS rates, which is just not supported by evidence, and the belief that homosexuality is a sin, but I can see how rescinding a job offer after finding out such information could give the appearance of making a job decision based on religion. Be that as it may, rare is the Republican who would have made such a decision.

I don’t know if Dr. Fitzgerald will be a good CDC Director or not. She seems to have the qualifications, and I can’t find anything egregiously disqualifying in her background. She is definitely pro-vaccine. She doesn’t seem to have the typical conservative Republican hangups about sex, gays, and evolution. Best of all, antivaxers who have bothered to say anything hate her. For instance, Ginger Taylor, who is the Dunning-Kruger Effect personified, posted this to Facebook:

What’s upset her? Dr. Fitzgerald’s’s Babies Need Their Vaccines article! Hilarity! The tears of betrayal following Taylor’s post are delicious. Then, a certain occasional commenter is also very, very unhappy.

So, am I happy with the appointment of Dr. Fitzgerald? “Relieved” is a better word to describe the feeling, although I must admit that it feels better than when Scott Gottlieb was appointed FDA Commissioner. He was basically the least bad of all the known candidates, but he is still a pharma shill who favors deregulation. Dr. Fitzgerald, in contrast, appears to be halfway decent in comparison.

Still, I have no illusions about Trump and vaccine policy. As Dr. Paul Offit wrote a couple of weeks ago, Trump’s budget takes aim at critical public health funding. If it passes, there will be less money for the CDC to do its job, less money to distribute vaccines, less money to intervene in the case of public health threats, and in general, less resources to do its critical job. Whether Dr. Fitzgerald can or would oppose such budget cuts, we have no way of knowing. Why anyone who is serious about public health would want to run the CDC under such circumstances, I don’t know.

Still, for a brief moment, I can’t resist feeling a bit of schadenfreude as I hear the wails of antivaxers who cry, “Betrayal!” Suckers. He conned you, too.

Comments

  1. #1 Julian Frost
    Gauteng North
    July 6, 2017

    Her name is Dr. Brenda Fitzgerald, and she’s Georgia’s Commissioner of Public Health

    Rosalynn Carter (wife of Jimmy) founded “Every Child by two”. I wonder if she’s involved with that.

  2. #2 Lawrence
    July 6, 2017

    It’s still going to be an long, upward slog for the next few years. Although Drumpf’s budget is DOA in Congress, it’s highly likely that public health programs are going to take a big hit.

    If there are champions in the right place, the damage might be mitigated somewhat, but if vaccine programs for the poor are hit as hard as they appear to be, then we end up with an entirely different issue – outbreaks not because of anti-vaxers, but because the poor can’t afford to get vaccinated.

    Of course, it is going to be interesting to see how the Gnat reacts if his hero does go ahead and appoint this woman to the CDC…

  3. #3 MrrKAT
    Finland, EU
    July 6, 2017

    Pfyuuu, I’m relieved too here on the other side of globe.

  4. #4 MikeMa
    July 6, 2017

    Saying it could have been worse is tantamount to cheering in 2017 America.

  5. #5 Jonas
    July 6, 2017

    I saw that Trump was considering Fitzgerald for CDC director a few days ago. She looks like a good choice.

    I hope she does get the job-the one thing that I suppose could lead Trump to choose someone else is if Pence looks at the fact that she rescinded the job offer she’d given to Dr. Walsh, and objects to her appointment, claiming that her decision not to give Dr. Walsh the job was “religious discrimination”. Pence seems like he is so religious that he might actually (privately) agree with some of the bizarre, disgusting remarks that Dr. Walsh made.

  6. #6 Jonas
    July 6, 2017

    @Lawrence-He’s already posted a letter on his blog begging Trump not to appoint Fitzgerald.

    As for Ginger Taylor, she has a spot in the Encyclopedia of American Loons, just like MJD.
    http://americanloons.blogspot.com/2013/01/383-ginger-taylor.html

  7. #7 Leigh Jackson
    July 6, 2017

    With Trump insanity is only ever an Executive Order away, but it’s a relief that he’s not placed AV nutters in positions to destroy lives.

  8. #8 Eric Lund
    July 6, 2017

    Given Trump’s history as a dignity wraith, I would be hesitant to accept any political appointment in his administration, even if my political views aligned with his (which they don’t). I am not aware of anyone who has come into Trump’s orbit with anything resembling a good reputation who has managed to retain it. SecDef Mattis, maybe, but give it time.

    That said, it is a nice change to see Trump actually appoint somebody competent. Too many of his political appointees have been not merely incompetent but anticompetent (DeVos, Pruitt, and Sessions, to name three).

  9. #9 BA
    Everywhere/nowhere
    July 6, 2017

    Ginger Taylor = Scott Tenorman

  10. #10 viggen
    Boulder
    July 6, 2017

    Phew.

  11. #11 KayMarie
    July 6, 2017

    Not surprising. Which has generated more rich people. Pharma companies that produce vaccines or anti-vax websites that produce..um…people who speak at anti-vax conventions and blog?

    If there is any choosing among people who managed to not say bad things about him that can be traced it is that he will pick the really rich people as wealth is the only metric that really counts.

  12. #12 Denice Walter
    July 6, 2017

    Interestingly enough, Trumpite, Mikey Boy ( Natural News) doesn’t even mention Dr Fitzgerald as he rants about the media and pharma shills.

  13. #13 MarkN
    July 6, 2017

    Just reviewed an interesting case of muscular damage due to any injection, diagnosis was some genetic-based ten-syllabic three word name.

    Pediatric Pt stepped on a nail, concern was to give/withhold the Td. After nationwide consult between specialists, debating whether to go ahead an provide deltoid IM which was already atrophied, provide subq, or withhold altogether. Ultimately did provide the vaccine as a subq, benefit greater than risk. No adverse event, and thus far, no resulting infection from the penetration injury.

    That was probably the most specialized scientifically valid debate on vaccination I’ve encountered, other than whether it’s a true anaphylactoid reaction or not. Interesting case.

  14. #14 MaineJen
    July 6, 2017

    How can both Oprah and the pope be the antichrist?

  15. #15 Roger Kulp
    July 6, 2017

    😀 😀

  16. #16 Roger Kulp
    July 6, 2017

    Interesting video,and very applicable to dealing with antivaxers.
    https://www.facebook.com/bravenewfilms/videos/687036894813511/

  17. #17 sadmar
    July 6, 2017

    Cool video, Roger. Thanks for sharing the link.

    Eric, you forgot Ben Carson at HUD. And that Flynn guy, but “anticompetent” isn’t quite the right term there, or for DeVos either. They’re basically counter-agents to the avowed purposes of the respective agencies, and I fear DeVos will not be anticompetent enough in swinging the wrecking ball.

    I’d joke that PGP has stolen KayMarie’s nym at #11, except I pretty much think the same thing. 🙂

  18. #18 Politicalguineapig
    July 6, 2017

    Sadmar: No, that’s not me at 11, though I have to say I agree with her. Although I’d think that Alex Jones and Mikey, not to mention the Crosbys, would have a lot more influence now. (Although I will note that Alex’s wife FINALLY came to her senses, divorced him and I think he lost joint custody of the kids, so maybe the White House isn’t one of his priorities.)

    I admit to being surprised that a competent person actually appears to be nominated. I suspect that Trumpet didn’t have much to do with the appointment, or he just threw darts and picked whoever’s name was closest.

  19. #19 Anonymous Coward
    July 6, 2017

    This feels like sheer blind luck given the kinds of appointments we’ve seen so far. Now I can only hope she can do her best with what she’ll be given and in spite of what is withheld from her.

  20. #20 Narad
    July 7, 2017

    How can both Oprah and the pope be the antichrist?

    Oprah is only “harboring the spirit.” It’s like Elvis.

  21. #21 Roadstergal
    Switzerland for one more month...
    July 7, 2017

    I’m actually a bit surprised. Anti-vax seems like something he really believed in, not for just cynical political reasons.

    Then again, he’s the master of Short Attention Span, and anti-vax might not have enough TV time and Adulation Of Him to be worth it. I wouldn’t be surprised if someone just tossed her name at him and he signed off on it, because assigning the CDC head is one of those boring things that doesn’t involve his name or concerts in his honor.

    I wonder who it would have been. She doesn’t seem up Pence’s alley.

  22. #22 Dorit Reiss
    July 7, 2017

    A. Surgeon General also appears competent.

    B. My guess is that the President’s focus is elsewhere right now and he left this to someone else. I would keep an eye on other appointments, though.

  23. #23 Michael J. Dochniak
    July 7, 2017

    Roger Kulp (#16) writes,

    Interesting video,and very applicable to dealing with antivaxers.

    MJD says,

    Q. Are antivaxxers attempting to maintain the tribal perspective.

    Antivaxxer:

    1) Vaccines cause autism;
    2) Autism affects cognitive empathy; and
    3) Decreased cognitive-empathy diminishes the tribal perspective effect.

    Thus, the “tribal perspective” may be a well intended aspect of the antivaccine movement.

  24. #24 Jonas
    July 7, 2017

    @Dorit Reiss-Yes, he does seem like a good choice. I was pleasantly surprised to learn that he supports needle exchange programs, given that AG Sessions wants to intensify the war on drugs.

    I think you might be right that Trump himself didn’t choose who he’d appoint to be the next Surgeon General and CDC director (same might be true of the FDA director, too, but if I recall correctly, he had listed 3 people as under consideration for that position, Scott Gottlieb being one of them, so he might have been more involved in that).

    Still, even if he left picking the next Surgeon General and CDC director to someone below him, he didn’t object to their appointment (or imminent appointment, in the case of the CD director), which is certainly a good sign.

  25. #25 Jonas
    July 7, 2017

    @Eric Lund (#8), @sadmar (#17) You are both forgetting about Rick Perry at the Dept of Energy-he’s leading the department he forgot all about and couldn’t name in 2011!

  26. #26 Ren
    July 7, 2017

    “he’s leading the department he forgot all about and couldn’t name in 2011

    I think that was the Trump team trolling him, to be honest.

  27. #27 brian
    July 7, 2017

    Sadly, Rick Perry’s dreams of becoming a veterinarian died when he received a D in a particularly challenging Texas A&M course called “Meats.” Apparently undaunted, Perry tried again to demonstrate his academic chops this week when he visited Coal Country and told the assembled multitudes, “Here’s a little economics lesson: supply and demand. You put the supply out there, and the demand will follow.”

    Apparently, that’s how the world seems to work to someone who can’t even get a passing grade in a course called “Meats.”

    http://www.businessinsider.com/rick-perry-supply-and-demand-2017-7

  28. #28 mark
    July 8, 2017

    Are we ever going to have people who write these blogs tell us what does cause autism, since they think vaccines can only do good. Nearly every other medical intervention has pluses and minuses, and it is admitted and publicized. But for some reason, injecting numerous vaccines with adjuvants like aluminum can never be a problem for babies and small children.

    Let’s not pretend that this blog is actual science. Science does not permit opinion to rule or leaving out any potential causative factor to just be omitted because it might muddy the water. Antivaxxers are not anti vaccine, they are pro safer vaccines.

    But this is probably a waste of time to say to people whose minds are closed and don’t actually practice science, just preach.

  29. #29 Panacea
    July 8, 2017

    Mark, this IS a blog about science. And the science tells us that the adjuvants are safe, and that vaccines have the best safety record of any medication ever invented by mankind.

    And in spite of that, bad things still sometimes happen. It’s rare. Very, very rare. A few hundred cases out of billions of doses administered.

    We don’t know what causes autism. We do know it’s not vaccines. Increasingly, evidence points to genetic factors and development in utero.

    Show us some real evidence that vaccines are harmful, and people will listen. Bombard us with debunked theories and guesses, and you’re rightly going to be excoriated for it.

  30. #30 Chris
    July 8, 2017

    mark: “Are we ever going to have people who write these blogs tell us what does cause autism, ”

    Yes. You can start here:
    https://spectrumnews.org/features/special-reports/the-genetics-of-autism/

    If you wish to be part of the solution and not part of the problem then have your family be part of this large research program:
    https://sparkforautism.org/

  31. #31 Se Habla Espol
    July 9, 2017

    mark #28 sez:

    Are we ever going to have people who write these blogs tell us what does cause autism,

    I’m certain that if and when the people that work on that subject find out, the anti-VPD bloggers will be eager to rub the anti-vaxxers’ noses in it. I’m also certain that the anti-vax religion will deny whjatever the findings are, since to them, it’s always the vaccines.

    since they think vaccines can only do good.

    Who around here (discounting the anti-vaxxers) has ever made that claim?

    Nearly every other medical intervention has pluses and minuses, and it is admitted and publicized.

    Just like the miniscule dangers of vaccination, and the even less frequent whoopsies of vaccines are admitted and publicized. Is there a problem, anywhere outside the anti-vaxxers’ imaginings?

    But for some reason, injecting numerous vaccines with adjuvants like aluminum can never be a problem for babies and small children.

    It’s well known what the risks of such problems actually are; it’s well known that they’re orders of magnitude smaller than the risks of the alternatives.

    Let’s not pretend that this blog is actual science.

    We’ll not pretend. Factually, this blog is indeed about science vs religions like the anti-vax ones.

    Science does not permit opinion to rule or leaving out any potential causative factor to just be omitted because it might muddy the water.

    Nor does science run around screaming about “potential causative factors” that have been demonstrated to be only imaginary, not even potential.

    Antivaxxers are not anti vaccine, they are pro safer vaccines.

    Is it ever possible for vaccines to be safe enough to satisfy the anti-vax religiosi?

    But this is probably a waste of time to say to people whose minds are closed and don’t actually practice science, just preach.

    That’s why not many people here take the time to respond to anti-vax trolls.