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Defense against dangerous epidemic outbreaks requires constant vigilance. With Robert F. Kennedy Jr. and Donald Trump headed to Washington, D.C., we are entering very troubling territory.
Elvis Presley hardly seems a likely candidate for the pantheon of public health heroes. But in October 1956 the ascending rock idol lent his considerable stardom to helping save lives.
His little remembered role is a cautionary tale as incoming President Trump advances a series of farright and unqualified appointees to major public agencies. The most dangerous is likely to be conspiracy theorist Robert Kennedy Jr. as Secretary of Health and Human Services, augmented by like-minded, perilous public health heads of the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), National Institutes of Health (NIH), Federal Drug Administration (FDA), and his choice for Surgeon General.
For a century, polio epidemics made it one of the world’s most terrifying diseases. A 1916 outbreak in New York City killed over 2,000 people; another in the U.S. in 1952 claimed over 3,000. Children were especially targeted, over 60,000 infected yearly, facing lifelong severe spinal injuries requiring braces, crutches, and wheelchairs, and the dreaded iron lung, an artificial respirator, or premature death.
Wealth and status proved no barrier, as evidenced by President Franklin Roosevelt who was diagnosed at age 39 in 1921 with polio and endured it the rest of his life. What was a safeguard was the first vaccine, developed by virologist/medical researcher Jonas Salk. The announcement on April 12, 1955 by University of Michigan School of Public Health scientist Thomas Francis, Jr., who declared it “safe, effective, and potent,” was greeted as a national celebration, spread rapidly over radio, television, and wire services.
Parents lined up to vaccinate their young children, plenty did not. Teen immunization levels stagnated at just 0.6 percent. Enter Elvis. He agreed to go on the popular Ed Sullivan TV show, not to sing, but to get publicly vaccinated, viewed by millions. Vaccination rates among American youth soared to 80 percent in just six months. Overall annual cases of polio plummeted within a year from 58,000 to 5,600. By 1961, only 161 cases remained. After an oral vaccine followed, polio disappeared in the U.S. completely.
Yet polio never vanished globally, especially in underdeveloped nations, as in Africa, and in war zones, including in Gaza today—driven by Israel’s decimation of public health protections during its catastrophic and ongoing assault. In 2022, the first U.S. case in decades was reported by the New York State Department of Health.
Defense against dangerous epidemic outbreaks requires constant vigilance, and public support for full embrace of public health safety measures, including vaccinations. The experience of Trump’s first tenure is far from reassuring, especially his abominable failure in the face of Covid-19, the worst global pandemic in a century which ultimately cost the lives of over 1.2 million Americans.
Initial skepticism over the polio vaccine has a long antecedent in the U.S., described early in the Covid pandemic by what Los Angeles Times writer Carolina Miranda aptly termed “toxic individualism” and rugged individualism. It is traceable to a virulent brew of misguided notions of individual liberty that undermine and sabotage the public good, or a commons of national and community interest. Much of its roots are linked to structural racism, as in the resistance to Civil Rights Movement measures, and continuing today in white opposition to reforms such as expansion of health care and other public programs, immigration rights, and other societal benefits.
That history provides context for the eruption of the anti-vax, anti-public health measures that exacerbated and prolonged Covid suffering and death and seeded the ground for opposition to other essential vaccines. It’s true, as medical ethicist Arthur Caplan writes, that much of “the damage to getting Americans to vaccinate has already been done… There are almost no serious state mandates for childhood vaccines. Parents who want to opt out are easily doing so, as can be seen by the resurgence in measles and whooping cough. Nearly 40% of teenagers are not up to date on the HPV vaccine even as Australia and Scotland are on the verge of eliminating cervical cancer thanks to serious immunization campaigns.”
Further, he adds “Democrats avoided vaccination as an issue this election year because they knew that, post Covid, vaccination has become something of a political third rail. Could Kennedy and [CMS nominee Dr. Mehmet] Oz make things worse—absolutely. But are matters already bad—sadly, yes.”
The Kennedy-Trump threat
Yet Kennedy and his coterie of other department heads can make matters much worse. With the imprimatur of a President-elect already lionized by an often-fawning base will likely discourage more resistance to vaccines that can turn schools into major disease vectors and hasten the spread of new epidemics sure to come.
Even in the wake of Covid, Kennedy, with his power as HHS Secretary has said he would pause NIH’s drug development and infectious disease research and shift its focus to chronic diseases that do need attention but not at the expense of combating global epidemics.
Kennedy has also indicated a desire to shutter “entire” FDA departments, which oversee safety and effectiveness of prescription drugs and vaccines. And he has threatened to purge FDA staff for “aggressive suppression” of unsafe products and therapies, such as raw milk, and discredited COVID treatments, including hydroxychloroquine.
There’s his lurid, scientifically refuted linkage of vaccines to autism and other conspiracies, such as his claim that Covid was bioengineered to exempt Chinese people, already targeted by Trump rhetoric that fueled hate crimes, and Ashkenazi Jews of Eastern Europe origin, reinforcing right-wing antisemitic bigotry.
And that’s not including his attack on fluoride in drinking waterwhich promotes oral health, as cited in a letter by 77Nobel Prize winners opposing Kennedy, or his speculated doubt that HIV causes AIDS and the effectiveness of AZT therapy.
Anti-vax consequences
Still, it is his fanaticism on vaccines that prompts the most alarm.
During the COVID-19 epidemic, Children’s Health Defense, a group Kennedy founded and led, petitioned the FDA to halt the use of all COVID vaccines. In a 2023 podcast, Kennedy proclaimed there is “no vaccine that is safe and effective,” and disputed CDC’s guidelines about if and when kids should get vaccinated.
The implications are alone enough for a mass movement to escalate pressure to block confirmation of Kennedy, and Trump’s nominees to lead the CDC, CMS, FDA, NIH and Surgeon General who mostly share his chilling views on vaccine safety. Multiple studies document what is at stake.
The World Health Organization estimates vaccines have protected 150 million lives over the past 50 years, and that 100 million were infants. About 4 million deaths worldwide are prevented by childhood vaccination every year. More than 50 million deaths can be prevented through immunization between 2021 and 2030. By 2030, it is estimated that measles vaccination alone can save nearly 19 million lives.
In November 2013, University of Pittsburgh researchers issued a similar study. It documented that about 103 million cases of disease had been prevented by vaccination since 1924. The disease with the most cases prevented was diphtheria, 40 million cases. Second was measles, 35 million cases.
Globally, reported Scientific American, measles vaccines, preserved 94 million lives over the past 50 years. It cited a 2024 Lancet study published in October that vaccines against 14 common pathogens protected 154 million people over the past five decades—that's a rate of six lives every minute. They have cut infant mortality by 40 percent globally and by more than 50 percent in Africa. Throughout history vaccines secured more lives than almost any other intervention.
Lancet found that each life defended through immunization contributed to 66 years of full health, without long-term linked to disease.Vaccines impact nearly every measurement of health equity, from improving access to care, to reducing disability and long-term morbidity, to preventing loss of labor and the death of caretakers.
Writing in Forbes, hardly a left-wing Trump critic, earlier this year, ER doctor/health researcher Arthur Kellerman also cited the Pittsburgh study, as well as Johns Hopkins data of nearly 88 million cases of illness. In 1900, he wrote, 30 percent of deaths in the U.S. occurred in children under 5 years of age. In 1999, they accounted for only 1.4 percent. "Vaccines," he concluded, "played a vital role in this progress.”
Measles, a highly contagious childhood disease that can lead to pneumonia and fatal brain swelling, declined rapidly after the first measles vaccine was introduced in 1963. But, the CDC cites 16 measles outbreaks in 2024. Kennedy’s alleged role in promoting vaccine misinformation during a deadly measles outbreak in American Samoa in 2019, which he denies, has also been widely reported. Unvaccinated families, writes Kellerman, “tend to cluster in communities defined by faith, culture or political ideology. When a highly contagious disease gets into such a community, an outbreak can occur. We’ve already seen localized outbreaks of measles, rubella, mumps, and pertussis.”
In 2022, Kennedy’s attorney and close advisor Aaron Siri petitioned the FDA to revoke approval of the polio vaccine for further study despite its long history of success.
Republican Senate Majority Leader Mitch McConnell, who endured polio as a child, has denounced the push “to undermine public confidence in proven cures” like the polio vaccine. Only a “miraculous combination of modern medicine and a mother’s love” saved him from paralysis he said in a statement. “The polio vaccine has saved millions of lives and held out the promise of eradicating a terrible disease. Efforts to undermine public confidence in proven cures are not just uninformed—they’re dangerous,” McConnell said.
Yet McConnell, and similar Republican critics have yet to publicly oppose Kennedy and his similar malefactors of health (to borrow FDR’s “malefactors of wealth” frame).
We can no longer count on Elvis to protect our children, families and communities. It is up to the rest of us.
"In 1959, the BBC asked [Bertrand] Russell, [public intellectual, historian, social critic, political activist and Nobel laureate] what advice he would give future generations. He answered: 'When you are studying any matter or considering any philosophy, ask yourself only what are the facts and what is the truth that the facts bear out. Never let yourself be diverted either by what you wish to believe or by what you think would have beneficent social effects if it were believed, but look only and solely at the facts." -- Humankind: A Hopeful History, by Roger Bregman, p. 253
This advice from Bertrand Russell, one of the 20th century's most prominent progressive intellectuals, toward the end of his long life is very sound. It resonated with me when I recently read it. I've been thinking for a while about how and why intelligent, well-meaning people sometimes hold onto beliefs or a particular ideology even when new information, or just the basic facts, should lead to a different view of things.
Unfortunately, my life experience has led me to realize that though most people do generally agree that an approach of facts and the truth of things, actual reality, must always come before ideology, this is too often not the way some human beings function, particularly when it comes to politics. And this very big problem transcends political ideology. It's true on the political right, center, and left and always has been.
As far as progressives, the biggest, most recent example is the Covid-19 anti-vaccination campaigns--not just individual points of view but public campaigns--of people like Robert Kennedy, Jr., Gary Null, and others. Despite over a year of successful experience with vaccines dramatically reducing deaths, hospitalizations, and total cases of the virus, these vaccine deniers, not just clinging to their general anti-vaccine ideology but actively campaigning against people getting vaccinated, have almost certainly increased the numbers in all three categories. It is shameful.
Then there's the public political position of the national Green Party--which I was a part of for many years, though no longer--that there was no difference between Hillary Clinton and Trump in 2016 or between Joe Biden and Trump in 2020. Jill Stein and Howie Hawkins, the GP Presidential candidates, took that position over and over, which turned out to be very unpopular on the left. Most people on the left did the right thing and put facts over ideology: Stein got 1.1% of the vote and Hawkins got about 0.4%.
I am fully aware that on too many issues, particularly the appalling US military budget, US foreign policy. and acceptance of corporate/big money domination of our society, there are similar approaches between Republicans and the usually dominant corporate wing of the Democratic Party. But if you think that overt racism, denial of women's and LGBTQ rights, denial of labor rights, poverty, and neo-fascism are very big issues, the common sense approach to take when voting for President under the existing US electoral system (it needs to be changed!), particularly if you are in a swing state where the vote is usually very close, is to vote for, yes, the lesser evil. Practically, that makes sense.
We're seeing a similar thing right now as far as the political left and the Ukraine war. Despite the plain-as-the-nose-on-your-face reality that this war is happening because Putin invaded Ukraine with 150,000 or so well-armed troops, with no provocation by Ukraine, a small percentage of those on the left who see themselves as part of the US peace movement are letting their particular brand of leftist ideology guide the positions they take on this huge issue.
The primary example is the United National Antiwar Coalition. What are their main demands, as listed on their website? No War With Russia. No to NATO. No Sanctions.
Contrast this with the demands of CodePink, one of the leading organizations on the left organizing mass demonstrations against the war: Stop the War in Ukraine. Russian Troops Out. No to NATO Expansion.
Both agree that NATO's expansion over the last few decades, since the Soviet Union dissolved, is an underlying reason why Putin took the action that he did. From a geopolitics standpoint, it is understandable why not just Putin but many Russians would be upset about having NATO military bases and missiles 100 miles or so from their western border, just as the United States 60 years ago was upset about having Soviet bases and missiles 90 miles away in Cuba.
CodePink, however, in its first two demands, addresses the fact that the reason for this war is Putin/the Russian government's unprovoked decision to invade Ukraine militarily, and Russian troops must leave if there is to be peace and national self-determination for Ukraine.
UNAC's "No War With Russia" demand completely obfuscates the fact of who started this war. There's nothing about Ukraine. Indeed, if you look at their three demands in their totality, there's nothing there that Putin disagrees with. He doesn't want the US or European countries to get involved in this war, he wants Ukrainians and their supporters to stand down or be defeated so he can seize their land. He's obviously against NATO. And he obviously doesn't want any sanctions on anybody in Russia, in general or on the oligarchs.
Ideology is not a bad thing. It's of value, very important really. Each of us as individuals should have a fact-based and justice-seeking worldview which guides us as we go through life, day by day. But when that worldview doesn't fit with the facts, as history and our lives develop, it's time to make some practical and ideological adjustments, look at things more closely. Ideology grounded in facts, not blind ideology, is what we must strive for.
The Covid-19 pandemic is a global health emergency that requires a coordinated and mobilized medical response, one based not only on public health expertise but also principles of social cooperation and solidarity. But in the United States cooperation and solidarity are almost alien values in a nation rent by growing political divisions and more substantively defined by extremes of wealth and class inequality.
In the hyper-capitalist United States, a threadbare social safety net is the norm and even people's health needs are commodified for financial profit.
In the hyper-capitalist United States, a threadbare social safety net is the norm and even people's health needs are commodified for financial profit. The culture of solidarity required to meet the challenges of a public health emergency is not exactly the default setting for a social system dominated by financial and political elites.
But it's worse than that. Today, the Republican Party operates as open saboteurs of public health. Across the nation, elected Republicans at every level of government display a callous disregard for the health and lives of the American people, sowing disinformation and resistance to public health efforts to contain and defeat the pandemic. In place of a united front of preventive community health action, Americans instead must contend with endless propaganda and nonsense from a far-right circus of liars and science deniers.
Far-Right Political Demagoguery
From the first days of the pandemic, when the spotlight of a public health emergency put President Trump's sociopathic misleadership on full display, the Republican Party was forcefully revealed as an entrenched lobby of billionaire lovers and public health defeatists. This is less a political party than a Trumpian cult of unabashed opportunists and far-right ideologues, willful traders in people's lives and health for whatever scraps of power and largesse they can hoard for themselves. Even basic public health measures to contain the spread of Covid-19, such as mask requirements for indoor settings, temporary restrictions on indoor gatherings, and more recently encouraging use of effective vaccines, have been demagogically politicized and resisted by Republicans.
To the extent his public health pronouncements run counter to the Republican agenda, even Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, has had to endure slanders and threats from the malodorous swamps of the Trump milieu. In fact, harassment and abuse of scientists who give media interviews or otherwise comment on the pandemic is now common, according to a survey by Nature. This is actually a global phenomenon, thanks to the rise of far-right extremism in multiple countries.
Indeed, inspired by former President Trump's contempt for science, many among his base of supporters have come to view the scientific community as just another interest group out to promote its own self-serving agendas. The scientific consensus of the threat posed by anthropogenic climate change, for example, is viewed by many right-wing climate change skeptics as just one opinion among many. And since everyone is entitled to their opinion, take your pick which one you like!
The public health Covid-19 vaccination campaign is now under assault by many Republicans, motivated less by reasonable health concerns than just politically charged scare tactics and propaganda. Its source is the same far-right political milieu that perpetuates the lie that Donald Trump won the last presidential election. It's no wonder this same political milieu considers it a priority to force women to give birth against their will, promoting highly restrictive abortion bans in Texas and other states regardless of their harmful impact on women's health. These dissemblers of knowledge and justice have become the norm in the Republican Party.
The hypocrisy in all this reaches particularly stunning heights at Fox News, where masks, vaccines, and science expertise are regularly impugned by right-wing hosts out to discredit the current public health campaign. The hypocritical rot at the core of Fox News is evident in the fact that the media company actually requires all of its employees to be vaccinated against Covid-19, or undergo daily testing. While many among Trump's base of supporters express a kind of casual skepticism on social media and elsewhere toward use of face masks to reduce the spread of Covid-19, indoor masking in the Fox News offices is strictly enforced. Of course, this doesn't stop media propagandists like FoxNews host Tucker Carlson from ridiculing the "cult of mask-wearing" as pointless. You just have to wonder if these posturing media cynics think medical masks are used in surgical settings just for dramatic affect?
What's next? Will Fox News eventually come up with an expose of Ignaz Semmelweis, the 19th Century German-Hungarian physician who in the 1840s championed hand-washing to prevent the spread of infectious disease, as a secret communist friend of Karl Marx? Dr. Semmelweis originally developed his ideas about hand-washing based on clinical practice and observation, before the germ-theory of disease could clearly establish the value of preventative hygiene measures.
Understanding Vaccine Hesitancy
Certainly not everyone who avoids Covid-19 vaccination is an "anti-vaxxer" opposed in principle to all vaccines. Nor are they necessarily right-wing malcontents who reflexively oppose any public health measures supported by liberals or Democrats. There are actually many reasons why so-called vaccine hesitancy influences a segment of the U.S. population. First, as has long been true, some people worry about the safety or side effects of vaccines. These legitimate concerns deserve to be addressed, not ridiculed. In fact, there's research to suggest large numbers of the currently unvaccinated are more "confused and concerned" than "absolutely opposed" to vaccines," as New York Times columnist Zeynep Tufekci notes in a recent commentary.
Interestingly, Tufekci cites research from the Kaiser Family Foundation (KFF) that shows lack of health insurance is the single most powerful predictor for who remains unvaccinated. But Covid-19 vaccines are provided free to the public, so why would that be? For one, lack of insurance is also a likely indicator of a more tenuous social relationship to the health care system. The uninsured are more likely to be among the 25% of the U.S. population who lack a primary health care provider to turn to for advice or information.
This shouldn't come as much of a surprise. The United States is one of the few modern nations that does not have some type of non-profit single-payer or national health care system. As a result, an everyday lack of access to affordable health care, especially in poor and minority communities, is a familiar aspect of American life.
The lack of access to affordable care is indeed a major failing of the U.S. health care system, experts note. "Some 30 million Americans are uninsured, and mostly shunned by doctors and hospitals," write physicians David Himmelstein, Steffi Woolhandler, and Adam Gaffney in a recent British Medical Journal (BMJ) commentary on vaccine hesitancy. "Even those with insurance encounter ever-larger out-of-pocket costs. Having disciplined patients for decades to expect financial roadblocks, we now expect them to suddenly understand that covid-19 vaccination is different--a fact many apparently doubt." Indeed, they observe, vaccination rates are lowest in the states with the highest uninsurance rates and among those most excluded from access to care.
Vaccine hesitancy may also express historic distrust among racial and ethnic minorities who have experienced a legacy of discriminatory treatment in the health system. Some people may be concerned, despite reassurance from public health authorities, that Covid-19 vaccines, initially approved for emergency use, were developed so quickly. Tufeckci also reminds us that there exists a surprisingly large sector of the population who have a fear of needles.
To be clear, people have the right to ask questions and seek assurances about vaccine safety and policies. The antidote to "anti-vaxxer" opposition isn't just blind faith in vaccine science. Medicine doesn't need uncritical "pro-science" sycophants constantly shouting its praises any more than it needs its imprudent deniers. Actually, it is in society's interest for the general public to be as informed and educated as possible--to think critically--about the science behind public health guidelines and recommendations. In turn, medicine also works best when health care practitioners value and respect their patients' input and perspectives.
At this juncture, the consistent right-wing Republican opposition in the United States to public health measures is less absurd than it is just deeply tragic. In the United States, the Johns Hopkins Coronavirus Resource Center reports 751,349 Covid-related deaths as of November 4. Worldwide, 5,027,964 deaths have been reported. Notably, the United States fares poorly in global comparisons of Covid-19 morbidity and mortality rates.
Nor is the Democratic Party establishment without blame in all this. For decades, neo-liberal austerity policies supported by both major political parties have taken their toll on the public health infrastructure. In fact, pre-pandemic spending on public health has been in decline for years, reports the BMJ, more recently constituting only 2.6% of total health spending. Driven by corporate profit, hospital bed capacity and stockpiles of available medical resources have been gradually reduced over the past four decades.
What does a fractured public health infrastructure look like in practice? Here's one example: the Centers for Disease Control and Prevention (CDC) currently reports only "breakthrough" cases of infection among vaccinated populations that involve hospitalization, according to Johns Hopkins. The more complete data reporting necessary to track the virus is left to state health departments, many of which fail to report all the data necessary to track surges, variants, and vaccine effectiveness. In fact, 14 states do not report any data on breakthrough infections.
A Vision for Social Justice and Health
Rich in technology and wealth, but poor in leadership, equality, and justice, the United States is a dysfunctional outlier compared to other rich nations when it comes to providing basic social infrastructure and a robust social safety net for its citizens.
None of the public health shortcomings or current political divisiveness over even the most basic public health measures should come as a surprise. Rich in technology and wealth, but poor in leadership, equality, and justice, the United States is a dysfunctional outlier compared to other rich nations when it comes to providing basic social infrastructure and a robust social safety net for its citizens. This is a society that expects to spend $8 trillion on military spending over the next 10 years, but somehow can't manage to pass a $1.75 trillion social spending bill that would mandate even modest expansions in Medicare or establish for the first time national policy on paid family and medical leave for working families, without a contentious and likely losing political battle in Congress.
"The covid-19 pandemic casts a harsh light on America's lethal inequalities, but also illuminates a path forward," conclude single-payer advocates Himmelstein, Woolhandler, and Gaffney in their BMJ commentary. "Contending with tomorrow's health emergencies will require reversing austerity and adequately funding public health agencies. We must go further to democratize care: implement universal coverage and abolish out-of-pocket costs; equalize the distribution of health infrastructure; and reverse the privatization and commodification of medical services."
These are dangerous times. In the United States, millions of Americans are under the sway of a megalomanic ex-president Trump, a corrupt, inveterate right-wing liar described by his own niece as an "instinctive fascist." While many Republican leaders continue to bow down to this malignant anti-democratic menace, a majority of Republican voters in their political stupor continue to deny this scourge of a leader even lost the election.
These are the agitated know-nothings who want to ban mask mandates, criminalize abortions, ban teaching in schools on the history of racism, and undermine the democratic right to vote. They are crawling in a muddy trench with their dystopian visions of authoritarian repression and ever harsher specter of social and class injustice. The expectation that the cautious elites of the Democratic Party, with their penchant for moderation in all things, can prevent this irrational base of aspiring neo-fascist Republicans from destroying what remains of democracy is not an optimistic one.
If there is a public health lesson here, it is that no one is safe until everyone is safe. The dangerous dynamic of the pandemic is that the longer it lasts, the more likely even more dangerous variants of Covid-19 will emerge. Worldwide equality in access to affordable medical care, including vaccine equity, is in the interest of the whole planet. Worldwide solidarity, scientific internationalism, democracy in everything and social and climate justice for everyone, including mass resistance to the growing far-right threats to our future, has never been more urgently needed.