Post-NECSS thanks

Hope you have a productive July 5th.

Will you have some RI related to climate-change denialism in the near future?

Here comes the Sun and I say, it's all right..... - George Harrison

I will look forward to the video as Mr Lapdog refused to attend something again that starts early in the morning but doesn’t allow him to take his latte into the auditorium. Maybe I’ll come on my own next year.

In the photo above it is clear the cap for your water bottle is missing.

Are you playing with it under the table, Orac?

I've was taught at a young age that there is no such thing as a bad question.

Trump hasn't been as bad as I thought he might be when it comes to vaccines. The administration seems to have abandoned the idea of setting up a "vaccine safety commission" led by RFK Jr., and his pick for FDA director is pro-vaccine.

Also, it looks like Trump is going to appoint Dr. Brenda Fitzgerald to be the next CDC director.

I don't know anything about her, aside from the fact that she is currently the head of the Georgia Department of Public Health, but I did see that Ginger Taylor is upset that Trump is choosing Dr. Fitzgerald, and if Ginger Taylor is opposed to Dr. Fitzgerald appointment as CDC director, I think it's pretty safe to assume that Fitzgerald is at least an OK choice for that position.

Hopefully, Trump's long history of anti-vaccine views won't have any impact on the decisions he makes as POTUS. So far, it hasn't (the meeting between Trump and RFK Jr. was before he was inaugurated), and I hope that continues.

We want to see videos of the NECSS.

I was there, and I enjoyed the presentations very much.

You need to watch out, though. You might develop a reputation as a pill pusher!

Yes, the anti-vax blogosphere is losing their minds over this potential appointment - since it is exactly the opposite of what they wanted Trump to do.....they just don't understand that Trump will do exactly what's good for Trump, and to hell with everyone else.

darwinslapdog,
The no drinks/latte policy was not luckily not enforced. I was prepared for caffeine deprivation, but fortunately, the worst did not come to pass. :)

At least she won't have to move house to take up the position, which may be a factor in government recruitment these days.

@Lawrence-Yes, I've seen that too. First Trump decides not to set up a bogus "vaccine safety commission", then he actually makes reasonable picks for FDA director and surgeon general, and now it appears that he'll make a reasonable pick for CDC director.

The anti-vaxxers absolutely hate it, of course...they were so sure that Trump would advance their "cause", so to speak.

Some anti-vaxxers also seem to have an inflated view of their importance/influence, too...for example, Jake Crosby wrote a letter on his blog asking Trump not to appoint Dr. Fitzgerald, and in his letter he wrote that "many" people voted for Trump because of Trump's anti-vax views-a claim that is obviously false. Most people didn't even know that Trump was anti-vax until he met with RFK Jr.

I'm not sure if Jake's ridiculous claim that "many" supported Trump because he is anti-vaccine is because he, like many anti-vaxxers, lives in an echo chamber and only hears others with views similar to his, or if it's because he (perhaps due to his autism) lacks perspective and cannot understand that very, very few people think about vaccination policy when deciding who to vote for.

Awww crap!
Orac in NYC and I didn't even know!

Maybe this President realizes vaccines are a "third rail". If so, concern is even more so if there is a second term.

@ Jonas

I've been saying here for months not to worry about Trump doing anything about vaccines, though there's still no reason for anyone here to give a sigh of relief.

To amplify what Lawrence says about Trump doing what's good for Trump, he defines that as gaining material advantage for himself, as 'winning' over some opponent. He has no anti-vax views because no views of any kind. Whatever ideologies he blurts are dispensable/mutable/reversible in the pursuit of "the art of the deal."

What we can say about Trump is that he displayed 'anti-vax sympathies'. His consistently stated position is 'vaccines work, but the little babies get too many at once". By his standards, that's a moderate position, evidence of a negotiating navigation between two opponents while keeping both on his side. I doubt he'd be saying anything about vaccines if not for his close personal and financial relationship with hardcore anti-vaxer Gary Kompothecras. He has to make some anti-vax-ish noises to keep Kompothecras happy. But there's not enough money or power in anti-vax land for Trump to be able to gain anything by going any farther than he has already. On the other hand, The Donald is tight with the money guys in Big Pharma. I don't think Orac has ever mentioned that the last time Trump had to make a financial disclosure, pharma stocks were the second largest chunk of his personal portfolio, following only Big Oil securities. And, yup, the pharmas helped feed his campaign coffers, as they do for any GOP pol (including the ones more overt with anti-vax stuff than Trump) as long as they support de-regulation. Of course, from the corporate perspective, the only thing they like as much as de-regulation is "tort reform", laws that make them harder to sue. So absolutely the last thing Donald Trump would ever do is mess with the vaccine court.

Trump did NOT 'have a meeting with Andrew Wakefield'. That was anti-vaxer propaganda hyperboie. What happened is that Kompothecras arranged to have Trump give a short audience to a small contingent of well-heeled anti-vaxers at a large fundraising event in Florida, and the potential donors brought Andy along for a photo op. He did have a 'real meeting' with RFKJ – I'd guess again to soothe Kompothecras – and whatever was said in private, Junior went overboard (if not full fantasy) in talking about it publicly, and that was the end of that.

And really, with all the domestic and international crises, and Trump's obsession with the press, anyone who thinks vaccines make his daily agenda one way or another now is simply untethered to reality.

But, for all the "not what we feared", the result may be far worse for keeping VPDs ion check. We're back to just 'repeal' on the ACA, and Paul Ryan's dreamed Medicaid cuts may still get passed and signed. This administration and Congress could be a general disaster for public health, and there certainly would be consequences for vaccines in low income communities. Since Tom Price has extreme views on individual physician autonomy, and the anti-government crew will be positively inclined to 'health freedom', we could see some legislation in that direction absent language or discussion about vaccines that would nevertheless make it easier for Bob-esque doctors to dole out sketchy exemptions and/or make state vaccine requirements for schools almost impossible to enforce.

You may now join me in return to trying to avoid the news on North Korea...

@ Chris H.

Uh, no. Vaccines aren't even close to a rail in our contemporary politics. A rusty little finishing nail in a deserted field, maybe, and in political terms the current running through it is so far from fatal it doesn't even register on the instruments.

And if there's a second Trump term, we're all f****d beyond any hope anyway.

Trump did NOT ‘have a meeting with Andrew Wakefield’. That was anti-vaxer propaganda hyperboie. What happened is that Kompothecras arranged to have Trump give a short audience to a small contingent of well-heeled anti-vaxers at a large fundraising event in Florida, and the potential donors brought Andy along for a photo op.

Citation, please? Evidence for this assertion, please?

Kent Heckenlively reports that it was a meeting that lasted over an hour. Now, Kent might be a deluded antivax fool, but he's not, as far as I've ever been able to ascertain, a liar. He could be mistaken, but in this case I tend to think he probably isn't.

Hi Sadmar,

I will agree vaccines don't seem to rate as "big", but if there are a lot of VPD outbreaks in the next 3 1/2 years and the media can pin them on the anti-vaxedness of this President, a lot of people would (IMHO) view that as unforgivable. Hopefully this is also realized in all this health care plan legislation as well, because as it stands, a lot of financial support for the VFC (Vaccines for Children) program could be gutted and that would decrease vaccination rates because not all children in poverty would be able to get them at no cost.

Jake's endorsement of Dr. Brenda Fitzgerald is a good sign for her prospects. Jake's previous endorsement of Ari Ne'eman, after all, led to Ari's 5 years on the National Council on Disability.

He did have a ‘real meeting’ with RFKJ – I’d guess again to soothe Kompothecras – and whatever was said in private, Junior went overboard (if not full fantasy) in talking about it publicly, and that was the end of that.

I suspect that Junior may well have accurately relayed the content of the meeting. And it don't mean a thing.

I suggested, on this very forum back in the day, that nothing would come of it, and that Trump was treating Junior just as he had treated Mitt Romney.

RFKJr and Romney said bad things about Orange Thinskin prior to the election. After the election, they have one-on-one meetings with the Orange One, and say nice things about him afterwards. Then they don't get what Trump promised them - SecState for Romney, vaccine commission for RFKJr.

But Trump got what he wanted, kind words from former detractors. He's a dick, but he ain't stupid.

I really enjoyed your talk at NECSS this year and you deserve a day off.

Chris Hickie: I will agree vaccines don’t seem to rate as “big”, but if there are a lot of VPD outbreaks in the next 3 1/2 years and the media can pin them on the anti-vaxedness of this President, a lot of people would (IMHO) view that as unforgivable.

I don't know where you're getting that idea. Trump voters and most Republican politicians- well, most Americans really- are A-OK with letting old people and kids STARVE, so I can't see them do more than shrugging if a lot of kids die from measles.
(Of course, if rubella comes back, it's going to get interesting, since people care a lot more about fetuses than they do about actual living children.)

Jonas: I think you're giving most of the country WAAY too much credit if you're assuming they're thinking at all.

MJD - everyone's caps on still on the water bottles in that image, as I can see.. Yes, there is such a thing as a stupid question.

Who cares, or how is the rotation of the earth affected if anyone is playing with a cap under a table??

Crazy time!

Jane Ostentatious (#22) writes,

Who cares...

MJD says,

The absence of a cap on Orac's water bottle may indicate a lack of empathy for others.

If the speaker table was bumped and all five of the water bottles tipped over, Orac and his companions would be in a very uncomfortable situation.

In my opinion, Orac's insensitivity to vaccine contraindications often places himself, and his minions, in a very uncomfortable situation when it comes to public safety.

Q. How is a water-bottle cap like a vaccine contraindication.

A. Both need to be taken seriously.

Trump did meet with Wakefield,but it was before he became president.

Andy also attended one of the inaugural balls.

@ Orac #16

My primary source was the story in Science Roger linked. Key details: 45 minute with donors at a fundraising event. Kompothecras, Blaxill Larson and AJW participated. I'm not saying Trump didn't know Andy would be there. But since Trump was there to raise serious money – which the first three have but Andy doesn't – it's fairly obvious they were the targets and primary talkers, with Andy supplying support. Larson's quote in the article suggests the contingent had prepped a sort of organized group presentation for the Donald in which each of the four 'activists' delivered a part in turn: "Andy told him about Thompson and gave him Vaxxed." And that was apparently the extent of Andy's roie.

While it's technically not false to say "Trump met with Wakefield" it's very misleading. It suggests they had a one-on-one sit down to have a discussion about vaccine policy. That's not what it was. I don't think there's any question Trump did do one of those with RFKJ, but the Florida event was a quid pro quo where the well-heeled AVs got Trump to listen to their concerns in return for the prospect of a donation.

In saying Andy was just there for the photo op, I was exaggerating in an attempt to balance the scales, and extrapolating that he'd been included in large part because they wanted to present it as "Trump meets with Wakefield". One of the others could have told Trump about Thompson and handed him Vaxxed. I'm sure they thought it would be more impressive if they had their 'star' performer, an actual (ex)-doctor, there in person. So Andy helped them spin their cause to Trump, and Trump helped them spin Andy's prominence to their fan-club.

I concluded it was Kompothecras's show because it was in Florida, and he's the one with a prior relationship with Trump. I don't remember specific sources, but there are numerous references here and there that suggest the two have been close for some time, and Kompothecras is the "many close friends" Trump knows who saw their kids turn autistic after their vaccinations.

Hey Chris H.

OK, I see what you're saying about how outbreaks could become an issue, but vaccines are hardly a third rail now. Even if we do get outbreaks, I'm not sure Trump or the GOP would get the blame, and I still think with Korea and Russia and yadda yadda yadda, a VPD problem would hardly dominate the news cycle enough to get genuine mass attention.

From the beginning, my point has been two pronged
1) forget the AV sympathetic rhetoric; don't worry about the vaccine court, or who will head the FDA and CDC;
2) worry about the effect of the larger budgetary policies, underfunded and demoralized staff, general public health programs slashed, the effect in low-income communities.

There weren't that many folks besides me singing that song then. Now you and Orac at least are going there. Welcome aboard this train of woe. I should be 'bigger' than to say 'I told you so' to anyone, but I get enough grief here I can't help it. Not from you, Chris though, and thanks for that. Sorry I came off so snarky in #15. 'Peace, bro' :-)

@ Orac

You took 'don't worry about the FDA/CDC appointments out of context. I only meant I didn't think Trump would ever appoint anti-vaxers at either agency. Some folks seemed to be worried he'd really put Andy at CDC or something. Of course, in a general sense those appointments do matter a lot, so the "don't worry" was just specifically about vaccines. Actually, I was indeed worried he'd go with one of Theil's kooks at FDA, and Gottlieb is still awful.

I'd say I'm fairly overt about being hyperbolic sometimes, but I still apologize for the 'just a photo op' thing, which surely came off more literally than was warranted, even as overstatement. I'll still take issue with "Trump met with four antivaxers" as a proper description for the event, because i think the fact it was well-heeled anti-vaxers attending a fundraiser is key to understanding it. See, you take "Trump met with four antivaxers" as evidence he credited anti-vax enough to consider doing something pro-actively about it, like messing with the vaccine court. All I see it as is evidence he'll hit up anyone for money, support, and the stroking of his ego. You can bet he gave more fundraising face time to pharma execs during the campaign and got a lot more cash out of them, too.

As for the details of the meeting itself: sure Andy should have been the star if they were smart and self-aware. But that's not how Blaxill and Larson talk about it. They could have said "Mr. Trump listened to Dr. Wakefield", but they said "He listened to us". The real rock star at the meeting was Donald Trump, and I'm sure the fanboy folks with the money were going to get their face time within his aura front and center and take their turn catting him up no matter who else happened to be there. Trump, of course, is going to focus his attention on the folks with the moola, unless they say "No, let Dr. Wakefield tell it," and they didn't do that. Here's the full Larson quote:

Mr Trump met with autism advocates in August. He gave us 45 minutes and was extremely educated on our issues. Mark stated 'You can't make America great with all these sick children and more coming'. Trump shook his head and agreed. He heard my son's vaccine injury story. Andy told him about Thompson and gave him Vaxxed. Dr Gary ended the meeting by saying 'Donald, you are the only one who can fix this'. He said 'I will'. We left hopeful. Lots of work left to do.

So it was a 4 stage relay: 1) Blaxil touts the 'epidemic' numbers, 2) Larson details the personal angst of the parents of the 'vax-damaged', 3) Andy explains the CDC conspiracy angle, 4) Kompothecras closes with an appeal to Trump's vanity, offering him the opportunity to act as the savior of the children...

In the end though, my point is less about who was there than what the context was: a serious policy discussion is different from a fundraising schmooze. Again, my comparison is to Trump's meeting with RFKJ. That's the 'worst' of all, because if you want evidence Trump credits anti-vax views, it's not complicated by a motive to work Junior for $$. Trump may have been considering actually appointing Junior to something, though I doubt it. I still think the best explanation for that meeting is that Trump owed a favor to Kompothecras and/or other antivaxers who did actually give him money, but the publicity from the RFKJ meeting was the extent of what he intended to give them, and he never seriously considering alienating other more powerful supporters by following through with Junior on anything substantive. That's why Junior was perfect for the role – it gives them the out of 'well he's a Democrat and environmentalist, so of course they couldn't make it work'.

I guess I'll frame my bottom line here as an observation that both anti-vaxers and pro-vaxers are naive about politics. Both see politics through the lenses of their own biases and commitments, and are easily taken in by moves that are no more than 'optics', imagining them to have some significant import on substance where they actually have none. Put on some political specs, and you'll see there's just no way taking any kind of serious anti-vax action is a political win... no way it's anything but a loss. The GOP is great at playing their base with false promises. From Burton to Issa, Chafetz and Posey, the AVs have gotten nothing more than hot air. Those guys are minor league at playing the rubes compared to Trump. Do you really have any doubt Trump ran those meetings, and everybody else in the rooms got played? Hell, even Larson seems to have sensed Trump's "I will" was less than an ironclad guarantee.

Look, I'm happy Fitzgerald got the CDC post, will choose the members of that committee, etc. I'm just not that surprised. So I'm not turning somersaults that she'll mitigate budget and staffing damage that were unconscionable to begin with, and likely remain unconscionable despite her efforts. Trump wasn't going to put an anti-vaxer in there, but he could have nominated a hack, I suppose... I wonder if his pharma supporters were in the loop on the appointment, or if he just went with someone close to Newt Gingrich.

What does play politically is screwing over poor people to fund tax breaks for the 1%. Since the election, you've spent a lot of time worrying about Trump doing something antivax, and only today have I seen you give any attention to the consequences of broader healthcare policy on things like vax uptake in low income communities. Trumpcare has boomed in the headlines, and passed largely without comment here. I think we've confirmed now, with Fitzgerald's appointment, that you've been barking up the wrong tree. Don't double down out of defensiveness. You got it wrong, but that was yesterday. The question is always what we can learn today, and what we're going to do tomorrow.

Orac: The once rock-solid bipartisan consensus on vaccines is breaking down.

The consensus on everything is breaking down. People used to think that the elderly not starving was a good thing, or that kids maybe shouldn't spend a lot of time being hungry. Not anymore.

There's a huge prolife movement- there are zero pro-child movements. People don't even agree on whether women and minorities should vote, or that national parks are a good thing. Most people don't even like clean air or water anymore.

@ Orac #31

Well, I think your post today (Friday 7/7) is awesome. Again, I was only talking about the federal level, and your analysis of how antivax can be a winner at the state level is excellent IMHO.

I don't do Twitter. Let me rephrase. I couldn't do Twitter and retain what's left of my sanity. I just read here and SBM, so consider my comments to be about the blog, not about you. I do know there's more to your opinions and actions than what appears here, but I still have to say I think it would good to have more of that on RI. Science and medicine have never NOT been political in the wider sense, and never will be. Sure, at times in terms of electoral politics and governance there are subjects of bi-partisan consensus, and I understand the desire to avoid upsetting the applecart when those outcomes are good. But good or bad those bi-partisan agreements are always the result of process – hard won and subject to change when counterforces come into play. And I'm not going to pretend that merely acknowledging this always-politcal nature of things leads to knowing how to address it effectively: who and what to critique and in what tone, etc. How to focus and balance the insolence and the respect...

As for the Florida fundraiser meeting: Of course, Larson could be BSing. I'll spare you the semiotic analysis argument about why I think her account is (just) probably more accurate than not. I'll leave it as this question (and it's not rhetorical): If Andy had been the star performer of that meeting, do you think he wouldn't have crowed about it? (Like, a lot?)

There's not one thing in your last paragraph of #30 I take issue with. Including that I would be naive if I thought anti-vax couldn't win again at the state level. I can indeed be naive about some things, but that's not one of them. it's not going to come here in Cali, or involve pols like Jerry Brown anymore. But Texas isn't California, and neither is Michigan, or... well it's a depressing enough list, eh?

Thanks for the discussion. I think we agree on this more than not in the end, but I learn stuff by hashing it all out.