We Can No Longer be Paralyzed by Indifference or Soon, Children and Young Adults will be Paralyzed by Disease

I am a hopeless romantic, an eternal optimist, and a cup half-full kind of guy. Those that have worked with me over the years, I suspect would tell you that I am not prone to exaggerating, panicking, catastrophizing, or overreaction. I value calm, emotion-free discussion, airing all points of view and giving thoughtful consideration when I have to make important decisions. A sign in my office had the word “drama” encircled with a diagonal slash going through it to warn those coming to my office with an issue to stick to the facts. A group of us fathers took our kids on a trip to give them a great experience and to give our wives a long weekend free from the kids (and us?) and the theme for the adventure was “Save the drama for your momma!” So, this blog piece is out of character for me, but it is hopefully a wake-up call for all my readers.

I do tend to give people the benefit of the doubt – to an extent that my wife saw it as a fault. She long identified people in our lives that no longer deserved that benefit before I got to that point. It is really hard for me to accept that there are people who are evil, as I try very hard to find the best in people. It is especially hard for me to accept that someone can be a physician and be evil.

I doubt that many of you know of this doctor, but you need to. His name is Kirk Milhoan. He is the new chair of the Advisory Committee on Immunization Practices (ACIP) of the CDC, appointed by Secretary of HHS, RFK, Jr. To me, it is also significant that his area of specialty is pediatric cardiology. That means that prior to subspecializing in heart conditions of children, he had to do training in pediatrics. Having trained in pediatrics, then he has to know how dangerous poliomyelitis is in children.

RFK, Jr. promised us radical transparency, however, at the last ACIP meeting, unlike those in the past, we had no advance materials other than the agenda. Even committee members were not clear on what they were being asked to vote on because they had gone to such lengths to avoid the public getting information prior to the meeting.

Then, in a surprising move, with no advance notice, with no public input, no input from true experts, and no public ACIP meeting, RFK, Jr. simply announced major changes to the childhood vaccine schedule.

I usually get a pretty good idea about what is going to happen at upcoming ACIP meetings, not because HHS or the CDC releases the official materials as has been the practice in the past, but because some of the more public anti-vaxxers on the committee with large social media followings cannot resist going on friendly platforms to discuss their non-scientific, non-medical views.

This time, the chair of the committee, Dr. Milhoan, went on a podcast, and while I have listened to anti-vax nonsense from various doctors for five years now and usually just end up annoyed that they are manipulating and misleading parents who want the best for their children with disinformation, this time, I was shocked and alarmed. Dr. Milhoan suggested on the podcast that the public might want to reconsider the use of polio vaccines (spoiler alert: the vast majority of Americans do not want this), arguing that individual freedoms should be the guiding principle, and in an incredible self-own of his total lack of qualifications indicated that the COVID-19 pandemic influenced his thinking on this (SARS-CoV-2 and the polio virus are completely different, transmitted completely differently and cause completely different diseases).

One might consider this to just be bluster with Dr. Milhoan giving his first interview, being thrust in a limelight that he has not previously had, and perhaps with a sense of self-importance given his appointment to the committee and to chair it. However, I think this was purposeful and calculated. This is the slowly boiling the frog in the pot strategy that we have seen played out in the last year, where RFK, Jr. makes some comments for a podcast that seem too outrageous for us to get all worked up about, then we see members of the committee reinforce those points of view, and then all of a sudden, they appear on the ACIP’s agenda. This is a doctor with pediatric training for heaven’s sake, who has spent his career taking care of children. How could he even think of this, let alone be the person to tee this up for the next meeting?

As a pediatrician, it is rich that he believes that personal freedoms trump protections for children. Is he advocating that if a parent wants personal freedom to have their infant unrestrained in a car without a car seat or an older child without a seatbelt, that is fine? Is he advocating that if a parent wants the personal freedom to discipline their child to the extent of breaking their bones, that should be okay? If a parent wants their personal freedom to go into a store and leave their child locked in a car in sweltering heat, is that just fine with him? If a parent wants their personal freedom to go out overnight and leaves their toddler at home alone, does that freedom trump any responsibilities to protect their child? Are there no responsibilities or accountabilities for parents who choose to have children if those ever come into conflict with the parent’s personal freedoms and choices?

Dr. Milhoan also made the ridiculous assertion that “I don’t like established science. Science is what I observe.” Well, I have news for Dr. Milhoan. Just because he has not observed someone plunge to their death from the top of a building does not mean that he should not accept the law of gravity. What he is really saying is that he likes to be guided by anecdotes rather than double-blind, randomized placebo-controlled trials, which is what other leaders of HHS departments have been telling us should be the gold standard.

His response to questioning on the podcast regarding polio was incredibly poorly informed: “I think also, as you look at polio, we need to not be afraid to consider that we are in a different time now than we were then. Our sanitation is different, our risk of disease is different, and so those all play into the evaluation of whether this is worthwhile of taking a risk for a vaccine or not.”

This is all nonsense. Perhaps before speaking publicly with the cloak of authority as chair of the ACIP about something he apparently knows little about, he should visit the 20-year-old man in Rockland County, New York, who was unvaccinated and traveled internationally, returning home with polio and now completely paralyzed – a condition that he will be in for the rest of his life. Perhaps he should speak to a virologist who specializes in polio viruses to understand that the virus has not become inherently less contagious or virulent. Perhaps he should speak with an infectious disease specialist or neurologist to understand that the unvaccinated are not at less susceptible to the risk of disease if exposed today than we were when parents were panicked about the potential for their children to be infected and disabled by this virus in the 1950s and how they formed long lines to get their children vaccinated when the vaccine came out and celebrations of the vaccine were held. We did not fill up rehab hospitals with patients in iron lungs to help them breathe or fit children with braces to be able to walk because everyone had outhouses or went down to a ravine to pee and poop due to lack of indoor plumbing. This is incredibly ignorant and irresponsible lack of knowledge for a pediatric physician.

We eliminated the wild-type polio disease from the U.S. in 1979. If we eliminate the requirement for polio vaccination, we will be the only developed country in the world to do so. Soon, we will have outbreaks, and without vaccine, I have no idea how Dr. Milhoan and the CDC intend to contain those outbreaks. We will soon be on travel advisories of other countries and our own tourism will suffer negatively impacting our economy. At a time when HHS is promoting MAHA, it is antithetical to now make children who have no ability to protect themselves face the prospect of lifelong disability. At a time when we have been reducing pediatric bed capacity in the U.S. because of our success with vaccine-preventable illnesses, we will place strains on our health care system. At a time when most people feel that health care costs are out of control, we will be significantly increasing health care costs with the huge costs associated with caring for these patients for the rest of their lives, not to mention the loss of their work productivity.

We can no longer remain silent and tolerate this dangerous ideology. I have been a life-long Republican. It is not enough for people to protect the rights of the unborn if they are going to fail to protect children who are born. If you believe that you are a wonderful Christian because you are anti-abortion, but you are also in favor of taking away food programs, health care and vaccines for children that can protect their health and lives, then you are reading a different Bible than I am.

And, at this point, we are all guilty if we do not speak up, contact our legislators, and show up at the polls to vote to make sure that those in power understand that they cannot endanger our children, grandchildren and great-grandchildren in pursuit of ideology or politics and pay no consequences. And God have mercy on our elected leaders’ souls who do not stand up to power to say, “Enough is enough!” I have no doubt that as two parents who are physicians, Dr. Milhoan’s children and grandchildren will obtain these vaccines. He is privileged, as is his son. To take the steps that he is broadcasting and forecasting to disadvantage and harm those who don’t understand the risks, who are disadvantaged, who don’t have access to health care, who are caught up in a web of disinformation, is pure evil.