“Gold Standard Science” on vaccines? More like gold-plated nonsense

It occurred to me yesterday that it’s been nine months since I last posted to this blog. never before in the 21 year history of the blog had there been such a long hiatus. (Heck, the longest hiatus before this was measured in days to weeks, not months.) The explanation as to why I was away for so long and my failures to resurrect the blog over that time might end up being a post of its own. Suffice to say that when I saw what happened yesterday I realized that I just had to get serious about issuing a heaping helping of not-so-Respectful Insolence. Longtime readers who might have left or given up on there ever being another post on this blog probably know what that event was. Yes, I’m referring to President Donald Trump‘s executive order on vaccines that was issued yesterday to make infectious diseases great again.

Orac rides again!

I guess it took this horrific parody of science and public health to prod me in the posterior to finally get this blog out of mothballs. Let’s see if I can keep it up. In the meantime, I’ll start with “highlights” of the press conference, look at the executive order itself, and then discuss why none of this should be a surprise given Trump’s history, even ignoring that his Secretary of Health and Human Services

A typical disinformation-filled White House press conference

I tried to watch the video of the White House press conference, but after a while all I could stand to do was to skim the transcript. If you are interested in torturing yourself, here it is:

Before I get to the EO, let me just touch on a handful of the “highlights” (if you can call them that) of this spectacle.

You can see that Trump wasted no time in trotting out a litany of antivax tropes, after first praising his Secretary of Health and Human Services (HHS), longtime antivax activist Robert F. Kennedy, Jr., for supposedly doing a “fantastic job.” I suppose you could call the job he’s doing working on dismantling the CDC-recommended vaccine schedule “fantastic” if you use a meaning of the word closer to fantastical, given that it is based in fantasy, pseudoscience, and antivax conspiracy theories. Come to think of it, that’s the word Trump should have used.

After praising RFK Jr. and NIH Director “Podcast Jay” Bhattacharya, Trump rambled in his usual semicoherent style:

For long and far too long, long period of time, America’s recommended more childhood vaccines than any peer nation and even twice as many doses as some European countries and even more than that. In many cases, we’re requiring 72 jabs for our beautiful, healthy, lovely, delicate little children, including giving the hepatitis B shot to infants and newborns on top of many other vaccinations. The hepatitis B shouldn’t be given until they are 14 or 15 years old. They were given early.

Effective immediately. my administration is recognizing gold standard childhood vaccine recommendations for only 11 core vaccinations against the most serious and dangerous diseases along with the MMR which hopefully will be split up. You have the MMR. We want it in three separate vaccinations given at separate times together. there could be a possibility they’re quite lethal and separately it looks like they are not at all lethal but just very effective so the MMR we want to have separate separate visits separate times the vaccine being broken into three separate single doses and vaccines being administered in separate visits for example at one year you should have five separate visits for vaccines rather than getting them all in the same day and I saw this early on and I’ve seen proof of it where they have a vaccination thing looks like the size of a a bottle of soda poured into a little child’s body and bad things happen in too many cases because this is an explosion. This is an epidemic.

Right off the bat, you can see that Trump started off with the “too many too soon” gambit, the claim that we are giving our infants too many vaccines at too young an age. Just for yucks, I looked up the very first time I ever wrote about this deceptive and untrue antivax trope, and it appears to have been in 2008, possibly earlier. (WordPress doesn’t have the greatest search engine.) I’ve also been discussing in detail why this trope is false at least since then (as have friends of the blog), with the issue popping up multiple times over the years like a child-killing Whac-A-Mole, because it’s antivax tropes never die. They just keep returning.

Like this gem from later in the Trump’s introductory remarks:

Decades ago, children received only a small fraction of the vaccines required today. In those times, people were much healthier. And of course, the high rates of autism now observed did not exist. So there’s a reason for such epidemic rates of autism. And we’re going to bring it back to much closer to where it was.

Once again, we have mountains of evidence accumulated over decades that vaccines are not associated with an increased risk of developing autism. I might have to do a separate post outlining the various lines of evidence that converge on the same conclusion: There is no detectable link between vaccines and autism.

I realize that, to the layperson, the idea of “too many too soon” seems to make “intuitive” sense in that to the layperson it would seem that throwing too many challenges to the immune system in too short a time in a developing baby might be harmful, but we have copious evidence that this is not so. For one thing, even though there are more vaccines, the design and manufacture of vaccines are much more precise, such that the number of antigens children receive today by age 4 is at least 25-fold fewer than it was 30-40 years ago even as children receive vaccines against many more diseases. When you compare the number of antigens in the vaccine schedule (a few hundred at most) to the many thousands of antigens they encounter just by living, the ridiculousness of the “too many too soon” talking point becomes obvious. It’s not just that, though. Scientists have actually done studies. For instance, in 2013 a study was published showing no association between total antigen exposure and the risk of autism or maximum antigen exposure at one visit (number of shots given in a single visit) and autism risk.

Over at my not-so-super-secret other blog, I’ve been writing about how when this administration says “gold standard science” it means anything but, the term primarily being a smokescreen to hide the distortion of science and the institution of Lysenko 2.0, in which ideology, in this case antivax ideology, determines the science that the government considers “gold standard.” As for the part about the hepatitis B vaccine, there are very good scientific and public health reasons why the CDC recommended the birth dose, which has long been a bugaboo among antivaxxers. The only likely effect of delaying the birth dose, as this administration has been trying to do, will be more cases of hepatitis B and, decades from now, more cases of liver cancer, the most deadly late complication of chronic hepatitis B infection.

You might wonder what he’s talking about when it comes to his “ordering” that the number of childhood vaccines on the CDC-recommended schedule be reduced to 11. This is simply a case of his trying to order what RFK Jr. failed to do as HHS Secretary when he unilaterally tried to “make America Denmark” by adopting the Denmark vaccine schedule as the US schedule.

What do I mean by that? On January 5, RFK Jr. decided to change change the US CDC-recommended childhood vaccine schedule to align with that of Denmark, not for any scientific reason that he could ever articulate but simply because, of all European Union nations, Denmark recommends the fewest childhood vaccines. Acting CDC Director Jim O’Neill at the time revised the US childhood vaccine schedule to remove six vaccines, with Denmark’s vaccine schedule serving as the basis for the recommendations promulgated in a highly flawed memo by Tracy Beth Høeg and Martin Kulldorff comparing the US childhood vaccine schedule with that of other countries. As I described it at the time in my not-so-secret other blog, in essence the administration outsourced our vaccine policy to Denmarkbecause RFK Jr. wanted to eliminate as many vaccines as he could as quickly as possible. This decision made the US one of the outliers when it comes to vaccine policy, and as a result we can expect in the next few years to see resurgences of rotavirus, meningitis, influenza, and other vaccine-preventable diseases for which the vaccine was dropped from the US schedule. (Seriously, Brazil, Mexico, Saudi Arabia, and Greece now recommend vaccinating against more diseases than Høeg’s schedule.) These changes were stayed while a lawsuit against the CDC over the new schedule proceed. Apparently Trump thinks he can just bypass that stay by issuing an executive order.

I’ll discuss the issue with the MMR in more detail in the next section when I discuss the EO itself. For now, suffice to say that Trump is parroting a false claim that the godfather of the 21st century antivax movement, Andrew Wakefield, was promoting over 20 years ago, namely that the combined MMR (measles-mumps-rubella) vaccine causes autism and that splitting the vaccine into its components and administering them separately. Longtime readers and those who’ve followed the antivax movement for a long time might remember that Wakefield had filed a UK patent application for an individual measles vaccine at the time he published his infamous 1998 Lancet case series claiming to link the MMR vaccine with autism and “autistic enterocolitis.” As for Trump’s claim that together there is “a possibility they’re quite lethal and separately it looks like they are not at all lethal but just very effective,” that’s just plain bullshit. MMR is an incredibly safe and effective vaccine, validated by five decades of use. I mean, you could say that there is a “possibility” that homeopathy works, but that possibility is so infinitesimally small that for all practical purposes it is indistinguishable from zero.

Before I discuss the EO itself, let’s look at a couple of the absolute stupidest things about vaccines that have likely ever been said in the Oval Office:

Very simply, large amounts of vaccine, large amounts of like vats of vaccine are currently pumped into your child’s body. And we’re doing 20% of that at each visit. And we’ll let time elapse between visits so the body can handle this massive amount of fluid being pumped in. I think it’s going to make a big difference. You know, there are some groups that have virtually no problem with autism and they un you know, I have to say this, they they’re groups that aren’t big into the world of vaccines.

“Vats” of vaccines? So much fluid that the baby needs time to handle the “massive amount of fluid” injected? WTF is Donnie talking about? Unfortunately, this sort of rhetoric is nothing new for our President. Does anyone remember the “monster shot”? Longtime readers might remember that in 2012 Donald Trump made a bit of a stir by parroting an antivax talking point, describing a “monster shot” that causes autism:

“I’ve gotten to be pretty familiar with the subject,” Trump said. “You know, I have a theory — and it’s a theory that some people believe in — and that’s the vaccinations. We never had anything like this. This is now an epidemic. It’s way, way up over the past 10 years. It’s way up over the past two years. And, you know, when you take a little baby that weighs like 12 pounds into a doctor’s office and they pump them with many, many simultaneous vaccinations — I’m all for vaccinations, but I think when you add all of these vaccinations together and then two months later the baby is so different then lots of different things have happened. I really — I’ve known cases.”

And:

They go in and they get this monster shot. I mean, have you ever seen the size of it? It’s like they’re pumping in–you know, it’s terrible, the amount. And they pump this in to this little body, and then all of a sudden the child is different a month later, and I strongly believe that’s it. They should have vaccinations, but do them separately and over an extended period of time, not all at one time.

We’re usually talking for a typical vaccine given to infants, at most, 1 ml, or one-thirtieth of an ounce of fluid, and most such vaccines are suspended in 0.5 ml of solution!

Unfortunately, Trump has been susceptible to antivax talking points for nearly 20 years (at least). The first time I ever encountered a news story in which he linked vaccines and autism was in 2007, when he said:

“When I was growing up, autism wasn’t really a factor,” Trump said. “And now all of a sudden, it’s an epidemic. Everybody has their theory. My theory, and I study it because I have young children, my theory is the shots. We’ve giving these massive injections at one time, and I really think it does something to the children.”

And:

“When a little baby that weighs 20 pounds and 30 pounds gets pumped with 10 and 20 shots at one time, with one injection that’s a giant injection, I personally think that has something to do with it. Now there’s a group that agrees with that and there’s a group that doesn’t agree with that.”

See what I mean? The message has been consistent for at least 19 years. Who knows how long before that 2007 interview Trump had been saying the same thing? That was just the first time I had ever encountered it.

Unsurprisingly, RFK Jr. jumped in to parrot the same antivax nonsense that he’s been promoting for 21 years (at least):

Our assessment found that the United States recommended more childhood vaccines than any other pure nation. as in Trump and it mentions the number that 72 jabs before 18, but it actually could be up to 94 jabs and nobody else has anything like that. And then many other countries or most other countries achieve high vaccination rates through education, informed consent, and public trust rather than mandates. Today, with this executive order, you are building on that work and acting on that evidence. We will preserve access to vaccines, strengthen safety monitoring, expand research, give doctors and parents better information, and restore informed consent and parental choice to their rightful place in American medicine.

Longtime readers and those who pay attention to antivax tropes will recognize the distortion and exaggeration in the claim above. I won’t go into the details of why the claim above is nonsense, save to cite Dr. Vincent Iannelli pointing out how “these numbers count individual vaccines in combination vaccines as single vaccines “boosting the number vaccine doses by counting combination doses separately, something that for some reason they typically forget to do when talking about vaccines in 1960,” and deconstructing other bad antivax math.

I could continue, but the rest of this press conference was truly embarrassing. RFK Jr. went on about how he was supposedly marshaling all the resources of HHS to look at environmental exposures as potential risk factors for autism, along with vaccines, of course, bragging about “no taboos, no sacred cows.” Seriously, real scientists have been studying for decades whether vaccines cause autism. They haven’t found any evidence that they do. It’s not a “sacred cow” to study vaccines as a cause of autism. It’s beating a dead horse, flogging a hypothesis that’s been tested and found wanting many, many times. It’s wasting money studying a question that has been asked and answered ad nauseam without compelling evidence to justify questioning that consistent answer and revisiting the question.

There were rants about how mandates supposedly destroyed “trust” in public health authorities, as usual, without any mention of the well-funded, years-long onslaught of misinformation about COVID mitigation measures and vaccine—you know, actual factors that certainly contributed mightily (and intentionally) to the current public mistrust of US public health authorities. There were even rants about Iran, because a reporter asked about the war in Iran, which led to further rants about how this generation of Democrats are supposedly actually Communists (because, I guess, we’re time traveling back to 60 or 70 years ago) or jihadists (because, I guess, we’re stopping at 20-25 years ago on the way back to the 1950s). I really couldn’t take anymore.

Amusingly, Podcast Jay tried to thread the needle. It’s pretty clear from his previous public remarks that he that he doesn’t actually believe that vaccines cause autism. However, he’s too cowardly just to say it clearly because his boss is a raving antivaxxer. So he equivocates:

The executive order recognizes the plight of millions of parents across the country with autistic children. Autism is a very complicated condition with very heterogeneous ranging from you know relatively mild symptoms where where kids are, you know, full functioning to a devastating condition that fundamentally alters their lives and life and the the lives of their families. I’ve you’ve heard from Secretary Kennedy and from the president their their passion for the plight of these families to see how we can help them understand the condition to help prevent those conditions from happening in the first place. And what this executive order does is it It orders us at HHS to take this extremely seriously as we have been for the last year and a half and more of the presidency. At the NIH the the what what what what we’ve done is we have established the Autism Data Science initiative which started almost a year actually more than a year ago where we funded a dozen and more major research teams to answer the question of what is the cause of autism.

It’s a complicated biological phenomenon. It’s not going to be a simple answer. it will have as as the secretary said potentially genetic predisposition but that cannot possibly explain why we’ve seen such a large rise in autism. There must be some other environmental factors involved and that’s the basis for thinking uh that’s driving these dozen and more research teams that are looking at this. The science takes time.

:You can tell that Podcast Jay was nervous and being very careful by the large number of “uhs” and “ums” that I had to edit out of the transcript, which is probably why he lands on blaming “mandates” for the lack of trust:

I mean, I believe fundamentally that many vaccines are important. I’ve said measles, for instance, the measles vaccine is important if we want to take control of the measles outbreak. But at the same time, we shouldn’t be keeping kids out of school because they they have made different decisions than other parents. Our European colleagues don’t do that. A lot of the collapse in trust in public in public health has come because of these mandates that we’ve seen imposed during the Biden administration on the COVID vaccine and so many other things.

There’s only one meme for a statement so lacking in context as this:

So what does the EO itself actually say?

An antivax EO disguised as “gold standard science”

Let’s now look at the actual EO itself, entitled Delivering Gold Standard Childhood Vaccine Recommendations for Americans. After a preamble that reads a lot like Trump’s opening remarks, complete with the same tropes about how the US supposedly recommends more vaccines than any peer nation and comparing school vaccine mandates to the way European countries supposedly promote vaccination, the EO launches into a “prioritization” of vaccines based on…what? I can’t tell, but let’s quote:

Sec. 2.  Recommendations for Childhood and Adolescent Vaccines.  (a)  Based on consultation with my advisors and review of available scientific evidence, it is hereby declared that the United States recognizes Gold Standard Childhood Vaccine Recommendations informed by the three distinct categories of childhood immunization recommendations identified in the scientific assessment, as specified below:

(i)    immunizations recommended for all children:  measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella;

(ii)   immunizations recommended for certain high-risk groups or populations:  respiratory syncytial virus monoclonal antibodies, hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY, and dengue; and

(iii)  immunizations based on shared clinical decision-making:  hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19.

The intent is obvious, which is to de-emphasize certain vaccines, thus making them entirely optional. That’s the whole purpose of “shared decision-making.” Ditto making a certain set of vaccines recommended only for “high risk” groups, without, tellingly, defining what makes these groups “high risk” and justifying those definitions with scientific, clinical, and epidemiological data. Again, “gold standard science”—I refuse to capitalize the term—is all about coing up with science-y sounding rationales for doing what the administration wants to do anyway.

The next part of the order makes that very clear. Indeed, Trump doesn’t even try to hide it very well:

(b) The Gold Standard Childhood Vaccine Recommendations also recognize that the combined measles, mumps, rubella (MMR) vaccine should be administered in three separate single-disease shots once such products are domestically available and that, to the maximum extent feasible, all childhood immunizations should be administered at separate medical visits.

What is the rationale for this recommendation? There is none, at least none presented. It’s incoherent, too, given how the EO keeps citing European countries’ vaccine schedules as models to base the US vaccine schedule on. Guess what? All of them include MMR and other combination vaccines. None of them break up MMR into separate vaccines to be given separately and individually. Nor does the EO cite any evidence that the MMR is harmful or even more risky than measles, mumps, or rubella. (Seriously, the risk of vaccines is lower than the risk of the diseases targeted by them.) Apparently, when it comes to Donald Trump and RFK Jr., “gold standard science” boils down to, “Trust us, bro.”

In an apparently implicit admission that there is no science behind its “gold standard childhood vaccine recommendations” the EO also demands that HHS find the evidence that vaccines cause autism, without explicitly saying so:

Sec. 3.  Improving Vaccine Research and Options for American Parents.  The Secretary of HHS, through the HHS Task Force on Safer Childhood Vaccines, shall, within 90 days of the date of this order, present plans to the President through the Assistant to the President for Domestic Policy to, to the extent appropriate and consistent with applicable law:

(a)  offer options to administer core childhood vaccines, starting with MMR, as single vaccines rather than combination products/doses, including by working with the private sector and other countries as appropriate, while guaranteeing continued availability of combination vaccines and those vaccines recommended for shared clinical decision-making;

(b)  assess the ideal timing and sequencing of all core childhood vaccines and adjust the Federal childhood and adolescent vaccine schedule as appropriate based on gold‑standard science;

(c)  develop additional alternative adjuvants to aluminum and conduct comparative safety and efficacy studies;

(d)  ensure continuous evaluation of the risk/benefit profiles of all childhood vaccines based on United States and international data; and 

(e)  improve vaccine safety monitoring, transparency, and research. 

Here’s a hint. Other than (a), the CDC and FDA have already long been doing exactly what is listed in (b), (d), and (e). Before Trump took over as President again and RFK Jr. was confirmed as HHS Secretary, that was the job of the CDC Advisory Committee on Immunization Practices (ACIP); that is, until June 2025, when RFK Jr. fired all of its members and replaced them with a bunch of antivax cranks and antivax-sympathetic enablers. As for (c), adjuvants have long been a topic of active research. (Indeed, just look at this review article on some of the strategies being used, which include, of course, AI.) It is difficult task, however, given how safe and effective aluminum adjuvants have long been demonstrated to be at a low cost.

As for (a), there is no scientific, clinical, epidemiological, or immunological evidence to justify undertaking a major research program, and doing so will be difficult at best and not likely to be accomplished any time soon. After all, no pharmaceutical company is likely to be very enthusiastic about investing money into a research program to develop separate vaccines when there is no market for them. This is, again, nothing more than a transparent excuse to sow fear and doubt about vaccines, all the more so given that the EO states that each “executive department and agency shall review the Gold Standard Childhood Vaccine Recommendations and take any appropriate steps to advance them, to the fullest extent allowable by law.” Under the law, it is not the President, but the CDC through ACIP, that determines the recommended vaccine schedule.

In fact, the real reason for this misdirection demanding that combination vaccines be separated into their component vaccines and administered separately is made obvious in the passage stating “that, to the maximum extent feasible, all childhood immunizations should be administered at separate medical visits.” In other words, instead of one visit for one dose of MMR, there would be three visits, one for the measles vaccine, one for the mumps vaccine, and one for the rubella vaccine. For disadvantaged children, children of working parents who have difficulty taking days off, and even for parents of high income households in which both parents work demanding jobs, the vast expansion of the number of visits required to receive all the currently recommended vaccines will inevitably result in a lot fewer children receiving all the recommended vaccines and plunging vaccine uptake. That’s the idea. Andrew Wakefield knew it when he first proposed splitting the MMR into its component parts, and RFK Jr. knows it now.

In reality, the rest of the EO boils down being an excuse to to justify the last part of the executive order:

Sec. 4.  Maximizing Parental Choice over Childhood Vaccines.  (a)  The Attorney General shall take appropriate measures to further meritorious legal actions challenging State laws that conflict with States’ constitutional and Federal statutory obligations related to parental authority, religious freedom, disability accommodations, and equal protection under the law, including, to the extent applicable under Federal law, States’ obligations to provide religious and medical exemptions from childhood and adolescent immunization requirements.

(b)  The Departments of Justice, Education, and HHS shall take appropriate action to ensure that their contractors and grantees, including States and localities, are compliant with their constitutional and Federal statutory obligations related to parental authority, religious freedom, disability accommodations, and equal protection under the law, including, to the extent applicable under Federal law, their obligations to provide religious and medical exemptions from childhood and adolescent immunization requirements.

Basically, Trump is ordering the federal government to put pressure on states to fall in line. RFK Jr., with Trump’s backing, will pressure states to modify their school vaccine requirements to line up with this executive order and to make religious and personal belief exemptions easier to obtain. Most likely, some states will resist, while others will acquiesce, depending largely on which party is in charge in each state.

They’re coming for your vaccines

I have long been arguing that, since he first “came out” as an antivaxxer in 2005, RFK Jr. has come to believe that vaccines are evil, that they are poison that causes autism and all manner of maladies, evidence that they do not be damned. As HHS Secretary, he has had the power to act on that belief. Make no mistake, RFK Jr. is coming for your vaccines. It might not seem like it, given its limitations, but this EO is yet another step in the direction of doing what he actively considered doing but did not as yet, eliminating the entire CDC-recommended vaccine schedule and making it more and more difficult to get vaccinated, to the point where they become almost irrelevant. The goal is to make measles great again, nay, to make all infectious diseases great again.