Vaccine divide helps Trump overturn accepted policies

• The question is how much are parents willing to trust their instincts — and what happens if the policy changes make it harder to access care in a timely way for parents who want to vaccinate their kids.

Late Friday, Trump ordered federal health officials to review the decades-old U.S. childhood immunization schedule and consider reducing the number of recommended vaccinations to align with developed nations like Denmark and Japan.

• The directive came the same day that a panel of Kennedy-appointed vaccine advisers voted to drop the decades-old federal recommendation that all infants receive the hepatitis B vaccine at birth.

Between the lines: The administration's moves come as more Americans are turning to the internet with questions about their health, and as suspicion and partisan cues are driving a wedge between the public and the medical establishment.

• Societal shifts that began during the COVID-19 pandemic have endured, driving perceptions that the government doesn't make the health of the public a priority and elevating messages about patient empowerment.
• Childhood vaccines are a particular friction point. Strong majorities believe they're safe and effective, but there has been a noticeable shift in some Americans' opinions over whether they should be required for kids to attend public schools.

By the numbers: The Pew Research Center last month found 63% of Americans have high confidence in the effectiveness of childhood vaccines, but that just over half trust their safety testing (53%) and are confident in the schedule (51%).

• The drop-off is especially visible among Republicans, whose support for MMR vaccine school requirements has slipped from 79% in 2019 to 52% today.
• Pew found 32% of Republicans have high confidence in the vaccine schedule's safety, and 31% have low confidence. Democrats are much more aligned: 71% have high confidence.

An Axios-Ipsos poll in October found that skepticism over child vaccination requirements has ticked up since Trump took office in January.

• 74% of Americans said parents should follow the recommended child immunization schedules, down from 81% in March.
• Some of that decline is driven by Democrats, whose support on this front slipped from 94% to 85%, in a possible reflection of their mistrust in the administration.

Reality check: The vaccine policy changes are driven more by politics than new concerns that the vaccines are unsafe. One of Kennedy's vaccine advisers suggested on Saturday they were pushback against health authorities' mandates.

• "ACIP's recommendations re Hep B vaccine reflect strong objection to vaccine mandates that prevent access to school & even clinical care from children not up to date with the vaccine schedule (including Hep B)," Retsef Levi, a professor of operations management at MIT, wrote on X.
• "Children should have undeniable constitutional right to education!"

Many public health authorities fear Trump's call to bring the U.S. in line with certain other developed nations will arrive at a predetermined conclusion.

• "Vaccine policy by decree begins now ... no need for an advisory committee or public discussion," former to Centers for Disease Control and Prevention official Demetre Daskalakis, who resigned in August, wrote on X.
• There were also signs that at least one member of the vaccine panel is worried that its work is being driven by political pressure.
• The new chair of the panel, pediatric cardiologist Kirk Milhoan, said on Friday he felt like he and panel members were "puppets on a string" instead of an independent advisory board, per a transcript of a private Zoom, the Wall Street Journal reported.

The bottom line: While calls for medical freedom and informed consent may sound appealing to some Americans, the vaccine policy pivot carries big political risk if there's a continued resurgence of preventable diseases.