The Dictatorship
I’m a pediatrician. When parents attack me for suggesting vaccines, I fume at RFK Jr.
So many parents refusing vaccines for the children I see in my examination room have been encouraged to do so by Robert F. Kennedy Jr., the charlatan President Donald Trump has picked to take the reins of the Department of Health and Human Services. The Senate Finance Committee will vote on Kennedy’s nomination Tuesday and, we should all hope, reject it.
I was raised by Depression-era blue-collar parents who knew firsthand the devastating diseases few of today’s parents would recognize. For them, each new vaccine increased the chance that theirs would be the first generation that didn’t expect to bury a child. I still remember how proud my mom was taking me to the pediatrician for vaccines. She was doing her job, keeping us safe. As a pediatrician, I see vaccines as a force field that we and parents use to protect young lives.
As a pediatrician, I see vaccines as a force field that we and parents use to protect young lives.
During medical school and then a residency at Children’s Hospital of Michigan, I cared for countless infants and children hospitalized with bacterial meningitis and invasive diseases caused by pathogens like Hemophilus, Streptococcus pneumoniae and Neisseria. These infections often resulted in devastating damage, such as hearing and vision loss — a fate Helen Keller tragically suffered. Then, a spinal tap was a necessary and routine part of the workup of infant fever. The high-pitched, painful cries of infants with meningitis will forever reverberate in my mind, along with the coughs of infants with pertussis drowning in their own secretions.
During my 30 years as a physician, I have seen how our carefully studied vaccines have revolutionized pediatric care. Because the vast majority of young Americans are vaccinated, bacterial meningitis and its devastating effects have become so rare that only the youngest infants now require invasive procedures like spinal taps during fever workups. In the vaccinated, Pneumococcus rarely causes bloodstream infections or the deadly pneumonia for which it is named. We no longer see the chickenpox infections that result in weeks of missed school and work. Hemophilus isn’t causing the loss of limbs, eyes and airways.
This progress, however, is being threatened by vaccine refusal. As Kennedy sat before a confirmation hearing with the Senate Finance Committee on Wednesdayphysicians like me, who’ve dedicated our lives to the health and welfare of children, watched with outrage and exhaustion. And disgust that Kennedy refused to own his anti-vaccine advocacy.
“I support the measles vaccine,” he told senators. “I support the polio vaccine. I will do nothing as HHS secretary that makes it difficult or discourages people from taking anything.” But the fact is that he has built a name for himself by discouraging parents from getting their children vaccinated.
As Kennedy sat for a confirmation hearing, physicians who’ve dedicated our lives to the health and welfare of children, watched with outrage.
Listening, I thought about the father who recently became angry with me for “insinuating” that his sick, unvaccinated infant needed a workup and hospitalization for his high fever without an obvious source. He accused me of making up concerns to make money for the hospital. As familiar as I am with this particular conspiracy theory, it hits me hard every time I hear it. And we are hearing it more and more often.
Instead of becoming defensive and judgmental, I treat these bedside conversations as a collaboration that has as its common goal a healthy child. I talk about my own experience, painting a picture of the wards from as recently as the 1990s. I told this father that I understood he was acting as an advocate for his child the best way he knew how. Ultimately, his wife heard me and agreed to the workup. By the time their child’s blood culture grew Pneumococcus the next day, their child was already getting his third dose of intravenous antibiotics.
After he was recovered, the mother described the near-tragedy on social media. She shared how worried they’d been and how they initially hadn’t sought care because they didn’t trust hospitals. She added that if her children had received their routine vaccines, then their infant son probably would have experienced Pneumococcus as nothing more than a mild fever or ear infection. And they’d have been spared a hospital bill.
The flames of vaccine hesitancy have been stoked to a bonfire by fictitious stories by self-serving individuals. When Andrew Wakefield first theorized that the measles vaccine caused autism, he may have truly believed that. But by the time more complete and accurate research showed no connection, his taste of fame and the power of sensationalism had seemingly overpowered integrity, and he stuck to his position.
Enter RFK Jr., who, along with his Children’s Health Defense, an anti-vaccine nonprofit group, preyed on the parents of children with autism who were searching for someone to blame. Research again and again has shown his assertions to be false. But repeating and funding independent vaccine studies took precious time. Time during which careers were made sowing fear and mistrust by discrediting the very physicians who’d dedicated their lives to defending their patients’ and the public’s health.
The people who accuse pediatricians of profiting from vaccines, Kennedy included, have ironically amassed fortunes doing so.
The people who accuse pediatricians of profiting from vaccines, Kennedy included, have ironically amassed fortunes doing so.
Parents who are vaccine hesitant are, of course, doing what they think is best for their children. They come to us having “done my research,” fueled by algorithms built to lead concerned parents down a rabbit hole of misinformation. Because they have little firsthand experience with bacterial meningitis, limb-threatening cellulitis, the devastation of measles or the infertility of mumps, they are easily convinced that vaccines are unnecessary — and even harmful.
When parents come in convinced of the deep state conspiracy, it is difficult to heal the partnership that we pediatricians seek to have with them. These conversations have stolen so much time from our ability to care for patients that many practices have chosen to exclude those who refuse vaccines for their children.
Many parents, though, seek our advice — even when they have misgivings. When we are able to have open conversations built on appreciation and partnership, parents often gratefully follow the well-studied vaccine schedule to protect their children.
One of my young parents was unvaccinated as a child and resents that her parents fell for the conspiracy theories. When she first brought her adorable children in, we had lots of conversations, including about immunizations. Like my mom, she sees herself as a fierce advocate for her children when they come in for their well visits and shots. Each visit, when I explain the shots they will receive, we both laugh when she says, “Lock and Load, Dr. Pat, Lock and Load!”
If Kennedy is confirmed as HHS secretary, he will have the ability to submit a generation of children to the experiment he has long hoped would finally prove his misbegotten theories promoting supplements and other measures as preferable to vaccines. Americans need only to look at Samoa for predictions of that outcome. There, in 2018, a nurse tragically used a vial of paralyzing muscle relaxant to dilute a vial of measles vaccine. That mistake resulted in the deaths of two infants. This caused Samoa to suspend the measles vaccination program. Kennedy visited the island, he later wrotebecause “government officials, including the Prime Minister were curious to measure health outcomes following the ‘natural experiment’ created by the respite from vaccines.”
One of my young parents was unvaccinated as a child and resents that her parents fell for the conspiracy theories.
The health outcomes included a measles outbreak that occurred months after Kennedy’s visit, which included thousands of infections and the deaths of 83 people, most of them small children. Kennedy reportedly told Samoa’s prime minister that the deaths were caused not by measles but by the vaccine used to prevent measles.
“I never gave any public statement about vaccines. You cannot find a single Samoan who will say, ‘I didn’t get a vaccine because of Bobby Kennedy,’” Kennedy told senators Wednesday.
Despite his claims that he wouldn’t discourage vaccinations, we have every reason to believe that Kennedy, if he’s put in charge of HHS, would discourage and even defund them. Defunding vaccines would mean even the parents who are steadfast in protecting their children may not be able to afford the vaccines needed to shield them. And that would put the patients I see at increased risk of disabling disease and death.
And then, incomprehensibly, we might owe declining vaccine rates and the return of long-forgotten infectious diseases not to some internet rabbit hole but to a U.S. Cabinet official charged with protecting the health of the nation.
Senators, the pediatricians who kept your children safe implore you to stand with them and with children in opposing the appointment of Mr. Kennedy to the Cabinet.
Dr. Patricia Wells
Dr. Patricia Wells, medical director at The Corner Health Center in Ypsilanti, Mich., leads a multidisciplinary team providing comprehensive, judgment-free healthcare for young people aged 12–25 and their children. There, and in a local emergency center, she witnesses firsthand the effects of gaps in care access and remains vigilant for the emergence of vaccine preventable illnesses.
The Dictatorship
Justice Jackson chides ‘oblivious’ Supreme Court conservatives…
WASHINGTON (AP) — Supreme CourtJustice Ketanji Brown Jackson has delivered a sustained attack on her conservative colleagues’ use of emergency orders to benefit the Trump administration, calling the orders “scratch-paper musings” that can “seem oblivious and thus ring hollow.”
The court’s newest justice, Jackson delivered a lengthy assessment of roughly two dozen court orders issued last year that allowed President Donald Trump to put in place controversial policies on immigration, steep federal funding cuts and other topics, after lower courts found they were likely illegal.
While designed to be short-term, those orders have largely allowed Trump to move ahead — for now — with key parts of his sweeping agenda.
Jackson spoke for nearly an hour on Monday at Yale Law School, which posted a video of the event on Wednesday.
Last week, Justice Sonia Sotomayor similarly talked about emergency orders in an event Tuesday at the University of Alabama that also took issue with the conservatives’ approach.
Jackson has previously criticized the emergency orders both in dissenting opinions and in an unusual appearance with Justice Brett Kavanaugh last month. But her talk at Yale, addressing the public rather than the other eight justices, was notable.
She referred to orders, which often are issued with little or no explanation as “back-of-the-envelope, first-blush impressions of the merits of the legal issue.”
Worse still, she said, was that the court then insists that “those scratch-paper musings” be applied by lower courts in other cases.
The orders suffer from an additional problem, she said, a failure to acknowledge that real people are involved, making them “seem oblivious and thus ring hollow.”
She also pushed back on the court’s assessment that preventing the president from putting his policy in place also is a harm that often outweighs what the challengers to a policy might face.
“The president of the United States, though he may be harmed in an abstract way, he certainly isn’t harmed if what he wants to do is illegal,” Jackson said during a question-and-answer session with law school dean Cristina Rodriguez.
The court used to be reluctant to step into cases early in the legal process, she said. “There is value in avoiding having the court continually touching the third rail of every divisive policy issue in American life,” Jackson said.
While she said she couldn’t explain the change, “in recent years, the Supreme Court has taken a decidedly different approach to addressing emergency stay applications. It has been noticeably less restrained, especially with respect to pending cases that involve controversial matters.”
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Jackson, often joined by Sotomayor and Justice Elena Kagan, has frequently dissented.
There have been conversations about emergency orders among the justices, Jackson said, but she decided to speak publicly with the goal of being “a catalyst for change.”
Also on Wednesday, Sotomayor issued a rare public apology to another justice, Kavanaugh, for what she termed “hurtful comments” she made last week during an appearance at the University of Kansas law school.
Referencing an opinion Kavanaugh wrote in an immigration case where the court granted an emergency order sought by the administration, Sotomayor said her colleague “probably doesn’t really know any person who works by the hour.” Her remarks were reported by Bloomberg Law.
The Dictatorship
Trump threatens to fire Powell if the Fed Chair remains with central bank after his term ends
WASHINGTON (AP) — Federal prosecutors made an unannounced visit this week to a construction site at Federal Reserve headquarters that is the focus of an investigation into a $2.5 billion renovation projectaccording to two people familiar with the visit.
Two prosecutors and an investigator from U.S. Attorney Jeanine Pirro’s office were turned away on Tuesday by a building contractor and referred to Fed attorneys, one of the people said. The two people familiar with the visit spoke on condition of anonymity because they weren’t authorized to publicly discuss an ongoing investigation.
The visit underscores that the Trump administration is not backing down from its investigation of the Fed and its chair, Jerome Powell, even though the probe has delayed the confirmation of a new chair nominated by President Donald Trump. The investigation is focused on cost overruns and brief testimony about the project last summer by Powell. Trump confirmed in an interview that aired Wednesday on Fox Business that he wants to continue the probe.
Last month, during a closed-door hearing before a federal judge, a top deputy from Pirro’s office conceded that they hadn’t found any evidence of a crime in their investigation of the headquarters project.
Robert Hur, an attorney for the Federal Reserve board of governors, sent an email to Pirro’s prosecutors about their visit and their request for a “tour” to “check on progress” at the construction site. Hur’s email, which The Associated Press has viewed, noted that U.S. District Judge James Boasberg concluded that their interest in the Federal Reserve’s renovation project was “pretextual.”
AP AUDIO: Prosecutors sought access to Federal Reserve building as Trump threatens to fire Powell
AP Washington correspondent Sagar Meghani reports on more drama surrounding a federal probe of a massive construction project at the Federal Reserve’s headquarters.
“Should you wish to challenge that finding, the courts provide an avenue for you; it is not appropriate for you to try to circumvent it,” Hur wrote.
Republican Tillis is key vote
Sen. Thom Tillis, a North Carolina Republican who is a key member of the Senate Banking Committee, has vowed to vote against Kevin WarshTrump’s nominee to replace Powell as Fed chair, until the investigation is dropped. With the committee closely divided on partisan lines, Tillis’ opposition is enough to block Warsh from receiving the committee’s approval.
Tillis on Wednesday criticized the investigation as “bogus, ill-timed, ill-informed” and repeated that seven Republican members of the banking panel have said they do not believe Powell committed a crime when he testified last June.
Tillis also said there aren’t enough votes on the committee or in the broader Senate to do an end-run around the committee and get Warsh confirmed some other way.
“There really is no path,” he told reporters, adding that Pirro and her aides were “asleep at the switch” because the investigation has essentially delayed Powell’s departure from the Fed, despite Trump’s obsessive criticism of the Fed chair. Powell has now said he won’t leave until the investigation is resolved.
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Tillis suggested Pirro blindsided the White House with her investigation. “They should have consulted with the White House, because I’m sure if they would have, (the White House) would have said, ‘no, we can wait,’” until Powell steps down.
But Kevin Hassett, the Trump administration’s top economist, said Wednesday that the Justice Department got involved because “the president wanted to investigate the cost overrun,” Axios reported.
The Banking panel said Tuesday that it will hold a hearing on Warsh’s nomination April 21. Powell’s term as Fed chair ends May 15, but Powell said last month he would remain as chair until a replacement is named.
Powell is serving a separate term as a member of the Fed’s governing board that lasts until January 2028. Chairs typically leave the board when their terms as chair end, but they can remain on the board if they choose. Powell has said he won’t leave until the investigation is resolved. If he remains it would deny Trump the opportunity to appoint someone else to the seven-member board.
Late Tuesday Tillis posted a link on social media to The Wall Street Journal’s article on the visit below an image of the Three Stooges and wrote, “The U.S. Attorney’s Office for D.C. at the crime scene.”
Investigation centers on building renovations
The investigation centers on an appearance by Powell before the Banking Committee last June, when he was asked about cost overruns on the renovations. The most recent estimates from the Fed suggest the current estimated cost of $2.5 billion is about $600 million higher than a 2022 estimate of $1.9 billion.
“It is probably corrupt, but what it really is, is incompetent,” Trump said. “Don’t you think we have to find out what happened there?”
The president’s support for the investigation threatens a timeframe set out by Sen. Tim Scott, a South Carolina Republican who chairs the Banking Committee. Scott said Tuesday on Fox Business that he believed the investigation would be “wrapped up in the next few weeks,” allowing Warsh to be confirmed soon after.
Threat to fire Powell
News of the unannounced visit by prosecutors comes as Trump has again threatened to fire Powell, if the Federal Reserve Chair decides to stay on the central bank’s governing board after his term as chair expires next month.
“Well then I’ll have to fire him, OK?” Trump said.
Trump has for months wanted to remove Powell, saying he has been too slow in orchestrating interest rate cuts that would give the U.S. economy a quick boost. Powell has said the investigation is a pretext to undermine the Fed’s independence to set rates.
Sen. Josh Hawley, a Missouri Republican, said Trump can only fire Powell “for cause,” meaning some kind of misconduct, “so that’s a pretty tall order.”
Supreme Court weighing another Trump removal
Trump’s threat to fire Powell comes as the Supreme Court is weighing the president’s effort to remove another central bank governor, Lisa Cook. Lower courts have so far allowed Cook to remain in her job while her legal challenge to the firing continues. The Supreme Court also seemed likely to keep her on the Fed when the court heard arguments in January. A decision could come any time.
The issue in Cook’s case is whether allegations of mortgage fraud, which she has denied, is a sufficient reason to fire her or a mere pretext masking Trump’s desire to exert more control over U.S. interest rate policy.
The Supreme Court has allowed the firings of the heads of other governmental agencies at the president’s discretion, with no claim that they did anything wrong, while also signaling that it is approaching the independence of the nation’s central bank more cautiouslycalling the Fed “a uniquely structured, quasi-private entity.”
___
AP Writers Seung Min Kim, Mark Sherman, Paul Wiseman, Alanna Durkin Richer, and video journalist Nathan Ellgren contributed to this report.
The Dictatorship
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