The Poison Pill to End the MMR is Tylenol

If you think Tylenol is bad for babies, wait until you hear about rubella virus

I didn’t think President Donald Trump could possibly beat the infamous “inject bleach” press conference from 2020 for unhinged insanity, but I should have known that announcing the cause of autism was not going to be a serious affair. Even for a man known for having a very poor grasp of medical science as Trump, he managed to give the wildest lecture on pharmacology and vaccine safety I’ve ever witnessed. It’s the first time I’ve heard a US president state that vaccines cause babies to “get fried” or scream “BREAK IT UP!” about the measles-mumps-rubella (MMR) vaccine.

Unfortunately, Trump was not alone. He was flanked by Health and Human Services Secretary Robert F. Kennedy, Jr. and all his lieutenants: FDA Commissioner Marty Makary, NIH Director Jay Bhattacharya, CMS Administrator Mehmet Oz, and Acting HHS Assistant Secretary Dorothy Fink. I’m not sure why Fink was present, except to be a smiling woman discouraging pregnant people from using the only pain reliever recommended during pregnancy. Women do not deserve pain relief if it comes at the expense of their function as baby-makers. Women should just “tough it out,” according to Trump, lest their more greatly valued babies be anything less than “beautiful.”

When Kennedy and Trump announced that, as promised, they discovered the cause of autism and it’s Tylenol, I was immediately suspicious as to why there was no mention of vaccines. Kennedy’s zeal for banning vaccines is legendary. He has made millions of dollars from his anti-vax law firm and the anti-vax organization he founded, Children’s Health Defense, by saying without evidence that vaccines cause autism. So why would this scheduled breakthrough discovery barely mention vaccines?

I did not need to worry, because Trump certainly mentioned them. He would not shut up about them.

Just break it up, break it up! It's too much liquid. Too many different things are going into that baby at too big a number. The size of this thing when you look at it. It's like 80 different vaccines and beyond vaccines.
-President Donald J. Trump, distinguished vaccinologist, obstetrician, pediatric neurologist, and authority on women’s health

I screamed internally without interruption as Trump delivered a truly spectacular deluded monologue about the dangers of both Tylenol and vaccines. He thinks that women should “tough it out” should they have pain or fever during pregnancy, since Tylenol is the only painkiller shown to be safe for pregnant people. A woman’s lot is to suffer the punishment of Eve!

It seems that is babies’ lot as well, since Trump urged people not to give babies Tylenol either, including for dangerously high fevers. He thinks that vaccines need to be delivered one at a time, even if inconvenient, because “breaking them up” is somehow safer. He claimed that babies get more than 80 vaccines in one doctor’s visit (at most they would get 7 or 8 at any one visit according to the CDC schedule). He also seems to think that vaccine volumes are massive. Trump shared an anecdotal tale about a hot receptionist at Trump Tower who cried that her beautiful baby was “lost” after being “fried” by a fever of 108 after immunization with the MMR. Amish people don’t vaccinate and they don’t have autism (they do). Autism can be treated with vitamin B9, which conveniently is available from supplement dealers like Oz, Makary, and Kennedy’s many anti-vax wellness grifter friends. None of this is reasonable, supported by evidence, or remotely true, but that does not matter. It is the course that Trump and Kennedy have charted for American health, leading towards more unnecessary suffering, more disease, and more preventable deaths.

As revealing as this madness was about the MAHA antipathy toward vaccines, evidence, women, and babies, it wasn’t all hallucinatory sophistry. Trump was laying out the game plan for the next phase of attack against America’s national immunization program. They are going to try to take down the MMR.

MMRV: the gateway vaccine for descheduling

The recent meeting of the Advisory Committee on Immunization Practices (ACIP) was a breathtaking display of ineptitude and a completely undisguised effort to paint the unscientific zealotry of its members with a veneer of credibility. Although the ACIP failed to push forward recommendations restricting access to the hepatitis B virus (HBV) and COVID-19 vaccines, they did vote to restrict access to the MMRV vaccine (MMR combined with varicella, or chickenpox) on the basis that includes a slightly elevated risk of febrile seizures compared to MMR + V as separate shots.

Febrile seizures, as the name implies, are seizures that occur in babies when they have a high fever. As ACIP member and pediatrician Cody Meissner noted, they occur in a certain percentage of children who develop fevers for any reason. Most commonly, febrile seizures occur when a baby has an infection. However, the MMR and MMRV are live-attenuated vaccines (weakened forms of the viruses that cause an infection without causing disease), so they can cause fevers too. On very rare occasions, they can cause febrile seizures (about 1 in 4000 vaccines for MMR, about 1 in 2000 for MMRV). Febrile seizures can be very scary for parents, but they are usually acute and do not cause lasting effects.

However, most of the ACIP did not agree. They voted to derecommend the MMRV for children under the age of 4. When Kennedy signs this, the MMRV will not be covered by many insurers and it will be unavailable to most people in practice. The first dose of the MMR vaccine series is scheduled for babies aged 12-15 month, with the second dose at ages 4-6. This effectively means that the MMRV is not available for the first shot, which is imperative as babies are extremely vulnerable to measles and rubella in particular. This will reduce access to the vaccine. Some parents would prefer to reduce the number of shots their kids get. Some places will not stock both the MMR + V. Some parents will confuse MMR with MMRV, or misunderstand the risk, and opt to not vaccinate at all. Medicaid and the Vaccines for Children (VfC) program, which supports immunization for low-income kids and is responsible for about 50% of childhood vaccinations in the US, will not cover the MMRV.

Although Kennedy loathes childhood vaccination, he is not going to ban vaccines. He doesn’t need to. Instead, he is going to pull every administrative lever he can to make them inaccessible. If you can’t get the vaccine, it might as well be banned. The MMRV was an effective demonstration of this principle. And now that the MMRV has opened the door for ACIP to restrict access by overplaying concerns about febrile seizures, the MMR is next.

Breaking up is hard to do

Here’s what I think is going to happen. The next ACIP meeting is scheduled for late October. A few days before the meeting, the agenda will be posted. MMR will be on the agenda. They will request that CDC scientists present on febrile seizures caused by MMR. The MMR has been administered to millions of kids since it came on the market in 1971, so the CDC scientists will have mountains of data to present. It won’t matter. The risk of febrile seizure is not zero, so the MMR will be recommended only for kids over aged 4, when the risk subsides.

There is a way to reduce the risk of febrile seizure, by the way. Reducing fever prevents febrile seizures. You know how you safely reduce fever in babies? Tylenol. Which has now been designated by Trump and Kennedy’s entire HHS as the cause of autism, despite having no evidence to support that claim.

So ACIP will say the risk of febrile seizures is intolerably high, it cannot be reduced without the supposedly dangerous autism pill, and the only solution is to withhold a vaccine that has successfully protected America’s children from viruses that are most deadly in babies for more than 50 years.

Removing access to all MMR immunization for the kids most at risk of death will still receive a lot of public outcry. Unfortunately, there is theoretically an alternative for ACIP to recommend in place of the MMR. Yesterday, Trump continually talked about the need to “break it up” regarding the MMR.

The MMR and the chickenpox…chickenpox has already been broken out. It’s a singular shot, but the MMR is not. And I’ve heard for years that there’s a problem with it, but they say there’s no problem if you do each shot separately, not put together. So an MMR, go out and do it separately.
-Trump, a one-man ACIP

Trump wants to make the MMR monovalent again! So instead of getting two doses of MMR vaccine, you will get six shots: two doses each of M, M, and R. The only problem with this is that monovalent (targeting only one virus) M, M, and R vaccines are not approved by the FDA, so this is not a viable alternative to the combined MMR. So to “break it up,” vaccine manufacturers would need to submit new licensing applications to FDA for each monovalent vaccine.

Kennedy, Makary, and several members of ACIP have all insisted that “gold standard science” means doing placebo-controlled clinical trials for every new vaccine considered by FDA for licensure. You cannot ethically do a placebo-controlled trial for any of the MMR components, because you would be knowingly placing children in the placebo control group at risk of contracting a potentially deadly infection. There is no scientific argument for conducting a placebo-controlled trial for MMR or any of its components. It is not “gold standard” anything. It is an impossible standard to meet, since no pediatrician, vaccinologist, or institutional review board will approve an unnecessary clinical trial that endangers thousands of babies, who cannot consent to participation.

ACIP will recommend that MMR be descheduled under age 4, with monovalent vaccines as an alternative. Except those monovalent vaccines are imaginary and are not actually available. In reality, there will be no MMR vaccination.

Parents should prepare to deal with diseases in their children they haven’t seen before. Measles elimination in the US is already on its way out and measles outbreaks will continue to grow. Rubella epidemics will wreak havoc in both babies and pregnant women. While there is no evidence that Tylenol during pregnancy presents a huge risk of neurodevelopmental disorders like autism, there are decades of data on congenital rubella syndrome, which causes blindness, deafness, and cognitive and intellectual disabilities and occurs when pregnant people are infected with rubella virus. During rubella epidemics, thousands of fetal deaths, stillbirths, and babies born with severe congenital disabilities were the norm. Mumps can cause meningitis and permanent blindness. How many children will have to die or be severely injured or disabled for America to realize that MAHA is a philosophy that supports mass disease and death?

I hope that I am wrong about this, but I have had the misfortune to be very right about many of my predictions for how vaccination will be undermined by this administration. I loathe the idea that Trump’s unhinged rambling laid out the roadmap for ushering in a wave of preventable sickness and death, but I think it has. There is still time to stop this. Americans need to raise our voices and demand continued access to the MMR. Write to your Senators and demand that Kennedy be impeached. Let Trump know that Kennedy must be fired and that our children’s lives take precedence over a cultish vendetta against vaccines and profiteering from alternative treatments that don’t work. Millions of lives are at stake. Raise hell any way that you can.