In Dr. Paul Offit’s latest post on his substack, Beyond the Noise, he states:
At a campaign rally on June 22, 2024, former president Donald Trump told a crowd of cheering fans, “I will not give one penny to any school that has a vaccine mandate.” Given that every public school in the United States has vaccine mandates, this would mean eliminating all federal funding for public schools. Will Trump’s statement pressure schools to eliminate mandates? More to the point, why are school vaccine mandates important?
The best way to understand school vaccine mandates is through the lens of measles virus, the most contagious vaccine-preventable disease. Measles vaccine first became available in 1963. At that time, every year in the United States, 3-4 million people would be infected with measles, 48,000 would be hospitalized, and 500 would die. Deaths were primarily caused by pneumonia, severe dehydration, and encephalitis (inflammation of the brain). By the late 1960s, measles vaccination led to a 95 percent drop in the incidence of the disease. By the early 1970s, however, immunization rates had become stagnant. Measles cases increased. In 1971, about 150,000 cases were reported. Although the number of states requiring vaccines for school entry increased from 25 in 1968 to 40 in 1974, health officials hadn’t enforced them.
By 1981, all 50 states had school immunization requirements. By 2000, because school mandates were enforced, measles was eliminated from the United States. However, 45 of 50 states now allow philosophical or religious exemptions to vaccination. Because a critical percentage of parents have now chosen these exemptions, measles is coming back. At the end of December 2022, schools and daycare centers in Columbus, Ohio, reported 85 cases of measles; 32 children were hospitalized; all were unvaccinated. During the past four years, 338 cases of measles have been reported. This year, 188 cases of measles were reported in the United States, triple the number of cases seen in 2023. If Donald Trump were to pressure schools to eliminate mandates, hundreds of cases of measles will become thousands of cases. The case-fatality rate for measles is about 1 in 1,000. If return to a time when measles infects thousands of people, children will once again die from a disease that is entirely preventable.
The notion that Donald Trump would withhold federal funding for schools is highly unlikely. But there is another way that Trump could weaken vaccine rates—eliminate the Vaccines for Children Program (VFC), which launched in 1994 and provides vaccines for all children who are uninsured or underinsured. The program is estimated to prevent about 30 million hospitalizations a year. Were the Trump Administration to eliminate the VFC, we could expect to retreat to a time, not that long ago, where every year polio paralyzed as many as 30,000 children and killed 1,500, rubella (German measles) caused 20,000 cases of birth defects, diphtheria was the most common killer of teenagers, and bacteria like Haemophilus influenzae type b (Hib) caused 25,000 cases of meningitis and bloodstream infections.
Although Donald Trump may have found an applause line at his campaign rallies, if his disdain for vaccine mandates translates into public policy, children who needlessly suffer preventable illnesses won’t be applauding.
Read more from Dr. Offit at his substack, https://pauloffit.substack.com/.