THE PROGNOSIS

President Trump – who once suggested vaccines can cause autism – has lately been mute on the topic even as the country’s measles cases spike.

Twenty states have reported 555 cases of the highly infectious, potentially deadly disease – the second-greatest number of cases reported since 2000 when health officials declared measles eliminated in the United States, per the Post’s Lena H. Sun. Most of the cases are concentrated among ultra-Orthodox Jews in Brooklyn, leading New York City officials to declare a public health emergency and order mandatory measles vaccinations.

Yet, at least so far, the president hasn’t tried to correct his previous, unscientific claims that vaccines have contributed to the rise in autism cases. Trump tweeted this five years ago:

Trump could choose to set the record straight, perhaps helping combat the rising influence of anti-vaxxers who have increasingly obtained exemptions from state vaccination requirements.

Here’s one way: He could simply retweet the guidance from his own appointee leading the Centers for Disease Control and Prevention, Robert Redfield, who has been urging people to get their vaccinations up-to-date in light of the measles outbreak.

Trump’s previous position on vaccines is just one more big point of difference between him and any of the Democratic contenders he may face in the 2020 election.

—As former California attorney general, Sen. Kamala Harris (D-Calif.) defended a 2015 state law requiring students at public or private schools and childcare centers to be vaccinated against 10 communicable diseases unless they obtained a medical exemption. The law did away with a personal exemption allowing parents to opt their kids out of vaccinations for any reason.

—Sen. Kirsten Gillibrand (D-N.Y.) has expressed support for a recent ban on unvaccinated children from countywide public spaces in Rockland Country, a suburb of New York City.

“This outbreak is particularly dangerous to the most vulnerable among us,” Gillibrand said in a statement. “We should be doing everything we can to end this public health crisis and educate New Yorkers about the importance of vaccines.”

—Former Colorado Gov. John Hickenlooper urged people to get vaccinated while serving as mayor of Denver. So has South Bend, Ind., Mayor Pete Buttigieg.

The issue has grabbed the attention of many state-level Democrats, who have tried to eliminate pathways for parents to duck vaccinating their kids. California, West Virginia and Mississippi are the only states without religious exemptions to getting vaccinated. Seventeen states allow personal or philosophical exemptions.

As my Post colleague Sarah Pulliam Bailey recently reported, state lawmakers in New Jersey, New York, Iowa, Maine and Vermont have proposed eliminating religious exemptions, and a Washington state lawmaker wants to tighten the state’s personal exemption.

In Colorado, which has the country’s lowest kindergarten vaccination rate, nearly 600 people signed up to speak at a Monday hearing on a bill requiring parents to fill out a standardized form at the state’s public health department the first time they request an exemption.

Republicans have mostly rejected such bills to tighten state immunization laws, Politico’s Arthur Allen reports. Even though many prominent Republicans embrace vaccines, Trump’s comments and similar suggestions from Sen. Rand Paul (R-Ky.) and Ben Carson, Trump’s Housing and Urban Development secretary, alarm some public health experts that vaccines could become as controversial as global warming.

Officials worry they’re “three Trump tweets away” from an even more polarized situation, Massachusetts Institute of Technology’s Adam Berinsky told Arthur.

“At the end of the day it’s not the arguments people are making, but who is making them,” Berinksy said.

AHH, OOF and OUCH

AHH: A new gene therapy has cured ten newborns with a rare genetic disorder known as "bubble boy" disease, our Post colleague William Wan reports.

Infants with the rare immune disorder called "severe combined immunodeficiency disease," or SCID, are essentially born without a functioning immune system and rarely survive longer than a year. They can be killed by common infections, like a cold, and the term “bubble boy” emerged because these infants were once kept isolated in sterile environments.

Earlier attempts to use gene therapy to treat the disease stopped in 2003 because the therapy was giving infants cancer. But William writes the new treatment “appears to have completely rid the babies of their immune disorder with no side effects or complications – a result scientists have sought for decades through painstaking research and heartbreaking setbacks.” The therapy involves correcting genetic defects in the newborns’ DNA, which prompts their bodies to generate the missing parts of their immune systems.

“It’s a game changer,” said pediatric immunologist Jennifer Hemall of Children’s Hospital of Philadelphia, who was not involved in the study. “For immunologists following this disease, gene therapy has always been out there as the hope of the future. It’s exciting to see this wave of treatments actually becoming a reality.”

OOF: Dozens of medical professionals, including 31 doctors, seven pharmacists, eight nurse practitioners and seven other licensed medical professionals were charged with prescribing pain killers in exchange for cash and sexual favors, our Post colleagues Sari Horwitz and Scott Higham report.

The charges against medical professionals in seven states stem from the government’s largest prescription-opioid takedown and involve 32 million pain pills across 350,000 illegal prescriptions in Alabama, Kentucky, Louisiana, Ohio, Pennsylvania, Tennessee and West Virginia, according to indictments unsealed in a Cincinnati federal court.

Brian Benczkowski, an assistant attorney general in charge of the Justice Department’s criminal division said it’s the “equivalent of one opioid dose for every man, woman and child” in the region.

“In a number of cases, according to the indictments, doctors across the region traded prescriptions for oxycodone and hydrocodone for sexual favors,” Sari and Scott write. “Some physicians instructed their patients to fill multiple prescriptions at different pharmacies. Prosecutors also documented how patients traveled to multiple states to see different doctors so they could collect and then fill numerous prescriptions.”

They add the indictments are “part of a broader effort by the Justice Department to combat the nation’s prescription pain pill epidemic, which claimed the lives of nearly 218,000 Americans between 1999 and 2017.”

OUCH: Google reportedly warned some employees in an email last week that at least one employee at the company’s headquarters in California had been diagnosed with measles, BuzzFeed News’s Stephanie M. Lee and Ryan Mac report. The company has been facing criticism that its search engine, as well as its video platform YouTube, has allowed misinformation about vaccination to spread. Public health experts have pointed to the spread of false information about vaccines on social media as part of the reason for a resurgence of measles cases.

“We have been working with the Santa Clara County Public Health Department and they would like us to share this measles advisory, which contains information on measles, exposure risks and actions to be taken,” staff doctor David Kaye wrote in an April 13 email. He added the note was “just a precaution.”

“A spokesperson for the county's public health agency confirmed Wednesday afternoon that an unnamed adult resident of San Mateo County ‘who visited Google’ had contracted measles,” they write. “The case is unrelated to previous cases in Santa Clara County, and there is no additional public health risk, according to the agency.”

AGENCY ALERT

— CMS administrator Seema Verma criticized Medicare-for-all during an interview on Fox News, calling it the “biggest threat to the American health care system.”

In response to a question about whether American hospitals would push back on the proposal, Verma suggested such a proposal would be an “incredible threat to innovation in our country. The American Health Care system is producing amazing innovation and a government system where there is no competition to innovate and provide high-quality care could lead to lower-quality care for all-Americans."

“All we’re talking about is moving costs to the government and increasing taxes,” Verma added. “What we should be focusing on addressing the underlying costs in the health care system… That’s why the president has been so focused on lowering drug costs for Americans.”

HEALTH ON THE HILL

— Democratic committee leaders said they will investigate the Trump administration’s changes to the recipients of funding from the Title X federal family planning program. House Energy and Commerce Committee Chairman Frank Pallone Jr. (N.J.) wrote a letter with Reps. Anna Eshoo (D-Calif.) and Diana DeGette (D-Colo.) expressing concern that the administration provided funds to an antiabortion group while cutting funding from four Planned Parenthood affiliates.

“In eliminating longstanding comprehensive sexual and reproductive health centers from the Title X network and directing funding to grantees that will not guarantee access to contraception or HIV and other STI prevention services, the funding decision contradicts the program’s longstanding purpose of ‘providing individuals with comprehensive family planning and related preventive health services,' " the lawmakers wrote, asking HHS for information about the change including communications between the agency and Obria Group, Inc, a chain of antiabortion clinics.

From Pallone: 

— And here are a few more good reads: 

MEDICAL MISSIVES
Food
Mondelēz Global said there were some instances in which the cornstarch “did not fully incorporate in the mixing procedure and solidified in the baking process.”
Lindsey Bever
Business
“Every single parent I know uses a Rock 'n Play -- literally everybody," one mom said. And some parents are keeping the rocker, despite the warnings.
Abha Bhattarai
OPIOID OPTICS
Across North America, tainted opioids are killing people who use drugs. Vancouver’s Mark Tyndall says we should start dispensing safer pills using high-tech machines.
Wired
REPRODUCTIVE WARS
DAYBOOK

Today

  • The Heritage Foundation hosts an event with the Institute for Behavior and Health and Smart Approaches to Marijuana, “Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence." 

Coming Up

  • The Kaiser Family Foundation holds a forum on the Trump administration’s HIV initiative on April 22.
SUGAR RUSH

Ivanka Trump on why she didn’t want the World Bank chief job