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What the top U.S. health official should be saying on vaccines

Health and Human Services Secretary Tom Price. (Joshua Roberts/Reuters)

During a televised town hall last week, the nation’s top health official was asked whether all children should get immunized for measles and other vaccine-preventable diseases. In his response, Health and Human Services Secretary Tom Price parsed his words carefully. He said state governments (presumably rather than the federal government) “have the public health responsibility to determine whether or not immunizations are required for a community population.”

His response angered many doctors and public-health officials, who say the top U.S. health official failed to give full-throated support for immunizations that prevent disease and protect communities at a time when anti-vaccine sentiment is on the rise.

Paul Sax, an infectious disease specialist at Boston’s Brigham and Women’s Hospital, said Price might have been choosing his words carefully for political reasons. Price, he noted, belongs to the Association of American Physicians and Surgeons, an organization that opposes mandatory immunizations. And there’s Price’s boss, President Trump, who has publicly expressed discredited concerns about vaccine safety.

So Sax decided to write tongue-in-cheek answers for what Price should be saying. The post appeared in the HIV and ID Observations blog published by NEJM Journal Watch.

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In an interview, Sax said he wanted to highlight the opportunity Price missed to underscore the importance of these lifesaving medicines.

“It seems to me you have such a no-brainer situation with support for vaccines, and where the secretary of HHS could really rally behind that effort in a really strong way,” said Sax, who is medical director of Brigham’s infectious diseases division.

Here’s what Price said during a CNN town hall hosted by Wolf Blitzer:

Blitzer: Dr. Price, you’re a physician. You believe in immunizations. You believe all children should get a shot for polio and other diseases?

Price: The question that you asked is what kind of health care ought to be provided to individuals. And there are certain things that we do — ought to do as a society, and we encourage, that’s the kind of education that is so important for folks, so that they know what’s best for them and for their families.

Here’s what Sax wrote for Neo-Price (meaning a new, improved Price), that the HHS secretary should have said:

Blitzer: So you believe in immunizations, you believe all children should get a shot for polio, and other diseases?

Neo-Price: Absolutely. We in the Department of Health and Human Services strongly support the state policies that require childhood immunizations. These policies have had a miraculous effect in reducing illness and death, particularly in children, and greatly improve public health for all. Some prevent cancer. They even save money! Talk about a win-win-win-win.

Sax goes on to make up more follow-up answers to actual questions:

Blitzer: I hear there has been an increase in so-called “nonmedical vaccine exemptions” in the United States. What are your thoughts on these?

Neo-Price: Frankly, each nonmedical vaccine exemption is essentially a misguided, selfish decision made by a parent at the expense of both the child’s health and public health. They should be more than strongly discouraged — they should be abolished.

Blitzer: One last thing before you go — there are some who say the vaccine policies are being set by individuals who have hidden agendas — conflicts of interest with the pharmaceutical industry, or with insurance companies, or are just ivory tower academics who don’t understand “real” people.

Neo-Price: The Advisory Committee on Immunization Practices (ACIP) — which is organized by the Centers for Disease Control and Prevention, a wonderful government institution — is a prime example of how doctors, scientists, and public health officials can come together for the public good. They carefully review the vaccine safety and efficacy data, and then issue policies that are broadly endorsed. It’s about as good an example as you can find for your tax dollars well spent. Makes me tear up a bit with patriotism just thinking about it.

In the pretend question-and-answer, Sax also has Price explain why vaccination is important for everyone in the community, also known as herd community, with a short video.

Sax said he has received mostly positive comments, but most readers of his blog are infectious disease specialists and clinicians who already “get it,” he said. They know, Sax said, that one reason for a measles outbreak in Romania that has killed at least 17 people is the falling vaccination rates.

One doctor commenting on Sax’s blog said Price isn’t likely to read the posts. She called on every doctor who believes in science to email the blog post to him at

A spokesman for Price did not respond to a request for comment.

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