> Monarez, a longtime federal government scientist, was sworn in on July 31.
> President Donald Trump nominated Monarez after withdrawing his first pick to lead the CDC, former Republican congressman Dave Weldon, hours before his confirmation hearing.
Also: he had no idea she was actually going to try doing her job. He was hoping for another yes-woman and got someone semi-competent. I doubt they'll make that mistake a second time, expect some reality-TV star to be the next nomination.
Scaramucci wasn't in a Senate-confirmed position, so while perhaps useful as a unit of longevity measure, he’s not a relevant confirmation–firing competitor.
Ironically, like any coward, he never does it face-to-face. He hates any possibility of personal confrontation.
The show would film him saying those infamous words, and show the reactions when the contestants were told. Likewise, in his current job he tends to fire people over Twitter.
The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law.
Other sources of guidance, such as the American Academy of Pediatrics' immunization schedule[0] and the WHO recommendations[1] are gaining prominence instead.
If you are an opponent of vaccines or a supporter of "MAHA", who is happy with what the CDC/FDA is doing, you might want to consider that the way they're doing it has utterly failed to convince the vast majority of people who are responsible for actually executing their guidance, and therefore will have limited impact.
As I am neither of those things, I am just glad these other options exist.
(And no, I am not looking to debate vaccines or whatever else with you. I'm making a point about how fringe movements who get into power then have to solve the same problems the powerful movements did originally.)
> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making
Same here.
And personally, as someone who isn't in the medical field in any way, what's been done to these agencies has removed pretty much all trust I have in their recommendations. They look like they are being run by political hacks for political purposes now, and actively disregard things like evidence and truth.
A concern of mine is where the insurance companies will get their guidelines, i.e., who pays. Also, being willing to pay out of pocket is not a panacea, as you can still be turned down.
Divergence from the CDC guidelines could also enable (scientifically meritless) lawsuits from patients against their doctors, no? What a sorry state of affairs.
Rhetorical question I suppose... I don't think Health Insurance should cover typical things. When I've gone to the hospital with kids or as someone nearing 40 its more expensive with insurance than without, not including the 30k in payments through employment we already endure. I don't care to subsidize the boomers.
I'm glad people are finally saying their true position is 'I don't care, let old people/disabled people die'. We're really starting to see the real American values system.
The boomer generation is also well known as the “me” generation, so it’s something they should expect, to be quite honest. They are the ones who raised us.
I'd expect insurance companies realize that paying for vaccines is a lot cheaper than paying for measles, mumps, covid, and the flu. They are in business to make a profit, not to pinch pennies at the cost of pounds.
Not to mention that common vaccines are not very expensive, even if you're paying out of pocket.
Why would they? Why would anyone buy insurance that didn't pay for treatments of illness?
I get frequent emails from both my employer and my insurance plan reminding me to get flu shots, annual physicals, etc. because it's cheaper for them if I stay healthy vs. having to pay (potentially a lot) for treatment of preventable illness or health problems.
My health insurance in Germany - "public", but we get to choose which of about 150 Krankenkassen (sickness funds) we want to go with - comes about as close as it legally can to bribing us to get vaccinated, both seasonal (flu and covid) and boosters for the ones you should have gotten as a kid.
Your health insurance here is also responsible for paying your sick leave, so they are SUPER motivated for you not to get the flu or covid.
"Nineteen states have laws or regulations that only let pharmacists administer vaccines recommended by ACIP, according to the American Pharmacists Association.
In those states, pharmacies may not be able to dole out shots even for people who fit the FDA’s narrowed range until the committee makes its recommendation."
> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law.
The risk in this implicitly will be that some vaccines may be declared illegal, or not permitted in some other licencing model, which means physicians will be at risk of their professional registration to make them available.
I could imagine a similar risk in the prescribing of Mifepristone/Misoprostol. Not to actually declare 'day after' pill illegal, but withdraw licence to use the drugs, and put doctors at risk if they go ahead.
This is already happening with covid vaccinations, in that only some age groups are getting approval. The decision is not being made according to safety, but justified with economics. I don't recall the FDA doing that before.
> This is already happening with covid vaccinations, in that only some age groups are getting approval. The decision is not being made according to safety, but justified with economics. I don't recall the FDA doing that before.
Incorrect.
A lot of scientists believe the Covid vaccinations should never have been approved in healthy young children. Omitting the Covid vaccine from the childhood schedule, in fact, is the position of the WHO, and many European countries, including the UK [1], Germany [2] and France [3]. The USA was an outlier [4].
I would have my kids get the vaccine in two seconds. I write-off all these EU concerns as capitulation to public pressure, which has no scientific basis. The same thing happened with the COVID vaccine requirement in California public schools.
I worry that the pharmaceutical companies won't have the funding to develop vaccines for new variants of existing diseases (like the yearly Covid-19 and flu variants), or even for "new" diseases (e.g. there's a dog vaccine for Lyme disease, but not one for humans). IIUC (please correct me if I'm wrong), vaccine development is expensive, and relies on government subsidies--which certainly won't be coming from the US in the near future. And even provision of existing vaccines depends on there being a market, where the US has been the most reliable such market--again, correct me if I'm wrong (I'm hoping I am!).
> In fact, the AAP recommendations include some extremely questionable vaccines for children in the USA, such as Mpox and Dengue. Filtering for duplicates, I count 19 recommended vaccines for children in the AAP document, vs. 10 for the WHO.
Having read the AAP's schedule: the recommendations are Mpox and Dengue are only for populations at risk, and not necessarily infants: e.g. Mpox is indicated for individuals 18+ and at risk; Dengue is indicated for ages 9-16 in areas with endemic Dengue and with history of prior infection.
Neither recommendation is in the WHO document for good reasons.
Mpox isn't endemic in the USA, and children under 18 were never a risk group here even during the outbreaks a year or two ago. This is purely political.
The Dengue vaccine is...not very good, and has serious interactions with the virus itself. Getting the Dengue vaccine before you get Dengue can put you in the hospital. Even suggesting that this should be on a document of "recommended" vaccinations is, quite frankly, stupid [1].
I recognize that the AAP puts asterisks on these things, but the point is that there are big differences between the schedules, and you can't just put blind faith in their recommendations because you've decided that the CDC is anti-science.
> Mpox isn't endemic in the USA, and children under 18 were never a risk group
> The Dengue vaccine is...not very good, and has serious interactions with the virus itself. Getting the Dengue vaccine before you get Dengue can put you in the hospital.
The "asterisks" contradict what you're saying: one of the Dengue recommendation's conditions are people who have diagnostic confirmation of a previous Dengue infection (endemic areas include Puerto Rico and American territories in the Pacific); Mpox is recommended for people over 18 (minimum age) which meet a series of risk factors primarily concerning being men-having-sex-with-men plus other conditions.
Seemingly having found more in the recommendations than you have, it seems to me the AAP's recommendations are complementary, rather than contradictory, save the recommendation for COVID-19 vaccination.
> Having read marginally more than you have, it seems to me the AAP's recommendations are complementary, rather than contradictory, save the recommendation for COVID-19 vaccination.
I mean...they're recommending a lot more vaccines in general, so I guess you can frame that as "complimentary", but the WHO document also has a number that are not on the AAP list:
Everyone is fixating on Dengue and Mpox because they think they know something about them, but just in the core set, there at least 9 major differences between the schedules: Hep A, Flu, Meningococcal, Covid, RSV, BCG (TB), Dengue and Mpox.
> Getting the Dengue vaccine before you get Dengue can put you in the hospital
They literally list a positive blood test for previous Dengue infections as one of the requirements for getting the vaccine, in the document you're looking at.
Please stop spouting bullshit while desperately searching for something to latch on to.
That's a 'i'm just asking questions' move here, you clearly implied the AAP recommended the Dengue vaccine to be used in a dangerous way.
Also, you wrote that Mpox was among vaccines recommended to children. The 18+ indicated in the document means you're incorrect, unless for you, people are children until 21.
> In fact, the AAP recommendations include some extremely questionable vaccines for children in the USA, such as Mpox and Dengue
Let's see:
> The AAP recommends dengue vaccination for children between ages 9-16 who have had a previous dengue infection confirmed by a laboratory test and live in dengue endemic areas (eg. Puerto Rico, American Samoa, US Virgin Islands)
> There is a vaccine available to individuals < 18 years who have been exposed to mpox (ie, JYNNEOS vaccine for post-exposure prophylaxis,) under expanded use authorization issued by the Food and Drug Administration.
> Point being: there's obviously a reasonable amount of disagreement here.
But fine, you've touched on 1 out of the 9 differences. You still won't find it in the WHO guide, which is odd, considering that the WHO is recommending vaccines for a number of countries around the world where the disease actually is endemic.
They have a 1-6 steps right on the first page. Step 1: "Determine recommended vaccine by age (Table 1)"
OK, turn to Table 1. Dengue:
> Seropositive in areas with endemic dengue (See Notes)
Mpox: 18+ "for certain high-risk groups or populations"
You can also turn to page 7 for the same notes for Dengue, and page 11 for what constitutes risk factors that would lead you to consider administering the mpox vaccine.
You can nit-pick if you want, but there are major differences between the two schedules, they're different for a reason, and my point is that there's actual scientific disagreement around many of these vaccines.
In the case of Mpox, it's because the disease isn't a risk for most children (especially not in the USA). In the case of Dengue, it's because you can actually kill someone by giving the vaccine before they get Dengue. It's not a great vaccine.
Rejecting one schedule because you read that it was "anti-science" is as non-sensical as accepting the AAP without knowing that it's actually very different than the WHO recommendations.
It's not nitpicking. It's the literal guidelines. You have a half dozen responses here refusing to recognize where you are wrong. You are either bullheaded or arguing in bad faith.
It's nitpicking. Mpox and Dengue are the two easiest ones to rebut (still not on the WHO schedule!), but there are 9 major differences between the core schedules.
> You can nit-pick if you want, but there are major differences between the two schedules, they're different for a reason, and my point is that there's actual scientific disagreement around many of these vaccines.
Ah so they're nitpicks when I call out your misrepresentations, but somehow they're still material to your overall point?
Your mpox and dengue points are nonsense, as already stated, but I wanted to get to this:
> Rejecting one schedule because you read that it was "anti-science" is as non-sensical as accepting the AAP without knowing that it's actually very different than the WHO recommendations.
Who are you even talking to? You've invented a strawman to respond to.
In fact, the CDC doesn't even have an updated vaccine schedule. If you go to their current site, guess which vaccines are included?
> Ah so they're nitpicks when I call out your misrepresentations, but somehow they're still material to your overall point?
They're nitpicks. Let's say I grant you that Mpox and Dengue are not really on the recommended AAP schedule, since they have asterisks. What about the other 7 differences? What about the Covid vaccine? BCG? Hep A? Flu?
> Who are you even talking to? You've invented a strawman to respond to.
It's the topic at the root of the thread. Presented these two options as better alternatives to the CDC.
> In fact, the CDC doesn't even have an updated vaccine schedule. If you go to their current site, guess which vaccines are included?
OK. So you're saying that nothing has actually changed? So what is the problem with the CDC? What's your applicable criticism of "MAHA"? Again, I refer you to the top of the thread:
> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law. Other sources of guidance, such as the American Academy of Pediatrics' immunization schedule[0] and the WHO recommendations[1] are gaining prominence instead.
> If you are an opponent of vaccines or a supporter of "MAHA", who is happy with what the CDC/FDA is doing, you might want to consider that the way they're doing it has utterly failed to convince the vast majority of people who are responsible for actually executing their guidance, and therefore will have limited impact.
Logistically / organizationally, what has to go wrong for the administration to nominate her, have her in place for less than a month, and then remove her? Like, before you send someone through confirmation, do you have a quick conversation to confirm, "I want to do X, I have expectations Y" etc and confirm that they're onboard? It sounds like Monarez wasn't willing to be a loyal obedient servant, and good for her -- but could the Trump administration really not determine that in advance?
Or was she put in that position for the purpose of being fired, just for the news story, and this is all going to plan?
You’re giving too much credit to the admin. They’re a rag tag group of below average IQ wannabes. They can’t possibly be smart about everything all the time. They can only hope people will fall in line with implied threats.
Like, I don't expect this administration to be _good_.
But Trump has had a _lot_ of experience fighting with his own appointees who aren't blindly obedient (e.g. he appointed Jerome Powell in 2017 and has spent months threatening to fire him). And this person was put up for confirmation b/c the last person had to be withdrawn at the last minute. You'd think the administration would at least have a checklist to confirm that people are willing to follow orders and parrot the party line.
This isn't what HN commenters were selling about a year ago. The popular comments were something along the lines of, what could go wrong with a shrewd businessman, Elon Musk and someone with Peter Thiel's backing?
I mean, that was leading up to the election. They wanted their tax breaks and crypto deregulation badly, and they were selling a pile of goods to everybody who would listen.
Now that they've won on every level, there's not much reason to keep bullshitting or trying to manufacture consent.
I heard from someone high up in the administration that it’s really hard for some of the political appointments it’s been hard for them to find qualified people, who are willing to take the job, and who haven’t publicly criticized trump. For some of these positions they might not have many people to pick from
> Weldon, a Florida representative from 1995 until 2009, has been critical of the federal government’s oversight of vaccine safety. While in the House, he sponsored a bill that would have taken vaccine safety oversight from the CDC and created a separate “Agency for Vaccine Safety Evaluation” under HHS, and as recently as 2019 repeated the disproved claim that “some children can get an autism spectrum disorder from a vaccine” in an interview.
This doesn’t seem to match the reality i see where anyone can get confirmed - Fox News has an entire roster of current and ex hosts that capable of fulfilling Trump’s order. Career drunks (Hesgeth, Pirro) are actually in adult professional government positions. Wild. Is Kid Rock an ambassador yet?
The current nominee (not confirmed) for Surgeon General is a wellness influencer and health supplement promoter. The previous nominee (withdrawn) was a Fox News contributor.
In terms of a CFO in a business: one month after you’re hired, the CEO asks you to lie on this year’s financial reports. You refuse, having joined up on the pretense that you’d be given some leeway to do what’s right, and they fire you. The CEO gets to filter out all future candidates for yeslings, makes clear to the marketplace that they’re powerful ans unconcerned with being viewed as evil, and gets to create suffering and woe for someone who stood up to them. Triple win, especially if sociopathy, and it’s a very effective honeypot for well-intended individuals with a “change from within” mindset.
> hint- the wealthiest man in the world for 20 straight years
Your hint doesn't help me much because, as far as I can tell, no individual has been considered the wealthiest person in the world for a period of twenty consecutive years since John P Getty[1], and he's been dead for fifty years. It seems unlikely that he had views about vaccine policy in the USA which are relevant to today, so who are you referring to?
I am trying to figure out what this means for me as a very pro vax person who is healthy - until I get any type of respiratory viral infection and my immune system over reacts.
Covid vaccines seem like they are going to be more of a pain to get because I will have to go to a doctor instead of the pharmacist. Flu and pneumonia vaccines don’t seem to be affected yet.
I am paying more attention to other country’s health departments since you can no longer trust the US.
On the other hand, the US was one of the last countries to admit that the COVID vaccines - especially the non mRNA variants effectiveness wore off. I got a booster off label a couple of months before it was officially recommended in the US based on credible evidence from other country’s health departments
I'm very pro-vax and less than healthy, having multiple sclerosis, which is famously not great when immune system production spikes as novel new viruses appear on the scene. My best case scenario for proactive management of my disease involves staying current and getting routine vaccines for seasonal flu and COVID-19.
I could literally scream until my lungs bled over the credulousness and willful ignorance of the broader populace. I understand there will always be esoteric areas of science and technology that no layperson should be expected to meaningfully comprehend, but why doesn't that still induce the natural response of "Ask my doctor,"? The lack apparent lack of critical thinking skills is frankly appalling.
If the Trump administration follows through and makes modern vaccines difficult to get, the simplest option for US citizens will be to take a brief trip over the border to Canada or Mexico and pay out of pocket for a dose. Generally vaccines are cheap enough, even the fancy ones, that the per-dose cost is negligible compared to the travel. You can even make it a short vacation and time the shot at the end, so the full impact and recovery time kicks in once you're back home.
I'm probably going to be down voted... but if an organization (business or government) is full of people that refuse to sing the same song, how can such an organization accomplish anything?
In politics, we saw what happens when the republicans can't agree with each other and failed to elect a majority leader. We also designate 1 person to control a significant part of our government, not a committee people with opposite view points.
Inconsistent messaging from leadership creates distrust amount the workers/population and prevents people from accomplishing anything.
> I'm probably going to be down voted... but if an organization (business or government) is full of people that refuse to sing the same song, how can such an organization accomplish anything?
If the purpose of the organization is based in science, what does it matter if you accomplish anything if you've fired all the scientists and all you have left are the politicians and spokespeople?
And if the acts of Congress that created your organization mandate that science be conducted, is it maybe time to do some soul searching about why no one wants to sing your terrible song?
> I'm probably going to be down voted... but if an organization (business or government) is full of people that refuse to sing the same song, how can such an organization accomplish anything?
How can an organization learn, recognize new facts, adapt to change, and synthesize knowledge if everyone is constrained to singing one song?
Most of them. No organization can function well if people don't push back when they see it going off the rails.
Dissent is an important part of good collaborative decision-making. Demanding that everyone "sing the same song" or get out eliminates the ability to adapt, improve, and correct.
How did you come to this weird world-view? People argue, politely, in every meeting I attend at work, in my hobbies, and while gathering at social functions.
I'm coming to realize a significant number of people on this site would commit heinous ethical violations if their boss asked them to. This is just another data point in support of that.
How on earth do you have any standing to make any pronouncement? "You've done your research"? You know better with your 5 minutes of googling than scientists that spent their careers studying these things?
Sigh ...
I despair for how stupid our discourse has become, and how loud and and proud are people's public displays of stupidity and ignorance.
> Monarez, a longtime federal government scientist, was sworn in on July 31.
> President Donald Trump nominated Monarez after withdrawing his first pick to lead the CDC, former Republican congressman Dave Weldon, hours before his confirmation hearing.
Is this a record from confirmation to firing?
Is it more or less than one Scaramucci?
Also: he had no idea she was actually going to try doing her job. He was hoping for another yes-woman and got someone semi-competent. I doubt they'll make that mistake a second time, expect some reality-TV star to be the next nomination.
> Is it more or less than one Scaramucci?
Scaramucci wasn't in a Senate-confirmed position, so while perhaps useful as a unit of longevity measure, he’s not a relevant confirmation–firing competitor.
Just shy of three Scaramuccis, in fact.
The Mooch!
The guy likes firing people, he had a whole tv show about it.
Ironically, like any coward, he never does it face-to-face. He hates any possibility of personal confrontation.
The show would film him saying those infamous words, and show the reactions when the contestants were told. Likewise, in his current job he tends to fire people over Twitter.
Anthony Scaramucci wasn't confirmed, but he was hired and fired in 11 days during Trump I.
The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law.
Other sources of guidance, such as the American Academy of Pediatrics' immunization schedule[0] and the WHO recommendations[1] are gaining prominence instead.
If you are an opponent of vaccines or a supporter of "MAHA", who is happy with what the CDC/FDA is doing, you might want to consider that the way they're doing it has utterly failed to convince the vast majority of people who are responsible for actually executing their guidance, and therefore will have limited impact.
As I am neither of those things, I am just glad these other options exist.
[0] https://publications.aap.org/redbook/resources/15585/AAP-Imm... [1] https://www.who.int/teams/immunization-vaccines-and-biologic...
(And no, I am not looking to debate vaccines or whatever else with you. I'm making a point about how fringe movements who get into power then have to solve the same problems the powerful movements did originally.)
> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making
Same here.
And personally, as someone who isn't in the medical field in any way, what's been done to these agencies has removed pretty much all trust I have in their recommendations. They look like they are being run by political hacks for political purposes now, and actively disregard things like evidence and truth.
A concern of mine is where the insurance companies will get their guidelines, i.e., who pays. Also, being willing to pay out of pocket is not a panacea, as you can still be turned down.
Divergence from the CDC guidelines could also enable (scientifically meritless) lawsuits from patients against their doctors, no? What a sorry state of affairs.
Why are insurance companies involved here at all?
That requires a lengthy US history lesson, which you can read elsewhere.
Rhetorical question I suppose... I don't think Health Insurance should cover typical things. When I've gone to the hospital with kids or as someone nearing 40 its more expensive with insurance than without, not including the 30k in payments through employment we already endure. I don't care to subsidize the boomers.
I'm glad people are finally saying their true position is 'I don't care, let old people/disabled people die'. We're really starting to see the real American values system.
Sow -> Reap
The boomer generation is also well known as the “me” generation, so it’s something they should expect, to be quite honest. They are the ones who raised us.
I'd expect insurance companies realize that paying for vaccines is a lot cheaper than paying for measles, mumps, covid, and the flu. They are in business to make a profit, not to pinch pennies at the cost of pounds.
Not to mention that common vaccines are not very expensive, even if you're paying out of pocket.
Not if you get to stop paying for treatments if they get sick!
Why would they? Why would anyone buy insurance that didn't pay for treatments of illness?
I get frequent emails from both my employer and my insurance plan reminding me to get flu shots, annual physicals, etc. because it's cheaper for them if I stay healthy vs. having to pay (potentially a lot) for treatment of preventable illness or health problems.
Same reason people buy baby formula that's poisonous: they don't know or are desperate.
Because you have no choice. In the US, I noticed a trend that companies are starting to offer one choice for Insurance, the cheapest for them.
There's always self insurance. These days that's likely cheaper.
My health insurance in Germany - "public", but we get to choose which of about 150 Krankenkassen (sickness funds) we want to go with - comes about as close as it legally can to bribing us to get vaccinated, both seasonal (flu and covid) and boosters for the ones you should have gotten as a kid.
Your health insurance here is also responsible for paying your sick leave, so they are SUPER motivated for you not to get the flu or covid.
Indeed,
"Nineteen states have laws or regulations that only let pharmacists administer vaccines recommended by ACIP, according to the American Pharmacists Association.
In those states, pharmacies may not be able to dole out shots even for people who fit the FDA’s narrowed range until the committee makes its recommendation."
https://apnews.com/article/covid-19-vaccine-insurance-covera...
> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law.
The risk in this implicitly will be that some vaccines may be declared illegal, or not permitted in some other licencing model, which means physicians will be at risk of their professional registration to make them available.
I could imagine a similar risk in the prescribing of Mifepristone/Misoprostol. Not to actually declare 'day after' pill illegal, but withdraw licence to use the drugs, and put doctors at risk if they go ahead.
This is already happening with covid vaccinations, in that only some age groups are getting approval. The decision is not being made according to safety, but justified with economics. I don't recall the FDA doing that before.
The economic excuse seems like a fig leaf over the true motivation to deny the vaccine to children, which is baseless fear of side effects.
> This is already happening with covid vaccinations, in that only some age groups are getting approval. The decision is not being made according to safety, but justified with economics. I don't recall the FDA doing that before.
Incorrect.
A lot of scientists believe the Covid vaccinations should never have been approved in healthy young children. Omitting the Covid vaccine from the childhood schedule, in fact, is the position of the WHO, and many European countries, including the UK [1], Germany [2] and France [3]. The USA was an outlier [4].
[1] https://www.nhs.uk/vaccinations/covid-19-vaccine/
[2] https://www.bundesgesundheitsministerium.de/en/coronavirus/f...
[3] https://www.lemonde.fr/en/health/article/2023/02/25/covid-19...
[4] https://archive.ph/aD00n (NYT link)
Wrong. Regardless of your links there, that's not the justification that FDA used.
I would have my kids get the vaccine in two seconds. I write-off all these EU concerns as capitulation to public pressure, which has no scientific basis. The same thing happened with the COVID vaccine requirement in California public schools.
I worry that the pharmaceutical companies won't have the funding to develop vaccines for new variants of existing diseases (like the yearly Covid-19 and flu variants), or even for "new" diseases (e.g. there's a dog vaccine for Lyme disease, but not one for humans). IIUC (please correct me if I'm wrong), vaccine development is expensive, and relies on government subsidies--which certainly won't be coming from the US in the near future. And even provision of existing vaccines depends on there being a market, where the US has been the most reliable such market--again, correct me if I'm wrong (I'm hoping I am!).
[flagged]
> In fact, the AAP recommendations include some extremely questionable vaccines for children in the USA, such as Mpox and Dengue. Filtering for duplicates, I count 19 recommended vaccines for children in the AAP document, vs. 10 for the WHO.
Having read the AAP's schedule: the recommendations are Mpox and Dengue are only for populations at risk, and not necessarily infants: e.g. Mpox is indicated for individuals 18+ and at risk; Dengue is indicated for ages 9-16 in areas with endemic Dengue and with history of prior infection.
Neither recommendation is in the WHO document for good reasons.
Mpox isn't endemic in the USA, and children under 18 were never a risk group here even during the outbreaks a year or two ago. This is purely political.
The Dengue vaccine is...not very good, and has serious interactions with the virus itself. Getting the Dengue vaccine before you get Dengue can put you in the hospital. Even suggesting that this should be on a document of "recommended" vaccinations is, quite frankly, stupid [1].
I recognize that the AAP puts asterisks on these things, but the point is that there are big differences between the schedules, and you can't just put blind faith in their recommendations because you've decided that the CDC is anti-science.
[1] https://www.cdc.gov/dengue/hcp/vaccine/eligibility.html
> Mpox isn't endemic in the USA, and children under 18 were never a risk group
> The Dengue vaccine is...not very good, and has serious interactions with the virus itself. Getting the Dengue vaccine before you get Dengue can put you in the hospital.
The "asterisks" contradict what you're saying: one of the Dengue recommendation's conditions are people who have diagnostic confirmation of a previous Dengue infection (endemic areas include Puerto Rico and American territories in the Pacific); Mpox is recommended for people over 18 (minimum age) which meet a series of risk factors primarily concerning being men-having-sex-with-men plus other conditions.
Seemingly having found more in the recommendations than you have, it seems to me the AAP's recommendations are complementary, rather than contradictory, save the recommendation for COVID-19 vaccination.
> Having read marginally more than you have, it seems to me the AAP's recommendations are complementary, rather than contradictory, save the recommendation for COVID-19 vaccination.
I mean...they're recommending a lot more vaccines in general, so I guess you can frame that as "complimentary", but the WHO document also has a number that are not on the AAP list:
https://cdn.who.int/media/docs/default-source/immunization/i...
Everyone is fixating on Dengue and Mpox because they think they know something about them, but just in the core set, there at least 9 major differences between the schedules: Hep A, Flu, Meningococcal, Covid, RSV, BCG (TB), Dengue and Mpox.
> Getting the Dengue vaccine before you get Dengue can put you in the hospital
They literally list a positive blood test for previous Dengue infections as one of the requirements for getting the vaccine, in the document you're looking at.
Please stop spouting bullshit while desperately searching for something to latch on to.
Nothing I wrote is incorrect.
That's a 'i'm just asking questions' move here, you clearly implied the AAP recommended the Dengue vaccine to be used in a dangerous way.
Also, you wrote that Mpox was among vaccines recommended to children. The 18+ indicated in the document means you're incorrect, unless for you, people are children until 21.
> In fact, the AAP recommendations include some extremely questionable vaccines for children in the USA, such as Mpox and Dengue
Let's see:
> The AAP recommends dengue vaccination for children between ages 9-16 who have had a previous dengue infection confirmed by a laboratory test and live in dengue endemic areas (eg. Puerto Rico, American Samoa, US Virgin Islands)
> There is a vaccine available to individuals < 18 years who have been exposed to mpox (ie, JYNNEOS vaccine for post-exposure prophylaxis,) under expanded use authorization issued by the Food and Drug Administration.
> Point being: there's obviously a reasonable amount of disagreement here.
Only if you misrepresent their recommendations!
> Only if you're dishonest about their recommendations!
I literally just went to the PDF guide the OP linked to, which presents it as a recommended vaccination (for a non-endemic disease in the USA):
https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule....
But fine, you've touched on 1 out of the 9 differences. You still won't find it in the WHO guide, which is odd, considering that the WHO is recommending vaccines for a number of countries around the world where the disease actually is endemic.
> I literally just went to the PDF guide the OP linked to, which presents it as a recommended vaccination (for a non-endemic disease in the USA):
https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule....
They have a 1-6 steps right on the first page. Step 1: "Determine recommended vaccine by age (Table 1)"
OK, turn to Table 1. Dengue:
> Seropositive in areas with endemic dengue (See Notes)
Mpox: 18+ "for certain high-risk groups or populations"
You can also turn to page 7 for the same notes for Dengue, and page 11 for what constitutes risk factors that would lead you to consider administering the mpox vaccine.
You can nit-pick if you want, but there are major differences between the two schedules, they're different for a reason, and my point is that there's actual scientific disagreement around many of these vaccines.
In the case of Mpox, it's because the disease isn't a risk for most children (especially not in the USA). In the case of Dengue, it's because you can actually kill someone by giving the vaccine before they get Dengue. It's not a great vaccine.
Rejecting one schedule because you read that it was "anti-science" is as non-sensical as accepting the AAP without knowing that it's actually very different than the WHO recommendations.
It's not nitpicking. It's the literal guidelines. You have a half dozen responses here refusing to recognize where you are wrong. You are either bullheaded or arguing in bad faith.
It's nitpicking. Mpox and Dengue are the two easiest ones to rebut (still not on the WHO schedule!), but there are 9 major differences between the core schedules.
> You can nit-pick if you want, but there are major differences between the two schedules, they're different for a reason, and my point is that there's actual scientific disagreement around many of these vaccines.
Ah so they're nitpicks when I call out your misrepresentations, but somehow they're still material to your overall point?
Your mpox and dengue points are nonsense, as already stated, but I wanted to get to this:
> Rejecting one schedule because you read that it was "anti-science" is as non-sensical as accepting the AAP without knowing that it's actually very different than the WHO recommendations.
Who are you even talking to? You've invented a strawman to respond to.
In fact, the CDC doesn't even have an updated vaccine schedule. If you go to their current site, guess which vaccines are included?
https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolesc...
So take it up with MAHA.
> Ah so they're nitpicks when I call out your misrepresentations, but somehow they're still material to your overall point?
They're nitpicks. Let's say I grant you that Mpox and Dengue are not really on the recommended AAP schedule, since they have asterisks. What about the other 7 differences? What about the Covid vaccine? BCG? Hep A? Flu?
> Who are you even talking to? You've invented a strawman to respond to.
It's the topic at the root of the thread. Presented these two options as better alternatives to the CDC.
> In fact, the CDC doesn't even have an updated vaccine schedule. If you go to their current site, guess which vaccines are included?
OK. So you're saying that nothing has actually changed? So what is the problem with the CDC? What's your applicable criticism of "MAHA"? Again, I refer you to the top of the thread:
> The physicians in my life - including my spouse - have essentially all abandoned the CDC and FDA as a source of decision-making on vaccines and pharmaceuticals, except for what is required by law. Other sources of guidance, such as the American Academy of Pediatrics' immunization schedule[0] and the WHO recommendations[1] are gaining prominence instead.
> If you are an opponent of vaccines or a supporter of "MAHA", who is happy with what the CDC/FDA is doing, you might want to consider that the way they're doing it has utterly failed to convince the vast majority of people who are responsible for actually executing their guidance, and therefore will have limited impact.
I, for one, will be happy to see Covid make a vigorous comeback in the US. Theories need to be tested.
COVID is endemic.
We're probably past herd immunity at this point.
Yeah, just like how no one gets other forms of the flu these days... herd immunity...
Because everyone knows viruses don't mutate.
Logistically / organizationally, what has to go wrong for the administration to nominate her, have her in place for less than a month, and then remove her? Like, before you send someone through confirmation, do you have a quick conversation to confirm, "I want to do X, I have expectations Y" etc and confirm that they're onboard? It sounds like Monarez wasn't willing to be a loyal obedient servant, and good for her -- but could the Trump administration really not determine that in advance?
Or was she put in that position for the purpose of being fired, just for the news story, and this is all going to plan?
You’re giving too much credit to the admin. They’re a rag tag group of below average IQ wannabes. They can’t possibly be smart about everything all the time. They can only hope people will fall in line with implied threats.
Like, I don't expect this administration to be _good_. But Trump has had a _lot_ of experience fighting with his own appointees who aren't blindly obedient (e.g. he appointed Jerome Powell in 2017 and has spent months threatening to fire him). And this person was put up for confirmation b/c the last person had to be withdrawn at the last minute. You'd think the administration would at least have a checklist to confirm that people are willing to follow orders and parrot the party line.
This isn't what HN commenters were selling about a year ago. The popular comments were something along the lines of, what could go wrong with a shrewd businessman, Elon Musk and someone with Peter Thiel's backing?
I don't know, I saw fewer of those comments and more predicting this mess. It was pretty predictable.
Surprise: people here are stupid, too!
I mean, that was leading up to the election. They wanted their tax breaks and crypto deregulation badly, and they were selling a pile of goods to everybody who would listen.
Now that they've won on every level, there's not much reason to keep bullshitting or trying to manufacture consent.
... Well, yeah, but why would you take any notice of HN commenters? Have you _seen_ the nonsense people spout on this website?
I heard from someone high up in the administration that it’s really hard for some of the political appointments it’s been hard for them to find qualified people, who are willing to take the job, and who haven’t publicly criticized trump. For some of these positions they might not have many people to pick from
Yep. He was forced to pull his first nominee for CDC director due to the nominee being an anti-vaxxer: https://www.politico.com/news/2025/03/13/dave-weldon-vaccine...
> Weldon, a Florida representative from 1995 until 2009, has been critical of the federal government’s oversight of vaccine safety. While in the House, he sponsored a bill that would have taken vaccine safety oversight from the CDC and created a separate “Agency for Vaccine Safety Evaluation” under HHS, and as recently as 2019 repeated the disproved claim that “some children can get an autism spectrum disorder from a vaccine” in an interview.
Doubt that would matter today. How much things have changed in such a short time.
This doesn’t seem to match the reality i see where anyone can get confirmed - Fox News has an entire roster of current and ex hosts that capable of fulfilling Trump’s order. Career drunks (Hesgeth, Pirro) are actually in adult professional government positions. Wild. Is Kid Rock an ambassador yet?
The current nominee (not confirmed) for Surgeon General is a wellness influencer and health supplement promoter. The previous nominee (withdrawn) was a Fox News contributor.
The timing of this and the announcement yesterday that the causes of autism will be released in September is pretty interesting.
In terms of a CFO in a business: one month after you’re hired, the CEO asks you to lie on this year’s financial reports. You refuse, having joined up on the pretense that you’d be given some leeway to do what’s right, and they fire you. The CEO gets to filter out all future candidates for yeslings, makes clear to the marketplace that they’re powerful ans unconcerned with being viewed as evil, and gets to create suffering and woe for someone who stood up to them. Triple win, especially if sociopathy, and it’s a very effective honeypot for well-intended individuals with a “change from within” mindset.
:(
I saw this happen once.
Old owners sell the business, become the C team with profit targets for a big payout.
Minutes after the payout the old C team resign to be with family/visit foreign country.
New C team comes on board.
New C team cant figure out how the numbers work.
New C team realises that the books arent as in the black as described.
New C team refuses to go down with the ship, resign to be with family etc.
Owner manages the business for a few months, sells it back to one of the original owners for pennies on the dollar.
Clawback clauses are a thing, both for company sellers and C-suite payouts.
So are the Seychelles.
You figure we'll get sold in pieces back to the UK, France, Russia, Spain, and/or Denmark? Or just picked up as one big colony for China?
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> hint- the wealthiest man in the world for 20 straight years
Your hint doesn't help me much because, as far as I can tell, no individual has been considered the wealthiest person in the world for a period of twenty consecutive years since John P Getty[1], and he's been dead for fifty years. It seems unlikely that he had views about vaccine policy in the USA which are relevant to today, so who are you referring to?
[1] https://www.madisontrust.com/information-center/visualizatio...
so you chimed in to say absolutely nothing
To quote the Talking Heads:
You’re talking a lot - but you’re not saying anything!
Can you maybe rewrite this in a way that doesn’t assume everyone that doesn’t know what you apparently know is clued in?
More discussion: https://news.ycombinator.com/item?id=45047395
Lets hope the Senate will not confirm anyone until 2027. The democrats should be be able to delay this confirmation.
This way maybe a real scientist will need to step in from the ranks instead of a Trump lackey.
He's a lame duck president! There's precedent for refusing to consider his nominations!
Yeah, I know: we don't have a majority... but we can hope.
I am trying to figure out what this means for me as a very pro vax person who is healthy - until I get any type of respiratory viral infection and my immune system over reacts.
Covid vaccines seem like they are going to be more of a pain to get because I will have to go to a doctor instead of the pharmacist. Flu and pneumonia vaccines don’t seem to be affected yet.
I am paying more attention to other country’s health departments since you can no longer trust the US.
On the other hand, the US was one of the last countries to admit that the COVID vaccines - especially the non mRNA variants effectiveness wore off. I got a booster off label a couple of months before it was officially recommended in the US based on credible evidence from other country’s health departments
I'm very pro-vax and less than healthy, having multiple sclerosis, which is famously not great when immune system production spikes as novel new viruses appear on the scene. My best case scenario for proactive management of my disease involves staying current and getting routine vaccines for seasonal flu and COVID-19.
I could literally scream until my lungs bled over the credulousness and willful ignorance of the broader populace. I understand there will always be esoteric areas of science and technology that no layperson should be expected to meaningfully comprehend, but why doesn't that still induce the natural response of "Ask my doctor,"? The lack apparent lack of critical thinking skills is frankly appalling.
If the Trump administration follows through and makes modern vaccines difficult to get, the simplest option for US citizens will be to take a brief trip over the border to Canada or Mexico and pay out of pocket for a dose. Generally vaccines are cheap enough, even the fancy ones, that the per-dose cost is negligible compared to the travel. You can even make it a short vacation and time the shot at the end, so the full impact and recovery time kicks in once you're back home.
There's some intense irony here that "vaccine tourism" used to be an active economic boost for the US (https://www.nbcnews.com/news/latino/covid-shot-tourism-latin...), and now it's going to be very much the other way around.
fires anyone who disagrees or does not fall in line. absolute tyrany
I'm probably going to be down voted... but if an organization (business or government) is full of people that refuse to sing the same song, how can such an organization accomplish anything?
In politics, we saw what happens when the republicans can't agree with each other and failed to elect a majority leader. We also designate 1 person to control a significant part of our government, not a committee people with opposite view points.
Inconsistent messaging from leadership creates distrust amount the workers/population and prevents people from accomplishing anything.
> I'm probably going to be down voted... but if an organization (business or government) is full of people that refuse to sing the same song, how can such an organization accomplish anything?
If the purpose of the organization is based in science, what does it matter if you accomplish anything if you've fired all the scientists and all you have left are the politicians and spokespeople?
And if the acts of Congress that created your organization mandate that science be conducted, is it maybe time to do some soul searching about why no one wants to sing your terrible song?
> I'm probably going to be down voted... but if an organization (business or government) is full of people that refuse to sing the same song, how can such an organization accomplish anything?
How can an organization learn, recognize new facts, adapt to change, and synthesize knowledge if everyone is constrained to singing one song?
It really depends on the song, doesn't it?
By engaging positively and understanding rather than creating a cult.
What successful organization isn't cult-like, where everyone sings the same song?
Most of them. No organization can function well if people don't push back when they see it going off the rails.
Dissent is an important part of good collaborative decision-making. Demanding that everyone "sing the same song" or get out eliminates the ability to adapt, improve, and correct.
How did you come to this weird world-view? People argue, politely, in every meeting I attend at work, in my hobbies, and while gathering at social functions.
Democracy (pre fascist coup).
Yup, you were downvoted to hell
But yes. Getting hired and directly opposing the direction your boss wants to take isn’t a recipe for a long career.
I'm coming to realize a significant number of people on this site would commit heinous ethical violations if their boss asked them to. This is just another data point in support of that.
I agree with you that a significant number of people on this site are humans.
God forbid she align with evidence based public health
The only hope we have here is if Trump is following the advice of RFK Jr. personally as closely as possible.
You sir are part of the problem.
How on earth do you have any standing to make any pronouncement? "You've done your research"? You know better with your 5 minutes of googling than scientists that spent their careers studying these things?
Sigh ...
I despair for how stupid our discourse has become, and how loud and and proud are people's public displays of stupidity and ignorance.
> The only hope we have here is if Trump is following the advice of RFK Jr. personally as closely as possible.
He may very well be, have you seen his current condition?
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Bragging about obeying trump is so. Freaking. Weird.
Grats, you fell for the scam.Trump and his superpacs were the largest donors to Stein's campaign. It was all a scam from day 1.