Less than one-quarter of Americans share President Donald Trump's scepticism about the safety of childhood vaccines. By more than a 2-1 margin - 54% to 26% - Americans say that the scientific evidence supporting the safety of childhood vaccination is "indisputable".

Two-thirds of Americans say that the issue of vaccinating is a national health matter, with 24% considering that it is a matter of personal preference. However, 56% say that they have a fair amount of trust in the government to set vaccination policies.

They might be disappointed.

Trump's flirtation with vaccine-safety sceptics

Last week, Trump met with Robert F. Kennedy Jr., a longstanding critic of vaccines, and rumours were that Kennedy will chair a panel that investigated vaccine safety.

Trump spokeswoman Hope Hicks, however, has denied that Trump will create such a commission by stating that "there is no decision made on this position or commission" in an email.

But Trump previously met with Andrew Wakefield, the disgraced physician who published false findings stating that vaccines cause autism, in August 2016. Wakefield also attended Trump's inauguration ball on 20 January - mostly invitation-only event.

It is uncertain whether Wakefield's attendance hints at his influence on how Trump's administration handles vaccination policies, however enough damage has been done. Health experts and public health advocacy groups are taking all precautions by making sure that Trump's pick to lead the Department of Health and Human Services (HHS) does not believe in the theory that vaccines cause autism.

On 17th January, a letter was written to the senators involved in Price's confirmation hearing, urging them to get Price on the record about vaccines.

"As you work through the confirmation process, we urge you to ensure that Chairman Price is committed to protecting the citizens of this nation from vaccine preventable diseases," the letter read.

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It appears that the request was heard. On 24 January, during Price's confirmation hearing, amidst having any potential conflicts of interest being weeded out and being interrogated on Trump's administration's plans for repealing Obamacare, Democratic Senator Bob Menendez of New Jersey asked "Do vaccines cause autism?"

Price replied," I think the science in that instance is that they don't."

This put some distance between himself and Trump on the issue and Americans can breathe a sigh of relief after this affirmation. However, Price's ties with the Association of American Physicians and Surgeons (AAPS) still poses a problem.

Price, an orthopaedic surgeon, is an eight-year active member of the AAPS, a libertarian medical group that blames immigrants as the source of disease outbreaks, suggested that HIV does not cause AIDS and abortion causes breast cancer, and advocates for easier declination of vaccines by parents for their children.

"We believe in patient freedom and the right to decline medical care," said Jane Orient, a spokeswoman for the AAPS, "We are against forcing medical treatment on patients who wish to decline it."

Reason to doubt, room for optimism

Reports say that Price's ties with AAPS cannot be easily severed - AAPS has also shown support for Price.

"The hope is that Tom Price will try to steer HHS in the right direction," says Andrew Schlafly, general counsel of AAPS. "We were glad he got picked. We support him. We like him. He's a good guy."

This is worrying as the Centres for Disease Control and Prevention - under the HHS - is responsible for setting the schedule for which shots children should get, and at what age. With Price leading the HHS, will he be influenced by the AAPS to reform vaccination policies?

Currently, there is no federal law that requires children to get shots, but there are laws in all 50 states that require children to be immunised before attending schools and daycares. This is still risky as some states offer different exemptions for religious or philosophical reasons.

From an epidemiological perspective, this weakens the overall immunity of the human "herd" against preventable diseases such as measles and mumps, therefore there is a possibility of the return of diseases that have been eradicated from the US.

Trump's flirtation with vaccine-safety sceptics is dangerous said Amy Pisani, director of Every Child By Two, a group that advocates for timely childhood immunisations. However she remains optimistic.

"As soon as the Trump administration sits down and starts to read the science, and gets together with the proper autism groups," Pisani said, "they're going to come to realise the science is in on the issue and that focusing on vaccines will only take away precious resources that should be allocated to promising autism science." MIMS

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