Vaccine expert worries child measles deaths are being 'normalized'

Summary

Consider This from NPR: Vaccine Expert Worries Child Measles Deaths Are Being 'Normalized'

Episode Title: Vaccine expert worries child measles deaths are being 'normalized'
Host: Mary Louise Kelly
Release Date: April 14, 2025

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Introduction

In this episode of NPR's "Consider This," host Mary Louise Kelly delves into the alarming surge of measles cases in the United States, now numbering over 700 with three reported deaths this year. The discussion centers on the role of the new Secretary of Health and Human Services (HHS), Robert F. Kennedy Jr., and his contentious stance on vaccines amidst the outbreak. A pivotal conversation with Dr. Peter Marks, the former top vaccine regulator at the Food and Drug Administration (FDA), sheds light on the administrative and public health challenges facing the nation's vaccination efforts.

Background: Robert F. Kennedy Jr.'s Position and Controversies

Robert F. Kennedy Jr., appointed as the HHS Secretary, has been a polarizing figure in the public health arena. Despite publicly supporting vaccines, his actions and statements have raised concerns among public health experts. During his confirmation hearing, Kennedy faced scrutiny from Senator Ron Wyden over his previous claims that parents have been "misled" about the dangers of measles and the safety of vaccines (00:00).

Kennedy's recent interview with CBS News echoed a seemingly supportive stance on vaccines when he stated, "People should get the measles vaccine" (01:30). However, contradictory remarks have emerged, such as questioning the safety tests of vaccines and promoting unproven treatments for measles (01:38).

Current Measles Outbreak Situation

The United States is currently grappling with significant measles outbreaks, primarily concentrated in Texas but affecting multiple jurisdictions. Measles, known for its high contagion rate, is preventable through a highly effective vaccine. Historically, vaccination has kept outbreaks rare and deaths even scarcer. Public health experts emphasize that vaccination remains the cornerstone of controlling the current epidemic.

Interview with Dr. Peter Marks: A Critique of the Federal Response

Mary Louise Kelly interviews Dr. Peter Marks, who served as the top vaccine regulator at the FDA until his recent departure. Dr. Marks provides a critical perspective on the federal response to the measles outbreak and the internal conflicts within the HHS under Kennedy's leadership.

Departure from the FDA

Dr. Marks explains that his exit was not voluntary but was precipitated by a series of events undermining vaccination efforts:
"It was one that became clear that it was going to happen based on an accelerating number of events that seem to be conspiring against vaccines in this country." (04:43)

He criticizes the HHS's official statement regarding his departure as "Orwellian speak," emphasizing his commitment to science and the Hippocratic oath over political directives:
"Anybody who knows me knows that that is Orwellian speak because they know that I am somebody that is guided by the science and that will follow the science in support of doing what is right." (06:01)

Assessment of the Federal Response

Dr. Marks describes the federal response to the measles outbreak as "tepid at best," lacking the necessary forcefulness to curb the spread effectively:
"I believe that the federal response has been tepid at best. It is not the type of forceful response that's necessary now." (06:48)

He advocates for a proactive approach, collaborating with states to tailor vaccination messages and dispel myths surrounding vaccine safety:
"A forceful response involves going into the various states, working with the states to find the best way to get across the message for vaccination in that particular state." (07:28)

Clarifying Vaccine Misconceptions

Dr. Marks addresses misinformation propagated by Secretary Kennedy, particularly regarding the efficacy and longevity of the MMR vaccine:
"Two doses of this vaccine provides essentially lifelong immunity. That kind of statement... are just ways to discourage vaccination." (08:49)

He vehemently rejects claims that the MMR vaccine's protection wanes rapidly or that it fails to provide adequate maternal antibody transfer:
"Those are just ways to discourage vaccination. And so that subtle way of, I encourage vaccination, but maybe it's not such a great idea." (08:49)

The Cost of Vaccine Hesitancy

Highlighting the stark choice between vaccination and natural infection, Dr. Marks underscores the preventable nature of measles deaths:
"If we decide that we want everyone to get the measles so they have lifelong protection, it means that one child out of every thousand will die." (09:44)

He expresses profound concern over the normalization of measles deaths, emphasizing that such fatalities are unnecessary in the United States:
"This is something I truly worry about, and it actually keeps me up nights because there is no reason in the United States for us to have a single child die of measles." (11:08)

Outlook on the Outbreak's Resolution

Dr. Marks anticipates that only after additional tragic deaths will there be sufficient impetus to mount a robust public health response:
"I think what's probably going to happen is at some point after a few more children die, someone will really get activated and we will have the kind of robust public health response that we need." (10:39)

Conclusion

The episode paints a concerning picture of the current public health landscape in the United States, where leadership conflicts and misinformation threaten to undermine vaccination efforts. Dr. Peter Marks' insights highlight the urgent need for evidence-based policies and proactive measures to contain the measles outbreak and prevent further loss of life. As the nation faces this preventable crisis, the clash between scientific integrity and political maneuvering becomes a critical focal point in the fight against infectious diseases.

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Notable Quotes:

• Robert F. Kennedy Jr.:
  "People should get the measles vaccine." (01:30)

• Dr. Peter Marks:
  "Anybody who knows me knows that that is Orwellian speak because they know that I am somebody that is guided by the science and that will follow the science in support of doing what is right." (06:01)

• Dr. Peter Marks on Vaccine Safety:
  "The vaccine doesn't kill children, the vaccine doesn't cause encephalitis, and the vaccine doesn't cause autism." (07:28)

• Dr. Peter Marks on Measles Mortality:
  "One child out of every thousand will die." (09:44)

• Dr. Peter Marks on Normalization of Deaths:
  "There is no reason in the United States for us to have a single child die of measles." (11:08)

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Produced by: Connor Donovan
Edited by: Courtney Dorning
Executive Producer: Sammy Yinigun

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For more in-depth coverage and updates on this story, subscribe to "Consider This+" at plus.npr.org/considerthis.

Transcript

[Mary Louise Kelly]

There's a moment from Robert F. Kennedy Jr. S confirmation hearing that now feels very relevant. Senator Ron Wyden, a Democrat from Oregon, is pressing Kennedy on his long history purveying misinformation about vaccines.

[Robert F. Kennedy Jr.]

In 2021, in a book called the Measles Book, you wrote that parents had been, quote, misled into believing that measles is a deadly disease and that measles vaccines are necessary, safe and effective.

[Mary Louise Kelly]

And Wyden asks Kennedy directly about measles.

[Robert F. Kennedy Jr.]

Mr. Kennedy, is measles deadly? Yes or no? The death rate from measles.

[Mary Louise Kelly]

The exchange quickly devolves into crosstalk. But at the end of it, before Wyden's time expires, Kennedy said this we need to move on.

[Robert F. Kennedy Jr.]

Senator, I support the measles vaccine. I support the polio vaccine. I will do nothing as HHS secretary. That makes it difficult or discourages people from taking anybody who believes that. On a look at the measles book, you wrote saying parents have been misled into believing that measles is a deadly disease, that's not true.

[Mary Louise Kelly]

This exchange is relevant now because the US Is in the midst of ongoing measles outbreaks, more than 700 cases so far this year, three deaths. As the secretary of Health and Human Services, Kennedy has said the measles vaccine is the best way to prevent the spread of the disease. He reiterated that in an interview last week with CBS News.

[Robert F. Kennedy Jr.]

Position My position is people should get the measles vaccine.

[Mary Louise Kelly]

But in the same interview, he raised false doubts about vaccines.

[Robert F. Kennedy Jr.]

Right now, we don't know the risks of many of these products because they're not safety tests.

[Mary Louise Kelly]

And alongside vaccines, Kennedy has talked up unproven treatments for measles. His department has also cut billions of dollars of funding to state health departments, which puts local vaccination programs at risk. And he forced out the Food and Drug Administration's top vaccine regulator, Dr. Peter Mar. In Marx's resignation letter, he wrote, truth and transparency are not desired by the secretary, but rather he wishes subservient confirmation of his misinformation and lies. Consider this. RFK Jr publicly promised he would support vaccines when he became health secretary. As a measles outbreak rages, Marks says his department is not doing enough. From npr, I'm Mary Louise Kelly.

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[Mary Louise Kelly]

It's Consider this from npr. Measles is an extremely contagious disease. It is also extremely preventable. The vaccine is highly effective. For decades it has made measles outbreaks in the US Relatively rare and measles deaths rarer still. That is why public health experts say vaccination is a critical part of getting the current outbreaks under control. Secretary Kennedy has a decades long history of undermining confidence in vaccines. So how is his department handling this outbreak? For one view on that, I spoke with Dr. Peter Marks. He was the top vaccine regulator at the FDA until he was forced out last month after clashing with Kennedy. May I begin with what happened last month? You had been in this top vaccine job at the FDA since 2016. Why did you leave?

[Dr. Peter Marks]

You know, it wasn't an elective departure, but it was one that became clear that it was going to happen based on an accelerating number of events that seem to be conspiring against vaccines in this country.

[Mary Louise Kelly]

Can you briefly walk us through what you were not on board with that you saw happening?

[Dr. Peter Marks]

We, I think, need to focus on what is in front of us right now in the world, which is right now we have outbreak of measles in the United States. We have other infectious diseases which are potentially preventable with vaccines, and we have vaccines for these infectious diseases that are both safe and effective.

[Mary Louise Kelly]

May I And I want to get into everything that you're setting us up to discuss about vaccines. But I do have another question about the circumstances of your departure. The HHS put out a statement in which they said if you do not want to get behind restoring science to its golden standard and promoting radical transparency than he, meaning you, Dr. Marks, he has no place at FDA under the strong leadership of Secretary Kennedy. End quote, May I ask your response?

[Dr. Peter Marks]

Yeah, so I'm happy to respond to that. Anybody who knows me knows that that is Orwellian speak because they know that I am somebody that is guided by the science and that will follow the science in support of doing what is right and in support of my Hippocratic oath as a physician. So I view that as something that I'd rather just move past because dwelling on that is not going to help save the next child that's likely to die from measles in the next two to four weeks in the United States, based on the current epidemic curve.

[Mary Louise Kelly]

Let me focus us on these measles outbreaks. The epicenter is in Texas, in rural West Texas. How satisfied are you with the federal response?

[Dr. Peter Marks]

I believe that the federal response has been tepid at best. It is not the type of forceful response that's necessary now that we have outbreaks of at least three cases in at least seven jurisdictions. There are many other states that have isolated cases and not every case is reported to cdc, the Centers for Disease Control and Prevention. And we estimate that the actual number of cases is probably roughly five times as many as has been reported to.

[Mary Louise Kelly]

So you're dealing, as ever, with imperfect data. What would a forceful response look like?

[Dr. Peter Marks]

A forceful response involves going into the various states, working with the states to find the best way to get across the message for vaccination in that particular state. Because this particular vaccine has benefits that so greatly output. Weigh the risks. I need to say it as many times as I can. The vaccine doesn't kill children, the vaccine doesn't cause encephalitis, and the vaccine doesn't cause autism. Okay? The vaccine has some transient short lived adverse effects in about 15 to 20 per hundred thousand. But compare that to 100 to 120 deaths per 100,000 children who get measles. And this is a remarkably good vaccine.

[Mary Louise Kelly]

But we should remember because some of what you're saying is directly at odds with recent remarks by Secretary Kennedy. So I just want to line up what you're saying with what he has said and let you respond. I mean, Secretary Kennedy has said he supports the measles vaccine, that he's on the record in his confirmation hearing saying that he has encouraged the public to get the vaccine. He has also said that the protection offered by the MMR vaccine, measles, mumps, rubella, that it wanes very rapidly. Is that true?

[Dr. Peter Marks]

That's a false statement. Two doses of this vaccine provides essentially lifelong immunity. That kind of statement, as well as the statements about how the vaccine doesn't give good maternal transfer of antibodies to a neonate as well as natural measles infection. Those are just ways to discourage vaccination. And so that subtle way of, I encourage vaccination, but maybe it's not such a great idea. That's not how we do public health messaging.

[Mary Louise Kelly]

Another point that Kennedy has made is talking about the benefits of infection. I'm referencing an interview he gave to Fox in which he said, you know, back in the day, everybody got measles. Measles gave you lifetime protection against measles infection, and the vaccine doesn't do that. Dr. Marks, your response?

[Dr. Peter Marks]

Okay, so if we want to go back to a time when we got our drinking water from the same place that we put our sewage, we can go ahead and do that. But we have made tremendous public health advances. One of them is vaccination vaccines that we have that come through the FDA approval process in the United States have been determined to have benefits that greatly outweigh risks. Measles vaccine provides protection nearly lifelong against a virus that kills otherwise about one in a thousand children who get the virus. So if we decide that we want everyone to get the measles so they have lifelong protection, it means that one child out of every thousand will die. Those are healthy children.

[Mary Louise Kelly]

When and how do you see this current measles outbreak ending?

[Dr. Peter Marks]

Well, I think what's probably going to happen is at some point after a few more children die, someone will really get activated and we will have the kind of robust public health response that we need. I hope that happens before too many children's lives are lost.

[Mary Louise Kelly]

But you think that's what it's going to take, more children dying? It's such an awful thought.

[Dr. Peter Marks]

I would have thought that after a second child died, we would have all been activated to do this, but it seems like because it's being normalized as well, children die of measles. This is something I truly worry about, and it actually keeps me up night some because there is no reason in the United States for us to have a single child die of measles.

[Mary Louise Kelly]

Dr. Peter Marks, he was until last month, the top vaccine regulator at the Food and Drug Administration. Dr. Marks, thank you.

[Dr. Peter Marks]

Thank you so much for having me.

[Mary Louise Kelly]

This episode was produced by Connor Donovan. It was edited by Courtney Dorning. Our executive producer is Sammy Yinigun. It's consider this from npr. I'm Mary Louise Kelly at Planet Money.

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