It must be tough being both a physician committed to scientific evidence and a politician running for the presidency.
Over the weekend, Dr. Jill Stein, a retired internist who is the Green Party's presidential candidate, got caught between the conflicting demands of those two professions when the Washington Post asked her a brief question about public health.
“Do you think that vaccines cause autism?”
That prompted the leftist, environmentalist candidate to zigzag between statements citing the proven benefits of mandatory childhood vaccinations and suggesting doubts about their safety and whether the pharmaceutical industry improperly influences the Food and Drug Administration's decisions about vaccines.
"I think there's no question that vaccines have been absolutely critical in ridding us of the scourge of many diseases—smallpox, polio, etc. So vaccines are an invaluable medication," Stein said. "Like any medication, they also should be—what shall we say?— approved by a regulatory board that people can trust. And I think right now, that is the problem. That people do not trust a Food and Drug Administration, or even the (Centers for Disease Control and Prevention) for that matter, where corporate influence and the pharmaceutical industry has a lot of influence."
Eleven of the 15 members of the FDA's Vaccines and Related Biological Products Advisory Committee are physicians who work at hospitals and universities, while just two physician-members work at drug companies, according to the Guardian newspaper.
Stein, a Harvard Medical School graduate, added that she had questions about vaccines while she was still practicing. She worked at Beth Israel Deaconess Medical Center, Simmons College Health Center and Harvard Pilgrim Health Care, serving as an instructor of medicine at Harvard until retiring from practicing and teaching about 10 years ago.
"As a medical doctor, there was a time where I looked very closely at those issues, and not all those issues were completely resolved," she said. "There were concerns among physicians about what the vaccination schedule meant, the toxic substances like mercury which used to be rampant in vaccines. There were real questions that needed to be addressed. I think some of them at least have been addressed. I don't know if all of them have been addressed."
Those and similar prior comments by Stein make her the third of the four top candidates in the presidential race to express doubts about or opposition to mandatory childhood vaccinations. Republican Donald Trump has repeatedly stated that vaccines hurt children and cause autism. Libertarian Party candidate Gary Johnson has expressed opposition to mandatory vaccinations in the past.
Only Democrat Hillary Clinton has stated firm support for mandatory vaccination (as did her Democratic primary challenger Sen. Bernie Sanders). “The Earth is round, the sky is blue, and #vaccineswork,” Clinton tweeted in February. “Let's protect all our kids.”
Finally, after facing strong criticism over the weekend, on Monday Stein tweeted: "I support vaccinations."
It should worry U.S. public health leaders when candidates of both the left and the right—particularly Harvard-trained doctors— make statements that defy the scientific consensus on the value and safety of childhood vaccines. Stein's comments, while hedged, echo the positions of anti-vaxxers who continue to argue contrary to the evidence that childhood vaccines cause autism and other conditions. Such beliefs, which have significant support in some affluent, well-educated communities, have driven down vaccination rates and led to outbreaks of measles, mumps and whooping cough.
But Stein's comments also should cause nervousness among drug and device makers, because she was voicing a widespread concern among many Americans about whether product manufacturers have weakened regulatory protections against potentially dangerous products. Such fears were heightened by the lack of a prompt and effective federal regulatory response to the recent spate of deadly infections spread by faulty endoscopes.
These public worries about excessive industry influence over the FDA, whether justified or not, could impede efforts by the pharmaceutical and medical device industries to pass the 21st Century Cures Act, a sweeping bill designed to speed FDA approval of drugs and devices.
So healthcare leaders may want to pay close attention to statements by the presidential and congressional candidates on health issues during this campaign season—and hold them accountable when they try to score political points at the expense of science.