New Trump vaccine order based on “no credible scientific evidence,” doctors say

特朗普签署新疫苗行政令，医生称其“缺乏可靠科学依据”

The American Medical Association came out swinging this weekend at an executive order President Trump signed Friday that reaffirms intentions to model US childhood vaccine recommendations after those of Denmark—a country with universal healthcare, less diversity, and a population about the size of Maryland’s. 美国医学会（AMA）本周末对特朗普总统周五签署的一项行政令进行了猛烈抨击。该行政令重申了将美国儿童疫苗接种建议向丹麦模式看齐的意图——丹麦是一个拥有全民医疗保健、人口多样性较低且人口规模仅相当于美国马里兰州的国家。

“There is no credible scientific evidence to support,” such a change, AMA President Bobby Mukkamala said in a statement. The current vaccine schedule “is built on decades of rigorous research and real-world data, and it is designed to protect children in the US when they are most vulnerable based on our nation’s disease burden,” he said. AMA主席Bobby Mukkamala在一份声明中表示：“没有任何可靠的科学证据支持”这种改变。他指出，目前的疫苗接种计划“建立在数十年的严谨研究和真实世界数据之上，旨在根据我国的疾病负担，在儿童最脆弱的时候保护他们。”

The plan to align federal childhood vaccine recommendations with Denmark’s was first revealed by anti-vaccine Health Secretary Robert F. Kennedy Jr. in January. The overhaul would see the total number of recommended immunizations drop from 17 to 11, walking back recommendations for shots against rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B. 将联邦儿童疫苗接种建议与丹麦接轨的计划，最初由反疫苗立场的卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）于1月份披露。这项改革将使建议接种的疫苗总数从17种减少到11种，撤回了针对轮状病毒、新冠肺炎、流感、脑膜炎球菌病、甲型肝炎和乙型肝炎的疫苗接种建议。

It stemmed from a December executive order by Trump to align US vaccine recommendations with the “best practices from peer, developed countries.” From that order, Trump administration officials carried out a “comprehensive scientific assessment,” which concluded the US should emulate Denmark. The work was carried out by two Trump administration political employees, Tracy Beth Høeg, a sports medicine doctor, and Martin Kulldorff, a biostatistician, neither of whom has expertise in vaccine policy, but both are anti-vaccine allies of Kennedy. 该计划源于特朗普12月签署的一项行政令，旨在使美国疫苗建议与“同类发达国家的最佳实践”保持一致。根据该命令，特朗普政府官员进行了一项“全面的科学评估”，结论是美国应效仿丹麦。这项工作由两名特朗普政府的政治任命人员完成，分别是运动医学医生Tracy Beth Høeg和生物统计学家Martin Kulldorff。两人均不具备疫苗政策方面的专业知识，但都是肯尼迪的反疫苗盟友。

The acting director of the Centers for Disease Control and Prevention at the time—Jim O’Neill, a technology investor—signed off on the changes. But in March, a federal judge issued a temporary injunction that reversed the changes, finding that Kennedy violated federal regulations in implementing them. 时任美国疾病控制与预防中心（CDC）代理主任、技术投资者Jim O’Neill批准了这些变更。但在3月份，一名联邦法官发布了临时禁令，推翻了这些变更，认定肯尼迪在实施过程中违反了联邦法规。

“Crazier and crazier” “越来越疯狂”

While the federal government is appealing that injunction, the new executive order on Friday reaffirms Kennedy’s plans to adopt Denmark’s strategy, calling for “realigning” US vaccine policy with “best practices from peer, developed countries.” It states that the scientific assessment written by Høeg and Kulldorff is a “guiding resource for the Federal Government” and that the CDC shall ” take any appropriate steps to update the United States childhood and adolescent vaccine schedule.” 尽管联邦政府正在对该禁令提出上诉，但周五签署的新行政令重申了肯尼迪采用丹麦策略的计划，要求将美国疫苗政策与“同类发达国家的最佳实践”重新对齐。行政令指出，由Høeg和Kulldorff撰写的科学评估是“联邦政府的指导资源”，CDC应“采取任何适当步骤更新美国儿童和青少年疫苗接种计划”。

As before, the AMA is strongly against the unilateral change made without backing from scientific evidence. “Altering [the vaccine schedule] without clear, evidence-based justification risks continued confusion for parents and patients, undermining trust in vaccines, and ultimately lowering vaccination rates,” Mukkamala said. “That would put more children and communities at risk of preventable illness.” 与此前一样，AMA强烈反对这种在没有科学证据支持下进行的单方面改变。Mukkamala表示：“在没有明确、基于证据的理由的情况下更改（疫苗接种计划），可能会导致家长和患者持续困惑，破坏对疫苗的信任，并最终降低疫苗接种率。这将使更多的儿童和社区面临可预防疾病的风险。”

On Monday, the American College of Physicians also released a statement, saying it was “deeply concerned” by Trump’s order. “This is the second time the administration has attempted to unilaterally substitute vaccine guidance from other countries to replace the US vaccine schedule which was developed for the specific needs of the US population,” ACP President Jan Carney said. “The changes that this executive order directs cannot be allowed to move forward.” 周一，美国医师学会（ACP）也发表声明，称对特朗普的行政令感到“深切担忧”。ACP主席Jan Carney表示：“这是本届政府第二次试图单方面用其他国家的疫苗指南来取代针对美国人口特定需求而制定的美国疫苗接种计划。该行政令所指示的变更绝不能继续推进。”

Even researchers in Denmark find the move bizarre. Anders Hviid, who leads research on vaccine safety and effectiveness at the Statens Serum Institut, Denmark’s equivalent of the CDC, told The New York Times in December that it did not make sense to compare the US to Denmark. “It’s not at all fair to say look at Denmark unless you can match the other characteristics of Denmark,” he said. 即使是丹麦的研究人员也觉得此举很荒谬。丹麦国家血清研究所（相当于丹麦的CDC）负责疫苗安全与有效性研究的Anders Hviid在12月告诉《纽约时报》，将美国与丹麦进行比较毫无意义。他说：“除非你能匹配丹麦的其他特征，否则说‘看看丹麦’是完全不公平的。”

Hviid also told the Times that the US public health policies under Kennedy “get crazier and crazier” by the month. “It is surreal, and it is difficult, from a Danish perspective, to understand what’s going on.” Hviid还告诉《纽约时报》，在肯尼迪领导下的美国公共卫生政策正逐月变得“越来越疯狂”。“这太超现实了，从丹麦的角度来看，很难理解到底发生了什么。”

As for whether Denmark even represents the best practices of “peer countries,” as Trump’s executive orders direct, an analysis in January by Stat News found that this is not the case. First, the outlet found that the US has not been recommending a wildly larger number of vaccines compared with other affluent countries and was in line with countries such as South Korea and Brazil. Denmark, however, is an extreme outlier on the other end of the spectrum, having the fewest recommended vaccines (10) among 20 peer countries. All other countries in the comparison recommended between 13 and 16 vaccines. 至于丹麦是否真的代表了特朗普行政令所指的“同类国家”的最佳实践，Stat News在1月份的一项分析发现事实并非如此。首先，该媒体发现，与其他富裕国家相比，美国建议接种的疫苗数量并没有多得离谱，而是与韩国和巴西等国持平。然而，丹麦在这一光谱的另一端是一个极端的异类，在20个同类国家中，其建议接种的疫苗数量最少（10种）。比较中的所有其他国家建议接种的疫苗数量都在13到16种之间。