MARY LOUISE KELLY, HOST:
Measles is an extremely contagious disease. It is also extremely preventable. There's a vaccine. It's highly effective. For decades, it has made measles outbreaks in the U.S. relatively rare - measles deaths, rarer still. But the U.S. has now seen more than 700 cases of measles this year and three deaths. The federal response is now under scrutiny because the health secretary, Robert F. Kennedy Jr., has made a career of spreading false information about vaccines.
So what are this administration's views on vaccines and what might they mean for what is already one of the worst U.S. measles outbreaks this century? For a view on that, I'm joined now by Dr. Peter Marks. Dr. Marks was the top vaccine regulator at the Food and Drug Administration until last month when he was forced out after clashing with Kennedy. Dr. Marks, welcome.
PETER MARKS: Thanks very much for having me.
KELLY: 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?
MARKS: You know, it's - 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.
KELLY: Can you briefly walk us through what you were not on board with that you saw happening?
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.
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, then 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?
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.
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?
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 CDC.
KELLY: So you're dealing, as ever, with imperfect data. What would a forceful response look like?
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 outweigh 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, OK? The vaccine has some transient, short-lived adverse effects in about 15 to 20 per hundred thousand. But compare that to a hundred to 120 deaths per hundred thousand children who get measles, and this is a remarkably good vaccine. But we should remember that...
KELLY: Can I just jump in there? - 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, he - 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?
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.
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?
MARKS: OK, 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 1 in 1,000 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.
KELLY: When and how do you see this current measles outbreak ending?
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.
KELLY: But think that's what it's going to take - more children dying? It's such an awful thought.
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 nights some because there is no reason in the United States for us to have a single child die of measles.
KELLY: Dr. Peter Marks - he was until last month the top vaccine regulator at the Food and Drug Administration. Dr. Marks, thank you.
MARKS: Thank you so much for having me.
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