Rabies used to run rampant throughout the world. It was once so common in the United States it was the plot arc of a family movie. Now, thanks to vaccines, it's not nearly the problem it used to be, especially in dogs. According to the CDC,
“The elimination of canine rabies virus variant (CRVV) from the United States is one of the most important public health successes of the 20th century…At the beginning of the 20th century, CRVV was enzootic in the United States, but beginning in 1947, animal vaccination and leash laws led to improved rabies control nationwide.”
This should go without saying, but rabies is…extremely unpleasant. With what is essentially a 100% fatality rate in humans, there isn't much that can be done for people who contract it. Symptoms include:
- Insomnia
- Delirium and hallucinations
- Hydrophobia and hypersalivation
- Seizures, paralysis, coma
- Death (less a symptom, more an inevitable outcome)
We have very safe and effective vaccines that can even be administered for a time after exposure to the virus. As a result, there are so few human cases of rabies in the U.S. each year that it’s newsworthy when it does happen.
MAHA and RFK Jr.
If the U.S. has such a handle on rabies, why are we discussing it? The reason is the rise of the MAHA movement, which is squarely focused on chronic disease. MAHA’s leader, RFK Jr., has stated that he thinks we've been focusing too much on infectious disease research, even saying,
“We’re going to give infectious disease a break for about eight years.”
That statement is extremely chilling, considering Kennedy's anti-vaccine views. One reason chronic diseases are such a problem in the United States and largely throughout the developed world is that we have improved our ability to control infectious diseases. We've done that through infectious disease research, which often results in vaccines (like that for rabies!).
I'm not here to relitigate Kennedy's views on vaccines. He’s told us time and time again what his beliefs are, stating.
“There’s no vaccine that is safe and effective.”
He has touted the fact that his kids were vaccinated as proof that he can't possibly be anti-vaccine. However, just because his children were vaccinated only means that he rethought his position in the last 24 years. That's a whole lot of unaccounted-for years. Highlights during that time include, but are not limited to:
- An infamous Rolling Stone/Salon article from 2005 alleging that ingredients in vaccines cause autism.
- Chairman of the notorious anti-vaccine group Children's Health Defense.
- Named as one of the ‘Disinformation Dozen’ for spreading false information about COVID-19 and COVID-19 vaccines.
- Linked with a horrific measles outbreak in American Samoa.
- Profited from litigation over the HPV vaccine.
- Remember polio? Thankfully, few Americans do. That's because the polio vaccine is highly effective. RFK Jr's lawyer sidekick wants to revoke its approval.
Few would disagree that chronic diseases must be better researched, but that doesn't mean pausing infectious disease research is the answer. Most chronic diseases manifest in our middle age or later. If we pause infectious disease research, we may not grow old enough to have a chronic disease. [1]
Growing Vaccine Hesitancy
The MAHA movement and RFK Jr. have done much to stoke people's fears about receiving vaccines, and these fears aren't species-specific. People are now expressing concern over vaccines for their pets.
In the write-up of their study in Harvard Public Health, authors Stecula, Motta, and Motta stated,
“Rabies was an urgent public health threat in the U.S. a century ago; we can't let it become one again. The rabies shot is the most important canine vaccination for protecting human health, and yet growing numbers of pet owners are skeptical of it.”
I wish I were joking.
“The connection between attitudes toward human and pet vaccines and how those of some people are changing is forcing veterinary professionals to more frequently explain the benefits of vaccines for pets. This can be particularly concerning because a reduction in vaccination increases the risk of spread of dangerous diseases among both humans and animals.”
Even if you believe that MAHA makes some good points, we cannot lose sight of our progress. Infectious disease research is the scaffolding upon which we build longer life expectancy. Without a firm foundation and structure, we will not make progress in any health or biomedical research, let alone chronic diseases.
Making Rabies Great Again
Apparently, measles and influenza are not sufficiently scary. If RFK Jr., MAHA, and those MAHA-curious truly aren't anti-vaccine, then let's call their bluff. We'll make the disease much scarier, raise the potential death toll, and increase the vaccine's effectiveness.
A thought experiment: RFK Jr. is confirmed as HHS secretary and continues to stoke vaccine fears. Vaccine hesitancy continues to grow among people and their pets. We have rabies outbreaks in local pet populations, leading to human infections. How many people would have to die before we see just how bad this problem actually is?
I've used rabies as an example because nothing else seems to get people’s attention. How do we feel about this scenario now? Is the thought of rabies roaring back sufficiently scary enough to force people to see the absurdity of the anti-vaccine rhetoric and RFK Jr. and MAHA for what they really are?
Do we need chronic disease research? Yes. Do we need infectious disease research? Also, yes. We don't have to choose. We can do both. In fact, we have been doing both. The implication that we can ignore infectious diseases is wishful thinking at best and downright malicious at worst. Growing vaccine hesitancy and the increasing popularity of anti-vaccine rhetoric are playing with fire. I just hope people realize the reality of rabies before we get burned.
[1] “Globally, infectious diseases, including acute respiratory infections, diarrhoea and malaria, along with preterm birth complications, birth asphyxia and trauma and congenital anomalies remain the leading causes of death for children under 5.” If you don't live long enough, you will never be concerned about a chronic illness.
Katie Suleta, DHSc, MPH
Katie Suleta is a regional director of research in graduate medical education for HCA Healthcare. Her background is in public health, health informatics, and infectious diseases. She has an MPH from DePaul University, an MS in Health Informatics from Boston University, and has completed her Doctorate of Health Sciences at George Washington University.
