My Big Pharma Check Must Be Lost in the Mail

AP Photo/Rod Lamkey, Jr.

I have been a vocal pediatrician on social media for about 6 years now. In the beginning I mostly talked about gun violence and common sense gun safety laws. Then, while running for Congress, I talked about anything and everything with an unfortunate but necessary focus on Nancy Mace. Since launching our nation’s first and only Political Action Committee for kids, Their Future PAC, I talk mostly about anything and everything that impacts our nation’s 73 million children.

And like every other person who shares their views on social media, I have acquired a nice collection of hate followers and trolls. First they were mostly from the anti- gun safety world. I quickly learned to ignore, mute and block these guys.

Then, of course, thanks to Nancy, they were from the “gender affirming care is child abuse” camp. (Gender affirming care isn’t child abuse. It basically means not being an a$$hole to kids. Let them express themselves. Support them. It’s most certainly not “cutting off the body parts” of minor children. Oh, and it sometimes saves their lives. So there’s that.) Interestingly, these folks are way more intense than the gun guys. But still, I learned to ignore, mute and block.

But now, thanks to the mind-blowingly irresponsible nomination of scientifically illiterate, brain worm-addled RFK Jr. to HHS Secretary, I have been talking a lot about infectious diseases and the vaccines that prevent them. And now I am not only a “gun-grabber” (I don’t want your guns) and a child abuser (on the contrary, I am actually a mandated reporter), I am also allegedly on Big Pharma’s payroll (I’m not. More on this in a bit).

As a pediatrician, vaccines are truly foundational to the work I have done every day since 2006. I vividly remember making flashcards to memorize the recommended vaccine schedule. I remember learning (from a textbook, not a real patient, because…vaccines) that the Measles rash spreads from head to toe (shout out to Microbiology Made Ridiculously Simple). I remember fumbling around with bandaids after immunizing 2, 4 and 6 month old infants. I remember learning about (and being completely terrified of) HIB Epiglottitis. (Don’t provoke the child! Don’t start an IV! Call Anesthesia or ENT for intubation stat!) I remember learning about the iron lung, and trying to make sense of how it worked (I was never very good at physics). I remember doing more spinal taps in the early days of my career than I do now, but never even close to as many as the doctors a generation before me did. I remember when the Rotavirus vaccine became widely available (a big setback for voluminous diarrhea, a big advancement for children everywhere).

And probably most importantly, I remember studying the impact of these vaccines. You hear doctors call vaccines medical miracles. Maybe that sounds hyperbolic. But doctors don’t say this lightly. We say it because the data supports it. Vaccines have saved 154 million lives globally since 1974. And that’s just mortality. It is nearly impossible to quantify the number of non-fatal illnesses, missed school days, missed parental work days, sick visits to the pediatrician, emergency department visits, and hospitalizations vaccines have saved. If that’s not worthy of being called a miracle, I don’t know what is. Of course we don’t mean a literal miracle. It’s science. (Yay science! Remember when you could say something like that and it didn’t sound political?) And the science behind vaccines has unequivocally proven them to be safe and effective.

Created by: Valentine Svensson, a PhD student in molecular biology at Cambridge University (Washington Post)

And that’s why vaccines are a foundational aspect of the practice of pediatrics. Because pediatricians are in the business of promoting child health.

Big Pharma influence has precisely nothing to do with pediatricians' promotion of routine childhood immunizations. But you wouldn’t know that by reading my Twitter mentions. If I had a dollar for every time I have been accused of being paid by Big Pharma, I could buy a couple dozen eggs (Thanks Trump!). What I mean is, there is an incredibly pervasive false assumption that pediatricians get money from pharmaceutical companies every time we vaccinate a child. And that is our motivation. From the inside looking out it is hard to even comprehend that many Americans actually believe this to be true.

So let me set the record straight. Pediatricians don’t promote vaccines for money. Big Pharma doesn’t pay me, or my colleagues. Pediatrician offices barely break even (if they break even at all) on the administration of vaccines. Pediatricians have to spend more and more time counseling vaccine hesitant parents in part due to the disinformation spread by non-doctors like RFK Jr. (who, by the way, has made a ton of money promoting anti-vaccine disinformation). Most of the time pediatricians don’t get to bill more for these longer conversations. We do it because it’s the right thing to do. Because, remember, we are actually in it for the kids.

To further illustrate how absurd this profit-motivated argument is, pediatricians are among the lowest paid physicians (see page 9, and in the spirit of full disclosure, despite having practiced for over 15 years I have NEVER made as much as this graph says pediatricians make). No one goes into pediatrics for the money. We aren’t the ones with the boats, the fancy cars and the vacation homes. We take the same classes and pass the same tests as our colleagues and then we CHOOSE to go into pediatrics, knowing we will make a lot less money than our internal medicine colleagues, our surgical colleagues, essentially all of our colleagues. If you want to find physicians who are in it to line their pockets and build personal wealth, you need to look elsewhere.

So if you want to talk about vaccines, let’s dispel the myth that Big Pharma is unduly influencing pediatricians, and let’s focus on the science.