If you’re a skeptic dedicated to promoting science and reason, these are scary times. My country, the United States of America, just unexpectedly elected a racist, misogynistic, conspiracy-mongering, scientific ignoramus (who, by the way, is rabidly antivaccine) as its next President thanks to the political relic known as the Electoral College. In actuality, Hillary Clinton won the popular vote by close to 350,000 votes at the last tally I checked this morning, but now, as in 2000, thanks to the Electoral College, the candidate with the most popular votes is not President-Elect. Hillary Clinton, like Al Gore, won the popular vote, but Donald Trump is going to the White House. Even now, two full days later, I have a hard time believing it’s true, but it is. Worse, thanks to the expansion of executive power under the last two or three presidents coupled with the fact that Republicans now control the Presidency, House, and Senate, Donald Trump will be arguably the most powerful President in history, at least early in his term. There will be little or no check on him in Congress, and he can use the precedents set by Presidents Obama and Bush when it comes to exercising executive power. Let that sink in for a moment before I move on.

As unusual and disturbing as this seemingly endless election was, there is one aspect of it that is the same as every election in years past. Once a winner is finally decided, supporters of that winner come out of the woodwork to press their demands on the new administration. This is all very expected and normal in a democracy. In this election, though, one of those groups is the so-called “alt right,” which is basically a white nationalist/supremacist movement that rabidly supported Donald Trump and now wants payback . It’s also all very expected and normal that some of those supporters will end up disappointed, because virtually every presidential candidate makes more promises than he or she can possibly keep, and I’m sincerely hoping that the alt right ends up being one of those groups of supporters.

Another, much smaller, group of supporters who think they can get something from the Trump administration after January 20, 2017 are antivaxers. As I’ve mentioned before, in general, antivaxers leaned heavily towards Trump, thanks to Donald Trump’s long, sordid history of antivaccine statements in interviews and on Twitter. I’ve documented them before on multiple occasions going back to 2007, which is the first time I learned of Trump’s antivaccine proclivities, leading me to frequently observe that, given Trump’s well-known history of flip-flopping and taking multiple sides of any issue based on convenience, his antivaccine views are quite possibly the one set of beliefs that he’s been utterly consistent about for at least a decade.

So it’s no surprise that antivaxers are very happy about the election of Donald Trump, and they hope to get something out of it. A week ago, I noted how Levi Quackenboss, the pseudonymous antivaccine blogger known for attacking a 12-year-old provaccine advocates (and ignominiously being slapped down by said 12-year-old), would want in on the action. After all, she loves to write about her “inside knowledge,” such as when she bragged about how Del Bigtree, producer of the antivaccine propaganda movie VAXXED, met with Rep. Jason Chaffetz about investigating the CDC and when Andrew Wakefield and company met with Donald Trump in August and reportedly received a sympathetic hearing. She even claimed that Wakefield gave Trump a copy of VAXXED, but who knows if he watched the movie. Given that it’s a pile of conspiracy-mongering so over-the-top that Leni Reifenstahl, were she alive, would likely say, “Genug!” or even “Mehr als genug!” (I know, I use that joke too much, but, damn, it’s appropriate.) Meanwhile, the VAXXED crew has been touring the country, trying to convince African-Americans of their antivaccine views and hitting up state legislators, including some in my state, to try to persuade them of the evil of the CDC and how they should eliminate school vaccine mandates.

Enter Levi Quackenboss (again) with @realDonaldTrump A letter from parents of the vaccine injured. Not surprisingly, she starts out by reminding Trump of her meeting with Andrew Wakefield, complete with a hitherto fore unseen photo of Andrew Wakefield and Donald Trump together. Next, she dives into a bit of anti-GMO nonsense:

But many parents on our side, both those who supported you in this presidential run and those who did not, are afraid that you’re going to go the way of Obama once you’re in the White House. They remember his campaign promises about the right to know if our food has been genetically modified, which dragged out for eight years and finally ended with him signing the Monsanto Protection Act while he and his family ate out of an organic garden— and he handed out federal appointments to any Big Ag honchos who complained about it.

It’s true that President Obama, when he was still a candidate fighting for the Democratic nomination in 2008, did make statements that could vaguely be interpreted (or misinterpreted) as lending support to the antivaccine belief that vaccines cause autism and autism is “vaccine injury.” I discussed it at the time. However, to his credit, he clearly learned his lesson and has never made statements like that again, even going so far as to promote vaccination against the flu. So, because as a presidential candidate Obama made the mistake of pandering a bit to antivaccine views (and arguably just barely) but in office didn’t do what antivaccine activists like Quackenboss thought he should have done, they think he “betrayed” them.

Quackenboss has ten demands. Some are hilariously delusional. Some are frightening. Only one is semi-reasonable, albeit pretty much impossible after the Citizens United ruling (“Work toward legislation to ban pharmaceutical campaign donations to Congressmen). It’s unlikely that any will become policy (fortunately), but given Donald Trump’s antivaccine views I can’t be as sure of that as I’d like to be. Let’s take a look:

1. Drain the swamp we call the CDC. Drain it of corruption, corporate influence, and public policies that fly in the face of health. Hell, drain it of all funding—you wouldn’t be the first to say it should be done. Nobody needs a billion dollars of Zika money in the United States. Nobody needs an ebola vaccine. The CDC has grown into a fear mongering monstrosity not worthy of having access to speak to the American people. Take vaccine safety away from the CDC and set up an independent agency to monitor it. If there is anyone who deserves to be grabbed by the private parts, it’s the CDC. At minimum, appoint a CDC Director who understands that health does not come from a needle and that food is medicine, and who is willing to build a national health foundation on giving access to truth.

Given Donald Trump’s famous penchant for eating McDonalds and Kentucky Fried Chicken, so much so that during the campaign it was noted that he was hoping to become the nations “fast food president,” I couldn’t help but laugh out loud when I read that last sentence. Be that as it may, though, the ignorance in that paragraph is appalling. There is little evidence of any serious corruption at the CDC. (Hint: Denying a vaccine-autism link and promoting vaccination are not signs of corruption. Science does not support a vaccine-autism link, but does support vaccination as one of the best strategies to keep children healthy.)

As for setting up an independent agency to monitor vaccine safety, as I said last time, Quackenboss really is living in a fantasy world. She thinks that starting a new bureaucracy is cheap and easy. However, the CDC has been tracking vaccine safety for decades. It has the infrastructure. It has the expertise. It has the personnel. Under Quackenboss’ fantasy, there’d be a new federal bureaucracy, and she thinks it could be set up without significant startup costs and a huge learning curve. For what purpose? It is an article of faith among antivaccine activists that the CDC is hopelessly compromised by pharmaceutical company influence. It’s a massive exaggeration. No one is saying that the CDC is perfect or that it doesn’t screw up from time to time. It’s an organization composed of human beings. By and large, though, it works, and this is definitely a case of, “If it works, don’t fix it.” Besides, any “independent” new bureaucracy, if truly independent and consisting of experts with the relevant skills and knowledge, would soon conclude that vaccines don’t cause autism, just as the CDC did long ago. Then there’d be new conspiracies to concoct.

Now for the hilarious:

2. Get Dr. Ben Carson to man up about autism. if you’re going to nominate him as Secretary of Health and Human Services. This so-called “lack of evidence that vaccines cause autism” is really a lack of investigation into vaccines causing autism and we all know it. Hold his hand and let him know that it’s OK to admit that in some children, vaccines do cause autism, and together you’re going to turn this tide. Tell him to sell his pharma stock first. He alreadys knows the schedule is dangerous, with his public references to “too many, too soon” and wanting to stick to the “core vaccines.” But if Dr. Carson is going to have the job of caring about human conditions then he needs to care deeply about the condition of the voiceless who have been robbed of the life they deserved. Don, Bobby Jindal is an unacceptable choice for HHS. Give him a job that gets him away from vaccines.

The thought of Ben Carson as Secretary of HHS is truly frightening, although not because he is antivaccine. Basically, the largest organization he ran was the Pediatric Neurosurgery Program at Johns Hopkins. Yes, it’s very prestigious, but it is also small, at least compared to the behemoth that is HHS. We’re talking the difference between an organization of at most a few dozen people compared to HHS, which has close to 80,000 employees. Carson would be in way over his head. As for his vaccine stance, I’ve discussed that before. Basically, Carson was very pro-vaccine, but willing to pander to antivaccinationists when it became clear that the Republican base has a lot of “health freedom”-style antivaxers. I suspect that he’s really pro-vaccine, but too cowardly to say so any more (or too full of hubris). Of course, Carson also believes that Mannatech quackery cured him of his prostate cancer. So he’s not exactly a great choice for anything involving science. Remember, the NIH falls under HHS.

Of course, another possible appointment for Carson is as Surgeon General. I’d actually be OK with that, because the Surgeon General can do a lot less harm than Secretary of HHS. However, I doubt that Carson would be satisfied with Surgeon General. He’ll want a department. Be that as it may, Quackenboss also wants Trump to “nominate a US Surgeon General who understands that autism is an illness,” whatever that means. Actually, what it means is that she wants a Surgeon General who thinks that autism is “vaccine injury” when it is not. I also can’t help but note at this point that she also wants Trump to “pardon Julian Assange and Edward Snowden,” because, you know, whistleblowers.

That brings us to:

4. Publicly acknowledge the CDC Whistleblower investigation. We know you know all about this, but most of America does not. I don’t know if anything will ever come from the CDC investigation, given that their actions are 16 years old by now, but the public deserves to hear that a CDC scientist regretted his actions and that of his team in covering up the MMR-autism connection. And they deserve to hear it from the President of the United States.

The “CDC whistleblower” phenomenon is nothing but one big conspiracy theory based on a highly incompetent “reanalysis” of a single study and the angry actions of a single disgruntled CDC employee named William Thompson. There is no connection between the MMR vaccine and autism. However, we all know that Trump loves conspiracy theories, and this one is one that Quackenboss might actually get to see, as is her other demand that Trump “make...[his] personal stance against vaccine mandates known.” We can hope that we don’t see the President of the United States saying that there should be no vaccine mandates or acknowledging a kooky antivaccine conspiracy theory, but it wouldn’t surprise me if he did. After all, if he just said something, that doesn’t mean he will do anything about it.

This next one is dangerous, not just because of its antivaccine nature, but because Quackenboss is advocating that a President directly interfere in the scientific conclusions made by an agency of the federal government:

6. Dilute the CDC vaccination schedule back to one that is reasonable. While states are responsible for setting their own vaccination requirements for school, states wouldn’t add doses of a vaccine that’s not on the CDC schedule. Make personal referrals for Dr. Carson when it’s time for him to staff the Advisory Committee on Immunization Practices to shake that schedule up. Send him experts who realize that one cannot keep a child’s body in a constant state of inflammation and low level infection without serious consequences. Make it clear that no more vaccines are to be added, period. The infant doses of hepatitis b should be removed entirely and required only when the mother is hep b positive. Remove the polio vaccine since the disease is eradicated in nearly every country of the world. Remove the chicken pox vaccine for being entirely unnecessary. Delay the MMR vaccine until four years old and demand that single doses replace the three-in-one again. Expose the flu vaccine for the hoax that it is. Don’t allow children to receive more than one vaccine at a doctor appointment, and get rid of five-in-one vaccines. Set fire to Gardasil and let us enjoy watching it burn to the ground. Immediately halt the practice of recommending vaccination of pregnant women for flu and pertussis. Ban recommending acetaminophen for pregnant women and infants. Forbid the CDC from uttering the phrase “herd immunity” during your presidency. Consult with Paul Thomas (buy his new book in that link) on what the new schedule should look like since he has eliminated new cases of autism from his medical practice with simple changes to the vaccination schedule. In fact, go ahead and tell Ben Carson to add Dr. Paul Thomas, Dr. Bob Sears and Dr. Rachael Ross to the ACIP.

The ACIP, as I’ve discussed before, has strict rules about conflicts of interest, and potential members are rigorously screened for such conflicts, and stringent measures are taken not only to assure technical compliance with ethics statutes and regulations regarding financial conflicts but also to address more general concerns regarding any potential appearance of conflict of interest:

People with specific vaccine-related interests at the time of application are not considered for appointment by the committee. Examples of such interests include direct employment of the can- didate or an immediate family member by a vaccine manufacturer or someone holding a patent on a vaccine or related product. In addition, before their names are submitted for final consideration, potential members are asked to resign for their term of member- ship from any activities that are, or could be construed as, conflicts of interest. These activities include provision of advisory or consult- ing services to a vaccine manufacturer or acceptance of honoraria or travel reimbursement from a vaccine manufacturer. Members are required to file confidential financial reports every year with the Office of Government Ethics and to disclose publicly all vaccine-related interests and work, including participation in clinical trials, at each meeting. They must also declare conflicts at each meeting of a WG. Any single conflict, real or apparent, may serve to disqualify a participant from participating in a WG. WG members may receive confidential and proprietary information from the FDA or others to assist them in their discussions. When appropriate, they are therefore required to fulfill confidentiality requirements and, when required, sign non-disclosure forms prior to receiving such information. If, despite all these safeguards, a conflict exists, limited waivers allow members to participate in committee discussions on con- dition that they are prohibited from voting on matters involving the specific or competing vaccine manufacturers. A member who develops an important conflict of interest during the 4-year term is required to resign from the ACIP.

Also, members are appointed for fixed terms of four years. If you look at the ACIP membership roster, most of its members’ terms don’t expire until 2018 or later, several not until 2020. Moreover, the Liaison Representatives wouldn’t change. Basically, it would take major interference in the CDC to do much to change the ACIP during the first (and hopefully only) term of a Trump presidency. For instance, the ACIP charter has to be renewed every two years. It was just renewed in 2016, which means it will have to be renewed again in 2018.

It’s basically an antivaccine myth that the ACIP is corrupt and controlled by the pharmaceutical industry. It’s not a surprise, though, that Quackenboss believes it. Hopefully, if anyone manages to get to Trump with this proposal, someone in government knowledgeable about how the ACIP actually works, as opposed to the fantasy of antivaxers of how they think it works, will convince Trump that there is nothing to be done here. I do worry, however, that antivaccine-sympathetic members might be appointed to the ACIP.

As for forbidding the CDC from uttering the phrase “herd immunity,” that is so stupid and scientifically ignorant that I can only laugh.

Finally:

8. Create an Autism Prevention Program. Vaccine induced autism is preventable. There is no one single path to autism, but the superhighway is the vaccination program. Force the CDC—if it will still exist—to get honest about autism prevention. Honest about SIDS prevention. Honest about anaphylactic food allergy prevention. Honest about juvenile diabetes prevention. They all stem from the same place. No reasonable person from the vaccine education crowd expects or asks you to ban all vaccines, but most vaccine injuries are avoidable on a lengthier and more diluted childhood schedule.

Um, no. Even if we were to eliminate all childhood vaccinations, it would not do one whit to decrease the prevalence of autism, because vaccines do not cause autism. Ditto SIDS, food allergies, and juvenile diabetes, none of which is caused by vaccines. Of course, Quackenboss wants Trump to “amend the National Vaccine Compensation Program” so that parents with autistic children can be compensated, science be damned.

Fortunately, I highly doubt that much, if any, of these demands will come to fruition. The most important reason is priorities. President-Elect Trump and the Republican Congress have far bigger fish to fry, such as “repealing and replacing” Obamacare (which will turn out to be far more difficult than they think), slashing taxes and spending, gutting environmental regulations, and the like. Even if Trump wants to do anything in line with his antivaccine beliefs, it would be way, way down his list of priorities, so much so that he’d be unlikely to get to it in the first two years, if ever. Also, government bureaucracies, such as the CDC and HHS, are resistant to change. It would take a concerted and prolonged effort to change the CDC in the way that Quackenboss wants it changed. Again, fortunately, it’s highly unlikely that these issues are high enough on Trump’s radar that he would want to spend the political capital necessary to accomplish it. Finally, vaccine mandates are the purview of the states. No President can come into office and wave a magic wand to change them. Each state would have to do it on its own, which is highly unlikely to happen.

Still, it is disturbing that Trump holds these views and that he would meet with an utter crank like Andrew Wakefield. It is disturbing that Trump’s views are such that an antivaccine loon like Quackenboss would think that he might actually be receptive to her proposals and that Mike Adams basically worships Trump and is beside himself with glee that Trump has won.

This man will be our President for the next four years and will have a compliant Congress for at least the next two. Those who advocate for science and public health should be very afraid.