I’ve been a physician for nearly 40 years. We are trained to evaluate information about human health based on a foundation of knowledge learned in 11-12 years of pre-med, med school and residency training, evidence-based research, and experience listening to and treating thousands of patients.

But in these dizzying and dysphoric times, health care providers and patients need to turn to the all-too-prophetic “1984” by George Orwell to understand the policies of the incoming health care czar:

“For, after all, how do we know that two and two make four? Or that the force of gravity works? … If … the external world exists only in the mind, and if the mind itself is controllable — what then?”

We live in an Orwellian world, with alternatives to reality spewing forth from the White House, and a secretary of Health and Human Services, RFK Jr., with no medical training, and the new state media outlet — Fox News — and right-wing podcasts.

In the meantime, the U.S. is seeing its worst flu season in 15 years, with over 33 million cases, 430,000 hospitalizations, and 19,000 deaths — surpassing the number of people dying from COVID. The number includes 86 children — 13 of whom have died because of encephalitis, a rare complication involving swelling of the brain.

The flu strains this year — H1N1 and H3N2 — are both in this year’s flu vaccine, and studies show that it protects against getting the flu over half the time; and when vaccinated folks get the flu, it is almost always a milder case. The vast majority of children and adults hospitalized with the flu, and almost all the patients who have died have not been vaccinated.

Unfortunately, since the antivax hysteria began with the COVID pandemic, flu vaccination rates have dropped from 60% in 2019-20 to 45% in 2023-24.

While COVID and flu vaccines have become controversial, the decision to get the MMR vaccine should be a slam dunk. Measles is a miserable childhood disease. It causes a body wide rash and hemorrhagic (bleeding) sores in the mouth, high fevers, light sensitivity, and sometimes pneumonia. For every 1,000 people who get the disease, 1 to 2 will die. A similar number get encephalitis, some of them up to 11 years after the acute illness; blindness is another complication.

Measles is extremely contagious. If you are exposed, and you are not immune, you have a 90% chance of getting the disease. Up until the early 1960s, millions of children caught measles, a thousand suffered encephalitis and 400 to 500 died — every year.

Fortunately, the development of a measles vaccine in 1963 changed all that. An improved vaccine that arrived in 1968 was combined with the mumps and rubella (German measles) shots to give the present MMR; in 1989 a second dose was added to improve immunity. Getting both MMR shots gives 97% immunity against the measles virus.

Outside of occasional fevers and rash, there few side effects from this vaccine.

The myth that MMR causes autism still persists 27 years after its invention by former British physician Andrew Wakefield, despite at least nine controlled medical studies disproving it. This fraudulent claim (along with vaccines causing sleep and speech disorders) is a prominent part of the website of the nonprofit group Children’s Health Defense, which RFK Jr. has chaired.

If 90% of the general population is immunized against measles, then everyone in the community benefits from what is called herd immunity. Measles is highly unlikely to spread. However, over the last 15 years, MMR vaccination rates have fallen below this threshold in all but 10 states.

Texas — with state laws permitting religious and personal exemption to vaccines — was a ticking time bomb: The recent measles outbreak there in rural counties, with 159 cases and counting, mostly in children and causing one death, was sadly unsurprising. RFK Jr.’s lukewarm endorsement of the vaccine was too little, too late — especially after his promotion of the “natural experiment” of not vaccinating Samoans with the MMR vaccine in 2019, which led to an outbreak of 5,700 cases and 83 deaths, most of them children.

Just as worrisome, the FDA canceled its March 13 committee meeting to discuss what strains to use in the flu vaccine next year. Vaccine manufacturers need about six months’ lead time to prepare the new vaccine. And RFK Jr. also canceled public comment on HHS decisions, despite promising “radical transparency” for the department.

Of course, none of this makes any sense. But in our new topsy-turvy version of the United States, George Orwell, in 1984, has an answer: “Power is in tearing human minds to pieces and putting them together in new shapes of your own choosing.”

Dr. David Gottsegen of Belchertown is a practicing physician at Holyoke Pediatric Associates.