Photo has been used for illustrative purposes.

Late in the fourth year of the Trump presidency, the United States is confronting a far more dangerous war than the “forever wars” he says he is ending. This is a multiphase conflict begun by the president himself, with new battle fronts opened daily. The deadly combat can end only if he is voted out of office.

It began as Trump’s war on science, which has cost tens of thousands of US lives due to the White House failure to contain COVID-19.

It has morphed into a Vaccine War, in which Trump contradicts his scientists with false claims that a vaccine will be generally available before the election. Yet the White House politicization of science creates such mistrust that only 4 in 10 Americans say they would take a vaccine if offered prior to November. Thus the president undermines the very cure he claims will save the country.

Moreover the price of Trump’s science wars extends beyond the relentless rise in the US death toll, now nearly 200,000. His reckless battles have undermined America’s reputation and security interests worldwide — and the cost will mount if they don’t end soon.

Trump’s battle plan was laid bare by his public slap down Wednesday of Robert R. Redfield, director of the Centers for Disease Control and Prevention. Redfield told a Senate committee a vaccine won’t be widely available until at least the middle of next year, with at best a “very limited supply” in November or December. Meantime, Redfield said, masks were “the most important, powerful public health tool we have.”

Yet a steady stream of derogatory critiques by the administration toward its scientific advisers continues to confuse the American public.

Only recently the top communications official at the Department of Health and Human Services, Michael Caputo, posted a Facebook video accusing CDC scientists of “sedition,” claiming they included a pro-Biden cabal “who do not want America to get well.” (Caputo came under such fire, he is stepping down for two months but is not resigning.)

The political tinkering with CDC directives, the presidential promotion of unproven cures, the false statistics used (and later retracted) by the Food and Drug Administration’s director, all point to a health bureaucracy under terrible pressure from Doctor Trump.

So it’s no wonder that a recent poll by the Kaiser Family Foundation showed that only 14% of Americans expect a vaccine before November, while 50% of Democrats, 41% of independents, and 36% of Republicans would refuse to take it.

“Trust is going to be an issue, and the current leadership has squandered trust,” I was told by epidemiologist Philip Landrigan, director of Boston College’s Public Health Program. “You can bet the anti-vaxxers are gearing up.”

Indeed, our beleaguered country is now enmeshed in a Vaccine War.

Anti-vaccination activists are mobilizing online, many of them Trump supporters. (He was once an anti-vaxxer.)

Meantime, many on the left and in the centre doubt the vaccine will be safe, given Trump’s politicisation of science. And many in the Black community are suspicious, given the history of the US Public Health Service’s Tuskegee experiments on Black men in the 1930s.

There are, of course, still US safeguards. Nine leading drug companies have pledged that they won’t submit vaccine candidates for FDA review until clinical trials ensure they are safe and effective.

And a top FDA official, Peter Marks, pledged to resign if the FDA authorises pre-election approval to any vaccine before data support its use. In such a case, pressure by the media, Congress, and scientists would be critical. But even if such pressure works, trust will take a further hit.

And the danger from Trump’s war on science extends beyond our boundaries. A recent Pew Poll shows a stunning plunge in America’s reputation among its democratic allies in Europe and Asia, in large part linked to how the United States has handled the pandemic. Across 13 countries polled, a median of just 15% say the United States had done a good job.

Trump’s war on science is indefensible, and will impose terrible costs at home and abroad if it continues. Only US voters can bring it to an end.