BY CARLIN SHERIDAN

A poster advocating that vaccines work despite what supporters of the anti-vaccine movement claim. Source: Raed Mansour
A poster advocating that vaccines work despite what supporters of the anti-vaccine movement claim. Source: Raed Mansour

Parents want what is best for their children. In the modern era where many first world families with the means to do so pursue healthy lifestyles centered on organic food, natural household care products, and homeopathic remedies, some have begun to question the safety and regulation of vaccines. Despite consistent and clear evidence proving the contrary, advocates continue to link vaccines to developmental disabilities such as autism. This mindset goes beyond mere ignorance; it is recklessly irresponsible and places entire communities at risk.

Beginning with Edward Jenner’s smallpox vaccine, inoculations have steadily developed over time to create a near perfect defense against a number of diseases that throughout history had devastating effects on humans. Polio, measles, rubella, mumps, and diphtheria are among the many illnesses that have nearly disappeared in developed countries due to their widely accessible vaccination programs. A study published in the New England Journal of Medicine “estimated the numbers of cases of polio, measles, rubella, mumps, hepatitis A, diphtheria, and pertussis that were prevented by vaccines by subtracting the reported number of weekly cases after the introduction of vaccines from a simulated counterfactual number of cases that would have occurred in the absence of vaccination.”1 Researchers estimate that a total of 103.1 million cases of these diseases have been prevented within the United States since the development of inoculations.1 The CDC currently recommends that children be vaccinated against 16 diseases. For many years, these advancements in preventive care were celebrated as achievements that improved the health, safety, and comfort of our society. In recent decades, however, a misinformed minority has banded together to become more vocal and advocate on behalf of the anti-vaccine movement.

The pushback against the vaccination schedule that is currently recommended by most doctors and the CDC has emerged in primarily upper middle class and well-educated communities. It is rooted in distrust for the government and its relationship to pharmaceutical companies, as well as the recent trend in pursuing supposedly natural lifestyles. Doctors point to an entitled mentality prevalent among patients in the Internet era; some begin to feel as though they should have complete freedom to control their medical lives and that online research empowers them and enables them to debate medical theory with their physicians. Advocates combat this message by arguing “that authoritarian, paternalistic approach[es] to medical care [aren’t] going to work in the 21st century.”2 Many of the areas at highest risk are extremely wealthy communities in California, a state that allows parents to relatively easily submit a personal belief exemption (PBE) if they do not want to vaccinate their children in accordance with most school mandates. In certain parts of California, the average PBE rate is as high as 9.1 percent of preschool age children, with some schools having as many as 68 percent of children incompletely vaccinated.2 “According to World Health Organization data, such numbers are in line with immunization rates in developing countries like Chad and South Sudan.”2 The danger of unvaccinated children affects more than just the individual; as a society, we rely on herd immunity to quell the spread of disease. Herd immunity holds that there will be a threshold percent of every community inoculated against a disease. This barrier can protect the elderly, infants, pregnant women, and those who for medical reasons were unable to be vaccinated.

Perhaps the most recognizable and widely distributed of anti-vaccine arguments is the supposed link between the vaccination of children under two and the development of autism. The movement has found a martyr in Andrew Wakefield, the man who in 1998 published a study linking the measles mumps and rubella (MMR) vaccine to the onset of developmental disabilities. The study was originally published in The Lancet, though the journal has since retracted the publication. Wakefield examined twelve boys who had been diagnosed with autism around the time they received the MMR vaccine and concluded that the correlation indicated causation.3 This singular study set off a wave of seemingly untenable public response and backlash against vaccination. It struck a chord with parents of autistic children who were desperate for any explanation for their children’s disability and spurred fear among parents everywhere that they were unknowingly damaging their children while trying to protect them. This anti-vaccine movement moved swiftly into media headlines, especially as celebrities like Jenny McCarthy and Jim Carrey jumped onboard as anti-vaccine advocates. This is noteworthy, considering that “24% of parents surveyed by the University of Michigan say they place “some trust” in information provided by celebrities such as McCarthy about the safety of vaccines.”4 The backlash against Wakefield was immediate and widespread in the medical community. All efforts to replicate his research failed, and study after study showed that there was no link between the MMR vaccine and autism. The Journal of Child Psychology and Psychiatry published a study that utilized Japan’s unique MMR vaccination program to examine the rates of incidence of Autism Spectrum Disorder for all children born between 1988 and 1992 in Yokohama, Japan. “MMR vaccination rates declined from 69.8% in the 1988 birth cohort, to 42.9%, 33.6%, 24.0%, and a mere 1.8% in birth cohorts 1989 to 1992.”5

A young girl receiving an oral vaccine for polio. Source: CDC Global
A young girl receiving an oral vaccine for polio. Source: CDC Global

Despite the decrease in the rate of MMR vaccination, the rate of Autism Spectrum Disorders in the area rose and continued to rise even after MMR vaccination fell to zero coverage in more recent birth cohorts. This is just one of many studies definitively concluding that there is no link between the onset of autism and vaccination. Andrew Wakefield had his medical license rescinded by a British General Medical Panel and it has since been shown that his work was teeming with ethical violations.  For example, he failed to disclose funding from lawyers who were mounting a case against manufacturers, misrepresented timelines, and subjected mentally handicapped children to unnecessary invasive testing.6 Despite this, many fiercely determined anti-vaccine advocates still herald him as a scapegoat and victim of a conspiracy between big pharmaceutical companies and government agencies.

Numerous blogs and websites designed to spread awareness of the supposed danger of vaccines, such as ThinkTwice, VacTruth, Safe Minds, and VacLib, continue to link developmental delays to vaccination. After Wakefield’s original claim was discredited, some turned to an alternative explanation of the autism-vaccine link: thimerosol, a mercury-containing preservative that previously was present in many childhood vaccines.7 Even though thimerosol was banned from all vaccines in 2003, many parents of disabled children associate it with the neurological problems their children face. The Omnibus Autism Proceedings combined the cases of nearly 5,000 families with autistic children who were seeking compensation from the National Vaccine Injury Compensation Program because they claimed thimerosol caused or worsened their children’s autism.8 Ultimately, the court ruled against the families, stating that they had failed to prove the link between vaccines and autism.

A study published in Pediatrics examined the diagnostic rate of Autism Spectrum Disorders in Denmark before and after the removal of thimerosol from vaccines. Researchers found that the incidence of autism increased and continued to rise after the removal, therefore indicating that thimerosol had no significant impact on the prevalence of autism in the population.9 Additionally, a 2007 study published in the New England Journal of Medicine involved giving 1047 children between ages 7 and 10 tests for 42 neuropsychological outcomes. It detected very few associations between thimerosol exposure and affects on neuropsychological function, and these affects were largely split between beneficial and detrimental outcomes.10 Ultimately, the benefits children receive from inoculation against disease far outweigh any potential risks.

In the face of growing numbers of unvaccinated children, health and government officials are scrambling to gain control over the dissemination of information. Attempts to combat the anti-vaccination movement have included new educational mandates that require parents in certain states to consult healthcare providers or watch informational videos before opting out of vaccinating their children. Though well-intended, a recent study published in Pediatrics concluded that not only are educational campaigns largely ineffective, they can actually solidify anti-vaccine sentiment in parents who are considering the decision. In this study, 1759 parents were randomly assigned to one of four different informational groups or a control group. Researchers concluded, “none of the interventions increased parental intent to vaccinate a future child.”11

Following the consistent conclusion of multiple studies that vaccines pose no severe health risk to the typical infant, many have come to feel that “given the sheer numbers of lives at stake there is a strong argument that the burden of proof be shifted to the detractors.”12 Valuable research dollars are being allocated to studies that many view as tautological and a waste of funds; this money would be more impactful if used to explore alternative causes of autism and other illnesses.13 Dangerous trends in public health are emerging as outbreaks of vaccine-preventable disease rise and pharmaceutical companies slow the development of vaccines due to fear of litigation. Public health officials face an uphill battle to combat the confirmation bias that runs rampant among a generation of anti-vaccination advocates who have never witnessed the truly devastating impact of diseases like measles, polio, and whopping cough. This is especially detrimental because of the significant disparities in vaccine allocation; “globally, one in five children lack access to immunizations that help keep children in the U.S. healthy. Every 20 seconds a child in the developing world dies from a vaccine-preventable disease.”14

As the anti-vaccine movement sweeps through privileged communities throughout the United States, large groups of people are being put at risk. “There are the 26 states plus the District of Columbia that don’t meet the Department of Health and Human Services’ guidelines of 95% coverage for the MMR vaccine. There are the 37 states that don’t even meet the CDC’s standards for properly gathering data on vaccination rates in the first place, and there are the 11 states with opt-out rates of 4% or higher.”15

Those who rely on herd immunity for their own health and safety are rightfully angered by the view taken by advocates who dismiss the advice of thousands of scientists and medical professionals in favor of conspiracy theories. Studies have consistently and conclusively shown that vaccines do not cause autism or other developmental disabilities, but it can be hard for doctors and public health officials to jolt people from their own willful ignorance. As the rates of infectious diseases like measles and whooping cough begin to rise again, hopefully people will begin to look beyond the surface clamor and see that society as a whole benefits when every child is given the chance to live a healthy, disease-free life.

Carlin Sheridan is a sophomore in Trumbull College. She is an undeclared major. She can be contacted at carlin.sheridan@yale.edu.
_______________

References

  1. Van Panhuis, W. (2013, November 28). Contagious Diseases in the United States from 1888 to the Present. The New England Journal of Medicine, 2152-2158. doi: 10.1056/NEJMms1215400.
  2. Baum, G. (2014, September 9). Hollywood’s Vaccine Wars. Hollywood Reporter. Retrieved from http://www.hollywoodreporter.com.
  3. Wakefield, A. (1998, February 28). Illeal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, and Pervasive Developmental Disorder in Children. The Lancet, 637-641. doi: 10.1016/S0140-6737(97)11096-0.
  4. Rochman, B. (2011, April 26). Jenny McCarthy, Vaccine Expert? Time. Retrieved from http://www.healthland.time.com.
  5. Honda, H. (2005). No effect of MMR Withdrawal on the Incidence of Autism: A Total Population Study. Journal of Child Psychology and Psychiatry, 572-579. doi: 10.1111/j.1469-7610.2005.01425.
  6. Dominus, S. (2011, April 20). The Crash and Burn of an Autism Guru. New York Times.
  7. Allen, A. (2002, November 10). The Not-So-Crackpot Autism Theory. New York Times.
  8. McNeil, D. (2010, March 12). 3 Rulings Find No Link to Vaccines and Autism. New York Times.
  9. Madsen, K. (2003). Thimerosal and the Ocurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data. Pediatrics, 604-606. doi: 10.1541/peds.112.3.604.
  10. Thompson, W. (2007, September 27). Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years. The New England Journal of Medicine, 1281-1292. doi:10.1056/NEJMoa071434
  11. Nyhan, B. (2014, March 3). Effective Messages in Vaccine Promotion: A Randomized Trial. Pediatrics. doi: 10.1542/peds.2013-2365.
  12. Berkley, S. (2013, January 17). Stick With the Science. New York Times.
  13. Harris, G. (2005, June 25). On Autism’s Cause, It’s Parents vs. Research. New York Times.
  14. Rochman, B. (2013, April 15). How Social Networks Influence Parents’ Decision to Vaccinate. Time.
  15. Kluger, J. (2014, October 16). Very Good and Very Bad News in the Vaccine Wars. Time.
Advertisements