Vaccinations Give Anti-Vaccine Movement the Needle

        Malcolm Gladwell introduces several ideas about the development of trends in his book, The Tipping Point. The “tipping point” refers to the point at which a product or an idea becomes a trend. Gladwell suggests that we should think of trends as, “…epidemics. Ideas, products and messages and behaviors spread just like viruses do.” Gladwell contends that an idea or product need only a few people to make a trend epidemic and calls this phenomenon, “the law of the few.” Trends can be fairly innocuous and come and go very quickly as in the case of fashions or music. However, more harmful trends mirror his theories. In 2003, the Center for Disease Control and Prevention announced the eradication of Measles, Mumps and Rubella in the United States. The eradication was due to the combined Measles, Mumps and Rubella (MMR) vaccine and mass vaccination program. Unfortunately, the United States, Australia, the United Kingdom and other western nations have seen MMR vaccination rates decline and increases in the incidences of these diseases start to rise again over the last five years. The continuing trend of declining MMR vaccination rates contribute to the return of measles, mumps and rubella in the population.

        Historically, vaccines have protected children from diseases that once maimed and killed. In the last 50 years, the world has witnessed the eradication of smallpox and polio in most of the world, yet a growing distrust of medicine is leading parents to not vaccinate their children with the MMR vaccine. The MMR vaccine is a combination vaccine that protects children against the potentially life threatening diseases, Measles, Mumps and Rubella. Viral vaccines work by injecting low doses of a less virulent form of the virus. Vaccinations stimulate the immune system to produce specific antibodies which mark foreign bodies and infected cells for destruction by other types of cells of the immune system. The more people that are vaccinated against a specific virus means that more people are protected against these viruses including the few that are not immunized. Therefore, the more people protected by vaccination helps prevent the spread of disease within a population. This means that individual protection not only works for the individual, but contributes to the protection of whole communities and populations. Immunologists call this protection herd immunity. Viruses become less virulent with herd immunity so less virulent strains of the virus are needed for vaccinations. Herd immunity leads to the eradication of diseases such as smallpox and polio. The downward trend of MMR vaccination rates began due to the harmful effects of one piece of bad science.

        Bad science attributed to the downward trend of vaccination rates. A highly publicized research paper by a group of British doctors led by Dr Andrew Wakefield claimed a link to the MMR vaccine and autism. The Lancet Journal published the paper in 1998. In February 2010, the Lancet Journal fully retracted Wakefield’s paper based on the results of a hearing by the General Medical Council because it was found to be bogus and unethical. The scientific method states that subjects in experiments must be randomized. Wakefield’s subjects were not randomized, but cherry-picked to acquire desired results. This single piece of research by Wakefield, et al, was the “Tipping Point” in the trend of people deciding not to vaccinate through fear of their children acquiring autism. Wakefield then engaged in an anti-MMR vaccination campaign and persuaded parents not to vaccinate their children. His campaign was a significant cause in the decline of vaccination rates, because it led to fear among parents who subsequently stopped vaccinating their children.

        Declining vaccination rates propelled by fear of the vaccination lead to a loss in herd immunity which slowly led to an increase in the incidences of measles. Investigative journalist, Brian Deer of the British newspaper, The Sunday Times shows graphs supplied by the UK Department of Health that show a steady decline in the proportion of mothers’ confidence in the vaccine. The decline in confidence mirrors a steady decline or MMR uptake at 16 months. For example, at the time of the release of the paper, MMR uptake (the proportion of children receiving the vaccine) was around 85%. In 2003 it had dropped below 70%. The incidence of measles was slow to begin with because of herd immunity. As the proportion of children completing their two year vaccination program declined, incidence of measles increased. For example, measles cases slowly increased over a five year period then steadily increased; 50 children in 2001 to over 400 in 2003. When people stop vaccinating their children in even small numbers, there is a reduction in herd immunity and the virus can become endemic again. Target vaccine rates to ensure herd immunity rates are usually around 90%. Out of this fear sprouted the anti-vaccine lobby. The mass media gave, and continues to give, the anti-vaccine lobby a voice and in doing so, exacerbated and sustained the continuing decline in vaccination rates by propagating the autism-vaccine myth.

        The biggest anti-vaccine advocate and propagator of the autism-vaccine myth is actress and ex-playboy model Jenny McCarthy. McCarthy claims that her autistic son developed symptoms of autism after he received the MMR vaccine. This gives considerable weight to her crusade as she spins the victim of “big pharma” yarn. Her anti-vaccine organization, Generation Rescue has a glossy website. full of name drops, references studies since disproven by the scientific community and misrepresents reports by omitting key information that would otherwise negate their claim. For example, the site cites the CDC’s January 2003 Morbidity and Mortality Weekly Report (MMWR) on VAER (Vaccine Adverse Event Reporting System), that “VAERS received 128,717 reports of adverse events, of which 14% were described as “serious” which means “death, life-threatening illness, hospitalization or prolongation of hospitalization, or permanent disability.” The figure quoted out of context makes it meaningless, but is intended to give the false impression of a high number of reports. The site fails to mention that the report goes on to state that over 1.9 billion doses were distributed during the same 10 year period. Note that the VAERS does not distinguish between types of vaccines. McCarthy’s celebrity status and personal interest stories give her unlimited access to mainstream media like the Oprah Winfrey Show and CNN to propagate the autism-vaccine myth to a very large audience. McCarthy is able to resonate with an audience in a way that faceless scientists and doctors cannot. Her disciples help spread her gospel and instill fear into parents convincing them not to vaccinate.

        Despite years of subsequent research showing no evidence of a link between autism and the MMR vaccination, the anti-vaccine lobby continues to cite and defend Wakefield’s research blaming persecution by what they call “big pharma.” The underlying cause for the years of suspicion of the MMR vaccine is that no one knows exactly what causes autism and this generates distrust and frustration towards the scientific community who cannot provide the psychological need for definitive answers to concerned parents — particularly those parents of autistic children. What the scientific community does know and what medical history has shown, is that vaccination programs work. To suggest that parents should not vaccinate their children is tantamount to telling people to stop washing their hands because they might get catch a cold. The benefits that vaccinations provide overwelmingly outweigh the very small risk of serious harm from vaccines.

        The anti-vaccine lobby provides comfort to parents of autistic children desperately needing answers that can give them a glimmer of hope, relieve them of guilt and give them someone, or something to blame. Gladwell calls those individuals responsible for “epidemic transmission” the “The Law of the Few.” The thing about these people is that there is a “stickiness” quality to what they say. Usually, the ideas are simple and “memorable and move us to action.” McCarthy says my son has autism because of the MMR vaccine, so people stop vaccinating their children. People do not want numbers, they want comforting. Jenny McCarthy’s celebrity status allows her to reach out to parents in a way that the medical community devoid of personal interest cannot. It is doubtful that the audience she attracts understands statistical concepts like the difference between causation versus correlation. If they did, they would know that correlation does not signify or prove causation. Correlations show possible relationships. Unlike Jenny McCarthy, science does not have a pretty face. Like her role in Playboy, Jenny McCarthy is also the centerfold for the anti-vaccine movement People will listen to celebrities with their anecdotal “evidence” because it’s easier to have a definitive answer to blame than to examine and understand why we have autism. For the anti-vaccine lobby and their followers, it has become a belief system and McCarthy is their God. It’s impossible to reason with the unreasonable. All we can do is point out the fallacies in their beliefs and prevent others from subscribing to the same falsehoods that continue to put the lives of children at risk.

Sources:

Deer, Brian. The Lancet Scandal: Brian Deer, Web. 14 Apr. 2010.

Gladwell, Malcolm. The Tipping Point. Boston, Little, Brown and Company, 2000. Print.

Melloni, L. Melloni, Ida G. Dox, B. John Melloni, Gilbert M. Eisner. “Infantile autism” Melloni’s Pocket Medical Dictionary: illustrated. 2003. Print.

McCarthy, Jenny. Generation Rescue. 2010. Web. 14 Apr. 2010.

National Health Service. Immunization Information. Immunization: The Safest Way to Protect Your Child. NHS, 2008. Web. Apr 2010.

Tortora, Gerard J., Berdell R. Funke, and Christine L. Case. Microbiology: an introduction. San Francisco: Pearson Benjamin-Cummings, 2007. Print.
United States. Dept. of Health and Human Services. Center for Disease Control and Prevention. Measles, Mumps& Rubella (MMR) Vaccines – What You Need To Know. 2008. Print.

United States. Department of Health and Human Services. Center for Disease Control and Prevention. 50 Years of Vaccine Progress. CDC, Oct 2006. Web. Apr 2010.

United States. Department of Health and Human Services. Center for Disease Control and Prevention. Vaccines and Immunizations: Some Common Misconceptions. CDC, May 2007. Web. Apr 2010.

Wakefield, Andrew Dr. et. al. “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children,” Lancet Journal. 1998. Web. 14 Apr. 2010. (Via Brian Deer website)

January, 2003 Morbidity and Mortality Report

The New Age of Comfort

Breakthroughs in science and technology make the world a better place for a large part of humanity. We are within an information and scientific age that provides us with information and sophisticated technology that only an elite educated few had access to twenty years ago. Better quality of life and life expectancy are a result of improvements in medicine, sanitation, air quality, public health and safety. Sixty years of medical history has witnessed the eradication of smallpox. The discovery of DNA allows us to map genomes that help us diagnose and treat disease. The relatively new sciences of molecular and cell biology led to the creation of the biotech industry that continues to develop drugs and vaccinations that fight and control disease. The reduction in infant mortality and morbidity rates are due in part to the development of vaccines that protect children from childhood diseases that once maimed and, or killed. Despite an endless list of scientific progress, there is another endless list of pseudoscience, junk science and superstitions that extend beyond the boundaries of mainstream religion and in turn discredit science leading to harmful ramifications.

The likes of TV shows such as The Oprah Winfrey Show have served as platforms to help, albeit perhaps unwittingly, to propagate quack remedies and other types of misinformation. According to a recent article in Newsweek, in 2007, Playboy model and actress Jenny McCarthy appeared on Oprah Winfrey’s show to tell of her experience with autism. Jenny went on to explain how she was convinced that the MMR (Measles Mumps and Rubella) vaccine caused her son’s autism. This is one example in a long line of unfounded claims regarding the link between the MMR vaccine and autism. Pediatrician Paul A. Offit, author of Autism’s False Prophets that featured in a January article, in the New York Times discusses the scientific evidence in favor of the vaccines. The vaccine provides protection against these diseases to millions of children. However, Measles is now endemic within the population and it is increasing. The June issue of Skeptic magazine features an article by Harriet Hall, MD who discusses the history of how the “manufactroversy”, evolved. Despite the overwhelming scientific evidence that shows no link between autism and the MMR vaccine, the “manufactroversy” continues highlighting a general distrust in medical science. As a result, measles is now endemic and we’re losing the herd immunity we once achieved through mass vaccination.

More recently, the UK Guardian reported that British Scientists called upon the World Health Organization to condemn homeopathic remedies for treating serious diseases such as HIV, malaria and influenza in poor developing countries. Homeopathic remedies have served as cheaper ineffective substitutes for effective medicines. The promotion of homeopathic alternatives to conventional medicine compromises the health of others, undermines science-based medicines and propagates misinformation and ultimately results in more untimely deaths.

Despite huge advances in scientific progress, why are the vast majority of people in the richest nations of the world walking around with their minds in the 12th or 13th century? People reject the boundaries of religious doctrine in exchange for not reason and science, but a different kind of faith such as psychic powers, astrology, faith healing, alternative medicine and other new age nonsense. Michael Shermer, the founding publisher of Skeptic magazine and author illustrates the extent of these beliefs and attempts to answer in his book, “Why People Believe Weird Things.” Shermer cites a 1990 Gallup poll that shows a staggering two-thirds of the 1,236 adults surveyed believe that they have, “Actually had a psychic experience.” 42% believe in “communication with the dead.” A similar 2001 Gallop poll shows significant increases in belief in every category of the paranormal over a decade. So, shroud some scientific terms in mysticism and you have a perfect recipe for nonsense that fits most people’s psyche like a glove. Quack medicine uses the language of science lending it more credence to the claims that its proponents make.

Shermer speculates that belief in weird things stems from a need for instant gratification. For example, seeing a psychic offers instant comfort in the face of grief or other life stressors such as faulty relationships or jobs. People seeking psychic guidance hear things that make them feel good and they return for more reassurance. The reassurance is the reinforcement which prompts them to return for more readings. It’s a similar effect of playing slot machines. Slot machines are designed to reward enough times to keep people playing. This psychological process is a form of learning called operant conditioning. The behavioral psychologist BF Skinner’s Skinner box experiments with rats demonstrated the behavior of reward and punishment with positive and negative reinforcement. Reinforcement is the reward that keeps people coming back for more of what provides them with comfort. It is why people continue to seek quack medicine, psychics and astrologers. Skinner demonstrated that “organisms tend to repeat those responses that are followed by favorable consequences.” All this may be an over simplified answer to a complex question. What does seem clear is how simple explanations to complex problems are more comforting to people because they’re easier to understand and offer definitive answers. Science offers no definitive answers. The complexity of the science behind natural phenomena requires more effort to understand and requires people to think.

The vast majority of peoples’ beliefs stem from their place of birth and the religious doctrines of their parents. Unfortunately, it appears that loss of mainstream religious faith is not synonymous with more reasoned thinking but replaced with a new age of comfort found within pseudoscience, astrology, psychics and probably the most dangerous of all, quack medicine.

What is more troubling with the new age of comfort is the concept that all ideas are equal and that science is just another alternative. Science is not an alternative and alternative medicine is not science. Science is based on empirical evidence and is apt to change based on new evidence. Pseudoscientific “evidence” is generally testimonial evidence and does not change. Testimonies do not constitute evidence because they are not the result of the scientific method of experimentation.

It is hard to imagine a solution to combat the proliferation of medieval remedies and other superstitious nonsense when the power base lies in a whole industry geared to play on people’s desires and needs. It is self-evident to see what sells. Go to any bookstore and look at the books that sell, self-help, astrology, special diets, peoples’ testimonies to their battle with [insert name of disease here]. The list is endless and unfortunately so is the road leading to reason, healthy skepticism and science. We should not be content with a new age that promotes comfort without reason.

Book Is Rallying Resistance to the Antivaccine Crusade

Once again we witness a disturbing account of people’s distrust of science. Although childhood immunizations have revolutionized public health by decreasing rates of childhood diseases like measles, there is a backlash among opponents who claim that the MMR vaccine causes autism. The New York Times article, Book Is Rallying Resistance to the Anti-vaccine Crusade, describes how Paul A. Offit, author of Autism’s False Prophets receives death threats and Dr. Gregory A. Poland, chief of vaccine research at the Mayo Clinic, receives threats against his children. Dr Paul A. Offit’s book discusses the scientific evidence in favor of vaccines.

According to a National Institute of Child Health and Human Development report, Why do people think that vaccines can cause autism?, the fear concerning the connection between autism and the MMR vaccine stems from a study that did not use scientific testing to show evidence of a link.

The proliferation of the anti-vaccine movement should not surprise us since people prefer to listen to celebrities who appear on Oprah and other talk shows rather than Pediatricians such as Paul A. Offit or Chief of Vaccine research, Gregory A. Poland.