Remind me why people are against vaccines again?

Posted: 07 15, 2015

By Ashley R. Scheaffer

A Guest Writer from the Wayne State University Department of Criminal Justice

Illustration by Meg Ryan

 


antivax_smallIn 2007, Jenny McCarthy stood on her celebrity platform and told everyone that certain components in vaccines contribute to the development of autism1. She has since become one of the most prolific opponents of required childhood vaccination schedules, though she is far from alone. While her heart is in the right place, as she is concerned for her son who has autism, her argument stems from a single, fraudulent study in England that created the current anti-vaccine movement. Andrew Wakefield and his colleagues claimed to have found that the Mumps, Measles, and Rubella vaccine (MMR) caused not only autism, but also inflammatory bowel disease2. The publisher retracted the article and this study has since been debunked, yet the movement continues. Many wonder how and why this misinformation has been perpetuated, and I think the answer is simple. First, the seed was planted; the information is out there and people want to believe there is an easy, scientifically-backed method to prevent autism by simply not vaccinating their children. Secondly, people don’t want to admit they have been mislead. How does one explain that they didn’t vaccinate their child in light of several vaccine-preventable disease outbreaks that have recently occurred, all because of one debunked science article and the misguided words of a few outspoken celebrities? That has to be a bit embarrassing.

The history of the MMR vaccine begins in 1963 when the measles vaccine was developed. Measles had been responsible for the deaths of hundreds of thousands of people, but with the development of this vaccine, it’s all but been eradicated in many countries, including the US. In 1971, vaccines against mumps and rubella were combined with the measles vaccine to become the MMR vaccine as we know it today. This vaccine, in addition to many others, such as the DPT (diphtheria, pertussis, tetanus), polio, BCG (tuberculosis), varicella (chicken pox), Hepatitis B, and HPV vaccines have revolutionized modern medicine and prevented countless episodes of undue human suffering and death. We have trusted scientists, pharmaceutical companies, and the FDA to be rigorous in the development of these vaccines, with efficacy and human safety as the top priorities. We also trust scientists to admit when they are wrong and revise theories and scientific principles, especially when the quality of human lives are on the line. At first glance, it would seem the Wakefield study was fulfilling this scientific responsibility. Perhaps the foreign entities contained within vaccines were truly contributing to the development of autism. Why, then, has there been such strong scientific backlash against the findings in this manuscript?

There were several aspects that contributed to the fraudulence of The Wakefield et al. study3:

  1. Children participants were used without obtaining parental consent, which is completely unethical.
  2. He falsified data, failing to report that one child out of the 12 participating children (a shamefully small sample size for this type of study) had autistic symptoms that began before they even received the MMR vaccine. Instead, the study reported that the vaccine was given first and the symptoms started within a week.
  3. The study claimed that symptoms began within a week or two after the vaccine was given (the average time being 6.3 days), but several parents of children in the study reported much longer periods of time between vaccine and first symptoms – up to 6+ months for some.
  4. Wakefield made the claim that autism is caused by vaccines prior to beginning his research. While the formation of hypotheses are necessary in research, a formal statement of fact before a single experiment has been conducted indicates that a potentially serious bias towards a particular outcome is included in the study.
  5. Other researchers have been unable to recapitulate any of Wakefield’s findings linking the MMR vaccine to autism4-7.
  6.  Wakefield was financially invested in his research claims, which is a conflict of interest. He was also attempting to file a patent on a “safer” measles vaccine that would likely only succeed commercially if the MMR vaccine was deemed unsafe.

It was very surprising that the results claimed 8 of the 12 participants presented with symptoms of autism shortly after being vaccinated. We now know this was not the truth; however, if we pretend that this finding was accurate, that’s a 67% chance of developing symptoms of autism following vaccination! Even though the sample size was small and room for error was potentially large, if this statistic was a reflection of the general population, it seems that there should be a lot more people with autism today. Indeed, the number of patients with autism has certainly risen over the past few decades, but there is a plausible explanation for this increase, in my opinion. Until the 1960s, autism was considered a part of schizophrenia8. Only in more recent times has autism been categorized as having a distinct spectrum from schizophrenia and other disorders, and awareness of autism has steadily increased. This heightened awareness, in addition to scientists still not fully understanding what genetic or environmental factors truly lead to autism, is responsible for the increased frequency of doctors and parents recognizing symptoms and accurately diagnosing children with autism.  Correlation does not imply causation – period. For example, in the summer when the weather is hot, ice cream sales skyrocket compared to the winter months. Additionally, shark attacks rise in the summer months. This coincidence does not prove that eating ice cream prompts sharks to bite people at the beach. On a more serious note, organic food sales and the number of children diagnosed with autism have increased together over the past decade and half. Few reasonable people would be convinced that eating fresh, pesticide-free tomatoes would suddenly begin to cause autism, and would chalk these statistics up to a coincidence. If only this concept were that easy to explain to an anti-vaxxer. The facts are out there, but one has to seek out the information and then also accept it as the truth.

Here’s a not-so-fun fact:  whooping cough, measles, and mumps have had significant comebacks because of the anti-vaccine movement. To put this in real numbers, in the first 28 days of 2015, there were more measles cases than there were during the entire following years: 2002, 2003, 2004, 2007, and 20129. Another fact: according to the FDA, thimerosal, a preservative in vaccines that contains mercury and is the component most often accused of contributing to vaccine-related health issues, was completely eliminated from childhood vaccines in 2001. The only vaccines that still contain miniscule amounts of thimerosal as a preservative are flu vaccines, which are not required childhood vaccines10. Additionally, no reputable scientific studies have found any link between the mercury containing compounds in vaccines and autism. Finally, the MMR vaccine reduced measles deaths around the world by 75% between 2000 and 2013, as stated on the World Health Organizations website.
The anti-vaccination movement is a great example of the influence that bad science performed without proper rigor and without a statistically significant sample size can have, especially in the hands of those who do not have a full understanding of the scientific principles being misrepresented. It is important to consider how to move forward after such a scientific catastrophe. In order to overcome (or prevent) similar situations in the future, it is crucial for scientists to communicate better with the public about true science. It baffles me that one study — that was later retracted– could convince thousands of people to become suspicious of vaccines while they were able to discount any study that contradicted those results. Despite multiple studies conducted in an attempt to confirm the results claimed in the Wakefield paper, there remains no scientifically sound evidence that vaccines, or any component contained in vaccines, increases the risk of or causes autism. It’s time that we all use our logical faculties and realize that we need to look to multiple sources, such as the FDA, CDC, NIH, and validated, peer-reviewed scientific literature before we make a decision that profoundly affects the health of so many. After all, it was the peer-review process and the ability of science to reform theories based on careful and extensive experimentation that led to the Wakefield study being debunked. To put the life of a child, elderly person, or an immunocompromised person at risk because you’ve been duped by one faulty study is selfish and irresponsible. I hope that one day Jenny McCarthy, and others who are like-minded, will come to terms with the data and realize that having her son vaccinated did not lead to him exhibiting symptoms of someone on the autism spectrum. This type of situation speaks volumes about how the general public requires better avenues of communication with scientists to foster trust and more effectively quash junk science studies.


References:

1. “CNN Larry King Live: Interview with Jenny McCarthy Transcript.” cnn.com. September 26, 2007.

2. Wakefield, A.J., Murch, S.H., Anthony, A., Linnell, J. Casson, D.M., Malik, M., Berelowitz, M. Dhillon, A.P., Thomson, M.A., Harvey, P., Valentine, A., Davies, S.E.,  & Walker-Smith, J.A. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, 28, 637-641.

3. Godlee, F. , Smith, J., & Harvey, M. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent. Student. BMJ, 19, 342.

4. Destefano, F., Price, C.S., & Weintraub, E.S. (2013). “Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism” Journal of Pediatrics, 163(2): 561-7.

5. Peltoia, H., Patja, A., Leinikki, P., Valle, M., Davidkin, I., & Paunio, M.  (1998). “No Evidence for Measles, Mumps, and Rubella Vaccine Associated with Inflammatory Bowel Disease or Autism in a 14-Year Prospective Study. The Lancet, 351.

6. Smith, M. & Woods, C. (2010). “On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes” Pediatrics, 125(6): 1134-41.

7. Farrington, C.P. , Miller, E. & Taylor, B. (2001). MMR and Autism: Further Evidence Against a Causal Association. Vaccine, 19(27): 3632-5.

8. Dvir, Y. & Frazier, J.A. (2011). Autism and schizophrenia. Psychiatric Times. Retrieved from: http://www.psychiatrictimes.com/autism/autism-and-schizophrenia.

9. Centers for Disease Control and Prevention. (2014). MMWR weekly: Summary of notifiable diseases. Retrieved from http://www.cdc.gov/

10. http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#act


Peer edited and reviewed by Nicole M. Baker and Chelsea Boyd

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This article was co-published on the SWAC Blog, The Pipettepen.

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