This year has not been good to those who oppose vaccination: first one of the most commonly cited (and one of the only existing) papers claiming to find evidence that vaccination causes autism was revealed to be a complete fraud by The Times1, and then the federal “vaccine court” ruled that parents who brought a lawsuit “failed to demonstrate that … vaccines can contribute to … causing either autism or gastrointestinal dysfunction.”2 I hope their year gets a lot worse.
Members of the anti-vaccination club have been bleating for some time that immunizations are unnecessary, a scam by drug companies, or the cause of autism. On all three accounts they could not be more wrong. First, vaccination is absolutely essential to public health. Measles, one of the vaccinations that activists rail against, is not a slightly worse case of chicken pox, as many people who have never encountered a case seem to think. It causes pneumonia in 10 percent of children and 50 percent of adults infected, and death in three out of every 1000 cases (30 percent in immunocompromised patients). It can also cause encephalitis and brain damage3. Now the virus is back with a vengeance in the UK, where vaccination rates have fallen below the 85 percent rate needed to create herd immunity4.
Anti-vaccinationists have claimed that mandatory vaccination schemes are a scam by pharmaceutical companies. This makes no sense. Pharmaceutical companies make almost no money off of vaccines, even with mandatory vaccination5. Also, no one has managed to find a single case where industry has influenced the results of a study on vaccines. Whatever their other faults, conspiracy theorists make excellent watchdogs – assuming you don’t mind being woken up at 2:00 a.m. to investigate shadows, reflections and squirrels.
Finally, activists claim that vaccines cause autism. They are either deluded or disingenuous. First of all, there has yet to be a large-scale controlled study of any kind linking vaccination to autism6, and many studies have found the exact opposite7-10. Some activists have pointed to observations by parents and educators that either autism has increased over the years (which is more likely a result of increased awareness and screening). One activist, Rebecca Estepp, asked “When does anecdotal evidence become enough?” The answer is never. At the risk of being trite, the plural of “anecdote” is not “data.” We do not credit people on television claiming that a diet program works when scientific studies show that it doesn’t; why should we credit anecdotes claiming that vaccines cause autism when studies show the exact opposite?
I would propose two reforms: first, mandatory vaccination schedules should be expanded to include all children (even those not attending public school) and the philosophical and religious exemptions should be removed. We do not allow parents to endanger their children by refusing basic medical care such as insulin or antibiotics11, and there is no reason to allow parents to deny their children vaccines.
Second, parents that refuse to comply need to be charged with endangerment and doctors that encourage them need to lose their licenses. Imagine parents that put their children in a chamber that has a one in 10,00012 (or even lower) chance of filling with cyanide gas, despite the fact that every piece of evidence says that it’s dangerous and no evidence showing benefit. They would (rightly) be hauled to prison. Parents refusing to vaccinate their children are no different, except that they’re endangering more than just their kids. The doctors bear just as much responsibility: they are supposed to be protecting their patients, not promulgating hippy-dippy pseudoscientific nonsense that has been shown to be incorrect.
Think of the children.
1) Deer B. MMR doctor Andrew Wakefield fixed data on autism. The Times 2009 February 8.
2) Johnston A. U.S. Court Rejects Vaccine Connection to Autism. The Wall Street Journal 2009 February 13.
3) Perry RT, Halsey NA. The Clinical Significance of Measles: A Review. The Journal of Infectious Diseases 2004 189(9):S4-S16.
4) MMR immunisation rate falls again. BBC NEWS 2004 September 23.
5) Goodman JL. Statement before the Committee on Energy and Commerce of the United States House of Representatives. 2005.
6) You can’t prove a negative. Thus no citation.
7) Gillberg C, Heijbel H. MMR and Autism. Autism 1998 2(4):423-424.
8) Madsen KM, Hviid A, Vestergaard M, Schendel D, Jan Wohlfahrt, Thorsen P, Olsen J, Mads Melbye MD. A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism. New England Journal of Medicine 2002 347(19):1477-1482.
9) Jefferson T, Price D, Demicheli V, Bianco E. Unintended events following immunization with MMR: a systematic review. Vaccine 2003 21(25-26):3954-3960.
10) Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D. Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations. Pediatrics 2006 118(1):139-150.
11) Hammar RR. 1991 March 15. The Right to Refuse Medical Treatment. In Church Law and Tax Report. <http://www.churchlawtoday.com/private/library/pcl/p18f.htm>. Accessed 2009 March 15.
12) Which is (according to my very rough calculations) less than the chance of an unvaccinated kid in Britain getting measles.