Herd Immunity: Anti-Vaxxers Are Killing It

In April 2014 I wrote about vaccines because there was a measles outbreak in New York City. An outbreak that should never have happened because there is a safe MMR (Measles/Mumps/Rubella) vaccine. With the dawning of outbreaks in Disneyland, and now possibly Arizona, it’s time to revisit the proof again.

And I am talking PROOF. Not what you read in a Facebook feed. Not what you overheard in your child’s playgroup. Not some anti-vaccination propaganda vomit dressed up as a scientific paper. Have you ever followed the supposed references listed at the end of those articles? I have. They lead to more bias drivel—if not outright lies—not scientific research.

I am very picky about nuances like that because I went through the rigors of earning a Microbiology B.S. and an M.D. from the University of Maryland. I’m not practicing medicine at this time, but I know vaccines are safe because I understand research. I have performed research myself and have extensive training in how to evaluate it.

I am not swayed by the hype that drives ratings sweeps and cranks up website pageviews. I have been on the inside of the medical profession and here’s a news flash: most doctors really do want to help humanity. Heck, most of us are too exhausted to concoct Evil Plans to Ruin the World. Why do you think the media always latches onto that one doctor who supports the anti-vaccine movement? Because generally, they can only find one or two out of about one million United States physicians. It’s easier to find a psychopath since they make up 1% of the population.

Also, while Big Pharma is a favorite punching bag, the fact is they manufacture the drugs and devices that save our lives. Also? While they do make profits off of vaccine production (as they should), they would make more money from treating the diseases the vaccines prevent. There is no Soylent Green conspiracy. It’s just medicine and business. It’s American altruism and capitalism. They are not mutually exclusive.

But speaking of America, we have rights and freedoms! You can make your own choices about vaccines! True . . . but not completely. I understand that as an individual, it may seem like no big deal for YOU to skip immunizations for your kids or to alter the administration schedule. Unfortunately, in this case, we are all in this together. You are part of a community or in immunological terms, a “herd.”

Herd Immunity: Anti-Vaxxers Are Killing It. Vaccinating is not just about you, it's about safety for all. Read the factual discussion. Sisterhood of the Sensible Moms

It all comes down to herd immunity: the collective level of inoculation that protects even the unvaccinated. When many people are immunized, it doesn’t leave a place for the diseases to “breed and live.” When the community at large is protected, it means people who are not eligible to be vaccinated—such as infants, pregnant women, and immunocompromised people—get some measure of protection from the disease because the collective community immunity doesn’t give it room to spread. This also means that even if a vaccine is not 100% effective (and none of them are because biology doesn’t work that way), people are unlikely to get sick because the disease is just not around.

So if YOU decide not to vaccinate your kids in an area with high immunization rates, your children will probably be fine. They’re getting the benefits from your community’s responsible actions.

The problem comes when you “herd” yourself with others who aren’t vaccinated. You create a lovely pool for the disease to infect and spread as can be seen in Disneyland with its visitors from all over the world. That park is a great example of our global society and shows measles can still gain a foothold when fear mongering prevents vaccination in the U.S. because other countries can’t afford the vaccine or don’t have the same vaccination rates. For example, the World Health Organization reports 57,564 suspected cases of measles, including 21,403 confirmed cases and 110 measles deaths, in the Philippines from January 1 through December 20, 2014. Additionally, during 2014, 25 US travelers who returned from the Philippines have become sick with measles.

And guess what? You’ve not only put your children at risk, but you’ve also put those at risk who can’t be vaccinated, like people fighting cancer with chemotherapy.

Oh, and one more thing, YOU may be at risk too. Up to five percent of children vaccinated fail to develop immunity and sometimes immunity can wane, but this is usually overcome by giving a second dose of MMR before entering school. However, the second dose policy was not implemented until 1989. Did you get that second dose? You’d better find out because the herd is not what it used to be. We’re moving to a wild-west-every-man-for-himself mentality.

The decision not to vaccinate seems to sprout like a fungus from false beliefs such as:

  1. Vaccines cause autism.
  2. Childhood illnesses are no big deal unless they cause death.
  3. Lawsuits equal scientific proof.

 

1. False Premise: Vaccines cause autism.

A few things first. I understand that scientific papers are hard to slug through. And not all research is created equal. Studies that are observational, do just that, observe what has already happened. These rely heavily on patient reporting.

This is a weaker study than the gold standard, randomized controlled trials, in which the subjects are randomly distributed into groups which are either subjected to the experimental procedure or which do not receive it and serve as controls. In this kind of study, there is less bias and it is easier to weed out coincidences.

Also, published research is not a proclamation of fact. It is a sharing of what has been discovered to advance science. It doesn’t mean it is flawless. “Discoveries” do not come from a single paper. Multiple scientists must replicate and advance a finding before a real “Eureka!” moment is reached.

It’s easy to forget this when the press latches onto a concept like “MMR causes autism,” and pukes it from the rooftops to stir panic and fear because that keeps you coming back for more.

All of the MMR vaccine misinformation can be traced back to one paper. The link between this vaccine and autism was proposed by a British physician, Andrew Wakefield, in the February 1998 issue of The Lancet. This finding has never been replicated by any other researchers. More importantly, it was discovered to be manufactured from fraudulent data and has been RETRACTED.

There were only twelve children in the observational study–this means that even if the findings were true, they really only provided a starting point for other research, not for conclusions. However, that hardly matters since the entire causal effect was based on what the parents reported as the length of time from the administration of the vaccine to onset of autism spectrum symptoms AND THAT DATA WAS FALSIFIED. The timelines of the children’s symptoms were misrepresented.

Also damning was Wakefield’s conflict of interest. How could an article with such a small sample size and the title, Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children, cause such a fervor? Wakefield had an agenda to advance because he was a paid consultant to attorneys representing parents with anti-vaccine lawsuits. The General Medical Council in the U.K. revoked Wakefield’s medical license because of his fraudulent report and unethical behavior.

What is atrocious is that it took until 2010 for that paper to be retracted and for Wakefield to lose his license. For over a decade the fires of misinformation have been fanned and stirred into a bonfire so raging that five years after it should be extinguished, it is still smoldering. Why is this paper still used in arguments in 2015?!

But the controversy has expanded. The original autism scapegoat was the MMR vaccine, but the blame game has subtly shifted to focus on the ethylmercury vaccine perservative, thimerosal. This shift was spurred more by activist and political groups than science. Regardless, thimerosal has been removed from vaccines, mostly since 2001.

My heart breaks for the parents who are just looking for answers for their children on the autism spectrum, but I seethe over all of the money that has been diverted from worthwhile autism research to prove over and over again that vaccines are not linked to it. With the combined studies to date, millions of children have been studied and no link has been found.

 

2. False Premise: Childhood illnesses are no big deal.

In the United States, some parents mistakenly think that refusing vaccinations is a benign choice because they do not remember, or maybe they have never even seen the diseases. But these childhood diseases aren’t just spotty rashes or coughs. They can cause lasting disabilities, and at times death. At the very least, they cause weeks of suffering for the patients, and prolonged time off from work for caregivers. Because these are viral diseases, there is generally no specific treatment once they are contracted.

Here’s a heart stopper. For measles encephalitis (swelling of the brain) which occurs in 1 in 1,000 patients infected with measles, the treatment is still just supportive: rest, fluids, and nutrition. Ribavirin may help, or it may not. There’s not a whole lot of current research going on because measles was declared eliminated in the United States in 2000. So really the treatment is no better than it was when author Roald Dahl’s daughter, Olivia, died from it in 1962. The only difference is he did not have the choice to vaccinate his daughter because it was not available until 1963.

Oh and if your child contracts measles before they are 2-years-old, you get to be on the lookout for subacute sclerosing panencephalitis (SSPE), a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles. So that herd immunity is pretty important for infants before they can be vaccinated because the worry never ends.

Thank goodness those complications are rare, but don’t forget measles can cause diarrhea (dangerous for young children because of dehydration), pneumonia, ear infections, deafness, and blindness. An acute infection with measles while pregnant can lead to premature birth.

I can’t believe in the middle of my scientific citations, I’m linking to Buzzfeed, but if you want to see what measles really looks like, they have an excellent article.

actual measles

Measles remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. Approximately 122, 000 people died from measles in 2012 – mostly children under the age of five.

You can’t avoid measles very well because patients are infectious for 4 days before the rash appears, but my goodness we have the power to prevent it.

 

3. False Premise: Lawsuits equal scientific proof.

While court decisions can be be based on scientific proof, scientific proof cannot come out of court decisions.  Just because a jury awards money in a vaccination lawsuit does not prove that vaccines are bad. Many decisions are based on the skills of the lawyers and the height of the emotions.

When discussing adverse outcomes of immunizations, the Vaccine Adverse Event Reporting System (VAERS) is often bandied about. This is a tremendously useful surveillance tool co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) that allows doctors and the public to report any adverse events they think may have been associated with vaccine administration. It receives around 30,000 reports annually.

What it is:

  • A gathering  of unfiltered information. Anyone can submit. (About 7% are from vaccine recipients or their guardians, 36% are from health care providers, and 37% are from the vaccine manufacturers.)
  • A place to monitor adverse vaccine events.
  • A tool to trigger further investigation if correlations are shown.

What it is NOT:

  • It is NOT the final outcome from research triggered by trends.
  • It does NOT show causal relationships.

No conspiracy theories necessary. (Did you notice the biggest contributor of information was Big Pharma itself?) And it works as can be seen in the case of the RotaShield vaccine.

VAERS detected reports for cases of intussusception (a condition where part of the intestine slides or telescopes into an adjacent part of the intestine) over what would be expected to occur by chance alone after the RotaShield rotavirus vaccine came out in 1999. Epidemiological studies were triggered and confirmed an increased risk, which contributed to the product’s removal from the US market.

For RotaShield, a risk was apparent less than a year after release, it was investigated, and the vaccine was removed. The MMR vaccine was released in 1971 to replace single doses of each viral vaccine that had been around for a decade longer. You can feel confident about its safety. I do.

Baby in a Basket

My oldest child was born in 1998 and was due for her first MMR vaccination in 1999, right when the Wakefield autism hysteria was gaining momentum. My husband and I had her vaccinated. I had read Wakefield’s paper for myself and realized the flaws. Also, a well performed study by Brent Miller was already published. He studied 498 children and could not find a link between the MMR vaccine and autism.

Since that time, millions of children have been studied and no links have been found with autism. In fact, the vaccine has been shown to be exceptionally safe on all accounts. Those who claim otherwise are lying or deceived by unreliable statistics. You can read a very good article about this in layman’s terms here.

Please weigh the scientific evidence versus popularized fraud when making decisions for your kids. Your decision not only affects them, but the health of the whole community. Don’t let herd immunity die.

-Ellen

 

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