Vaccination

Vaccination doesn’t cure fear

In Opinion by Morgan Bye1 Comment

Trust is not simply a matter of truthfulness, or even constancy. It is also a matter of amity and goodwill. We trust those who have our best interests at heart, and mistrust those who seem deaf to our concerns.Gary Hamel

The year is 1998, a respected British surgeon, Dr. Andrew Wakefield, publishes a paper in the prestigious medical journal, The Lancet. In this paper, Dr. Wakefield and coauthors make a claim that they have seen a link between children receiving the measles, mumps and rubella (MMR) vaccine and their development of autism and bowel disease.[1]The Lancet (1998) – article

To quote paper’s introduction

We saw several children who, after a period of apparent normality, lost acquired skills, including communication. They all had gastrointestinal symptoms, including abdominal pain, diarrhoea, and bloating and, in some cases, food intolerance.

These initial observations could spell some serious consequences for the millions of children that have been receiving the MMR vaccine since 1971.

Like all other scientific manuscripts, this paper had undergone the peer-review process. This is where unbiased experts in the same, or similar, field read through the manuscript to ensure reasonable procedures, sound findings and voice any concerns before the paper is published and released to the world.

For one of a number of reasons this manuscript passed the peer-review process with little concern. It is important to remember, that peer-review is NOT always conducted anonymously – so the authors’ reputation holds sway. The review process, whilst important, is done in addition to a clinician’s normal work. It is more than likely, that the reviewers of this manuscript were overworked clinicians, who had greater concern for their own patients than with the intricacies of a manuscript.

The manuscript however, had some flaws that should have been highlighted

  • There was no control group – no set of people did not receive the vaccination or a placebo for comparison to those that did receive the vaccine
  • There were no statistics performed
  • The study comprised of only 12 boys
  • Results relied heavily upon the memories of small children and their parents – not doctor’s notes
  • The conclusions were vaguely drawn on statistics that did not make sense

The problem of course with publishing something as controversial as saying that a vaccine causes autism – especially one that has been administered to almost all children in the developed world for the last 25 years – is that it draws a lot of attention and follow-up studies.

In 1999, approximately 50,000 children in Britain were receiving the MMR vaccine EVERY MONTH. [2]Clinical Infectious Diseases (2009) – article

At this point, it needs to be pointed out that children only start to show signs of autism between the ages of 1 and 2 – the same age that MMR is administered. Also, in 1998 the chance of autism in the UK population was 1 in 2000.[3]The Lancet (1998) – article By pure chance alone,  25 children a month in the UK would be given autism diagnoses.

1999 also saw the publication of the first follow-up study featuring 498 autistic children.[4]The Lancet (1999) article From the report

Our analyses do not support a causal association between MMR vaccine and autism. If such an association occurs, it is so rare that it could not be identified in this large regional sample.

Yet still, there were concerns. Concerned parents do not want to take any chances with the health of their children – even if it is a very rare chance. So, further studies were conducted.

In 2000, a second follow-up study in the UK was conducted. This time looking at 10,000 children.[5]The British Medical Journal (2000) – article They found that…

…the data provide[s] evidence that no correlation exists between the prevalence of MMR vaccination and the rapid increase in the risk of autism over time

The science then, at this point is starting to look rather conclusive. I study with 12 boys in a single hospital said that they might have seen something. 2 national studies and 10,500 children have found absolutely nothing.

Despite everything, in the media thanks to some high-profile celebrity publicity grabs and scare tactics, the public remain wary.

2002 saw the release of the biggest study so far. Over the course of 7 years, clinicians in Denmark reported on 537,303 children (representing over 2 million years of human life), 82 % had received the MMR vaccine (representing over 440,000 children). Their conclusion…[6]New England Medical Journal (2002) – article

This study provides strong evidence against the hypothesis that MMR vaccination causes autism.

That same year, a similar 6-year study in Finland of 535,544 immunised children found[7]Pediatrics (2002) – article

We did not identify any association between MMR vaccination and encephalitis, aseptic meningitis, or autism.

In 2004, the Lancet very quietly in an editorial made a partial retraction of the original paper[8]The Lancet (2004) – article as 10 of the original 12 authors made a statement withdrawing the paper (1 could not be contacted).[9]The Lancet (2004) – article

A review of 31 independent studies in 2005, the combination of data from 10 million children around the globe that had received the MMR vaccine, found[10]Cochrane Database of Systematic Reviews (2005) – article

No credible evidence of an involvement of MMR with either autism or Crohn’s disease

Fast forward to 2012, a review of 58 studies, totalling some 14.7 million children. Besides finding that the vaccine was up to 98 % effective at preventing measles, mumps and rubella they found that[11]Cochrane Database of Systematic Reviews (2005) – article

We could assess no significant association between MMR immunisation and the following conditions: autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn’s disease, demyelinating diseases, or bacterial or viral infections.

Why?

There have been exactly zero credible studies linking vaccines to autism. Yet 1 in 4 parents in the US think that vaccines cause autism in healthy children.

Measles was officially eradicated in the UK in 2000. In 2012, thanks to an antivaccination movement, a disease that did not exist anymore infected 2,000 children.

France was also declared measles free in 2000, but a massive outbreak in 2011 confirmed 15,000 new cases.

The antivaccination movement does not concern itself with any particular vaccine. This can clearly be seen in the US where the Center for Disease Control (CDC) keeps detailed records for many diseases. Whooping Cough (pertussis) is a highly infectious lung infection, that is easily prevented by vaccination.

Whooping Cough had over 150,000 recorded infections in the US in the 1960s. After vaccination became widespread at the end of the 1960s, there were approximately 5,000 cases in the 1970s and 2,900 in the 1980s.

Whooping Cough Incidence Rates

There was a sudden surge in new cases in 2004 as fear of vaccines spread.

26,000 new cases in one year, of a disease that had been all-but eradicated.

In 2012, as fear rose again around vaccination, 50,000 new cases of Whooping Cough were diagnosed – killing 20 children.

The common myths

Vaccines are made with toxic chemicals

Bad news I’m afraid. Technically speaking, everything around you is a chemical – any piece of plastic, metal, food, everything. Steel, to stop it rusting is mixed with chromium (a wildly cancerous chemical) – but when mixed with everything else it is safe. Uranium – the heart of nuclear bombs and power stations can be handled pretty safely…

The simple truth is, many things in this world are dangerous. The real question is how you handle them and how you compose them into other things.

Yes, a guy on the street injecting liquid mercury into passing children, would rightly be locked away. However, a scientist with 20 years training, working with over a 100 years of combined human endeavour and knowledge on bacteria and vaccines is something quite different.

Finally, the thiomersal that is often cited by the antivaccination movement as containing mercury, does actually contain a mercury atom. However,

  1. the mercury is only one atom in a big, complex compound.
  2. thiomersal is a well known anti-fungal agent, it works very effective as a preservative – it is commonly used in tattoo ink to stop infections.
  3. thiomersal has been removed from every vaccine except winter flu shots.

Not vaccinating my child only affects my child

False. Many vaccinations work using a herd immunity philosophy.

If 99 % of a population is immune to a disease, then the chances of it spreading are very low, as the chances of meeting someone you can infect while you are infectious is low. This is a very good thing because there will always be people with weak immune systems (ie cancer patients) or people with an allergy to the vaccine.

When everybody is vaccinated, it does not matter that the occasional person cannot be vaccinated because the population does not transmit the infection. However, if the immunity of the “herd” reduces, then the chances of those that cannot take the vaccine actually catching the disease are sky-high.

Finally, put yourself in the position of a doctor. If you watched a child in your care die from Whooping Cough because the parents decided, with no scientific justification, that a vaccine, costing much less than a cup of coffee, was not for their child… How would you feel?

Too many vaccines can be too much for a child

False. The day your child was born it went from an environment of relative safety to literally a whole world of disease. Every day for a baby, is a day surrounded by millions of new bacteria and viruses.

A vaccine is just a virus that has been handicapped or already killed.

But the evil drug companies are just doing it for profit

The MMR vaccine is supplied by Merck to the US’s CDC for less than $5 a dose. You can literally look it up on the CDC website, it is not a secret, look here is a link.[12]CDC (2015) – link

The World Health Organisation estimates that the global vaccine market is now worth $24 billion.[13]Kalorama (2014) – article

That sounds like a huge amount of money until you realise that the global pharmaceutical industry is worth trillions. That $24bn is worth less than 3 % to the pharmaceutical industry. One of the largest pharmaceutical companies, Pfizer, has even stopped manufacturing flu vaccines because the margins were so low, that they simply are not interested in the market.[14]The Atlantic (2015) – link

The truth

The reality of the situation is that vaccination works.

Vaccination wiped smallpox off the face of Earth. Vaccines are predicted to be saving over 8 million lives every year.  New vaccines are predicted to saving another 4 million children by the end of 2015.

Vaccines help with so many things, big and small. They help the elderly survive the winter without severe flu. They are helping dramatically drop the rates of cervical cancer in women from the human papillomavirus (HPV). If you want to go to any of the areas of this map marked in green, then the World Health Organisation strongly recommends a Hepatitis B shot[15]World Health Organisation (2012) – link

Hepatitis B global prevalence

Why are we even here? Well, as it turns out the former doctor (having since had his medical license withdrawn), Andrew Wakefield had a small conflict of interest. Dr. Wakefield as it turned out had a patent filed for a single measles injection (not a combined MMR vaccination). If the combined MMR vaccination was suddenly withdrawn from the market, then countries would have to go back to multiple, single injections and he was set to significantly gain financially.

So here we are. One disgraced and discharged doctor tried to make himself very rich, using fear. 17 years later, the general public still does not trust science because nobody has taken the time to explain the situation. Instead, the conversation has been dictated by ignorant television celebrities. Meanwhile, the New York Times reports children going to Disneyland are coming home with measles.[16]The New York Times (2015) – link A disease that should be nothing more than a footnote in a history book. An ancient disease that we beat. Just like smallpox.

Trust dies but mistrust blossomsSophocles
About the Author

Morgan Bye

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Morgan Bye is a British science writer, out of Vancouver, Canada, dedicated to helping scientists better communicate their science. He has a Masters in Biochemistry, a PhD in Biophysical Chemistry and even spent time as a scientist at an Israeli research institute.

References   [ + ]

1. The Lancet (1998) – article
2. Clinical Infectious Diseases (2009) – article
3. The Lancet (1998) – article
4. The Lancet (1999) article
5. The British Medical Journal (2000) – article
6. New England Medical Journal (2002) – article
7. Pediatrics (2002) – article
8. The Lancet (2004) – article
9. The Lancet (2004) – article
10. Cochrane Database of Systematic Reviews (2005) – article
11. Cochrane Database of Systematic Reviews (2005) – article
12. CDC (2015) – link
13. Kalorama (2014) – article
14. The Atlantic (2015) – link
15. World Health Organisation (2012) – link
16. The New York Times (2015) – link