Anti-Vaccine Claims, Mainstream Media, and Children

I recently came across an op-ed in a local paper in California which was very full of anti-vaccine tropes, some of them extremely problematic. This is my response.

The starting point is that my belief in free speech does not mean that I believe that mainstream media should give a platform to every problematic claim there is. This editorial is an example of something mainstream media should not give a platform to. There are plenty of forums for anti-vaccine activists to spread their claims in; indeed, an article examining this found that a search for the term “vaccination” led to a majority of anti-vaccine sites.[1]

But giving them a platform in a local or national journal implies a legitimacy their claims simply do not have.   In the vaccination debate, one side has facts and the other side has misinformation. We do not provide a forum for the flat earth society, because their claims are not based in facts; neither are anti-vaccine claims, but unlike flat earth claims, the anti-vaccine misinformation can actually harm children. They deserve less of a role, not more. Let’s be clear: vaccine safety and effectiveness issues appropriately receives a platform: for example, mainstream media examined the limitations of the pertussis vaccine and vaccine problems that are actually supported by evidence. Anti-vaccine misinformation should not.

The op-ed in question was an excellent example of that type of misinformation. Let’s take the authors’ claims from the top:

A. “[T]he vast majority of those diagnosed with pertussis, or whooping cough, were either fully or partially vaccinated. Vaccinated children may be more likely to contract the disease according to several studies.” It’s true that in absolute numbers, more vaccinated individuals contracted pertussis. It’s hardly surprising, since the national immunization rate for young children for DTaP is 82.5%, according to the last data we have – in other words, more children are vaccinated. The author is, however, incorrect that vaccinated children may be more likely to catch the disease: in fact, study after study shows that the rates of pertussis are much higher in the unvaccinated – 9-23 times higher.

Let me explain the difference between absolute numbers and rates with an example. Imagine the following calculation: a school with 1000 children, 95% (950) vaccinated, 5% (50) unvaccinated. A whooping cough outbreak. 10% of the vaccinated get it: 95 children. 80% of the unvaccinated: 40 children. There are more vaccinated children who got pertussis, but your chances to get it are much higher if you’re in the unvaccinated group: you’re at larger risk. It’s much safer to be vaccinated.

B. The author claims: “As for measles, this once common, beneficial childhood disease conferred lifelong immunity, something the vaccine simply does not and cannot offer.” Describing a disease complications that include death, deafness, encephalitis and pneumonia as “benign” is beyond problematic. Yes, the people who survived measles unscathed mostly had lifelong immunity – at the price of the suffering of the disease and potential disability or death. Here is one rare but exceedingly nasty complication that happened to two children in Germany: SSPE, only caused by the wild measles virus, in which the virus resurfaces after years and destroys your brain. It’s fatal. No cure.   This is what the author calls benign.

I’m glad her grandmother survived. That is not a reason to dismiss the death and suffering of others. We can now prevent this death and suffering. The author opposes that.

The author’s claim that the vaccine cannot confer lifelong immunity against measles is also challenged. For example, at least one source explains that for measles “…both serologic and epidemiologic evidence indicate that the vaccine induces long-term — probably lifelong — immunity, in most persons.”

C. The author claims that vaccines cannot confer long term immunity. But as the quote above regarding MMR demonstrates, as a generalization, that is problematic. Just like not all diseases are the same, not all vaccines are. Some vaccines provide longterm immunity. Pertussis, for example, does not: but then, natural pertussis does not provide lifelong immunity, either. The tetanus vaccine confers years of immunity. Natural tetanus infection confers no immunity.   Even for a vaccine that does not confer life long immunity, well, so you’ll need a booster; an extra needle prick v. suffering and potential harm or death.

D. The science does not support the author’s claim that vaccines cause autoimmune disease. Here is one review.

E. The author refers, in the context of vaccines and autism, to “the now 86 peer reviewed, published studies that do support a link.” She is referring to the list compiled by anti-vaccine activist Ginger Taylor. That list is debunked: it does not support a link between vaccines and autism. Some of the studies have nothing to do with vaccines. Others are fatally flawed anti-vaccine bad science.

In contrast, credible studies that looked for a link found none. The anti-vaccine movement suggested several hypotheses for how vaccines cause autism; each was debunked in turn, and the movement changed its claims accordingly. See here.

F. “Those of us who have consciously chosen not to vaccinate our children have spent thousands of hours researching the vaccine issue in peer reviewed medical literature and have ascertained the truth for ourselves. Vaccination has nothing to do with promoting good health and everything to do with destroying it.”

If the author spent hours researching peer reviewed medical literature, her skills in reading it could probably use work. Her conclusions fly in the face of a scientific consensus.

G. “Parents unfamiliar with the subject need only read a product insert for any of the 49 doses of 14 vaccinations children now get by Kindergarten to realize that vaccination is tantamount to poisoning your child.”

Anti-vaccine activists like to try and scare people by pointing to vaccines ingredients as something to be feared. That gambit, however, ignores two important facts. The first is the famous fact that “the dose makes the poison” – each vaccine vial is 0.5 ml, a tenth of a teaspoon, and most of that is liquid, usually distilled water – and this is true for combined vaccines like MMR, too. In other words, we are talking about tiny amounts of these ingredients.

The second is that our world is not a sterile world: we are surrounded by the ingredients in vaccines, they are part of our natural environment. Take aluminum salts: aluminum is the third most common mineral on earth, in the air we breathe, the food we eat. Babies get it from breast milk or formula. Our body was designed to deal with tiny amounts of such ingredients – and the amounts in vaccines, as explained, are tiny. Here is a good source on vaccine ingredients, explaining why they’re there and how we know they’re safe: http://www.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/; in PDF: http://www.chop.edu/system/galleries/download/pdfs/articles/vaccine-education-center/vaccine-ingredients.pdf

H. In addition, when reading inserts, it might help parents to learn something about the legal framework under which inserts are written: legal language is not always everyday language, as I learned in law school. An accomplished professor said, for example, in a conference I attended, that it took her half a semester to realize that the term “consideration” does not mean being kind to others (in contracts, consideration means payment). Like most legal documents, understanding the terms and the requirements of this heavily regulated document is crucial.   Here is a source on reading inserts.

I. Contrary to the author’s claims, the data on vaccines’ safety and effectiveness is abundant. A 2013 Institute of Medicine Report examined the evidence in detail and concluded: “Upon reviewing stakeholder concerns and scientific literature regarding the entire childhood immunization schedule, the IOM committee finds no evidence that the schedule is unsafe.” There are many more sources of such information.

J. The author tells a story of alleged harm from a vaccine. Stories of vaccine injuries are also touching. But many of those anti-vaccine activists hold on to are problematic, often without medical evidence or against it. The fact that a parent believes that a vaccine harmed their child is not alone proof of it, and not a good reason, if the science shows the vaccine is safe, to refuse to protect your own child. Here is a discussion of this sensitive, potentially painful point.   The op-ed should not have been published. It’s a disservice to readers, and can directly harm children.

[1] Robert M. Wolfe & Lisa K. Sharp, Vaccination or Immunization? The Impact of Search Terms on the Internet, 10 JOURNALOF HEALTH COMMUNICATION 537(2005).