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Anti-vaccination activist running for governor of the state of Colorado?

Unfortunately for them, folks in Colorado have a hard core anti-vaxer named Dawn Winkler running for governor on the Libertarian ticket. I’m hoping for their sakes that, as a third party candidate, that she has virtually no chance of winning. Check out some of her rhetoric posted on Whale.to seven years ago in response to an essay by Dr. J. Thomas Megerian of Children’s Hospital in Boston. Even though it’s seven years old, I present part of it because it is so astonishingly clueless and because, as you will see later, Winkler apparently hasn’t learned a thing since then:

How on earth did we survive for millions of years WITHOUT VACCINES? Could it be that our immune systems actually worked on their own? We only started mass vaccination in the past century. Do you have any concept of time? Where did the plague and scarlet fever go? If anything does us in as a species, I promise you, it will be vaccines and antibiotics. They are overused. As a matter of fact, how in the world does anything survive in the wild? Do we vaccinate deer, skunks, elk, birds, insects, etc????????????? Think about how RIDICULOUS the notion is that humans will die out if we do not interfere with Almighty allopathic medicine. We ought to be the only species alive at this point by your calculations. Don’t give medicine too much credit. Good health is a God given birthright and I will not allow ANYONE to take that away from my son. It’s too late for my daughter and for myself.

Even counting that Winkler had lost a daughter to SIDS, which she blamed on “mercury poisoning” (also here) from vaccinations and giving her the benefit of the doubt for her personal loss and the trauma that she suffered because of it, I still have a hard time letting a statement that ignorant pass unanswered and unnoticed, particularly since the evidence for such a link is very weak to nonexistent. (In fact, recent evidence is starting to suggest that vaccination may be associated with a decreased rate of SIDS, which is not surprising given that a major hypothesis is that bacterial toxins may be a cause or contributor to SIDS.) As horrific as it is for a young mother to lose a child unexpectedly the loss of a child does not immunize her from criticism on this issue, especially since she is running for Governor and continues to oppose vaccination and spread misinformation. Indeed, her campaign website parrots all the same discredited rhetoric linking thimerosal-containing vaccines to autism (which, as any regular reader knows, I’ve written about extensively) and increasing numbers of autoimmune diseases.

Winkler started out with a number of strawmen. For instance, no one that I know is claiming that humankind would die out without “allopathic” medicine or vaccines. However, there is no doubt that there would be a lot fewer of us, that many more of us would either die or be debilitated by infectious disease, and that infant mortality would skyrocket without them. It is virtually certain that, without “allopathic medicine,” a lot more of us would be living in mortal fear of infectious diseases that are quite preventable through vaccines and/or treatable with antibiotics right now. No, the loss of what Winkler contemptuously called “allopathic medicine” certainly wouldn’t be enough to do in the human race, but why on earth would we want to return to such a primitive state? Remember, it was only 50 or 60 years ago that polio was a real fear in this nation, where pools would be shut down in the summer during outbreaks and people found themselves in iron lungs when struck by severe cases. The polio vaccine changed all that. And that’s just one example of the elimination of a disease by vaccines.

Winkler was also good with the red herrings, some of them quite laughable. For example, plague was eliminated largely through sanitation, given that it is carried by fleas that live on rats. Keep the rat population under control, and plague is largely not a problem, especially now that there are antibiotics to take care of the few cases that still occur. Scarlet fever disappeared not because of vaccination or better hygeine, but because antibiotics are highly effective in eliminating the group A streptococcus infections (usually causing sore throat) that can progress to scarlet fever. Indeed, I personally am profoundly grateful to modern medicine for this, because I had scarlet fever as a child. If it weren’t for modern antibiotics, there’s a good chance that it would have either killed me or led rheumatic fever, which could have permanently damaged a heart valve. It did neither, and I survived to be a generally healthy adult.

I suppose that you could say that our immune systems “worked” on their own back then. For most microorganisms, our immune system is very effective at checking uncontrolled growth and disease. Indeed, because of our immune system, we live in harmony with billions of bacteria that live on our skin and on any mucous membrane that communicates with the outside world, including our respiratory and digestive tracts. Unfortunately, our immune systems aren’t as effective at controlling some pathogenic organisms, and even an “effective” immune system can result in enormous death and suffering. For example, let’s say a certain infectious disease kills 40% of those who are infected. In the long term on a population basis, the immune system “worked.” After all, more than half of the people getting the disease do not die. Over time, the disease can act as a selective force for evolution, with those with immune systems better able to handle the disease having a greater chance of reproducing to pass on their genes for resistance to the next generation, leading to more resistance. Of course, that takes many generations to significantly increase the percentage of resistant people in the population, and during that time the infectious agent, be it bacteria or virus, will also evolve. Eventually, usually a sort of homeostasis between infectious agent and the population it infects is reached. But all of this is happening on a population level. During that time, at an individual level huge numbers of people would die. Now take a disease that only kills 5% of those it infects. On a strictly population level, again, the human immune systems would be considered pretty darned “effective,” considerably more so than the previous example. They would “work” to eliminate the infection in 95% of the population. Of course, that’s a small consolation to you if you happen to be one of the 5% whose immune systems couldn’t control the disease, and, even if you were one whose immune system could, you’d probably prefer not to get sick in the first place and take even the 1/20 chance of dying, particularly if the symptoms of that infection are debilitiating or if there are other complications from the disease.

That’s what vaccinations are for.

Dr. Megerian tried to remind Ms. Winkler what life was like before the common vaccines:

When I think about these issues in my own life, all I need to do is remember the last case of a child with hepatitis, or the last case of a child with seizures due to h. flu meningitis, or the deformed, mentally retarded, seizing children with congenital rubella syndrome, now adults, that were unfortunate enough to be born before the advent of the Rubella vaccine…when I think of that, the question about whether to vaccinate my children is answered easily.

Indeed. Dying isn’t the only major complication of these infections. Life long disabilities, which are now preventable, are the consequence of letting such diseases run unchecked. Worse, vaccine effectiveness depends upon a high percentage of the at risk population being vaccinated, usually more than 90%. This is because no vaccine is 100% effective, and those whom the vaccine might fail are protected by the “herd immunity” of the rest of the population, where the infectious agent being vaccinated against just can’t get established because most of the population is immune. Dr. Megerian explained well what the real questions are:

You state that we have no right to tell people whether they should or shouldn’t vaccinate…I’ll believe in personal choice as well…but only when that choice does not harm others. The choice to smoke is personal, as long as its done in private, away from children or others who do not want to smoke. The choice to drink alcohol, personal as well, as long as the drinker doesn’t get in a car and endanger other. The choice to vaccinate…if your child is unvaccinated, but plays with other kids who are under-vaccinated or for whom a vaccine did not work well, are you giving those parents and children choice?

If your children go to any public places, they are putting others at risk. There’s a saying that I’m sure you’ve heard. Those who do not learn from the mistakes of history, are doomed to repeat them. Before you comment about how well humans did before the advent of vaccines and antibiotics, read some history about the causes of death, ages of death, infant mortality, occurring over the last 500 years. Do you realize that the chances that any of your children or my children surviving into adulthood has probably quadrupled in that time? Why do you think that has happened?

Why, indeed?

It certainly wasn’t because of people like Ms. Winkler, that’s for sure, who clearly has learned nothing in the seven years since she wrote the above rant other than how to couch the same nonsense she was spewing above in more reasonable-sounding (and politics-friendly) terms. In fact, people like Ms. Winkler are the reason that pertussis has made a return in the state of Colorado, reappearing in the prosperous city of Boulder, where there are a lot of people who think like or are influenced by people who think like Ms. Winkler. Thanks to them, Boulder has one of the lowest per capita vaccination rates and, not surprisingly, one of the highest per capita whooping cough rates in the country. In the U.K., thanks to the bogus MMR scare sparked by Andrew Wakefield’s dubious and now discredited study linking the MMR vaccine to autism, vaccination rates fell precipitously in the late 1990’s and early 2000’s, and measles has come roaring back (increasing from 4,204 cases to 56, 390 cases in just two years), leading to the first death from the disease in 14 years.

Yes, vaccines have risks, but they are very small. They have to be because vaccination involves a preventative intervention in a healthy population. History has shown that, in relation to the risks of the diseases vaccinated against, the risks of vaccinating are minuscule by comparison. What has thus happened is that, because vaccines have been so successful, people like Ms. Winkler forget about the risk from vaccine-preventable disease and concentrate on the minuscule risks from vaccines. If the voters of Colorado want to have the levels of pertussis throughout the state that Boulder has already achieved and want to see the return of vaccine preventable diseases, to boot, they can elect Ms. Winkler, who has already done much mischief by fighting mandatory vaccination in California and Colorado and promises to do the same if elected.

Fortunately, there is only a very small chance of that happening. We can only hope it stays that way.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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