The anti-vaccine war on science: An epidemic of fear

Many have been the times over the last five years that I’ve called out bad journalism about medicine in general and vaccines in particular, especially the coverage of the discredited notion that vaccines or mercury in vaccines somehow was responsible for the “autism epidemic.” That’s why I feel a special responsibility to highlight good reporting on the issue. Indeed, reporting on this issue is so uniformly awful that when I see something this good, I want to do everything in my power to hawk the hell out of it. So, I want you to read this article in the November issue of WIRED Magazine entitled An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All by Amy Wallace. I’ll wait until you come back. No, seriously. Click on the link, read, and then come back. I’ll still be there.

I will point out right from the outset that there is one thing I (somewhat) disagree with Wallace about:

This isn’t a religious dispute, like the debate over creationism and intelligent design. It’s a challenge to traditional science that crosses party, class, and religious lines. It is partly a reaction to Big Pharma’s blunders and PR missteps, from Vioxx to illegal marketing ploys, which have encouraged a distrust of experts. It is also, ironically, a product of the era of instant communication and easy access to information. The doubters and deniers are empowered by the Internet (online, nobody knows you’re not a doctor) and helped by the mainstream media, which has an interest in pumping up bad science to create a “debate” where there should be none.

I agree that the anti-vaccine movement is partially a reaction to the depradations of big pharma, accelerated by the easy access to instant information on the Internet. After all, how many times have I lamented how useful idiots like Jenny McCarthy can attend “Google University” for a few hours or days, reading about vaccines and autism, and then emerge with the attitude that they know better than experts who have studied vaccines or autism their entire professional lives? If science were that easy to pick up, it wouldn’t take so long to become good at it. I also agree that sensationalistic journalism promoted this campaign of fear. This was particularly true in the U.K., where the media were every bit as culpable as Andrew Wakefield, if not more so, in pumping up the manufactroversy over the MMR and autism.

Where I tend to disagree is that the manufactroversy over vaccines and autism is actually primarily religious at its core, if you define religion fairly broadly. It’s not about conventional religions, such as Christianity, Judaism, or Islam (or the many sects in each of these religions). Rather, underlying much of the fear of vaccines is either a New Age “spirituality” or a variant of primitive vitalism, where disease isn’t really due so much to microbes but rather to “toxins” and where people who are perfectly “healthy” (whatever that means) don’t need vaccines because they’re somehow naturally resistant to pathogenic organisms. (Shades of Bill Maher!) Delve for a while into the message boards of the anti-vaccine underground, and you’ll see worship of the idea of “natural” to the point where many anti-vaccinationists will say, with utter seriousness, that it’s better to get the disease naturally than to take a vaccine. It’s the worship of an idealized version of “nature,” and vaccines are viewed as “unnatural.” I’m not claiming that this is true of all anti-vaccine zealots, but it’s definitely true of at least a significant minority of them, if not a clear majority.

One thing I also liked about this article–lot!–is how Wallace calls out spokespeople of the anti-vaccine movement, like Jenny McCarthy, Don Imus, Robert F. Kennedy, Jr.; debunks common anti-vaccine canards; and lists for additional writings for more information. In particular I like this part:

Anti-Vaccine Websites

Though many of these organizations would not define themselves as such, these are the most active organizations and websites in the current battle against vaccines:

National Vaccine Information Center
Autism One
Generation Rescue
SafeMinds
Treating Autism
National Autism Association
Autism File

My only quibble is that Wallace missed listing Age of Autism. Fortunately, she makes up for it by getting it right here:

In May, The New England Journal of Medicine laid the blame for clusters of disease outbreaks throughout the US squarely at the feet of declining vaccination rates, while nonprofit health care provider Kaiser Permanente reported that unvaccinated children were 23 times more likely to get pertussis, a highly contagious bacterial disease that causes violent coughing and is potentially lethal to infants. In the June issue of the journal Pediatrics, Jason Glanz, an epidemiologist at Kaiser’s Institute for Health Research, revealed that the number of reported pertussis cases jumped from 1,000 in 1976 to 26,000 in 2004. A disease that vaccines made rare, in other words, is making a comeback. “This study helps dispel one of the commonly held beliefs among vaccine-refusing parents: that their children are not at risk for vaccine-preventable diseases,” Glanz says.

“I used to say that the tide would turn when children started to die. Well, children have started to die,” Offit says, frowning as he ticks off recent fatal cases of meningitis in unvaccinated children in Pennsylvania and Minnesota. “So now I’ve changed it to ‘when enough children start to die.’ Because obviously, we’re not there yet.”

No, Dr. Offit is right. We’re not there yet. In fact, I’m a lot more pessimistic than he is. He says “enough” children will have to die before anti-vaccine loons like Jenny McCarthy are relegated to the lunatic fringe, where they can wallow in conspiracy websites like Rense.com or show up on late night paranormal radio shows like Coast to Coast. They can be taken with all the seriousness that David Icke and his Lizard people idea is as he blames the swine flu on the Illuminati. My prediction is that a lot of children will have to die before the anti-vaccine movement looses its influence. Hundreds. Thousands. Tens of thousands, even. We have a short memory as a society. A mere 60 years ago, people lived in fear of polio. Every summer, in various parts of the country, swimming pools would be shut down based on its appearance. Children were condemned to iron lungs. Thanks to the polio vaccine, that all came to an end. Even more recently, a mere 20 years ago, Haemophilus influenza B was wreaking havoc among children:

In the very recent past, Haemophilus influenzae type b (Hib) was what could truly be called a scourge to humanity. As recently as 1987, this particularly nasty bacterium caused invasive disease in a startling 1 of every 200 children in the U.S. under 5 years of age. Approximately two-thirds of these children developed meningitis, with a mortality rate of about 5%. Up to 30% of the survivors suffered permanent brain damage. Those children lucky enough to avoid meningitis developed pneumonia, septic arthritis, osteomyelitis, cellulitis, epiglottitis, or generalized sepsis. Fortunately I have never seen or treated a child with invasive disease due to Hib. That’s because I began my pediatric training in 1991 when vaccination against these horrendous diseases was just beginning. What was once a common and devastating menace to children, the dreaded nightmare of every pediatrician, was quickly brought to it’s knees. By 2006, the incidence of invasive Hib disease had been cut by 99%. Within a short period of time, the very nature of pediatric medicine seemed changed forever.

Thanks to vaccines.

As I’ve said, we have a very short memory. Deadly microbes taught us a deadly lesson over hundreds of years, until we learned how to keep them at bay with vaccines. I fear we will receive a refresher course on how deadly they can be, courtesy of Jenny McCarthyand her allies.

ADDENDUM: The anti-vaccine loons have already descended upon the article. A little sanity to counter them would be in order.