How the Antivaccine Movement Threatens Us All
Paul A. Offit
Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. Professor of Vaccinology at the University of Pennsylvania. Founding member of the Autism Science Foundation. More than 140 peer-reviewed papers on vaccination.
Death, blindness, paralysis, and stunted growth were ever present in childhood until the latter half of the twentieth century. Let us begin by simply noting the number of children affected by preventable diseases before vaccinations. Measles infected four million American children every single year, 10,000 of whom were hospitalized, 500 of whom died. In the early 1900s diphtheria killed 12,000 American children. Rubella meant 20,000 babies were born deaf or blind. While 300,000 cases of whooping cough led to 7,000 deaths. It wasn’t just the deaths, the grieving and the hospitalization that caused such misery; the illness itself was quite tough on the young child. Whooping cough is not just a bad cough that causes discomfort. Here’s what happens when a child gets whooping cough. First there is congestion, coughing, and a runny nose. Then a thick mucus coats the windpipe, which is impossible to cough up. The child coughs and coughs then panics. While panicking he continues to cough, though now without breathing in, depriving himself of oxygen. He becomes blue in the face. The bacteria then travels to the lungs causing pneumonia. Seizures commence as the brain is starved of oxygen. As the mucus continues to block the windpipe the child starts to suffocate. Some cough so hard their ribs break. Some die. A simple, harmless vaccine prevents all of this.
Elderly people who grew up in America remember the symptoms of whooping cough. They remember the children who grew into adulthood with a permanent limp from a shortened leg caused by polio. They also remember these diseases being almost wiped out in the Western hemisphere due to vaccination. This, at least, is one irrefutable fact that all should agree upon: vaccines work and have prevented death and disability on a huge scale. Perhaps because they saw the ill effects of these diseases people of that generation embraced vaccination. Inhabitants of townships throughout the country even banded together funding vaccination programs from their own money to stamp out various diseases. Remembering the effects of these childhood diseases is now at the limits of living memory, childhood health and infection control is taken for granted, and there is a trend among parents to withhold vaccinations from their children.
Vashon Island is a small commuter island in the state of Washington. Inhabitants there tend to be affluent, have higher level qualifications, and embrace a natural lifestyle. Farmers’ markets are commonplace—as are unvaccinated children. At least 25% of children on Vashon Island do not receive any form of vaccination. On a small island this translates to 458 cases of whooping cough every year, with a year-on-year rise. Outbreaks of whooping cough have now reappeared in seven other states. Due to a refusal to vaccinate, Hib has reappeared in Minnesota, Pennsylvania, New York, Oklahoma, and Maine—a disease that causes meningitis, pneumonia, septicaemia, and infection of the joints. American grandparents remember Hib as it causes permanent brain damage. Measles and mumps too are enjoying a return. Mumps leads to pancreatitis, meningitis, deafness, facial paralysis, and inflammation of the ovaries. Measles still kills children at a rate worldwide of sixteen per hour. These are not benign diseases with simple red spots that a child can endure.
There are a number of reasons driving this new refusal to vaccinate. These reasons include the belief held by parents who adhere to Steiner eduction principles that vaccinations “interfere with karmic development and the cycles of reincarnation.” This very principle led to a whooping cough outbreak at a Steiner school in California. However, in recent times the most infamous reason for delaying vaccination is a fear of autism.
In 1998 a prominent English doctor practicing at the Royal Free Hospital in London published a paper in the prestigious medical journal The Lancet. He put forth the idea that the combined MMR vaccine, which protects against measles, mumps, and rubella, causes autism. The article noted that the MMR vaccine entered the intestine and caused inflammation, the intestines then became leaky, proteins entered the blood, travelled to the brain, causing autism. Moreover, he had tested this theory upon children who developed autism shortly after receiving the MMR vaccine. The medical establishment sat up and took notice. There was no whitewash, no sweeping the evidence under the carpet; the status of the author, his thirteen coauthors, and the peer-review process of The Lancet meant that the article was taken with absolute seriousness. Within days the conclusions of the article were front-page news, the British press reacted hysterically, and soon parents stopped their children from having the MMR vaccine. Within a short period of time measles reappeared in England, hospitalizations followed, deaths occurred. The story was too big to ignore.
Scientists and researchers took the new findings seriously. Twelve groups of researchers in several countries set out to confirm the findings. But there was a problem: they couldn’t. Not a single researcher in multiple countries could replicate the Lancet study. Children with autism were not more likely to have the measles vaccine virus in their intestine, nor have intestinal inflammation, and there were no brain-damaging proteins in the bloodstream of children who had the MMR jab. And then the study really began to unravel.
There were only eight children in the study, a small sample by any standard, and five of those eight were suing a pharmaceutical company. The lead author was being paid £440,000 to act as an expert witness. The blood of those children had been drawn for testing at a birthday party and each child was paid £5. Ten of the thirteen coauthors immediately withdrew their names from the study. One testified that a key test showing measles vaccine genes in spinal fluid had been falsified. The Lancet retracted the article, something that almost never happens, and the General Medical Council in England, which licenses all medical doctors, withdrew the license of the the lead author, finding him guilty of subjecting children to unnecessary spinal taps and biopsies.
In 2002 yet another study was conducted, this time a large Danish study, which again found no link between the MMR vaccine and autism. With a raft of large, international, heavily scrutinized studies all failing to show a link between the MMR vaccine and autism, opponents of vaccines took to the internet to assert that it was mercury in the form of the preservative thimerosal causing autism. Conversations amongst the educated chattering classes in England and beyond resounded with claims that mercury in vaccinations was damaging children. There was a significant problem with this claim: mercury is used in some MMR formulations, it was not used in England—ever. And rates of autism were rising in England just like everywhere else. Six large, international studies were conducted looking for a link between mercury in vaccinations and autism. There was no link. None whatsoever. The results were clear and reproducible. In 2001 thimerosal was taken out of the MMR vaccination in America and the rates of autism continued to climb. It simply could not be mercury that was causing autism.
In 2002 the Omnibus Autism Proceedings took place in the United States Vaccine Court—a court set up during the Reagan administration to assess compensation claims for disabilities caused by vaccination. A tremendously huge amount of evidence was heard, lawyers representing children with autism presented their cases and expert witnesses were called to testify on mercury, the MMR vaccine, and autism. Both sides of the debate were heard in full. The evidence presented was so vast it took fifteen months to reach a decision, the court transcripts ran to 4,500 pages, and the medical literature numbered tens of thousands of pages. There was a unanimous verdict in a court that had previously and repeatedly awarded damages to children adversely affected by older vaccines. There was no evidence of a link between autism, mercury, and the MMR vaccination. But the judges went further. They noted that many of the expert witnesses called by the antivaccine lobby were not actually experts and questioned their credentials. This is a constant trend among antivaccine scaremongers: the people spreading fear about vaccines are often celebrities, media personalities, authors, all of whom have ear of news organizations; or they are blog posters, mothers or fathers, lurkers on internet forums; and sometimes they are doctors with no track record of research, no publications, no real expertise in immunology. It’s strange that this rag-tag group of unqualified individuals who often promote hearsay, rumor, and conspiracy, who time after time fail to present or are not aware of the actual evidence, are preferred over hundreds of expert researchers across the world whose profession is immunology and the study of vaccines. Unless of course there’s a conspiracy.
If not mercury or MMR perhaps it’s the aluminum that has been in vaccines for the last seventy years. Consider the evidence on aluminum. It’s the third most abundant element on earth. It’s everywhere, in the air, in our water. Our exposure to aluminum comes principally from food as it’s naturally present in tea, spices, and herbs, meaning we consume 5–10 mg of aluminum every day. A baby who is fed exclusively by breast milk has had 10 mg of aluminum by the age of six months; bottle-fed babies have had 30 mg; soy-fed babies have 120 mg. All the vaccines combined into one and given in one single dose would only contain 4 mg of aluminum, with half of it eliminated in one day. Nevertheless, university researchers still tested plasma levels of aluminum in babies before and after vaccination and found no difference. They had between 1 and 5 billionths of one gram of aluminum circulating regardless of whether they were vaccinated or not.
Mercury, aluminum, and the MMR jab are all nonfactors in the rise of autism, and are not linked to any significant side effects. The next charge that is often made against vaccines is perhaps more reasonable. Surely there are too many vaccinations given too quickly, with too much pressure from pharmaceutical companies, who perhaps motivated by financial interest do not test their vaccines vigorously?
It is true that more vaccines are now given than in any other time. At the start of the twentieth century the only vaccination offered was against smallpox. Now, depending on where a person lives, fourteen vaccinations are given to children. Fourteen vaccinations for a small child seems a lot yet the figure is misleading and needs to be unpacked. What matters is the number of immunological agents in a vaccine, not the number of vaccines, as it is the immunological agents that have a biological effect. The single smallpox vaccine given in the early 1900s contained 200 viral proteins. The fourteen vaccines given today contain a total of 160 viral proteins, bacterial proteins, and polysaccharides, forty less immunological agents than the single smallpox vaccine given over one hundred years ago.
As soon as they enter the birth canal babies are exposed to more threats to their immune system than these 160 agents. A baby has more bacteria on its skin than cells in its body. Not all of this bacteria is good bacteria. Each bacteria in turn contains between two and six thousand immunological components. Some of these can invade the child’s body and cause harm, meaning the child makes large quantities of antibodies to see off the threat. On top of bacteria a baby encounters viruses such as rhinovirus, which causes the common cold, echovirus, adenovirus, and many more. Unlike the viruses used in vaccines, which reproduce poorly or not at all, these wild viruses reproduce thousands of times causing an intense immune response. Just a single infection of a common cold causes a greater immune response than all the current vaccines combined.
Two immunologists at the University of California, San Diego, set out to definitely answer the question of whether fourteen vaccinations exceed the immunological capacity of young children. They did so by studying antibodies that are made by B cells. Each B cell makes antibodies against only one immunological unit called an epitope. Given the number of B cells known to be circulating in the bloodstream, each of which makes antibodies to attack an epitope, and given the number of epitopes in a vaccine, and the rapidity with which a sufficient number of antibodies could be made by the B cells, it is estimated that a baby could theoretically respond to 100,000 vaccines given in a single setting. Fourteen vaccines, containing just 160 immunological agents, and given over two years, do not pose any sort of challenge to the young child. This finding vindicates the vaccination schedule laid down by numerous experts at the Center for Disease Control and Prevention and should reassure parents thinking of making up their own untested, unproven ad hoc vaccination schedule. This point was recently hammered home by a University of Louisville study that found children who had vaccinations at the recommended intervals were not more likely to have neurological problems than those who had delayed vaccination. Those who delayed vaccination were more at risk from the ravages of whooping cough, measles, and mumps.
Whooping cough, measles, and mumps were not the only childhood diseases that caused untold suffering, misery, disability, and death. Perhaps the most celebrated vaccine is the first vaccine: the smallpox vaccine developed in its modern form over two hundred years ago. Consider this: smallpox killed more people than the Black Death and all the wars of the twentieth century combined. An estimated 500 million people died from smallpox; hundreds of millions more were left disfigured. When European settlers both inadvertently and deliberately introduced smallpox to the native American community that population declined from 70 million to just 600,000. There is a certain irony that inoculation against smallpox was developed by the Ottomans. This knowledge arrived in England and was presented to the Royal Society, Edward Jenner would then develop the smallpox vaccine, the number of smallpox cases halved, the disease was eventually eradicated, and hundreds of millions of lives saved. Yet at the time large crowds gathered to protest against the vaccine. Pamphleteers, the bloggers of their day, made false accusations coupled with equally false science. It was asserted that the smallpox vaccine would turn you into a cow or that the vaccine contained snake and rat blood—it didn’t in case anyone is wondering. It was a sustained, popular attack, vaccination rates plummeted and it had all the hallmarks of today’s antivaccination movement, including the needless deaths of unvaccinated children.
Our grandparents quickly recognized the benefits of vaccinations and knew that society at large would benefit from them. They knew, as clinicians and researchers know, that herd immunity—that around 95% of the population needs to be vaccinated—is vital. They were different to Generation X and Millennials who came of age in the 1990s and 2000s characterized by a selfish “me first” attitude. Unfortunately, this “me first” attitude is problematic. If you don’t vaccinate your child you are not just putting your own child at risk, it is not just your choice, you are putting many other people at risk. In 2009 a single unvaccinated boy infected 1,500 people with mumps after travelling to England at a time when people were abstaining from the MMR jab. If the current trend against vaccinations continues your unvaccinated child will be protected for a while because there is herd immunity, not because of a natural lifestyle or homeopathy tablets. But once this herd community breaks down then your child is at serious risk, as are those children who want vaccinations but can’t due to illness or drug therapy, and eventually other unvaccinated children will start to suffocate from whooping cough or limp from polio, as diseases that were obliterated reappear.
The evidence is clear. In the scientific literature, among every expert across the world, among learned scientific bodies, among health organizations, across countries, in legal cases, and from 250 years of history we learn that vaccines are a blessing. They work. They do not cause autism. They do not contain mercury. Aluminum content and immunological overload is not a threat. If you think that Hollywood celebrities, small e-books, forums, blogs, internet experts, mothers on Yahoo Groups, Steiner schools, or the lady down the street have contrary evidence then think again. Seriously, think again.