The Vaccine War

I've just finished watching a new PBS Frontline documentary called The Vaccine War. The documentary covered the current dispute between parents and medical professionals over whether vaccines are safe to give to children.

Both sides of the question were given ample time to present their respective cases, including plenty of screen time for anti-vax cheerleader Jenny McCarthy. Frontline did an excellent job of hearing out the claims made by the anti-vaccine advocates and then debunking them by presenting the scientific evidence and credible explanations by experts in the field.

The documentary also made exposed the major tactic of pseudoscientific proponents which is to shift the goalposts once the scientific facts on their previous claim have been gathered. Led by Andrew Wakefield, the vaccine denialists first pronounced that the MMR vaccine caused detrimental effects in young children who received immunisation. This was shown by epidemiological studies in Denmark, Japan, and the US to be false. Furthermore, it was explained that Dr Wakefield's flawed study had been retracted by the prestigious medical journal in which it was originally published. The anti-vaccine advocates then switched to blaming mercury present in the thiomersal preservative for the autism their children developed after receiving multiple vaccinations. The claim was once again shown to be false by epidemiological evidence. It was also made clear by the scientific experts that the correlation between vaccination and autism was only due to the coincidence in timing between the onset of autism and childhood vaccination schedule and causation should not be assumed (a post hoc, ergo propter hoc fallacy). Finally, the vaccine denialists were left calling for more studies and generic testing even in the face of overwhelming evidence that vaccines are safe and efficacious.

The last segment of the program focused on the harm that anti-vaccine advocates are causing. The first and most obvious problem is that the children who are not vaccinated get sick with these deadly diseases. I some cases, such as polio and measles, anti-vaccination movements have actually prevented these diseases from being eliminated from our planet. Every year people get sick and die from vaccine-preventable diseases, yet vaccine denialists still promote the non-use of these life-saving measures (see the Jenny McCarthy body count - 509 deaths at the time of writing). The second issue is that of lost herd immunity. Some, because of age or ill-health, cannot safely be vaccinated and rely on those around them not to pass on diseases. With the lower levels of vaccinations, this herd immunity is lost. The Vaccine War included the story of one little girl who almost died from Pertussis (whooping cough) a disease many young doctors have never even seen in their patients. The final problem is that of distraction. The money and time spent on eliminating the MMR vaccine and thiomersal as a potential cause of autism could have been better spent studying the actual causes of autism and providing real results to desperate parents who have so many unanswered questions.

One final point that Frontline touched on but did not provide a definitive answer for, was that of requiring parents to vaccinate their children. After all, we expect parents to take reasonable care of their children, to prevent injury and sickness as best they can. Since vaccines are such a success, perhaps parents should have no say in the matter and vaccination should be mandated by the government. Although the ideal situation would be for informed parents to make the right choice and get their children vaccinated, I think it the importance of preserving herd immunity and wiping out these deadly diseases outweighs the slight loss of parental freedom. Ironically, if every parent had their children properly vaccinated, these diseases would disappear and there would be no need for a continued vaccination program. Smallpox is currently the only virus which has been eradicated and other diseases could be eliminated if only people would listen to the experts and get immunised. Overriding the parents' choice is not the perfect system but as long as vaccine denialists continue to spread their misinformation, it may be a necessary one.