The anti-vaccination movement is potentially the single greatest threat to public health.
Note that I don't qualify that as "in America," or "in the third world" or "in westernized countries." They are potentially the single greatest threat to public health, period.
Let me go a step further, if you do not get your child vaccinated, or worse, you convince someone else not to get their child vaccinated, you are guilty of child abuse by any reasonable (if not legally-actionable) definition of the term. You're playing roulette with their lives and hoping that they're fortunate enough never to be exposed to any of the diseases which vaccines will protect them from.
Also in the interest of full disclosure, I should mention the following: vaccines are, collectively, the lowest-cost, highest effectiveness, most portable, dispersable, and long-term solution to most of the world's diseases. This, incidentally, is not a matter of my own opinion, it's a matter of track record. Small pox, polio, tetanus, diphtheria, measles, rubella, and other diseases which, in Canada and the US, are little more than a distant memory. It's estimated that one in five people would not now be alive if not for this medical miracle.
Now, let me add a one last statement to the preceding ones. If you do not get your child vaccinated, you are abusing the children that child will go to school with. Morally, I see the refusal to get your child vaccinated as the equivalent of taking a baseball bat to a baby, then walking over to the houses of the children that child will go to school with, and taking a baseball bat to them, too. This, unfortunately, is the leap that the anti-vaccination movement never makes. By not getting vaccinated, you are not only harming your own child, you're harming someone else's.
By that standard of evidence Jenny McCarthy and Jim Carrey have been brutally bludgeoning countless millions of children.
Metaphorically speaking.
Let's start with the basics:
Vaccines do not cause autism. The one study which has ever presented a link between vaccination and autism was shown to be fraudulent.
In the interest of completeness, here is that particular citation.
Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoidnodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351:637-641
By contrast, however, we have papers showing no link between vaccines and autism:
Dales L, Hammer SJ, Smith NJ. Time trends in autism and in MMR immunization coverage in California. JAMA. 2001;285:1183-1185.
Davis RL, Kramarz P, Bohlke K, et al. Measles-mumps-rubella and other measles-containing vaccines do not increase the risk for infl ammatory bowel disease: a casecontrol study from the Vaccine Safety Datalink project. Arch Pediatr Adolesc Med. 2001;155:354-359.
DeStefano F, Bhasin TK, Thompson WW, Yeargin-Allsopp M, Boyle C. Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan Atlanta. Pediatrics. 2004;113:259-266.
DeStefano F, Chen RT. Negative association between MMR and autism. Lancet. 1999;353:1986-1987.
Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine. 2001;19:3632-3635.
Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics. 2001;108:E58.
Fombonne E, Cook EH Jr. MMR and autistic enterocolitis: consistent epidemiological failure to fi nd an association. Mol Psychiatry. 2003;8:133-134.
Honda H, Shimizu Y, Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. J Child Psychol Psychiatry. 2005;46:572-579.
Kaye JA, del Mar Melero-Montes M, Jick H. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis.
BMJ. 2001;322:460-463.
Madsen KM, Hviid A, Vestergaard M, et al. A populationbased study of measles, mumps and rubella vaccination and autism. N Engl J Med. 2002;347:1477-1482.
No link between Thimerosol (a preservative found in vaccines) and autism (or, for that matter, any ill-effects):
Andrews N, Miller E, Grant A, Stowe J, Osborne V, Taylor B. Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United Kingdom does not support a causal association. Pediatrics. 2004;114:584-591.
Fombonne E, Zakarian R, Bennett A, Meng L, McLean- Heywood D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics. 2006;118:E139-150.
Heron J, Golding J. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United Kingdom does not support a causal association.
Pediatrics. 2004;114:577-583.
Hviid A, Stellfeld M, Wohlfahrt J, Melbye M. Association between thimerosal-containing vaccine and autism. JAMA. 2003;290:1763-1766.
Madsen KM, Lauritsen MB, Pedersen CB, et al. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003;112:604-606.
Schechter R, Grether J. Continuing increases in autism reported to California’s developmental services system: mercury in retrograde. Arch Gen Psychiatry. 2008;65:19-24.
Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. Am J Prev Med. 2003;25:101-106.
Verstraeten T, Davis RL, DeStefano F, et al. Study of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases. Pediatrics. 2003;112:1039-1048.
And, just for good measure, studies showing no link between vaccines and inflammatory bowel disease:
Peltola H, Patja A, Leinikki P, Valle M, Davidkin I, Paunio M. No evidence for measles, mumps and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. Lancet. 1998;351:1327-1328.
Just to be clear on this.
So, why do people still claim that vaccines cause autism?
Well, let's start with the issues that they have with the above studies. You never, ever, ever hear them go after the actual studies themselves. On the contrary, they always, always, go after the authors. If they got funding from, or were employed by, a manufacturer of vaccines, they clearly could not be trusted (but, for some reason, when one deliberately falsifies their data, that article is gospel). See for yourself: from Generation Rescue's own website, they never once, ever address the science. They present the scientists as if, because they had jobs which involved making vaccines, created a bias in their data. Even if that is true, they never explain, ever, how that alleged bias produces an error in their results.
By contrast, they offer no argument in favor of their own position.
Again, from their own website:
In 1983, autism rates were 1 in 10,000 and there were 11 vaccines in the pediatric schedule. Today there are 36 pediatric vaccines and autism rates are reported as high as 1 in 80 in local school districts in Oregon and New Jersey.
Clearly, nobody ever told them that correlation does not denote causality. For example, consider the following argument:
Since 1988, there has been a dramatic increase in the importation of oranges from Mexico. Also since 1988, there has been a dramatic reduction in the number of traffic fatalities. Therefore, we should increase our importation of oranges in order to eliminate traffic fatalities.
Ridiculous? Exactly. And it's the exact same argument that Operation Rescue is attempting to make with regards to vaccination. One could just as readily claim that Netscape (which did not exist in 1983) causes autism, or that M. C. Hammer pants suppress it.
Put simply, the fact that two events occur concurrently is not evidence that there is a causal relationship, or for that matter, any relationship at all.
That's not to say that correlative data is not very valuable. Often, you can establish causality using correlative data. However, there are a few things which need to be established first.
1) a mechanism of causality must be established. In the case of vaccines, no causal mechanism by which children could even be potentially harmed has any evidence to support it.
2) We must be able to predict ahead of time what will happen, given a set of criteria. I'll come back to this in a second.
3) confounding factors, where present, must be addressed and accounted for. This last one can be very difficult, which is part of the reason why Project Rescue's data is complete bullshit. They make the claims that a) the US has the largest vaccine schedule, and b) the US has one of the highest rates of autism. There are an enormous number of confounding factors here, not the least of which being the fact that autism is a random affliction with an ill-defined pathology, and a tendency to be over diagnosed.
Let's address that second criteria for a moment.
Let's take Project Rescue's own numbers and consider the hypothesis of vaccines resulting in early infant mortality.
Now, first things first. Note that their numbers are the total mortality rates for children under five.
In other words, every child under five who dies in a car accident, every child who ever dies of diseases not included in the vaccine schedule, every child who dies in a plane accident, of cancer, or of any other of the millions of possible afflictions or accidents that can befall a child, is counted in that number.
In other words, while vaccines are a medical miracle, they won't protect your child from an automobile accident, or from drowning in the bathtub, or from falling off of a playground slide. When counted against those causes of death in the countries listed, the number of children who die from diseases which vaccines prevent pales to insignificance. The reason it pales to insignificance is that as long as assholes like Jenny McCarthy and Jim Carrey are having a relatively minor effect on vaccination rates, most people in the US are still vaccinated against these diseases.
If you actually plot the infant mortality rate against the number of vaccines, you get something which shows no clear correlation at all. None. It's a blob of data points.
Which is pretty much to be expected, since the overwhelming majority of children who die under five don't die of something that a vaccine could have prevented. Largely because a vaccine prevented them from dying of it.
But, let's try the other side of the coin. What happens if, suddenly, we stop vaccinating? Let's consider a single disease: diptheria.
Remember, in order to establish causality, we need to make sure that three important concerns are addressed: a mechanism of causality is established, prediction of the outcome in advance based upon that mechanism of causality, and a minimum of confounding factors. The reason I picked diptheria is because it is a disease which is primarily fatal to children under five years old.
So, if we were to look at a country where diptheria vaccinations suddenly dropped off what would we predict?
Remember, we have a proposed mechanism of action: the reason that diptheria rates are so low is because most people are being vaccinated against it. Most children have immunity to the disease from childhood and are therefore not being infected. Therefore, we can predict what would happen if the rate of vaccination suddenly dropped off. Not immediately, but within ten years, we would see a massive increase in the rate of the disease.
In the Soviet Union, in 1991, 2000 cases of diptheria were reported. As the soviet block disintegrated, vaccination rates went into free-fall.
Now, another reason I chose diptheria is because it significantly reduces the number of confounding factors. Transmission is virtually always directly person to person. Break-down of infrastructure would have very little effect upon its transmission.
So, what would the prediction be for diptheria, if the vaccinations stopped?
Well, a number of people carry diptheria asymptomatically, which is what makes it such a dangerous disease. They're contagious, but they don't look like they are. In a population of individuals which is largely immune due to vaccination, these carriers are of no real concern. This is due to something called herd immunity. I'll get to that in a second.
However, if, for some reason, the level of immunity in a population drops, not only can more people catch it, but it can spread more easily through a population.
Sure enough, in the Soviet Union in 1991, 2000 cases of diptheria were reported. That was when the vaccination against it dropped precipitously. Within eight years, over 200,000 cases, with 5000 deaths reported from it. That's a hundred-fold increase.
Now, consider the criteria I laid out before.
1) a mechanism of causality has to be established. Vaccines provide an immunity from disease.
2) we can predict, in advance, the outcome of a specific perturbation, based upon the mechanism of causality. If the above is correct, we should observe a resurgence of the disease after immunization is cut off.
3) confounding factors are reduced. In this case, we're dealing with the exact same population over eight years, and the transmission vector of the disease is well-understood.
And it's not just that. The opposite was observed in the case of Pertussis in the United states. Immediately after the introduction of the pertussis vaccine, cases plummeted into freefall.
We are now seeing the same thing happening in the United States, as a direct consequence of the anti-vaccination movement. People are dying, and people like Jenny McCarthy and Jim Carrey are killing them.
Now, here's the side of things that anti-vaccination advocates don't realize. They're not just harming themselves. They're harming everyone else. That's the side of the equation you never, ever hear from Generation Rescue, or any of the other anti-vaccination movements. A critical component of the vaccination schedule is herd immunity. If enough people in a population are immune to a disease, they are individually better protected against it. You get better protection if you are completely unvaccinated, and are surrounded by a herd, friends and neighbors, who are protected than you are if you are completely protected, and surrounded by a herd which is not. This is a non-trivial point, and something you never hear Jenny McCarthy mention in any of her interviews or press conferences. Every single person who gets convinced not to vaccinate harms not only themselves, but those around them.
In the case of childhood vaccinations, we're talking about children. Children at the Kindergarten level and younger. Even if those children are vaccinated, if enough individuals in their herd are not, they're less well protected.
Seriously. Get vaccinated. If you don't care about your own kid, the least you could do is care about someone else's.
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