Endless Thread presents a special series, "Infectious: The Strange Past and Surprising Present of Vaccines — and Anti-Vaxxers." This is Part Two. Find Part One here.
The Flintstone Dilemma
There was a time when Fred Flintstone was ubiquitous. And so were the measles. At least, common enough that they were a regular plot point in an average sitcom with about the same stakes that a sitcom usually has:
Wilma and Fred and the gang had to miss a cake-baking competition, which is a pretty far cry from how we typically hear about measles these days:
So which is the measles? A minor inconvenience and source of comedy in "The Flintstones," or a growing, deadly international emergency?
If you talk to the official organizations whose solemn mission it is to protect the health of the population, measles outbreaks are a crisis. The Centers for Disease Control and Prevention have now confirmed more than 700 cases across 22 states in the United States in 2019 alone. That’s despite the disease having been declared eradicated in the U.S. in the year 2000.
Globally, the World Health Organization reported more than 170,000 cases of measles from just 10 countries in a six-month span between September 2018 and February 2019.
"I think you should be skeptical of anything you put in your body," says Dr. Paul Offit, a professor of pediatrics at Children’s Hospital of Philadelphia and the director of the Vaccine Education Center. But when it comes to vaccines, Offit says the evidence is indisputable. "The record of vaccines has been remarkable."
But Offit and the huge majority of health professionals who recommend vaccines have competition, like prominent anti-vaccine activist Del Bigtree, who often cites a scene from "The Brady Bunch" when making the point that the measles isn't a big deal.
"There was never a sitcom that made fun of cancer. There was never a sitcom that’s made fun of AIDS. But we did make fun of measles at one point. Why? Because we weren't afraid of it," says Bigtree
Many anti-vaccine activists also argue that so-called "natural immunity," which is acquired by contracting and surviving measles, is stronger than vaccine-induced immunity. Dr. Offit actually agrees ("I think that is true"), but he says natural immunity also comes with serious risk: "I had to suffer the price of natural infection [as a kid]. Fortunately I didn't die, but I could have been one of the 500 people that died every year from measles before there was a vaccine."
Today, certain segments of the population, including cancer patients and the elderly, are at much higher risk of serious complication from the measles than others. Dr. Offit argues putting those people at risk isn't worth it because the immunity people get from vaccines is plenty strong. "The measles vaccine was so effective that we eliminated measles by the year 2000."
What 'Anti-Vaxxer' Really Means
The argument over vaccines begins with the term anti-vaxxer itself. "Vaccine hesitant," "selective vaccinator," and "vaccine resistant" are all labels that some prefer. Epidemiologist Rene Najera has spent much of his career interacting with anti-vaxxers online and has identified three different types of people who fall under that umbrella term:
- The first "are the people who don't know better and they are reasonably afraid of a vaccine adverse reaction." (i.e., new parents who heard something scary about vaccines and have a lot of questions.)
- The second "have a medical degree or a science degree and they totally misinterpret or misunderstand the information that they’re reading." (i.e., the "experts" who generate a lot of the misinformation about vaccines that's out there.)
- The third are "the showmen, the people that are making money off of this ... They may or may not know that they're lying, but they do a lot of lying. And they're doing so for monetary gain." (i.e. the people who spread misinformation about vaccines.)
Of course, Dr. Najera says these categories are not mutually exclusive. "You may have overlap of all three at some point."
Vaccines And Autism
If there was a medical paper patient zero for the debate over vaccines in our current era, it’s a study from 1998 in the U.K. by a gastroenterologist named Andrew Wakefield. In it, Wakefield drew a connection between vaccines and autism.
The study has been thoroughly debunked by the medical community. People even discovered that Wakefield’s research was funded by people suing vaccine makers — a clear conflict of interest. Wakefield has since been stripped of his credentials, but his false claims continue to permeate the conversation around vaccines, even after more than 100 different studies, including a recent one involving 650,000 children in Denmark, with evidence to the contrary.
President Trump even repeated the unfounded autism claim during one of the 2015 Republican debates.
Najera has an idea about why the idea of a link between vaccines and autism is appealing to a lot of people, in spite of mountains of evidence to the contrary:
Autism diagnoses happen more or less around one year of age, when the child is developing and is starting to have their first words ... And that's around the time [they] get the MMR vaccine. And so you have these folks who went and got their children vaccinated [and] then a couple of weeks later, the child is not developing as expected and they get the diagnosis of autism. And where do they look for the blame? The vaccine.
We posted to the autism community on Reddit to get their thoughts on the vaccine/autism claim. Their reaction was swift and strong. Most of the responses, many from people with autism or families affected by the disorder, captured a sentiment shared by Redditor NerdThreePointZero:
A Cultural Controversy
What is happening now is tough to explain, from the continued and seemingly increasing prevalence of anti-vaccine misinformation online, to outbreaks of previously eradicated diseases in communities across the country.
Dr. Offit says there is a controversy, "but it's not a scientific controversy," as anti-vaxxers often claim. "It certainly is a cultural controversy, and for that reason, I think it needs to be confronted as a cultural controversy." And a big part of the reason that this controversy exists is, well, the internet.
The internet is the thing that makes this current moment different from the early days of vaccine resistance. On the internet, it is not about how accurate one's information is. It is about how much noise someone makes and how many people they reach.
In the next episode of "Infectious," we look at the spread of misinformation online — how it’s reinforcing beliefs and opinions in the debate over vaccines, and how we begin to fix it.
Thanks to Redditor u/Demonsora883 for this week's artwork. You can find him on Instagram.