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The anti-vaccine myths that need to go away

According to the World Health Organization, vaccine refusal is one of the top 10 global health threats in 2019. There is a growing trend of parents not vaccinating their children because of some beliefs they have about vaccines and are obtaining misleading information from the internet. In this article, I will be addressing these beliefs and what’s wrong with them.

Argument 1: “Diseases were already going away before vaccines were even used”

There were several factors that could have contributed to controlling diseases before the invention of vaccines. Better sanitation, better socioeconomic conditions, development of antibiotics, and less crowded living conditions all played a positive part. However, the introduction of vaccines was what really drove the number of some diseases to drop dramatically.

If we look at developed countries like Great Britain and Japan, we can see how the retraction of vaccines had a big impact. These two countries had temporarily retracted the vaccine for pertussis (whooping cough) in 1974. In Great Britain, people were questioning the safety of the vaccine because of the Kulenkampff et al. study where they suggested that neurological complications of 36 children were caused by the vaccine. After there was a drop in people getting the pertussis vaccine, an epidemic occurred where there were more than 100,000 cases of pertussis and 36 deaths by 1978.

In Japan, they also temporarily stopped using the vaccine because there were reports of deaths following the vaccine. In 1974, there were 393 cases of whooping cough and no deaths, but these numbers jumped to 13,000 cases and 41 deaths by 1979 after the vaccine wasn’t used. From these cases, we can easily see that the development of vaccines made a great impact on the decrease on the prevalence of pertussis.

The main point is that diseases would not be disappearing with the retraction of vaccines and vaccines play a key role in stopping and potentially eradicating several dangerous diseases.

Argument 2: Vaccine-preventable diseases are no longer a threat we need to protect ourselves from

Though it is true that we have seen a decrease in vaccine-preventable diseases, it does not mean that we should stop vaccinating our kids.

In a survey completed by 391 parents who claimed exemption from vaccines for school requirements, 20.9% indicated that the disease was not dangerous so they did not have their children vaccinated. This is problematic because while it may seem most of the diseases have been in control, vaccines are still crucial in keeping that control.

Let’s look at the case of measles. In 2018, there were 372 cases of measles in the United States. Now, in 2019, the number of cases has jumped to 1261 cases. According to the CDC, many of the cases are from people who have not been vaccinated against measles. Measles is a highly contagious disease, so an infected person can easily spread it to someone who has not been vaccinated against it. If you can be vaccinated, then get vaccinated. You are not only protecting yourself, but you are also protecting those around you who cannot get the vaccine due to allergies or compromised immune systems.

Argument 3: Vaccine causes autism

Measles cases reported in the United States, 1944-2007. Other countries where vaccines were widely implemented display similar trends. Image credits: CDC.

What really caused the popularity of the anti-vaxx movement to take off was when Jenny McCarthy, an American actress, model, and author claimed that vaccines caused her son’s autism.

She linked her statement to a (now retracted) 1998 study by Andrew Wakefield, a British doctor, and his 12 colleagues. In response to Wakefield’s study, many new studies came out immediately that rebutted the link between MMR vaccination and autism. There were many things wrong with Wakefield’s study, from terrible study design to experiments that were unethical and painful for children.

In the end, it became clear that the researchers only selected data that fitted their case and fabricated facts. On top of that, Wakefield had a financial interest where he was funded by lawyers who were engaged in lawsuits by parents against vaccine-producing companies. Consequently, Wakefield’s study and his doctor license were retracted. Nevertheless, despite all these problems, many people still believe Wakefield’s fabricated study.

Argument 4: Multiple vaccinations will overload children’s immune system

As children, it is important that they are exposed to different antigens in their environment so their immune system can build antibodies. There is a hypothesis called the “biodiversity hypothesis” where it states that people who have reduced contact with the natural environment can affect the composition of their microbiota, which are good bacteria found in our bodies as a defense mechanism. Less exposure to the natural environment can decrease the ability for the immune system to adjust to different antigens. By exposing oneself to the natural environment, they are protecting themselves from allergy and inflammatory disorders. Every day, children are exposed to many foreign antigens from playing outside, eating food, and infants placing objects or their hands in their mouths. Vaccines do the same thing because they are introducing specific antigens into the child’s body to help build antibodies against it. Administering multiple vaccines is really no different from the child being exposed to many different antigens in their environment. In fact, advantages from receiving multiple vaccines in one doctor visit are early exposure to vaccines which protect children during the early months of their lives, reduces the number of doctor visits which saves the parent money and time, and ensures that there will be no missed opportunities to get the recommended vaccine. Children are already being exposed to many different antigens from their environment, so adding a few more from vaccines is not overloading their immune system.

Conclusion

Vaccines were invented for a reason and have been proven countless of times that they are effective in preventing outbreaks of diseases. Natural immunity is just not enough. Getting vaccinated does not only protect your child, but it also protects everyone around them. Vaccinations are important in keeping our population healthy and that cannot be stressed enough.

For the Nth time – measles is bad. Here’s why…

Measles is a highly contagious virus that initially causes a runny nose, sneezing and fever and later leads to a blotchy rash starting on the face and spreading to the rest of the body. The majority of the people infected will recover, but measles can cause diarrhea and vomiting, which can lead to dehydration, middle ear infection (otitis media), which can lead to hearing loss, or pneumonia or potentially fatal encephalitis (swelling in the brain).

When people get an infection, their immune system produces antibodies to fight the infection. After the body gets rid of the infection, special immune cells remember that specific pathogen and help the body mount a faster defense if that same pathogen invades the body again. But not with measles. The virus reboots children’s immune system and the “amnesia” makes them vulnerable to other pathogens that they might have been protected from a previous infection.

In one study [M.J. Mina et al., Science, 366:599–606, 2019], measles infection in unvaccinated children in a community in the Netherlands was associated with up to a 70% decline in antibodies to other pathogens following infection. After cases of severe measles, unvaccinated children lost a median of 40% (range 11-62%) of their already existing pathogen-specific antibodies and after a case of mild measles, children lost a median of 33% (range 12-73%) of these pre-existing antibodies.

On the other hand, kids vaccinated retained over 90% of their antibody repertoires over the same period. The researchers examined blood from 77 unvaccinated children infected with measles in the Netherlands during a 2013 outbreak and compared these samples with the blood of 115 uninfected children and adults using the VirScan system, a tool that detects antiviral and antibacterial antibodies in the blood. Samples were taken prior to and after measles infection.

The team found that rather than a simple loss of total IgG, the most common type of antibody found in blood circulation, there is a restructuring of the antibody repertoire after measles. This is the first study to measure the immune damage caused by the virus and is further evidence for the “immune amnesia” hypothesis (that by depleting antibody repertoires, measles partially obliterates immune memory to previously encountered pathogens).

The same investigators also infected macaques with measles and monitored their antibodies against other pathogens for five months. The measles-infected monkeys lost 40–60% of their antibodies against pathogens they have previously encountered suggesting that measles infection wipes out long-lived plasma cells in the bone marrow that can create pathogen-specific antibodies.

A separate, independent team published a related study [V. N. Petrova et al., Sci Immunol, 4:2019] showing that measles infection causes incomplete reconstitution of the naïve B cell (not exposed to an antigen) leading to immunological immaturity and compromised immune memory to previously encountered pathogens due to depletion of memory B lymphocytes that persist after measles infection. The study provides a clear biological explanation for the observed increase in childhood deaths and secondary infections several years after an episode of measles.

These two new studies emphasize the importance of measles vaccination and suggest that given these findings, booster shots against other illnesses, such as hepatitis or polio, may be necessary for children infected with measles.

In 2017, the World Health Organization (WHO) reported 110 000 measles deaths globally, mostly among children under the age of five. The actual number of people infected with measles is most probably higher given that the WHO only collects data on cases confirmed through lab testing or clinical visits excluding thousands who do not seek medical attention.

With the global trend of vaccine hesitancy, skeptical parents are refusing to get their children vaccinated due to false concerns about their safety. These 2 new studies add strong evidence and undoubtedly confirm what scientists and public health experts have known all along: measles bad, vaccines good. This time let’s remember… let’s not have amnesia that measles can cause immune amnesia.

A 10% increase in dog vaccination reduces human deaths by 12.4%

Rabies is a virus that is usually spread by a bite or scratch from an infected animal. The virus attacks the central nervous system and can cause inflammation in the brain, eventually leading to death. In principle, no human today should die from rabies, and yet rabies is responsible for an estimated 59,000 human deaths and over 3.7 million disability-adjusted life years (DALYs) lost every year.

That total is not as high as the death toll from tuberculosis, HIV/AIDS, and malaria; but, unlike those diseases, rabies seems able to infect all and every mammal species we know of. Dogs, the predominant host in most regions, can become infected from any rabid wild animal, and then infect humans. 

The World Health Organization has made it a goal to eliminate human rabies deaths due to dog bites by the year 2030. An increase in dog rabies vaccination rates decreases dog rabies cases, human exposure, and human deaths, according to a new article in PLOS Neglected Tropical Diseases.

Implementing the goal of rabies elimination requires understanding the complex interaction between dog rabies vaccinations and human risk and response. Between 1995 and 2005, there was a rapid decline in dog and human rabies cases in seven Latin American countries following investments in both dog vaccination programs and human post-exposure prophylaxis (PEP) use.

New research by investigators from the School of Economic Sciences and the Paul G. Allen School for Global Animal Health at Washington State University, analyzed data from those seven countries — Brazil, Colombia, Peru, Venezuela, Nicaragua, Dominican Republic and Mexico. The data, compiled from reports published by the Reunión de Directores de los Programas de Rabia de las Américas (REDIPRA) from 1995 through 2006, included rates of dog vaccinations, dog rabies cases, reported human exposures, human PEP use, and human rabies cases.

The researchers found that a 10% increase in dog rabies vaccination rates decreases cases of dog rabies 2.3%. They add that this leads to a decline in how often humans are exposed to cases of rabies. At the same time, however, the reported number of cases of rabies stays constant or even increases — as more people report exposure to the same infected animal “which may result from higher rabies awareness due to anti-rabies campaigns,” the team notes.

While human exposures decline as dog rabies cases decline, exposures per dog rabies case increase, likely due to increased awareness. In addition, a 10% increase in dog vaccination leads to a 2.8% decrease in PEP use, and each 10% increase in PEP use decreases human deaths by 7%. Overall, a 10% increase in dog vaccination reduces human deaths by 12.4%.

“The findings highlight the critical importance of mass dog vaccination, heightened public awareness, treatment access, and the use of clinical algorithms to reduce both false negatives leading to death and false positives leading to costly unnecessary PEP prescriptions,” the researchers say.

World Rabies Day, observed on September 28 every year, aims to raise awareness about rabies prevention as well as highlight progress in defeating this horrifying disease. The day also marks the death anniversary of Louis Pasteur, the French chemist and microbiologist, who developed the first rabies vaccine.

Italy: No vaccine, no school

After months of heated debate, a law in Italy has finally entered into force, mandating that children must be vaccinated to be accepted into school. Children have been reportedly told to not turn up to school unless they can prove they have been vaccinated.

Image in public domain.

Italy’s populist government has strongly crusaded against vaccines. Italy’s Five Star movement and its coalition partner, the far-right League, both voiced their opposition to compulsory vaccinations. This campaign got very heated (and dirty) at points, with advertising campaigns using Jewish imagery to liken vaccination to Nazi campaigns.

But although the idea of rejecting a proven scientific method of eliminating a disease is laughable, its effects are anything but. Italy accounted for 34% of all measles cases reported by countries in the European Economic Area, and outbreaks killed 12 people in 2017-2018 — all of whom were unvaccinated.

Doctors have expressed serious concerns that this is just the start of a massive problem, as Italy’s vaccination rate has plummeted to below 80%, compared to the World Health Organisation’s 95% target —  the point at which “herd immunity” kicks in, protecting those who cannot be vaccinated. Attempting to stop this growing concern former  health minister Beatrice Lorenzin introduced a policy in 2017 obligating children to receive ten compulsory vaccinations.

“Italy’s measles vaccine coverage was par with Namibia, lower than Ghana,” commented Roberto Burioni, a professor of microbiology and virology at San Raffaele University in Milan. “But the law was working, the coverage was improving. We should strengthen it, not weaken it. Now, children who are not vaccinated will endanger other children at school who are too small for vaccines or cannot be vaccinated because they suffer from immunosuppressive diseases.”

[Also Read: Populism and antivaxxing go hand in hand, new study finds]

However, political hostility quickly ensued, and Italy’s populist politicians were keen to take advantage of this. Deputy Prime Minister Matteo Salvini repeatedly said that the 10 obligatory vaccinations, which include measles, tetanus and polio, “are useless and in many cases dangerous, if not harmful” — an idea which is devoid of any scientific base or factual truth.

Salvini and his political allies tried to delay or stop the mandatory vaccination law, but it finally entered into force today. Parents had until today to provide documentation regarding vaccines. Children under 6 and over 16 can be turned away from school. But while children aged 6-16 cannot be banned from attending school, parents will get fines of up to €500 ($560) if they send their unvaccinated children to school without a serious reason.

In addition to reducing exposure to potentially dangerous diseases, this will also ensure that children who are suffering from serious health issues, who cannot be vaccinated, can attend school safely. For instance, an 8-year-old who spent months receiving treatment for leukaemia was unable to attend school because he was at a high risk of infection because a proportion of pupils in the school had not been vaccinated — including several in the same class.

Teddy bear vaccine.

Michigan cut vaccine waivers by 35% by exploiting parents’ laziness

Since evidence and well-argument facts fail to convince parents to vaccinate their children, Michigan state authorities have taken up a more convincing approach — by requiring extra effort to get a vaccine waiver.

Teddy bear vaccine.

Image via Pixabay.

So most people agree (with the science, that is) that we should vaccinate our kids. But the perks of wiping out horrible diseases isn’t enough to convince everybody, for some reason. Granted, some kids need to steer clear of vaccines because they’re allergic to them, or due to a host of immunodeficiency conditions. I don’t think anybody wants to force them to take the shots. But the vast majority of parents opt out of vaccinations based on religious or philosophical reasons, and I guess we’ll have to get used to that until facts aren’t a make your own adventure type of thing any longer.

Or… do we? Michigan says ‘haha, no.’ The state set a pretty nifty system in place to gently, passively, stealthily persuade parents that maybe, just maybe, they should get their kids vaccinated. And it’s surprisingly simple: they just added more red tape to the process of getting a waiver.

So to get your child off those hidden-agenda vaccines and just go on faith (sorry kid), you need a little slip of paper known as a vaccine waiver. Between 2013-2014 Michigan had the fourth highest rate of children entering kindergarten with a vaccination waiver in the US, around 22%. This came down to how easy it was to get the waiver — over the Internet, the phone, or simply by mailing a form. But following outbreaks of whooping cough and measles in the state, legislators added the ‘inconvenience factor’ in December 2014, requiring parents to consult with a health educator before they would be granted a waiver. With this extra bureaucratic step, which parents have to do in person, the state has managed to bring this rate down by 35% in one year’s time.

Vaccination rates also rose accordingly. The percentage of children who took the state-required fourth round of immunizations for diphtheria, tetanus, and pertussis in the state rose from about 78 to 85% during this time. Rates of unvaccinated children dropped from 22 to 15% — bringing Michigan to about the national average for this vaccination metric.

“The idea was to make the process more burdensome,” Michigan State University health policy specialist Mark Largent, who has written extensively about vaccines, told KHN.

“Research has shown that if you make it more inconvenient to apply for a waiver, fewer people get them.”

This approach removed messy debates over vaccines with opponents, Largent added, because “by heightening the burden, you change some of the [parents’] incentives” in the first place.

“Moral claims and ideology don’t matter as much when it’s inconvenient,” he explains.

Celebrities endorsing an anti-vaccine rally. Credit: io9 // Gizmodo

Why the Anti-Vaxxers Threaten Us All

Celebrities endorsing an anti-vaccine rally. Credit: io9 // Gizmodo

Celebrities endorsing an anti-vaccine rally. Credit: io9 // Gizmodo

In recent years, anti-vaccine proponents have been successful in persuading an increasing number of parents that their children don’t need to be vaccinated. Some anti-vaccine advocates, unfortunately, also come from the medical field. Dr. Andrew Wakefield’s articles allege that vaccines against measles cause autism. In addition, celebrities like Jenny McCarthy have made second careers of being concerned mothers crusading against vaccination.

The sad fact is that neither science nor sense are on their side. Wakefield’s research is thoroughly discredited. Scientists at both the U.S. Centers for Disease Control (CDC) and the National Institutes of Health, leading centers of U.S. medicine, are unequivocal that Wakefield’s data is not supported by the science behind either autism and vaccines.

There is no data indicating that vaccinations cause autism. In fact, researchers are still studying what does cause it. They have found that 90% of individuals with autism also have gastrointestinal problems — perhaps indicating a connection between autism and digestive health, but not between autism and vaccinations.

As for McCarthy, she is simply using a celebrity platform to promulgate what are in essence lies put into circulation by Wakefield and others.

Anti-Vaxxers Threaten Public Health

The other sad fact is that the growing ranks of anti-vaxxers are a danger to use all. A number of diseases that used to threaten illness or death have been eradicated by vaccines. Anti-vaxxers are bringing them back.

For instance, in 2002, the CDC announced that measles had been eradicated in the U.S. Measles can cause deafness and possibly death. However, measles is once again not only present in the U.S., but it’s on the upswing.

In Minnesota, measles was epidemic in 2015. A three-three-old Minnesota boy was identified as the patient zero, or the entry point. He exposed over 3,000 people.

His parents had read the erroneous reports that the measles vaccine caused autism. As a result, they didn’t vaccinate him, and he contracted measles on a family trip overseas.

They were not alone, either. In their community, vaccinations fell dramatically over the 2004 to 2014 period. In 2004, more than 90% of people were vaccinated. Ten years later, just over 50% were — and all as a result of the false information that there was a link between vaccines and autism.

Thanks to anti-vaxxer propaganda, the U.S. is no longer free of measles.

The vaccination of a large percentage of the population strengthens herd immunity. The anti-vaxxers threaten herd immunity.

Making a Good Health Measure Into Bad Health Fears

What the anti-vaxxers are doing has the potential to roll back one of the major medical successes of the twentieth century. Throughout the 1900s, one disease after another was fought into submission.

Influenza was a major epidemic in 1918, killing thousands of people. Flu still has the potential to kill people worldwide in pandemics. Even milder strains can kill the elderly. However, for the population as a whole, flu vaccine protects from common flu strains.

Polio was a major crippler of twentieth-century children until a vaccine was developed. Polio meant that an afternoon swim could result in contracting the disease, potentially resulting in life-long paralysis. The vaccine changed all that.

[ALSO SEE] Vaccines work: only 15 polio cases in 2016 — by 2020 it should be completely eradicated

One of the tragedies is that the public health successes of vaccines made life seem safer, and inadvertently set the stage for the anti-vaxxers. Although infectious diseases are still among us (Zika virus and Ebola come to mind), it has been decades since such childhood diseases like measles and polio were commonly viewed as threats.

Because of vaccinations, they ceased to be present dangers — to the point where the anti-vaxxers seem to have forgotten that the world is full of health dangers.

Anti-vaxxers draw on a historical wellspring of fears concerning vaccination. Historians of medicine point out that people a century ago feared that vaccines would cause disease — partly because some vaccines were made of live viruses. But such fears were ill-founded then, just as they were ill-founded now.

Anti-vaxxers also seem to be people who are more swayed by alarmism and anecdote than by science and rational thought. They may also be more politically conservative and distrust government claims such as those by the CDC.

Again, though, the data here is clear: There is no link between autism and vaccinations. Yet the science has not persuaded anti-vaxxers.

When a Personal Choice Affects All of Us

Anti-vaxxers frequently emphasise the role of personal choice in the vaccination decision. The backdrop is the increasing emphasis on personal choice in contemporary life.

However, the anti-vaxxer choice is not solely a personal choice. Because diseases are spread among social units — many of them are carried through bodily fluids or through the air — the choice to exert a precaution against diseases is a social one as well.

After all, society has supported quarantines of people with infectious diseases when there was no readily available treatment in decades past. Those suffering from yellow fever and tuberculosis, for example, were isolated until the disease had passed. Indeed, as we’ve seen with the Zika virus and Ebola, treatment for untreatable infectious diseases includes quarantine and protection for medical personnel now.

In some ways, vaccination is the positive side of disease protection, and perhaps it ought to be treated as more mandatory than a choice because of is potential social impact.