Childhood immunizations have been controversial for centuries. To many, the idea that protection or immunity can be gained by deliberate exposure to a disease is counter-intuitive. That unease, coupled with the possibility that a child might have an allergic reaction to a vaccine’s ingredients, is enough to cause many parents to question the wisdom of inoculation.
Anti-vaccination sentiment began early, even prior to Dr. Edward Jenner’s creation of the first smallpox vaccine in 1796. In Boston in 1721, Reverend Edmund Massey published a paper titled “The Dangerous and Sinful Practice of Inoculation,” which argued that diseases were sent by God to punish evildoers and that attempts to prevent them, therefore, were sinful.
By the late 1800s, anti-vaccine movements, present in both Great Britain and the United States, were active. The Anti-Vaccination Society of America was founded in 1879, and the protest against vaccinations continues today. Ironically, the movement expanded even as the number of smallpox outbreaks was reduced because of inoculation.
By 1900, many states – including New York, Massachusetts, California, and Pennsylvania – passed laws requiring vaccinations for any children attending public schools. Now, this is required by all 50 states – though all do provide some form of medical, religious, or philosophical exemption. The U.S. Supreme Court ruled in 1905 that states have the right to enforce compulsory vaccination laws, a ruling subsequently confirmed in 1922 and most recently in 2014.
Despite the opposition, vaccines for smallpox, rabies, typhoid, cholera, diphtheria, tuberculosis, tetanus, polio, measles, mumps, and rubella were in use by the 1970s. In 2014, the Centers for Disease Control estimated that vaccinations had prevented more than 21 million hospitalizations and 732,000 deaths among children since 1994.
The Andrew Wakefield Study
The controversy over mandatory vaccinations for children has intensified since the publication of a study in The Lancet in 1997 by British former physician Andrew Wakefield linking the measles-mumps-rubella (MMR) immunization to autism.
Claims Within the Study
Wakefield’s study involved 12 patients treated at a London hospital. He and his colleagues reported that all 12 children had intestinal abnormalities and development regression beginning one to fourteen days after the MMR vaccination. The study went on to suggest that the vaccine caused a gastrointestinal syndrome in susceptible children that triggered autism.
Recognizing the profitability of a public controversy – fueled by all parents’ desire to protect their children – the popular press and fringe-favoring talk show hosts in the UK and U.S. immediately fanned the flames of public reaction and spread news of the study far and wide. According to a Salon article, U.S. newspapers mentioned the link 400 times in 2001 and more than 3,000 times in 2009 – and there were five times the number of television evening news stories on the link in 2010 than in 2001. As a consequence, vaccination rates in Great Britain decreased significantly.
The British Medical Journal Investigation of the Study
British Investigative journalist Brian Deer – funded by the Sunday Times of London and the British Channel 4 network – subsequently investigated the study and Dr. Wakefield in a series of articles published in the British Medical Journal. Deer concluded that the study was deliberately faked by Wakefield, specifically identifying the following major problems:
- Children were not randomly selected. None of them lived anywhere near the hospital where Wakefield examined them, one even coming from California. All were recruited by an anti-MMR vaccine campaigner.
- Wakefield was a paid consultant to a lawyer suing an MMR vaccine manufacturer. While the relationship was not disclosed, Wakefield received about $668,000 plus expenses.
- Five of the twelve children had development problems prior to receiving the MMR vaccine. Only one of the twelve children had regressive autism, even though the study reported nine with the condition. Three of the twelve were never diagnosed with autism.
- In nine of twelve cases, gut examinations were changed from “unremarkable” to “non-specific colitis.”
- For all 12 children involved, medical records and parent accounts contradict case descriptions in the published study.
- Dr. Wakefield was also patented a measles vaccine in 1997 that might succeed if the combined MMR vaccine was withdrawn or discredited.
The Aftermath of the BMJ Investigation
As a result of the controversy, the UK General Medical Council conducted their longest-ever inquiry and judged Wakefield to be “dishonest,” “unethical,” and “callous,” and removed his medical license in 2011. The Lancet partially retracted the research in February 2004, and made a full retraction in 2010 following the General Medical Council’s finding.
In 2004, Wakefield sued Brian Deer. The suit was subsequently dropped with Wakefield liable for the costs of Deer and other defendants. In January 2012, after moving to Texas, Wakefield sued Deer and the British Medical Journal again. The case was thrown out of district and appeals courts and Wakefield was again found liable for the defendants’ costs. Despite the numerous setbacks and challenges to his conclusions, Wakefield continues to inspire the anti-vaccine movement although he no longer practices medicine.
The American Academy of Pediatrics’ Position on Autism and MMR Vaccine
Study after study – including from the American Academy of Pediatrics (AAP) and Institute of Medicine of the United States’ National Academies – state that there is no causal link between the MMR and autism. According to the AAP, “Autism is a chronic developmental disorder, often first identified in toddlers from age 18 months to 30 months. MMR is administered just before the peak age of onset of autism symptoms. This timing leads some parents to mistakenly assume a causal relationship. There is no evidence that MMR causes autism.”
Despite the subsequent reports rejecting any link between autism and vaccinations, the argument continues. Vaccination rates have fallen significantly, and outbreaks of measles have increased in both countries.
In a related claim linking autism to vaccines, some public figures such as Robert F. Kennedy, Jr. have suggested that the preservative thimersol, present in some vaccines, causes autism. Even though thimersol has been removed from all routinely used childhood vaccines (except the flu vaccine), there has never been any evidence suggesting a link between the chemical and autism.
Despite the overwhelming preponderance of studies asserting the value of vaccination and the low likelihood of harm, the issue of mandatory vaccination remains controversial and has become an issue in national politics.
Public Opinion and Politics
A national poll by Vanderbilt University in 2000 found that one-quarter of parents believed that their child’s immune system was actually weakened by too many immunizations and children get more immunizations than are good for them. A Pew poll released January 29, 2015 indicated that more than one-third of adults (37%) under the age of 50 believe that parents should be able to decide whether or not to vaccinate their children. As a consequence, it is not surprising that politicians are anxious to pander to vaccination foes.
Kentucky Republican Senator Rand Paul publicly announced in a February 2015 CNBC interview that “the state doesn’t own your children. Parents own the children, and it [vaccinations] is an issue of freedom and public health.” His belief apparently mirrors the sentiment of his father, former Representative Ron Paul, who according to The Huffington Post stated, “I don’t think anything should be forced upon us by the government, [and] immunization is one thing that we’re pressured and forced into.”
Another 2012 presidential candidate, Michelle Bachman, claimed that HPV vaccines can “put little children’s lives at stake.” In a public 2011 debate, Governor Chris Christie, afraid that Paul might gain a political advantage in the race for the presidency in 2016, seemed to agree, saying that immunizations are a matter of parental choice. Parents should note that both Senator Paul and Governor Christie have immunized their own children.
While Republicans seem to lead the attack against childhood vaccinations – likening the issue as an example of big government’s attack on personal freedom – liberal Democrats have also attacked vaccinations as a cause of autism and other neural disorders. Reflecting the potential political consequences of supporting vaccinations, both Hillary Clinton and President Barack Obama have lent credence to the anti-vaccine crowd with their tepid response that the issue requires more study before reaching a conclusion about the value or threat of inoculation.
As a consequence, vaccination rates have fallen dramatically in some areas of the country, raising the specter of deadly outbreaks of such past killers as measles, whooping cough, and smallpox. According to the World Health Organization, the measles vaccination rate in the United States is lower than third-world countries like Rwanda and Bangladesh.
Opposing Views on Mandatory Vaccination
Support for Optional Vaccination
People who oppose mandatory childhood vaccinations argue the following:
- Constitutional Freedoms Are at Risk. According to Barbara Low Fisher, co-founder of the National Vaccine Center, “If the State can tag, track down, and force citizens against their will to be injected with biological products of known and unknown toxicity today, there is no limit on which individual freedoms the State can take away in the name of the greater good tomorrow.” In 2011, Ron Paul concurred, commenting, “Freedom over one’s physical person is the most basic freedom of all, and people in a free society should be sovereign over their own bodies.”
- Protected Religious Freedoms Are Being Attacked. According to Mary Baker Eddy, founder of the Christian Scientists, a “calm, Christian state of mind is a better prevention of contagion than a drug, or than any other possible sanitive method.” The Church of Illumination has long opposed vaccination and immunization.
- Vaccines Contain Harmful Ingredients and Are Unnatural. Vaccines may include such potentially harmful substances as aluminum, formaldehyde, glutaraldehyde, and chicken or yeast proteins, among others. It is also argued that natural infection almost always causes better immunity than vaccines. Kurt Perkins, a Colorado-based chiropractor, claims that “immunity is a natural thing. Vaccines are an artificial thing.”
- Targeted Diseases Have Disappeared or Are Relatively Harmless. Over the last quarter-century, there have been few U.S. cases of diphtheria, tetanus, polio, rubella, or mumps. Chickenpox and measles are just rashes and easily treated with rest, fluids, and acetaminophen (Tylenol), which can also be used to treat rubella.
Support for Mandatory Vaccination
Parents who favor mandatory childhood immunization claim the following:
- Vaccines Save Lives, Disfigurement, Misery, and Money. In the past century alone, millions of cases of deadly diseases have been prevented or their effects reduced. In the 20th century, according to the CDC, diphtheria killed 21,053 people annually, measles caused 530,217 fatalities, mumps caused 162,344, and rubella, 47,745. The number of deaths has declined by 99% because of vaccinations, according to Dr. Walter Orenstein of Emory University in a presentation titled “An Overview of Vaccinology” to the National Foundation of Infectious Diseases on March 9, 2012. In addition, the last case of smallpox in the United States was in 1948, and polio in this country has virtually disappeared. An average of about 30,000 people have had adverse reaction to vaccines (one per million), with 13% classified as “serious,” according to the Department of Health and Human Services.
- Vaccine Ingredients Are Safe in the Amounts Used. Very small amounts of ingredients are used in vaccines and they require more than 10 years of testing before they can be licensed. Children are exposed to more aluminum in breast milk and infant formula than in vaccines, for example. Thimersol has been removed or reduced to trace amounts in all vaccines for children under six years of age.
- Major Medical Organizations State That Vaccines Are Safe. The Centers for Disease Control (CDC), Food and Drug Administration (FDA), Institute of Medicine (IOM), American Medical Association (AMA), American Academy of Pediatrics (AAP), UNICEF, U.S. Department of Health and Human Services (HHS), World Health Organization (WHO), Public Health Agency of Canada, Canadian Paediatric Society, National Foundation for Infectious Diseases (NFID), and American Academy of Family Physicians (AAFP) all state that vaccines are safe.
- Protection From Disease Is Directly Correlated With the Percentage of Population Inoculated. A “herd” or community immunity is present when 92% to 94% of the population is immunized. Unfortunately, there are children who cannot be immunized due to their young age, allergies, and medical conditions that leave them immunocompromised. They depend upon a “herd immunity” to keep deadly disease at bay. Since many vaccine-preventable diseases continue to exist elsewhere in the world and are only a plane ride away, any non-immunized person remains at risk. Amish missionaries returning from the Philippines were responsible for a measles outbreak in Ohio in June 2014. In 2015, a similar measles outbreak began at Disneyland from a suspected overseas traveler. In fact, any unvaccinated person is at risk when going to theme parks, airports, or other tourist destinations.
All parents worry about their children’s health. Whenever a child becomes ill or is hurt, we agonize over what we could have done to prevent it. At the same time, each of us has a duty to protect other children just as we protect our own.
I am thankful that my own children reached adulthood without confronting the deadly consequences of smallpox, measles, and polio – diseases that killed, maimed, and disfigured millions of children over the ages. I hope for the same with my 10 grandchildren.
While I understand the fears of every parent, I – and the majority of Americans, Republicans or Democrats – agree that mandatory immunization should not be a matter of private choice, but public health. No parent would allow their child to take a loaded gun or a hunting knife to school. Failing to vaccinate your children may expose them to a similar risk of life or death.
Where do you stand on the vaccine debate?