Feb 03 2015

Vaccine Debate Heats Up

We seem to be going through a spasm of debating vaccines (if social media is any guide), probably provoked by the Disneyland measles outbreak (102 cases in January, mostly stemming from the outbreak). This recent outbreak has finally garnered the attention of the public at large who are starting to realize that antivaxxers are a threat to public health. This resulted in a wave of criticism.

At first it seemed like the antivaxxers were just going to lay low and ride out this recent outbreak, but I guess the tide of anti-antivax was just too great. Now they are starting to push back with, of course, greater levels of crazy, driving even more criticism. The debate has percolated up to the political class, with the predictable embarrassing comments by clueless politicians. And around it goes.

Given that I have been covering this issue for over a decade, I guess I have to jump back into the fray.

A recent Pew Poll regarding whether or not vaccines should be required is very interesting. It shows no significant difference by sex, race, or income (Hispanics were slightly more pro-vaccine). However, there was a significant age effect: 18-29 year olds were 59% in favor of required vaccinations, with increasing numbers in each age category, and 65+ year olds being 79% in favor. The question is – is this an age effect or a generational effect? If the latter then we could see waning support for requiring vaccines in the future.

In 2009 there was no party difference in this question: 71% of Republicans and Democrats supported required vaccines. In 2014, however, Republicans dropped to 65% and Democrats increased to 76%. This is still a small difference, but the change is interesting.

A recent re-analysis of the 2009 Pew data also reveals that those who do not support required vaccines have decreased trust in big government, which may explain why the numbers are skewing to the right. However, 2009 may be an anomaly because this was during the H1N1 epidemic and there were many questions about how the government was handling the overall epidemic. We need to see if this correlation holds up in different years.

I suspect it will. Other data shows that those who are anti-vaccine are more likely to accept other conspiracy theories (such as the moon landing hoax). But the anti-vaccine movement remains a complex assortment of various narratives. It includes anti-corporate, anti-government, and generic conspiracy theorists. It includes some on the fringe of the environmental movement, and it includes some who follow an “alternative medicine” world view.  There’s a little something for everyone in the anti-vaccine movement (except for those who follow reason and the scientific consensus).

I certainly hope that anti-vaccine sentiments do not become more politicized, specifically that neither party adopts a position on the anti-vaccine spectrum as their party line. Governor Chris Christie (to whom people are paying attention because he is a likely presidential candidate) was asked while touring a medical facility in the UK if he believes in mandatory vaccines. He said:

“Mary Pat and I have had our children vaccinated and we think that it’s an important part of being sure we protect their health and the public health. I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.”

Yikes! This is likely generic political pandering – not wanting to piss off any potential voters, so throwing in something for everyone rather than taking a firm stand. The problem for Christie is that vaccines is one of those issues that you can’t dodge with a soft call for “balance.” Christie was soundly criticized, and his office recently put out a statement to “clarify” what the governor meant:

“The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.”

This is why politicians need to have a civic level of scientific literacy. I don’t think Christie will be courting the anti-vaccine vote. He just stepped into it out of ignorance.

Very much unlike Republican Senator Rand Paul. NBC reports:

Republican Sen. Rand Paul is standing by his statement that most vaccinations should be “voluntary,” telling CNBC that a parent’s choice not to vaccinate a child is “an issue of freedom.”

In an interview with the network Monday, Paul said that vaccines are “a good thing” but that parents “should have some input” into whether or not their children must get them.

And he gave credence to the idea – disputed by the majority of the scientific community – that vaccination can lead to mental disabilities.

“I have heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines,” he said.

His sentiments are clearly anti-vaccine. Paul represents the extreme Libertarian wing of the Republican party, who are decidedly anti-government and pro-freedom. This may be the reason for the change in the party numbers over the last six years discussed above.

Meanwhile, the media has been trotting out the outrageous crank de jour. They like to justify this with their own sense of “balance” (really false balance), but everyone knows that it’s just an excuse to have a freak show. This time around it’s “paleo-cardiologist” Jack Wolfson (he sounds like a character out of the series Angel).

It started with Wolfson’s rant against all the criticism of antivaxxers coming from the recent measles outbreak. The rant is an alternative medicine, natural is awesome, chemicals are yukky, conspiracy mongering load of nonsense. He includes this gem:

“Be angry with pharmaceutical companies for allowing us to believe living the above life can be treated with drugs. Correctly prescribed drugs kill thousands of people per year. The flu kills just about no one. The vaccine never works.”

Wolfson clearly belongs to the – “I’m just going to make up my own facts as I wish” crowd. The flu kills 3-49 thousand Americans each year – thousands of people a year. The flu vaccine clearly works. The major variable is the match between the strains covered in the vaccine and the ones circulating during flu season.

Wolfson also stated that, in his bizarro world, children have a right to contract serious illnesses like measles.

In the name of false balance, his rant got him the attention of the media who have been interviewing him, revealing further gems.

“I’m not going to sacrifice the well-being of my child. My child is pure,” Dr. Jack Wolfson said in the interview. “It’s not my responsibility to be protecting their child.”

When pushed on this point, whether he would feel bad if another child died because he did not vaccinate his own, he said:

“I could live with myself easily. It’s an unfortunate thing that people die, but people die. And I’m not going to put my child at risk to save another child.”

His philosophy comes through clearly here. He and his children have “purity of essence” which makes them invulnerable to illness. They have gained this magical purity by following all sorts of naturalistic nonsense. If you are not pure, then it’s your fault (see his rant), and you and your children deserve to die. His conscience is clean.

What about the poor girl with leukemia who cannot be vaccinated and contracted measles from the Disneyland outbreak?

“As far as I’m concerned, it’s very likely that her leukemia is from vaccinations in the first place,” Wolfson said.

So, it’s her parent’s fault for violating her purity with the evil vaccines. Got it.

While I deplore false balance, I wonder if on the whole it is a good thing that Wolfson is being showcased by mainstream media. He is a dangerous raving lunatic, in my opinion, and an embarrassment to my profession. If this is the face of the anti-vaccine movement, I think most of the public will appropriately recoil.

Conclusion

The current measles outbreak is not yet over, and neither is the public debate it has provoked. It is good to see the public and social media backlash against antivaxxers go beyond the skeptical community to the broader culture. I don’t know what the final outcome will be, but hope it will push antivaxxers further to the fringe.

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