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.

29 responses so far

29 Responses to “Vaccine Debate Heats Up”

  1. John Danleyon 03 Feb 2015 at 12:18 pm

    Polarization and its discontents. Instead of separating church and state, the manufactroversy mavericks have opted for separating science and state. We all knew it would eventually come to this. And the irregular beat goes on…

  2. Wolfbecketton 03 Feb 2015 at 12:31 pm

    Ugh. I made the mistake of starting to read some of the comments on the linked Wolfson article. I give up, humanity is doomed, the best we can hope for is that a large meteor will come along and put us out of our misery.

  3. Willyon 03 Feb 2015 at 12:52 pm

    I see some blaming immigration for measles outbreaks. I know that Mexico’s vaccination rates are very high (96% ?); does anyone have data for other Central American countries?

  4. Andyoon 03 Feb 2015 at 1:09 pm

    Willy,

    http://data.worldbank.org/indicator/SH.IMM.MEAS/countries

    Says it dropped kind of harshly to 89% in 2013 specifically for measles. Doesn’t matter though.

  5. Willyon 03 Feb 2015 at 2:12 pm

    Thanks, Andyo. I wonder if the reported drop is a typo, given such a large change from 99% for the previous period to 89% currently. I note that Honduras had a similar drop.

    At any rate, it would seem that immigrants from south of our border aren’t likely sources for the measles outbreak in the US. Most of those countries do better than we do.

  6. Andyoon 03 Feb 2015 at 2:25 pm

    Oh, it’s just racist tripe from the usual suspects. It’s irrelevant too since even if it came from somewhere else (which didn’t have to be Mexico) it likely wouldn’t have spread if not for the antivaxers. It’s not like it would be the first time a Measles case came from elsewhere.

  7. hardnoseon 03 Feb 2015 at 3:26 pm

    Parents should have some rights, states should have some rights. We don’t have to give all the important decision-making power to a massively corrupt central government.

    I think Christie was being sensible when he said vaccinations are a matter of degree. Some are necessary and maybe should be required, but others should be optional.

    Steve N seems to think the anti-government pro-freedom crowd are a bunch of nuts. Apparently he believes the central government can be controlled by scientific experts, and that scientific experts are rational and elevated above the general public. Therefore we can turn off our skepticism and brainlessly go along with whatever the central government thinks is best for us.

    I am very glad there are people who are skeptical about vaccines and who think they may be over-used.

    It’s similar to the problems we have with antibiotics — because they can be life-saving they tend to be over-used and misused.

  8. Willyon 03 Feb 2015 at 3:28 pm

    Andyo–Agreed 100%. I just wanted real data to cite to, as you so accurately put it, the usual (racist) suspects.

  9. Gallenodon 03 Feb 2015 at 4:12 pm

    Steve,

    More return shots are being fired by the anti-vaxxers as we type. A link to this article seems to have just started making the rounds in social media:

    “Studies Show that Vaccinated Individuals Spread Disease”
    http://globenewswire.com/news-release/2015/02/02/702199/10118172/en/Studies-Show-that-Vaccinated-Individuals-Spread-Disease.html

    It’s got lots of citations, but the few I looked at didn’t seem to support what the article is claiming they support. There has to be a rational takedown of this, but I am not equipped to do it. However, I am thinking you (or someone over on SBM?) are. Any chance you could do another post debunking this so I have something to link to when this pops up in my Facebook news feed again?

    Thanks. 🙂

  10. Steven Novellaon 03 Feb 2015 at 4:28 pm

    HN wrote: “Steve N seems to think…” followed by utter nonsense. You don’t seem to be able to infer what I think from what I write. Suffice to say I don’t subscribe to any of the beliefs you assign to me.

    If you think vaccines are over used, show me the evidence. The analogy to antibiotics is not apt.

  11. RickKon 03 Feb 2015 at 4:50 pm

    hardnose – Christie’s comments were in the context of MEASLES, not a debate about the efficacy of the latest flu vaccine. So don’t try to paint this as anything other than a public health debate.

    This is about people making choices that are (1) contrary to clear evidence; (2) motivated in most cases by fear and ideology than by rational decision making; and (3) putting public health at risk. Vaccines work, just like public sanitation works. Should public sanitation be optional? I’ve been in countries where defecation on the sidewalk was not illegal. Really, is one person defecating on the sidewalk any more of a health risk than one family choosing not to vaccinate? The two examples are quite comparable – MUCH more comparable than your antibiotics analogy.

    But if you want to make it about ideology, then let’s address your other point:

    “Steve N seems to think the anti-government pro-freedom crowd are a bunch of nuts.”

    You can’t use a term like “anti-government” without definition. From my perspective (not speaking for Steve):

    If by anti-government you mean people that think that our federal government (burdened with courts and whistleblower laws and the FOI Act) is dramatically more corrupt than other governments, corporations, religious institutions, or any other large organization of humans – yes, they’re nuts.

    If by anti-government you mean people who look at the freedom of individual action in Somalia with longing while polishing their personal body armor – yes, they’re nuts.

    If by anti-government you mean people who believe in grand government conspiracies to destroy the World Trade Center, stage the Sandy Hook massacre, hide tens of thousands of troops in Malta, or fake the Moon Landing – yes, they’re nuts.

    If by anti-government you mean people who reject proven vaccines simply because they’re distributed by government programs – yes, they’re nuts.

    These people are sufficiently buried in their own motivated reasoning to have lost the ability to weigh evidence rationally. hardnose, in your opinion, how far must a person’s ability to judge reality erode before they qualify for your definition of “nuts”?

    Given the origin and history of the anti-vax “movement”, and given the ideologically-driven positions of people like Rand Paul and Dr. Wolfson, how is this MMR debate anything other than “uninformed people influenced by ideologically-motivated agitators versus an effective, well-documented and rigorously tested public health measure.”?

  12. Ekkoon 03 Feb 2015 at 6:05 pm

    I actually like that hardnose comments here because he provides so many textbook examples of poor logic and reasoning.

    “I think Christie was being sensible when he said vaccinations are a matter of degree. Some are necessary and maybe should be required, but others should be optional.”

    In his mind he probably thought he was being sensible, from a politically expedient point of view, in trying to pander to as wide a base as possible. Your second sentence though is quite funny. Who the %^&*%^ are you or CC to be able to evaluate or decide this?

  13. Kent1423on 03 Feb 2015 at 6:17 pm

    I don’t believe that Rand Paul’s comment that ‘vaccines are “a good thing”’ sounds remotely “anti-vaccine”. As a medical doctor, he is well aware of the benefits of vaccination. His complaint has more to do with the rights of parents to make health care decisions for their children. If the government can force children to receive one medical intervention, then the fear is that the government will escalate its power and strip away the rights of parents.

  14. tmac57on 03 Feb 2015 at 8:06 pm

    I just stumbled on to a new (new to me that is) line of attack in the anti-vaccine narrative :

    Looking at the rising tide of vaccine resistant infectious outbreaks in the U.S. and abroad — chickenpox, shingles, mumps, whooping cough (pertussis), influenza, HPV (Gardasil), hepatitis B, to name but a few — through the lens of the peer-reviewed and published literature on the topic, it is clear that the vaccines and not those who refuse to subject themselves to them are at the root of the problem. And nowhere is this more clearly evident than in the measles vaccine.

    The article goes on to “prove” this thesis with citations that look credible (but I suspect don’t say what the author thinks they say).

    http://www.greenmedinfo.com/blog/disney-measles-outbreak-mousetrap-ignorance

    The site looks like the ‘usual suspects of woo’ type nonsense, which also posits that the vaccinated themselves are the culprit in other linked posts as others have mentioned.

    So to summarize, the vaccines are ineffective because of “vaccine resistant” infections (apparently cause by the overuse of vaccines?), to prevent disease, and the vaccinated are the carriers of the disease outbreaks. You may facepalm now.

  15. MaryMon 03 Feb 2015 at 10:37 pm

    It’s certainly a case of chickens coming home to roost. I don’t understand why people say that they hate to say we told you so. We told you so.

    But speaking of chickens, there is a bizarre twist on the anti-vax front from organic/enviros. Have you seen the push to get vaccines de-listed from the national organic standards list?

    If anyone can define what traditional breeding would be for these, please let us know. https://storify.com/mem_somerville/traditional-breeding-of-vaccines

    I would run like hell from these people at the dog park. And the day care. And from barbecues.

  16. BillyJoe7on 03 Feb 2015 at 10:48 pm

    hardnoise,

    “I am very glad there are people who are skeptical about vaccines and who think they may be over-used…It’s similar to the problems we have with antibiotics — because they can be life-saving they tend to be over-used and misused”

    It’s totally different.
    Vaccine experts make decide on the most cost effective vaccine schedule, but some doctors who pander to the demands of the anti-vaccine crowd do not stick with the expert recommneded schedule.
    Antibiotics experts produce protocols on the use of antibiotics, but some doctors who pander to the demands their patients do not stick with the expert protocols.
    So you have the shoes exactly on the wrong feet.

  17. tmac57on 04 Feb 2015 at 9:29 am

    Regarding false balance, I have been noticing an unhelpful trend on Facebook where when I click a link about stories like this that support the science, when I come back to Facebook, there will be at least one suggested article below it that supports anti-vaccines (for example).
    Today I read a Politifact fact check on a Fox News story that was pro-vaccines (which they judged as true), and when I went back to my Facebook page, below it was that piece of crap article by Wolfson that Steve referenced above. So if I shared the Politifact piece with my FB friends who might be on the fence or anti vaccines, they will also be served up with just the ammunition they might want to ‘discredit’ it. Sigh!

  18. chadwickjoneson 04 Feb 2015 at 12:33 pm

    Willy,

    http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tscoveragemcv.html

  19. steve12on 04 Feb 2015 at 2:08 pm

    I find this debate re: parent vs. gov’t choice to be nonsense.

    The gov’t says that you MUST feed your kids, you must educate them, you may not abuse them, you must buckle them in your car in a specific manner, etc, etc. If you choose not to look after them properly they can be taken away by force of gov’t. We all more or less agree that this is the appropriate role of the gov’t in these situations.

    Now how are vaccines different? Every time someone tries to justify how it is they either (1) commit the fallacy of slippery slope (if they can vaccinate your kids today, they can feed the to them to the Balrog tomorrow!) or (2) they go back to the science, where they may as well be arguing that they don’t need to feed the little brats.

    Completely incoherent nonsense.

  20. BillyJoe7on 04 Feb 2015 at 3:10 pm

    steve,

    “If you choose not to look after them properly they can be taken away by force of gov’t”

    Unless you have a religion.
    Then you can get away with assault and battery and manslaughter.

  21. AmateurSkepticon 04 Feb 2015 at 3:37 pm

    Here are some charts which very effectively illustrate how successful vaccines have been.

    http://www.dailykos.com/story/2015/02/03/1361929/-Point-Set-Match?detail=email

  22. steve12on 04 Feb 2015 at 3:48 pm

    “Then you can get away with assault and battery and manslaughter.”

    Right. Invoke magic and somehow it becomes a “debate”.

  23. Willyon 04 Feb 2015 at 4:10 pm

    chadwickjones: Thanks!

  24. Wolfbecketton 05 Feb 2015 at 5:11 pm

    In a turn that should surprise no one but that surely gives many a sense of smug satisfaction, it looks like Dr. Wolfson is being investigated by the Arizona Medical Board.

    http://www.cnn.com/2015/02/05/health/anti-vaccine-doctor-jack-wolfson/

  25. Willyon 06 Feb 2015 at 12:43 pm

    I am reading claims that the measles vaccine is not good for life, but needs to be redone at some point. Any truth to this?

  26. grabulaon 10 Feb 2015 at 9:19 pm

    Willy, I know some vaccines need boosters overtime, measles may be one of them.

  27. Willyon 11 Feb 2015 at 11:26 am

    grabula–I’d just like to be certain of the facts in this case; there is so much bad info out there that I’d hate to add to it.

  28. BillyJoe7on 11 Feb 2015 at 3:03 pm

    Willy,

    You could simply Google the vaccination schedule.
    Here is the Australian version:

    http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips-ctn

    Measles vaccine is given at 12 months, 18 months, and 4 years.
    The measles vaccine given at 18 months was added just recently.
    Maybe that’s what you are referring to.

  29. grabulaon 11 Feb 2015 at 9:48 pm

    Willy – according to this site: http://www.drugs.com/mtm/measles-mumps-and-rubella-mmr-vaccine.html the boosters your recieve between 4 and 6 yrs of age. I can’t seem to find anything indicating you need one beyond that.

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