Jan 29 2015

Anti-Vaccine Tropes Stirring

The Disneyland measles outbreak has the anti-vaccine movement on the ropes a bit. As I and pretty much all of my colleagues at Science-Based Medicine have predicted for years, once previously contained infectious illnesses start to seriously return, public opinion will shift against the anti-vaxxers.

We are seeing more mainstream stories like this one, Mom: Family that refused vaccination put my baby in quarantine, from CNN, and this one, Vaccine deniers stick together. And now they’re ruining things for everyone, from the Washington Post. As I mentioned in my earlier post, The Onion also nailed it with this satire, I Don’t Vaccinate My Child Because It’s My Right To Decide What Eliminated Diseases Come Roaring Back.

Of course, the cranks are unmoved. Their position is not based on a rational assessment of the evidence, and therefore evidence will not move them from their perch. What they have been doing is repeating tired anti-vaccine tropes. Unfortunately they are getting some exposure from residual false balance in the media.

This is a separate problem we have been fighting, and making some headway. Mainstream media has to learn that they don’t need to have a crank give the “other side” every time they report a science or health news story. In 2014 the BBC changed their policy to explicitly move away from false balance in science reporting. This was a great victory for critical thinking in science reporting, but it has yet to become the standard everywhere.

Orac writes today about the persistent problem of false balance, citing a recent New York Times article that quote anti-vaccine loons for “balance.”

“It’s premature to blame the increase in reports of measles on the unvaccinated when we don’t have all the facts yet,” said Barbara Loe Fisher, the president of the National Vaccine Information Center, a group raising concerns about inoculations. “I do know this: Fifty-seven cases of measles coming out of Disneyland in a country with a population of 317 million people is not a lot of cases. We should all take a deep breath and wait to see and get more information.”

Nothing to see here. Move along.  Let’s not draw the obvious conclusions until the news cycle moves on and the public’s short attention span kicks it. What – the Patriots deflated their footballs? Let’s talk about that.

Anti-vaccine doctors keep reassuring us that measles is no big deal, even though 25% of those infected had to be hospitalized. Anti-vaxxers are also continuing to try to benefit from the success of vaccines. Eighty-seven cases is not that many in the big picture, although the number is certain to rise. But this misses the point – we are seeing the return of outbreaks of a disease that, prior to vaccines, affected tens of thousands of people.  These outbreaks are not worse precisely because most people still get vaccinated. The rate for the MMR vaccine is about 90% overall. Without the protection of vaccines the Disneyland outbreak would have affected thousands of people.

Another instance of false balance gives us another common anti-vaccine (and alternative medicine in general) trope – if only we had good nutrition and didn’t inject chemicals into our bodies we would be immune to all disease. The article, Valley doctor: Don’t vaccinate your kids, cites Dr. Jack Wolfson of Wolfson Integrative Cardiology.

Wolfson does not believe in vaccination. “We do not need to inject chemicals into ourselves and into our children in order to boost our immune system,” he said.

The cardiologist also believes the key is to have a healthy immune system. In order to have that, he says, you have to avoid chemicals, get enough sleep, exercise, take good supplements, and have proper nutrition.

“I’m a big fan of what’s called paleo-nutrition, so our children eat foods that our ancestors have been eating for millions of years,” he said. “That’s the best way to protect.”

Right – avoid chemicals. In order to avoid chemicals you would have to avoid food. You wouldn’t survive very long without chemicals.

A healthy lifestyle is, of course, a good thing and a solid part of science-based medicine. It is a complete fiction, however, to claim that a healthy lifestyle will make one immune to infectious disease or other illness. It will make you healthier, but not immune. We are engaged in biological warfare with infectious microbes. We do not have an insuperable advantage over them. Sometimes they win. Sometimes we win, but the infections cause pain, suffering, lost productivity, and permanent damage in the meantime.

He also trots out the “ancient wisdom” trope, as if our cavemen ancestors had the perfect diet. They lived on the brink of starvation and death. Their fossils indicate that they were disease ridden. The Western diet is not perfect and suffers from excess, but it is vastly superior to our prehistoric ancestors. We have access to a far wider variety of food, including fresh fruits and vegetables year round. We are taller and healthier because of superior nutrition.

By the way – millions of years? Millions of years ago our ancestors were scavengers eating raw meat and marrow. Next, I guess, we’ll see some guru pushing the “roadkill diet.”

But the alternative medicine gurus need you to believe that modern society is killing us, so that they can sell you their snake oil. They fearmonger about toxins and chemicals and then sell you the solution, whatever their nonsense of the day is.

The anti-vaccine movement also depends greatly on scientific illiteracy, including a fundamental misunderstanding about what vaccines are and how they work. Generally speaking, vaccines provide either a weakened version of the infectious agent, a killed version, or just proteins that provoke an immune response. Our immune systems have memory, so when we encounter the wild type virus or bacteria our vaccinated immune systems will already have cells that remember how to make antibodies against them. We will launch a much more rapid and vigorous response, and fight off the infection before we become symptomatic or can spread the disease (or at least reduce the severity and potential for spread).

This is just a safe and clever way to target our immune system against known infections. The approach works, and has perhaps the highest benefit to risk ratio of any medical intervention developed by our species.


The anti-vaccine movement was always a minority movement, but large enough to erode herd immunity, especially in pockets of the overly privileged who have the benefit of living in a time when they are not familiar with the diseases that we are protected from by vaccines.

If history is any guide they will likely be with us as long as vaccines are with us, and their popularity will wax and wane in cycles. I think we are seeing a serious downswing in their popularity as the predictable outcome of their anti-science views begins to manifest. They will likely be pushed further to the fringe, awaiting a future generation that once again forgets about measles and other diseases that have been rendered rare due to vaccines.

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