Time to act on vaccination
Vaccination is one of the greatest achievments of modern science. Yet despite accumulating evidence that vaccines are safe, uptake is falling. This month's (December) superb Editorial in Nature Immunology (9, 1317; 2008) asks why more outbreaks of mumps and measles have occurred this year (2008) in the United States, Canada, the United Kingdom and other Western countries, when both diseases had been almost completely eradicated in the Western hemisphere before the 1990s because of the introduction of the measles mumps and rubella (MMR) vaccine in 1979.
From the Editorial: "A decrease in 'uptake' of the MMR vaccine fuelled by vaccine skeptics is the main cause behind the resurgence of these diseases in recent years. In 1998, Andrew Wakefield and colleagues published a paper in The Lancet linking the MMR vaccine to autism. This coincided with a growing belief that environmental cues were causing the increase in autism. The anti-vaccine movement jumped on this, and the ensuing media frenzy continues to this day.
Many studies have refuted Wakefield's claims. Furthermore, Wakefield had a serious conflict of interest, as his research was secretly funded by personal-injury lawyers whose clients were suing MMR vaccine makers. The paper was retracted and Wakefield is being tried for professional misconduct. Despite this, the rumors that the MMR vaccine causes autism persists."
The Editorial goes on to outline other vaccine scares dating back to the early nineteenth century, showing that arguments used by vaccine skeptics both past and present have changed relatively little. "They often suggest that vaccination is motivated by profit and is an infringement of personal liberty and choice; vaccines violate the laws of nature and are temporary or ineffective; and good hygiene is sufficient to protect against disease. Governmental conspiracy theories also abound."
The facts are that to achieve herd immunity and avoid disease outbreaks on a mass scale, mandatory vaccination is needed. "Huge numbers of scientific papers support the safety and efficacy of vaccination. If governments were determined to 'cover up' side effects, then why was the rhesus monkey–derived rotavirus vaccine immediately withdrawn once a side effect was noted?"
From the Editorial: "The internet is increasingly used as a source of health information. Unfortunately, vaccine skeptics have recognized this, and anti-vaccine websites have proliferated. Some are filled with anti-vaccine quotes from physicians linked financially to autism research. They use scare-mongering tactics with pictures of children allegedly injured by vaccines to feed on parents' concerns. Alongside such pictures, stories written by other parents who feel their child's disability was caused by vaccination, on the basis of temporal rather than causal evidence, abound. Risks associated with vaccination are exaggerated and the scientific literature is 'cherry picked' to deceptively support their bogus views.
In the West, where vaccine scares are more common, parents with unvaccinated children tend to be well educated with ready access to information sources. Fed misinformation by vaccine skeptics, such parents prefer not to immunize their children because they percieve the risk of vaccination to be greater than that of a disease they have never encountered. What vaccine skeptics fail to mention is that diseases such as measles can be lethal or can cause life-long disabilities. Another pro-vaccine argument often ignored is that healthy children perform better at schools, and healthy adults are more productive at work."
Irresponsible and ill-informed media coverage is partly responsible for this state of affairs, but according to the Editorial, governments are not blameless. The Editorial recommends that they should "be more proactive, funding mass-education campaigns to relay the facts simply and emphasize the many advantages of vaccination. Immunologists themselves should stand up and publicly promote the history, successes, safety and efficacy of the world's vaccination program."
Read the full Editorial here.
