Vaccine Mythbusters Part I: Misinformation and Resistance

Published Online: Wednesday, November 9, 2011

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The modern anti-vaccine movement in the United States was born in 1982, with the unfounded claim that the pertussis vaccine caused brain damage, but it really took off in 1998 with the publication of a paper in The Lancet claiming that the measles, mumps, and rubella (MMR) vaccine causes autism. Along the way, vaccine additives such as thimerosal and aluminum have been fingered as harmful and, as memories of the ravages of vaccine-preventable disease have faded, many have argued that vaccines are more dangerous than the diseases they prevent. Celebrity vaccine opponents such as Jenny McCarthy have drawn a great deal of media attention.
 
Vaccination rates in the US remain high overall, but pockets of resistance have developed, leaving some communities vulnerable to disease outbreaks. In recent years, Haemophilus influenzae type b (Hib) has broken out in at least five states, pertussis in at least seven, and measles in at least 14. In 2006, mumps swept across the Midwest, infecting more than 6,500 people. If public confidence in vaccination erodes further, much larger outbreaks could be on the way.
 
To discuss the problem of vaccine resistance and how it can be countered, MD Magazine: Peers & Perspectives recently convened a panel of four of the nation’s leading vaccine experts: Henry (Hank) Bernstein, DO, of Cohen Children’s Medical Center of New York and Hofstra North Shore– LIJ School of Medicine; Arthur L. Caplan, PhD, of the University of Pennsylvania; Douglas S. Diekema, MD, of the University of Washington School of Medicine; and Margaret C. Fisher, MD, of the Children’s Hospital at Monmouth Medical Center. The panel was moderated by Peter Salgo, MD, of Columbia University and New York–Presbyterian Hospital. (Editor’s Note: The following transcript has been edited for clarity and length.)

An Epidemic of Vaccine Misinformation and Resistance?

Salgo: To start off, can someone briefly explain the arguments that may make parents resist vaccinating their children? What are parents hearing?
 
Caplan: Parents hear a great deal from a lot of sources. If you go on the Internet, for example, and search for vaccine safety, you quickly get to sites claiming that vaccines are pretty dangerous, that they can not only cause autism, they can cause death. There are all kinds of unfounded allegations flying around.
 
Salgo: This got to the point where just a year ago when the H1N1 crisis came on, people were simply not vaccinating even though the reports on H1N1 were that it was a horrific disease both for adults and for children. What are the scientific arguments against these fears about vaccines?
 
Diekema: There is abundant data to support the fact that vaccines are in general very safe, and the majority of side effects that we do see are transient and minor. The kinds of side effects that a parent would really be concerned about are extraordinarily rare and are more than balanced by the risks of vaccine-preventable diseases.
 
That’s the other argument that you hear frequently, that these diseases are so rare that they don’t pose a risk. But recent events have proved otherwise. We had at least 10 deaths in California last year and we had a baby die in Washington this year, all from pertussis, or whooping cough. I’m not aware of a single death in the United States in the last several years from a vaccine, and yet we’ve lost at least a dozen children to vaccine-preventable diseases in the past year.
 
Salgo: All right, say I’m a parent and I come to you and you’ve got the syringe in your hand loaded up and I say, “Wait a minute, I’m the parent here. Can you guarantee me 100% that my kid is going to be okay with this vaccine? It won’t make my kid sick, it won’t kill my kid?”
 
Diekema: No, I can’t do that.
 
Salgo: I can hear the parents now, they’re shrieking out the door, saying, “I don’t want it!”
 
Fisher: What I would tell the parent in that scenario is, as they well know, there are no true, 100% guarantees in life. But vaccine safety is about as close to a guarantee as you’re ever going to get. Vaccines are not only tested before they’re licensed for use, they are tested in an ongoing way every day of the year to ensure that no new safety issues come up, or no new possible adverse events come up.
 
Caplan: One point about that parent who is headed to the door. As they run out the door saying, “I don’t want it! I don’t want it if you can’t guarantee,” you have to say to them, “If you’re taking your kid home in an automobile, that’s a lot more risky than the vaccine.” Give them examples of relative risk. If they let the kid have a dog, if they let the kid have a swimming pool, if they let the kid ride a horse, they’re way out of risk relative to what a vaccine poses. The benefit of vaccines is pretty strong, and the relative risk is tiny.

To read the next part of our expert panel discussion on vaccine resistance, click here.

Join the conversation:

• Do you think vaccine resistance is increasing or decreasing?
• Should pediatricians "fire" families from their practices who refuse to follow the vaccine schedule?
• How do you handle vaccine resisters?