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Culturing Science

Biology as relevant to us earthly beings

On vaccines: scientists can't stop doing science because of crazy people

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Last week, the US Institute of Medicine released a report on the adverse effects of vaccines. And their finding? That vaccinations cause negative reactions in very few people; that vaccines have no connection to autism or type 1 diabetes; overall, that vaccines are safe.

The report was commissioned by the National Vaccine Injury Compensation Program, whose employees bear the task of sorting through a few hundred claims every year made by people who think they have suffered injury from vaccination. But because there had never been a thorough analysis of what vaccines can actually cause what complications under what circumstances, evaluating each claim is slow-going. With the report now released, the office should be able to sort through them more quickly -- a benefit for everybody.

When I got the press release for the report in my email, I was nervous: oh great, I thought, here is an opportunity for the press to incorrectly play up the supposed dangers of vaccines (which, I repeat, are limited to a few people with immune problems, as I wrote about in my Nature Medicine blogpost on the subject.) But overall, they didn't. The press release was entitled "Few health problems are associated with vaccines," and all news outlets I saw followed this line, even highlighting that they don't cause autism. (If you did find coverage otherwise in the mainstream media, let me know in the comments.)

So overall I was content and let it pass. But yesterday I read a blog post by science journalist Erika Check-Hayden about how the report missed an opportunity to communicate with the public:

But only someone who is completely out of touch with today’s society would fail to realize that such a report needed to be thought out and presented much more carefully than it was to avoid fueling the anti-vaccine panic that is raging across the country.

I do understand this idea. The 600+ page report is a horrendous read, drenched in jargon and pretty poorly organized, for what it is. If you just glance at the thing, it wouldn't be hard to get caught up in the length and incomprehensible text and just throw your hands up -- "there must be many terrible things in here!"

But, in the end, this is a report about the adverse effects of vaccines. It wasn't about judging the safety of vaccines. I guess you could say that therein lies the core problem: that refusing to make a statement about their safety is a cop-out. But I don't know how the panel could have said more and stayed accurate. Adverse reactions do happen, albeit very rarely. The summary for the report says, "overall, the committee concludes that few health problems are caused by or clearly associated with vaccines," and members noted that these events are very rare, both within the report ("we do want to emphasize [that] many of the adverse events we examined are exceedingly rare in the population overall") and to the media.

More important than what is actually contained in the report is how it will be used. Yeah, the media reports on it, we can blog about it, but in the end it will be used by those who actually matter: doctors. Yes, the people who do the most to inform patients about their health and health risks, and who, most of the time, have the strongest sway.

The doctors I spoke with about the report were all quite excited about it. The vaccine compensation office doesn't have a reference guide to vaccine adverse effects; but neither do doctors! When parents and patients come in with questions about vaccines, doctors have to generalize about the safety and risks. They are relieved to now have a resource they can point to -- to say "this report came out and there are so few adverse effects, that vaccines are exceedingly safe. But if you want to talk more, here is what we know, and here is what we can do to plan."

And if doctors are more confident in their statements, the report can only help soothe those on-the-fence about vaccines.

But what upset me more was the suggestion that the report should not have been released in the first place if it wasn't going to suitably assuage the general public. Check-Hayden finishes her post with:

The Institute of Medicine committee gathered 16 eminent doctors and public health specialists who truly care about protecting the nation’s children against vaccine-preventable diseases. Didn’t any of them realize that it probably wasn’t a good idea to release a report that focuses so myopically on the drawbacks of vaccines in today’s increasingly anti-vaccine climate?

Scientists can't stop doing their work, including commissioned government reports, so that people won't freak out. Sure, the committee could have written a better summary in nice language. But if people are going to ignore rationality, and listen to their friends before they listen to their doctors, the problem is deeper than one that can be solved by clearer writing in an Institute of Medicine report.

The sad truth is that the people who are going to freak out about this report probably wouldn't listen to scientists saying that vaccines are safe anyway. If they were going to listen to scientific evidence, they already would have.

The views expressed are those of the author and are not necessarily those of Scientific American.

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