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While Searching for the Perfect Vaccine, Keep Using the Very Good

The anti-vaccine movement fails to live up to its own rhetoric

This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American


Disciples of the anti-vaccine movement insist they’re not anti-vaccine. Rather, they say they’re simply advocating for vaccines that are safer and/or more effective than what’s currently available. Sounds reasonable. Who wouldn’t want better vaccines? For that matter, who wouldn’t want safer cars, an untainted food supply and an easier way to vote that didn’t require you to stand in line for hours?

Nevertheless, you’ve probably noticed that people haven’t stopped driving, eating or casting ballots while waiting for these improvements to come along. Women haven’t abandoned their birth control methods while waiting for researchers to develop new ones for their male partners. Most of us use what’s available now, even if imperfect, for two good reasons. They’re all we have, and they meet our basic needs, albeit not perfectly.

We love the idea of perfection. Perfection (e.g., Simone Biles’ triple-double floor routine) inspires awe. We admire and pursue this trait to a fault.  Some of us want to be more attractive; others better athletes or smarter students. Efforts to reach this goal, even if we fall short, are usually considered a good thing. It fits our cultural narrative because people think perfection is synonymous with success.


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But perfection, no matter how it’s defined, is exceedingly difficult to achieve, and the single-minded chase can cause us to lose sight of what really matters. Worshipping the false god of perfection denigrates the fact that mere excellence not only exists, but also thrives, in many places and at many levels. Hitting over 0.400 in Major League baseball during the course of a season (a feat last achieved in 1941) means that you failed 60 percent of the time, but achieving this milestone would likely guarantee you a spot in the Hall of Fame.

It’s this “good enough, and it works” attitude that separates those who use vaccines (the vast majority of the population) from people who choose not to. There’s a simple way to determine if people who claim they are pro-vaccine are actually anti-vaccine. Simply ask them which vaccines they approve of. They’ll bob and weave like Ali, but if they can’t name a single one, then they are clearly anti-vaccine. I’ve had in-depth conversations with vaccine opponents who claim they do it to keep their children safe. I believe them, and I acknowledge that some vaccines are not as effective as we hoped they could be.

However, I part company with them because I know our current vaccines, though not perfect, provide strong protection against a plethora of infectious agents that can sicken and even kill us. I also know that a world that was suddenly devoid of vaccines would be quickly overwhelmed by a global tsunami of suffering and death. I vaccinate because I want no part in making infectious diseases great again.

Vaccine opponents peddle fear. They’ll direct you to heartbreaking online videos of people who they claim have been seriously injured by vaccines. These anecdotal stories are offered up as proof that vaccines are harmful, though medical records backing up such claims are seldom provided. In fact, these narratives stand in direct contradiction of epidemiological data obtained by studying hundreds of millions of vaccinated people that show vaccines are both safe and highly effective. This is not to downplay the suffering of others, but the risk/benefits ratio for vaccines is very heavily tilted towards giving preventative immunizations to all qualified individuals.

I suspect that a number of the illnesses presented in the anti-vaccine videos are actually due to some of the thousands of rare diseases, many of which are difficult to diagnose. Symptoms of many of these disorders first appear at the same ages that kids are getting the majority of their childhood vaccinations. Examples include Tay-Sachs, Canavan disease and adrenoleukodystrophy (ALD), a neurological disorder made famous by the 1992 movie Lorenzo's Oil. Effective treatments for these diseases, sadly, lag our ability to find out exactly what causes them. While the basis of these three disorders has been identified at the molecular level, a majority of rare diseases have no known causes. Most of these illnesses are genetic in nature and are actually present (though not manifest) at birth; vaccines could not cause them. Determining the genetic underpinnings of these other rare diseases in likely to progress rapidly with the recent advent of affordable genomic sequencing technologies. Autism is also a genetic disease; vaccines do not cause it.

WHEN INFECTIOUS DISEASES WERE RAMPANT

Those who are opposed to vaccines have somehow failed to locate the much larger repository of stories about people whose lives were devastated, or even ended, by infectious diseases. The medical literature is full of detailed statistics about illness and death from contagious pathogens, broken down by year and by state. Books have documented the fear and suffering caused by the Spanish flu epidemic in 1918 (John Barry’s The Great Influenza) as well as the polio epidemics of the 1950s (Polio: An American Story, by David Oshinsky).

Media reports about these diseases are not as common as they used to be, simply because vaccines have so effectively reduced the number of afflicted individuals. When was the last time you saw a polio survivor interviewed on TV? I remember the heavy leg braces worn by these people when I was growing up, and I’m fortunate never to have had to see a loved one forced to live out their life in an iron lung.

There are many factors that go into designing effective vaccines. Creating them is anything but trivial. If you don’t believe this, consider that there’s still no effective HIV vaccine more than three decades since the start of the AIDS epidemic. This is not for lack of trying. Even though there are effective drug treatments these days for HIV, they don’t work for everyone, and they’re expensive. There are hundreds of thousands of families in the U.S. who’ve lost someone they cared about to this virus, and who would have rejoiced if any HIV vaccine had been developed that could have short-circuited this viral purveyor of sorrow, anger and loss. Trust that success still lies ahead of us. After all, heroic efforts to combat another lethal virus, Ebola, have resulted in what appear to be both effective drugs and a vaccine.

Dedicated teams of doctors and scientists who’ve received many years of training are on the front lines of vaccine research. Biology is the hardest science imaginable, and gaining insights into ways to prevent and treat infectious diseases requires enormous amounts of money. This applies as well to cancer research, Alzheimer’s studies and preventing birth defects. That’s why concerned people organized a Race for the Cure, The Walk to End Alzheimer’s and a March for Babies. People join these fundraisers because they want to accelerate efforts to develop effective treatments for these diseases. You know what I’ve never seen? Anti-vaccine groups organizing a walk, bike ride or bake sale to raise money to fund research into safer and more effective vaccines.

Many of the people who do vaccine research have some connection to drug companies. That’s because their research findings need to be translated into effective treatments, and that’s beyond the capabilities of many academic investigators. This linkage is distasteful to vaccine opponents because they simply don’t trust drug companies to develop safe products. Sadly, pharma’s poor reputation with the public contributes greatly to this animus.

LACK OF EXPERTISE IN THE ANTI-VACCINE MOVEMENT

Most leaders of the anti-vaccine movement are not doctors; they tend to be lawyers or media personalities. Think Jenny McCarthy, Robert F. Kennedy Jr. and Del Bigtree. Shopping for books on Amazon about vaccines? Note that many of the ones that oppose vaccines are not written by physicians or scientists, despite the stock doctor photos on the cover. Misinformed politicians such as Michele Bachmann and Jonathan “vaccines are sorcery” Stickland add to the witlessness, parading their ignorance in a desire to add voters.

There are a few actual doctors involved in the movement, but a number of them have either lost their licenses to practice medicine (e.g., Andrew Wakefield), or are actively engaged in selling books or “immune boosting” supplements to their supporters. These supplements, of course, are pitched as safe and effective alternatives to vaccines, and these modern-day snake oils put a lot of money in the purveyor’s pockets.

Take natural cures promoter Joseph Mercola, whose income dwarfs that earned by most doctors. According to this article, his company, Mercola.com LLC brings in around $9.8 million annually, with additional income coming from Mercola.com Health Resources LLC ($5.2 million) as well as Mercola Consulting Services LLC (around $320,000). The anti-vaccine folks don’t care if he makes Big Money from selling these unproven vaccine alternatives, because he’s not shilling for Big Pharma.

A large number of marketed immune boosting and herbal supplements, by the way, undergo no rigorous scientific testing, nor are they tested in FDA-reviewed clinical trials. Some even contain some of the same “toxins” that immunization opponents point to when claiming vaccines are unsafe. I’m still waiting for folks in the anti-vaccine movement to condemn the dangerous practice of attempting to cure kids of autism by giving them chlorine dioxide enemas. Why aren’t they fighting this if the health and safety of children is their primary concern?

Much as we’d all like to see vaccines provide complete protection from infectious diseases, that’s not possible right now. That goal might not even be achievable, given the genetic diversity of humans. We’re also going to need even more vaccines in the future as global warming leads to the spread of infectious disease carrying organisms. Thankfully progress is being made in creating effective vaccines against chlamydia, Chikungunya and Zika, among others. In the meantime, we should take full advantage of the wide variety of available vaccines. They provide safe and effective protection against diseases that used to routinely kill or maim millions of people.

Concerned about side effects? Want to know just how strongly the risk/benefit ratio comes down on the side of vaccines? Ask your doctor, just like you’d do if you (or a loved one) had a heart attack, breast cancer, renal failure or Parkinson’s. Don’t risk the health of your child listening to misinformation peddled by lawyers, filmmakers and celebrities. Avoid the advice of physicians who’ve lost their medical licenses or are filling their pockets with money earned by selling vaccine alternatives.

I’ve tried to convince immunization opponents that vaccines are one of mankind’s greatest innovations, but I’ve failed more often than I’ve succeeded. I’ll focus my efforts instead on those whose minds remain open to using vaccines. I’ve come to accept, as New York Times columnist Frank Bruni put it recently, that “some people are beyond reaching and teaching.”