Health officials have declared that California is experiencing an epidemic of pertussis, better known as whooping cough. So far this year California alone has experienced 910 confirmed cases and there are 600 potential further cases under investigation. Five infants have died so far, all under the age of three months. Considering how deadly pertussis is to very young children, that number will only increase.
This is not the first time in recent years the state has had a problem with whooping cough. Why California? The answer is simple: California is the center of the American anti-vaccine movement.
The principle behind vaccines is very simple: inject the body with something resembling a virus or other disease-causing microorganism. This allows the body’s immune system to develop antibodies that will “recognize” the actual virus or microbe and will kill it before the body can be infected. Vaccines have been hugely successful; after clean water they are the most successful public health measure in human history.
However, vaccines have always been somewhat controversial and still are today, in spite of modern vaccines being proven to be entirely safe. The modern anti-vaccine movement can be traced to a 1998 paper in The Lancet by the British surgeon (yes, surgeon) Andrew Wakefield linking the MMR vaccine (mumps, measles, and rubella) with autism.
It was later realized that Wakefield’s research was funded by litigants against vaccine manufacturers and that he had not disclosed this conflict of interest; if he had, the paper would not have been published. In 2004, 10 of the 12 co-authors of the paper formally retracted it. In 2009 it became known that Wakefield had manipulated the patient data and misreported results in his paper. In 2010 The Lancet’s editors fully retracted the paper. In May 2010 Wakefield was stripped of his medical license in the UK for ethics violations.
Both the US and UK have spent tens of millions of dollars investigating a possible link between vaccines and autism; they have found none. In the US, the CDC and the National Academy of Sciences (our most prestigious scientific organization) have found no link between the MMR vaccine and autism. In the UK, the National Health Service reached the same conclusion. In February 2009, a special court in the US ruled that the parents of autistic children have no grounds for seeking compensation from vaccine producers.
Jonas Salk was considered a hero; now the inventors of vaccines are sent death threats. There is absolutely zero evidence linking vaccines to autism, yet increasing numbers of American parents are not having their children vaccinated. Why?
The answer is simple: we fear the unknown. And until very recently, the causes of autism were not understood. It is a frightening and challenging condition that causes parents a huge amount of stress and worry. It is not surprising that they are looking for an easy target to blame. However, we now understand some of the genetic risk factors for autism. And as with many conditions, environment (as in, before and during pregnancy) plays a role. Vaccines, very simply, do not.
So why does this matter? For one, children are dying. It is not just whooping cough that is spreading in the US. Many parents justify their refusal to vaccinate their children by arguing that this or that disease is no longer present in the US. However, the reason why it is no longer present is that the population has been vaccinated; the populations of other countries have not been. For example, there was a global effort to eradicate polio, much like smallpox. However, several groups of Muslim imams in Egypt and Pakistan opposed the use of the polio vaccine, meaning the virus is still present in humans. “But that’s not in the United States,” opponents of vaccines argue. This is true, but there is a form of transportation known as the plane. I think you can figure out the rest. And besides smallpox and polio there have been no global efforts to permanently eradicate any diseases.
This is of course completely unfair to the children involved; they do not understand what is going on and are being put at risk. However, the issue is more complicated than that. There are a number of individuals in our society who simply cannot be vaccinated. This can be because of a compromised immune system. Or it can be that they are too young, as the five deaths in California illustrate. There is also an unlikely worst-case scenario: if the virus becomes too widespread, it will inevitably mutate. If it mutates too much, our vaccines will no longer work; you and I will no longer be immune. Fortunately, vaccination rates are still high enough to prevent this.
Unfortunately, there is not much we can do about this issue. Doctors and scientists have been placing study after study in front of the opponents of vaccines to no avail; in the face of scientific denialism it seems that there cannot be any progress. Be prepared for more stories like the California epidemic; diseases we have not seen in a long time in the United States are returning. Though for now, this is not our biggest public health concern. That title probably belongs to either climate change or drug-resistant bacteria. Maybe we should not be talking about cutting the NIH’s budget.