IMM250 February 22, 2018 Fighting the Good Fight: Separating Science from Non-Science in the Struggle for Vaccination You’d have to forgive a parent who knows nothing about vaccination their initial trepidation. The very word “vaccination”, after all, might evoke in some visions of a deranged scientist in a lab coat jabbing wildly at their child with strange fluids, like some macabre hack- and-slash killer from a horror movie. That’s natural. We’re at our most emotional when we’re thinking of our kids—our desire to protect and nurture them is a force that has a hold over every parent. However, in order to keep our families happy, healthy, and strong, it is an emotional response that needs to be overcome. This same paranoia and fear, in what currently manifests as a generation of anti-vaccine parents and politicians (anti-vaxxers), is nothing new. Edward Jenner, back in 1795, met such resistance after he created the first vaccine, designed to counter a disease in smallpox that was killing 400,000 people a year at that time. Caused by the virus Variola major, the disease would blister and scar the skin of its unfortunate hosts, blinding some and killing one-third of those infected. Jenner, searching desperately for a way to prevent its spread, noticed something curious however. Milk-maids, although sporting nasty blisters on their hands from the cowpox virus present on bovine udders, did not contract the disease. Did previous exposure to cowpox (a less virulent relative of smallpox) in some way prevent the development of the disease, he wondered In 1796, Jenner inoculated a young boy named James Phipps with the pus from one of these cowpox blisters and then exposed him to scabs from smallpox patients to test his hypothesis. Phipps developed a slight fever, but quickly recovered and otherwise walked away unscathed. Despite it’s life saving power, parents throughout England objected to vaccination strongly. Parents thought it barbaric to harm their children through the act of inoculation, while the clergy seconded their outrage out of concern for the use of animal secretions in the vaccine itself, a perversion they deemed unnatural. Indeed, over the next century the mistrust between the paranoid and the scientific community would grow so much that over a hundred thousand citizens would come out to protest compulsory vaccination law in the city of Leicester in 1885. When all was done and dusted though, it was the vaccination technique that Jenner helped pioneer that led to the complete eradication of smallpox just under two centuries later, in 1980, by the World Health Organization. Vaccination, in the cases of smallpox, polio, and many other diseases, has undoubtedly changed the course of history for the better. However, just as in the 19th century, modern opposition threatens to derail that good work and leave the most vulnerable among us at risk. The best way to deal with this anti-vaxxer mentality is through education— dispelling the myths that surround vaccination is the best way to increase its adoption once more, and the point of this article is to do exactly that. The first pervasive myth that often scares parents away from vaccination is the link between the MMR vaccine (a vaccine that provides immunity against measles, the mumps, and rubella simultaneously) and autism. In an explosive paper published in 1998 by the prominent medical journal Lancet, Andrew Wakefield, an English gastroenterologist, claimed that nine of twelve previously normal children he studied developed autism (this form of autism, affecting what had been normally developing children, is described as regressive by those within the medical community) within weeks of MMR administration. Panic overtook the world, and vaccination uptake rates in England dropped from 92% in 1995 to 80% in 2003. The link was damning but had just one issue—it wasn’t backed by any science. In a brilliant piece of investigative journalism, Brian Deer of the Sunday Times interviewed the families of the study’s subjects and found that only one of nine children purported to have developed regressive autism actually had developed regressive autism. Five of the rest had pre-existing conditions, and a further three didn’t have autism at all. Additional sleuthing put the final nail in the paper’s coffin—Andrew Wakefield had been paid 150 pounds per hour throughout the course of the study by parents eager to launch an anti-vaccine lawsuit through a lawyer named Richard Barr. Although the paper was eventually retracted, and Mr. Wakefield’s medical license stripped, Mr. Wakefield would earn roughly 436,000 pounds from the fiasco and would do irreparable damage to the kids suffering from the measles outbreaks that ran amok following his forgery. Although among the first in the modern era, it wouldn’t be the last allegation to hit vaccines—soon, mistrust would popularize the idea of immune “overload” and cripple vaccine uptake yet again. The MMR vaccine, as mentioned above, provides protection to measles, the mumps, and rubella simultaneously. It does this by presenting the body with weakened, or attenuated, forms of the viruses they are designed to immunize against; this way, the body gains an introduction to the antigens (the toxins that the immune system responds to) that the microbial invader produces and learns to respond to them without threat of actual infection. Next time, when the immune system encounters those viruses in the real world, it is able to mount a defence so quickly that not even the more virulent strains are allowed to spread. Some parents worry, though, that the MMR vaccine, by providing exposure to three different (albeit attenuated) viruses at the same time, will
“overload” their child’s immune system and leave them vulnerable to secondary infections. While the idea might seem scientifically plausible, research has shown that the exact opposite is true. A study from the Health Protection Agency in England looked at children ranging in age from twelve to twenty-three months in London and found that the MMR vaccine led to a reduced risk of both bacterial and viral infection in the thirty days following administration, with no increased risk in any time period after. The Center for Disease Control in the United States added their voice in support, noting that the efficiency of multi-antigen vaccination also saved parents considerable time and money. As these rumours swirled, one more myth came to dominate vaccine discussion. Concerned parents, politicians, and even celebrities like Robert De Niro (who offered $100,000 to anyone who could prove vaccine safety) found a vaccine ingredient that just wasn’t sitting right with them. A ubiquitous vaccine preservative, the compound thiomersal sounded innocent enough—however, concerned groups weren’t letting the fact that it contained mercury slip past them. Mercury gets a bad rap today, and rightfully so. If you’ve ever read Alice’s Adventures in Wonderland, you’d be interested to know that the Mad Hatter’s madness didn’t simply strike out of the blue—Lewis Carroll, the author of the classic work, took inspiration from the issues surrounding real-life hatters, who used mercury nitrate to turn animal fur into the felt they needed. Prolonged exposure to the element was toxic, and many craftsmen soon developed hallucinations, physical tremors, and a host of personality disorders. The heavy metal, as scientists eventually discovered, is incredibly toxic to the central nervous system and can be lethal in sufficient doses. However, the form in which mercury is present in the human body matters, and with thiomersal, mercury’s presence is safe. A mercury derivative known as methylmercury is the form that is toxic to humans, and its presence in seafood is the reason regulatory bodies advise that the consumption of certain fish should be limited. However, when thiomersal is metabolized by the human body, it breaks down into ethylmercury and another compound called thiosalicylate, both of which are excreted with ease. Mercury is not allowed to build up, and so its deleterious effects are never felt. The World Health Organization, the American Academy of Pediatrics, and the European Agency for the Evaluation of Medicinal Products have all launched independent studies that reject any link between thiomersal consumption and health risk. There is no scientific evidence to doubt the safety of vaccines, and until peer-reviewed evidence gives us reason to worry, these myths will continue to be exactly that—myths, and nothing more. Some, however, do not frame the issues surrounding vaccines as medical in nature. Instead, according to politicians like Rand Paul and Chris Christie, it is a matter of liberty, and parents must have “some measure of choice”. It simply isn’t right for the government to tell concerned parents what they can and cannot do when it comes to their children. There’s a serious flaw in this argument, though. Libertarians all agree that the individual should have complete freedom of choice, and that is an admirable goal—but freedom doesn’t give one the right to inflict harm on others, whether voluntarily or involuntarily. John Locke, the grandfather of the Libertarian movement himself, declared that the paths that one pursues cannot harm the “Life, Health, Liberty, or Possessions” of another. Parents who refuse to vaccinate their children not only threaten the health of their own children, but also threated the health of the ill, the old, and those too young to undergo the process. It provides a vector for disease to target the most vulnerable among society and infringe upon their right to life, and that’s why the debate surrounding vaccination shouldn’t be about choice either. Vaccination is a duty that one holds to the rest of society, and so the faster this clamor is laid to rest, the better. Works Cited “BBC History – Edward Jenner.” BBC. N.p., 2018. Web. 23 Feb. 2018. Deer, B. “How The Case Against The MMR Vaccine Was Fixed.” British Medical Journal 342.1 (2011): 5347. 23 Feb. 2018. Dórea, José G., Marcelo Farina, and Jo o B. T. Rocha. “Toxicity Of Ethylmercury (And Thimerosal): A Comparison With Methylmercury.” Journal of Applied Toxicology 33.8 (2013): 700-711. 23 Feb. 2018. Locke, John. Two Treatises Of Government, And A Letter Concerning Toleration. New Haven, Conn.: Yale University Press, 2004. Print. “Mercury And Health.” World Health Organization. N.p., 2018. Web. 23 Feb. 2018. “Multiple Vaccines And The Immune System.” Center for Disease Control. N.p., 2018. Web. 23 Feb. 2018. “On The Wrong Side Of History.” Nature Microbiology 2.4 (2017): 17046. Web. 23 Feb. 2018. Stowe, Julia et al. “No Evidence Of An Increase Of Bacterial And Viral Infections Following Measles, Mumps And Rubella Vaccine.” Vaccine 27.9 (2009): 1422-1425. Web. 23 Feb. 2018. Summers, Daniel. “The Evidence For Vaccine Safety Is Abundant. That Will Be $100,000, Please..” Washington Post. N.p., 2018. Web. 23 Feb. 2018. “Thiomersal In Vaccines.” World Health Organization. N.p., 2018. Web. 23 Feb. 2018. Thompson, Gavin. Measles And MMR Statistics. London: Health Protection Agency, 2018. Print. “Vaccine Types.” US Department of Health and Human Services. N.p., 2018. Web. 23 Feb. 2018. Waldron, H A. “Did The Mad Hatter Have Mercury Poisoning .” British Medical Journal 287.6409 (1983): 1961-1961. 23 Feb. 2018.