The Anti-Vaccination Movement by Rameen Walters

1. Introduction

rwalters2013 — 2019-04-10 16:27:24 UTC

Modern medicine has completely changed how humans are able to interact with the world around them and this has in no small part been thanks to the development of vaccines. Many diseases that once decimated humankind have become all but extinct in many parts of the world. Unfortunately, despite all the good vaccines have done, there are many who oppose the use of vaccines often stemming from a fear of adverse reactions and side effects rather than the diseases the vaccines prevent. The anti-vaccination movement has been gathering more steam since the development of the internet and poses major risks to society as a whole.

2.1 History of Vaccines - China

rwalters2013 — 2019-04-10 19:41:34 UTC

The Ancient Chinese had a basic understanding of immunization following exposure to a disease. In the late 1600's, the Chinese emperor K'ang Hsi had his children become immunized using pre-vaccination means. The scabs of smallpox victims were ground up and blown into the nostrils of his children and the matter from smallpox sores were scratched into their skin. While seemingly barbaric, these practices were adopted by people in Europe and survived for centuries due to their effectiveness. The process was later called "variolation."

2.2 History of Vaccines - Europe and "Variolation"

rwalters2013 — 2019-04-10 19:48:08 UTC

In 18th century Europe, when smallpox ravaged society, practices similar to those used by the Ancient Chinese were known as "variolation." This process involved coating a lancet with matter from the pustule of an individual who was suffering from smallpox and insert the virus subcutaneously. Variolation was common and, interestingly, was 10x less fatal than the naturally occurring disease. Eventually, variolation would become decreasingly used with the development of the vaccine by Edward Jenner in 1796.

2.3 History of Vaccines - Edward Jenner

rwalters2013 — 2019-04-10 19:58:15 UTC

Edward Jenner was an English physician and scientist who became interested in the tales he had heard that milkmaids had somehow become protected against smallpox after contracting cowpox. In order to test this, Jenner inoculated an 8 year old boy with cowpox, who developed the disease, and waited for the boy to recover. A few months later, Jenner inoculated the boy with smallpox...and the boy never developed the disease. Thus the first vaccine was created. While Jenner's discovery was already well known amongst dairy farmers, he ultimately brought this to the attention of the scientific community.

2.4 History of Vaccines - Since Jenner

rwalters2013 — 2019-04-10 20:03:51 UTC

Ever since Jenner vaccines have blown up. Experiments performed by Louis Pasteur led to the development of the cholera vaccine and the anthrax vaccine. Two vaccines for Polio have been developed, one live-attenuated and one inactivated. There has also been the development of a vaccine against Measles, Mumps and Rubella (MMR). And of course the influenza vaccine. Modern immunology has even been looking to develop vaccines against HIV and even cancers with some promise.

3.1 History of the Anti-Vaccination Movement - Early Criticism of Immunization

rwalters2013 — 2019-04-10 20:08:01 UTC

Criticism against the various forms of immunization have been around since their development. Prior to Jenner, advocates for variolation often had to defend the immunization practice against charges that the practice was more harmful than the diseases it was intended to prevent. This is certainly understandable as both variolation as well as Jenner's initial smallpox vaccine involved scoring flesh and inserting lymph from a blister of someone with disease. In many cases, however, contention came from religion, believing vaccination was "unchristian" as the vaccine came from an animal. Contention also came from a distrust in medicine.

3.2 History of the Anti-Vaccination Movement - Autism and Vaccines

rwalters2013 — 2019-04-10 20:25:42 UTC

In 1998, Andrew Wakefield, a former British Doctor, and 12 of his colleagues published a case series study in a journal called The Lancet. The study suggested that the MMR vaccine may predispose children to developing autism. This, of course, led to major controversy and a widespread drop in MMR vaccination rates. Quickly after it was published, numerous studies were conducted and ultimately refuted Wakefield's speculative conclusions. It was later found that Wakefield cherry-picked his data and also had financial interest in getting the results his paper presented. Wakefield was stripped of his medical license and was proven to have committed scientific fraud. But unfortunately, his influence can still be felt in society today.

3.3 History of the Anti-Vaccination Movement - Thimerosal

rwalters2013 — 2019-04-10 20:41:04 UTC

The controversy surrounding thimerosal has been around since the early 2000s. Thimerosal is a mercury containing compound that has been used as a preservative in vaccines, and thanks to Wakefield, became controversial as a possible link to vaccines and autism. This again has been refuted by many studies; however, in order to appease people's worries, thimerosal was removed or greatly reduced in many vaccines including influenza.

4.1 Arguments and Misconceptions About Vaccines

rwalters2013 — 2019-04-10 20:46:17 UTC

"The majority of people who get disease have been vaccinated."

This statement itself is not wrong, but it does not support the anti-vaccination movement. The phenomenon can be explained by 2 factors:
1. There is no vaccine that is 100% effective and therefore not every vaccinated individual will develop full immunity.
2. A vast majority of people have been vaccinated.

This makes it a numbers game.
Example:
Total people = 1,000
Vaccinated = 995
Unvaccinated = 5

Vaccinated individuals that develop disease = 7
Unvaccinated individuals that develop disease = 5

7/1000 (<1%) of vaccinated individuals develop disease.
5/5 (100%) unvaccinated individuals develop disease.

4.2 Arguments and Misconceptions About Vaccines

rwalters2013 — 2019-04-10 20:53:30 UTC

"Vaccines cause many harmful side effects, illnesses, and even death - not to mention possible long-term effects we don't even know about."

Vaccines are generally very safe and a vast major of adverse events following vaccination are minor and temporary, i.e. a sore arm, mild fever. The vaccines themselves go through a rigorous testing process that takes several years before they are licensed and approved by the FDA and recommended by the CDC.
The more severe adverse reactions, such as anaphylaxis or seizures, are very rare (on the order of 1/1000 to 1/1000000). Those who are unable to receive vaccination because they are susceptible to such a reaction, rely on others to get vaccinated.

4.3 Arguments and Misconceptions About Vaccines

rwalters2013 — 2019-04-10 21:03:16 UTC

"Vaccine-preventable diseases have been virtually eliminated from my country so there is no need for my child to be vaccinated."

Those in many developed countries have been fortunate enough to have had access to vaccines causing many diseases to be brought down to very low levels. These diseases, however, still exist around the world and are especially prevalent in less developed areas. It is very easy for travelers to bring diseases across borders where they can spread quickly in communities that are not vaccinated.
So it is important to vaccinate not only to protect yourself but also to protect those around you. Those who either cannot be vaccinated or do not respond to vaccines, rely on those around them to be immunized in order to stop the spread of disease. This is a concept known as Herd Immunity.

4.4 Arguments and Misconceptions About Vaccines

rwalters2013 — 2019-04-10 21:11:39 UTC

"Giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system."

Parents will, of course, worry about the risks posed by vaccines. However, as evident by all the ridiculous things children stick in their mouths, children are exposed to an enormous number of foreign antigens on a daily basis. Vaccines really aren't much different. Studies have also shown that there is no increased risk or burden on the immune system when given multiple vaccines.
Despite this, many parents look to space out vaccinations due to their worries. But it must be noted that immunization schedules that have been put in place for children are carefully designed to maximize their effectiveness and keep those children healthy during some of the most vulnerable years of their life.

5. Conclusion

rwalters2013 — 2019-04-10 21:19:33 UTC

Whilst living in a modern society free of horrible diseases that once decimated civilizations, it is easy to forget how far we have come and how fortunate we are today. Unfortunately, the influence of misinformation like that of Andrew Wakefield's paper, fuels individuals innate biases and continues to dissuade people from vaccinating. This has led to problems such as the resurgence of measles. Its incidence is climbing every year with more cases occurring in the first 3 months of 2019 than in all of 2018. Hopefully, this spread of misinformation can be halted by correct information and vaccination rates can be increased around the world.

6. References

rwalters2013 — 2019-04-11 12:59:41 UTC

Health and Human Services. (2017). Vaccine Safety. Retrieved from https://www.vaccines.gov/basics/safety/

Kluger, J. (2019). Measles Is Returning to a Range of Places - But Not for the Same Reasons. Retrieved from http://time.com/5375687/measles-return/

Lord, A. (2015). Anti-vaccination in America. Retrieved from http://americanhistory.si.edu/blog/anti-vaccination-america

Merriam-Webster. (n.d.). Inoculate. Retrieved from https://www.merriam-webster.com/dictionary/inoculate

Miller, B., MD. (2017). Risks of spacing or delaying vaccines in children. Retrieved from https://chw.org/newshub/stories/risks-of-spacing-or-delaying-vaccines-in-children

NBC News. (2019). Measles count in U.S. this year already more than all of 2018. Retrieved from https://www.nbcnews.com/storyline/measles-outbreak/measles-count-us-year-already-more-all-2018-n989581

Sadarangani, M. (2016). Herd Immunity: How does it work?Retrieved fromhttps://www.ovg.ox.ac.uk/news/herd-immunity-how-does-it-work

Phadke, V., Bednarczyk, R., Salmon, D., & Omer, S. (2019). Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007135/

Rao, T., & Andrade, C. (2011). The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/

Riedel, S. (2019). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/

Schwartz, J. L. (2012). New Media, Old Messages: Themes in the History of Vaccine Hesitancy and Refusal. Retrieved from https://journalofethics.ama-assn.org/article/new-media-old-messages-themes-history-vaccine-hesitancy-and-refusal/2012-01

The College of Physicians of Philadelphia (2018). History of Anti-vaccination Movements | History of Vaccines. Retrieved from https://www.historyofvaccines.org/index.php/content/articles/history-anti-vaccination-movements

The College of Physicians of Philadelphia (2019). Timeline | History of Vaccines. Retrieved from https://www.historyofvaccines.org/timeline#EVT_1

The Immunisation Advisory Centre (2017). A brief history of vaccination. Retrieved from http://www.immune.org.nz/vaccines/vaccine-development/brief-history-vaccination

World Health Organization (2019). WHO | Six common misconceptions about immunization. Retrieved from https://www.who.int/vaccine_safety/initiative/detection/immunization_misconceptions/en/index2.html