It is that time of the year when I get my annual dose of frustration. Even with the overwhelming evidence supporting the value and safety of both childhood and influenza vaccines the vocal and irrational advocates of the antivaccine movement have come out to spew their vitriol in the media. The recent media frenzy over the Wired article by Amy Wallace and the half-informed “discussions” by various TV “news” personalities about the H1N1 vaccine only show the power this uninformed group has over a national health priority. The problem is that the whole movement is driven by fear and a fanatical belief that remains firm even in direct opposition to cold, hard facts.
Let us start with the most obvious fact, children have been vaccinated against multiple diseases since the 1960s (with the MMR vaccine licensed in 1971) and yet the rapid “increase” in autism cases doesn’t appear until the 1990s. Is it more likely that the increase is due to vaccination protocols that have been used for decades before the perceived rise (even though vaccines were added to the schedule, others were removed) or to the increased diagnosis of a confusing and heterogeneous spectrum of related disorders. Likewise, the idea that the preservative thiomersal is responsible for the rise in autism rates does not hold up under scrutiny. The preservative, while present in some of the influenza vaccine preps, was voluntarily removed from childhood vaccines during the 1990s, yet we have continued to see dramatic rises in autism rates. Again, we are forced to ask the question of whether it is more likely that the rate is due to the limited chance of receiving thiomersal in the annual influenza vaccine (which has a significantly lower use rate than childhood vaccine) or that the preservative is not a causative factor (an idea supported by multiple studies directed at this specific question).
The most insidious manifestation of autism is late-onset, where abilities regress suddenly. This happens at around two years of age, about the same time as the end of the US vaccine schedule (first part) and coincidence equals consequence to people desperate for an answer to why their child has been affected. Unfortunately there is no simple answer as to why autism occurs. So many disorders are listed in the autism spectrum that a simple etiology is impossible and it is likely that most of them are due to multifactorial causes (a mixture of genetic, environmental, and/or infectious factors). While I empathize with these parents, I temper my empathy with the realization than regular and consistent vaccination of the children in our country has prevented at the very least thousands of deaths and countless incidents of hospitalization and needless suffering. I also recognize that these diseases are not eradicated (a feat only ever accomplished with smallpox) and that as vaccine rates drop due to the anti-vaccine fear-mongering these diseases will reemerge. It is already apparent that this effect has hampered the worldwide effort to eradicate polio and has slowed the eradication effort for measles (a virus that has a 30% fatality rate in developing countries).
There is no illusion that this is an argument that a single blog post can win, but it is important that those who understand the science speak out. I might not be a Hollywood celebrity or a faux news personality, but I have read the studies and I have looked at the facts and it seems abundantly clear that the evidence points to the safe and effective use of vaccines.