On the anti-vaccination movement

The polio years

An “Infantile Paralysis” warning poster on a house wall. © March of Dimes

In 1916, there were 27.000 registered cases of polio and 6.000 polio deaths only in the United States. When a member of a family was infected, the family was quarantined, and special signs were posted on their doors to warn people that there was a sick person in the house — not unlike the London plague of the 17th century.
A lot of the infected were in New York. People escaped the cities and moved to isolated mountain resorts. Public gatherings had been suspended, and cinemas were closed.
It is important to understand the weight of the situation, and why I compared it to the bubonic plague in particular.
Most of the victims were children — hence the name polio was given at the time, “infantile paralysis”.

The child’s leg was deformed as a result of polio. Source — CDCP PHIL

Here’s the course of the disease. In most of the cases, polio is asymptomatic and does not affect the health of the infected. In some cases, the disease causes flu-like symptoms — upper respiratory tract inflammation, aching throat, temperature. That passes too, not harming the central neural system.

Only 0.5% of the infected — people with a weakened immune system and children — have muscular weakness, to the point of certain muscles stopping functioning altogether. Polio can infect not only appendages, but also muscles answering for the functioning of important internal organs — the heart, the diaphragm, etc. — which can lead to cardiac arrest, stopping the breathing and other complications, including death.

To some it might seem like 0.5% of the infected is a small number, and the disease is not too dangerous. Sadly, back in 1916 polio was diagnosed only when the symptoms appeared. 27.000 infected. 6000 dead. In the timeline of this article, these numbers shall grow — leaving a dark trail of dead and crippled people in the history of America and the world.

We’ll have to remember this fact when we talk of another disease, which parents often don’t take seriously — measles.

Polio epidemics started happening every summer starting from 1916. In 1949 there were 42.172 registered cases of polio in the US and the disease spread to Canada and the UK. The governments and health structures of these countries tried to combat the disease at the limit of their capabilities — which, apparently, was not enough. Medication and sanitary were some of the attempted methods. These did succeed in limiting the amount of polio deaths — but not stopping the epidemics of curing the disease. And polio would continue to spread unopposed.

During the polio epidemic of 1952 57.628 people were infected, 3.145 people died, and 21.269 had muscle paralysis of varying degrees.

Overall, polio would kill around half a million people worldwide between the years of 1940 and 1950.

Back in 1935 Maurice Brodie attempted to create a polio vaccine by killing the polio virus with formaldehyde. The experiment was a failure. Attempts to activate the immune system with the help of vitamin C failed too. Antibodies from the blood of the people who had defeated polio would grant temporary immunity in 80% of the cases, but only for two weeks.

Everything changed when medical researcher Jonas Salk introduced his inactivated poliovirus vaccine (IPV). The first experimental uses of the vaccine were in1952, and Salk declared the vaccine a success in 1955. A massive vaccination program followed, which resulted in the decline of polio infection cases from 58.000 to 5.600 in 1957. Most of those infected were from isolated communities that did not participate in the vaccination program. 8 years after Salk’s vaccine’s discovery, Albert Sabin introduced his oral vaccine with attenuated live poliovirus. Only 161 cases of infection were registered in the US in 1961.

It would seem like the nightmare was coming to an end.

Every time a “Big Pharma using vaccines to profit” discussion starts, remember that Jonas Salk and Albert Sabin could have patented their vaccines and sold the rights to produce and use them. That would have made them billionaires. Fortunately, they decided that everyone should have access to the polio vaccine.

How do these vaccines work? First, the poliovirus is killed or attenuated so that it cannot infect the recipient, even if the latter’s immune system is weakened or not fully formed. Those “scary substances” contained in the vaccine in minuscule amounts serve to attenuate or kill the virus. There are also other substances to stop bacteria growth in the vaccine. The human organism reacts to the dead or weakened virus the same way it would react to the live one — produces antibodies and fights it. When it “defeats” the vaccine, the immune system “remembers” how to produce antibodies for the specific virus for years to come. This is known as temporary immunity. While this immunity works, the organism is prepared to to the virus.

It is the temporary nature of this immunity that makes periodic vaccination necessary.

Can you remember the last time you saw a person infected with polio? Back in 1988 there were 350.000 people in the world suffering from it. In 2015 this number declined to 74. All this — thanks to mass vaccination programs.

Smallpox killed 300 to 500 million people worldwide only in 20th century. It might be the disease to have killed most people overall.

Now you don’t have to be afraid of it. Thanks to the efforts of the World Health Organization, smallpox was declared extinct by 1979. Eradicated thanks to mass vaccination.

Why talk about diseases that have been completely or mostly defeated? To reflect upon the diseases that still exist and are widespread. Measles, for example. There’s an opinion that measles are nothing to be worried about: temperature, rash, permanent immunity after recovery. I have even observed something called “measles parties”: as with mumps and chickenpox, the parents of healthy children take their kids to play with infected ones. This is sometimes observed as a group activity. The reasoning given for this is that children “recover from measles with more ease and it leaves no lasting effect, unlike adults”.

Yet measles is one of the leading causes of child mortality, according to statistics. Before 1980 2.6 million people in average died of measles yearly — worldwide. 545.000 children died of measles only in 1990. 96.000 measles deaths were registered in 2013.

In 2015, 134.000 people died of measles worldwide. That’s 367 people daily, in average. 15 people for every hour of the day.

Every parent who decides that “they know what is best for their children” and replaces vaccination with intentionally infecting their child should remember this statistic. They should remember, that, in case of being infected, the survival rate of vaccinated children is pretty high. Actually, it’s around 100%. The declining death toll because of measles is thanks to the vaccination.

With good intentions

As the saying goes, the road to hell is paved with good intentions. I’m sure the parents who decide against their children being vaccinated do believe they are acting in the best interests of their children. Still, the claims the movement makes about vaccines causing health problems (autism, for example), do not seem to originate with concerned parents.

So let us try to analyze and understand the origins and nature of the anti-vaccination movement, its demands and goals.

Statistics speak for me, when debating whether the anti-vaccination movement acts in the best interests of children or not. Where it gains influence, measles cases follow.

A simple and recent example of this would be the 2017 measles outbreak of Minnesota, which mostly affected the families of Somalia immigrants. Why? One of the reasons is the tight-knit community those families live in, which results in them sharing both disease pathogens and anti-vaxxer ideas. But we’ll talk more about that a bit later.

By 10th July, 2017 the number of infected children in the Minnesota measles outbreak was 78. I hope those children recover with no serious repercussions, but it will take time.

Suaado Saleh is a 26-years-old young mother who has immigrated from Sommalia. She, like many others who have immigrated from Muslim states, prefers to live in a community of expatriates.

Suaado Saleh has moved to the US seeking safety for herself and her children. “I thought: ‘I’m in America. I thought I’m in a safe place and my kids will never get sick in that disease”, she told The Washington Post.

Members of her community advised her against measles, mumps and rubella vaccination, claiming that those vaccinations cause autism in children.

Suaado Saleh took their advise.

Not that her son, aged 3, and her daughter, 18 months old, are infected, she regrets her decision.

This is a particularly painful topic for Suaado Saleh: when she was a child living in Somalia, her 3 years old sister died of measles.

Her daughter was placed in a hospital back in spring. Cough, rash, high temperature — the usual picture of measles. The doctors had to assign oxygen and intravenous liquids to the child for four days.

The local Somalian community often participated in meetings organized by local anti-vaccination groups. Anti-vaccination activists would invite Andrew Wakefield — the “father of anti-vaccination movement” — to have talks with concerned parents. We shall follow up on Andrew Wakefield later in the article.

Suaado Saleh no longer believes that vaccines cause autism. Sadly, she had to pay a high price for this understanding — and it could have been worse.

I talked about measles and its dangers in the previous part of the article. The picture is clear and easy to understand — less vaccinations mean more infected children. One of the problems is, parents deciding against vaccinating their children don’t endanger only their children. Unvaccinated kids can pass the disease to vaccinated ones. Sure, vaccination will help to overcome the disease, but this is still a risk every parent should consider.

Parents who decide against vaccination endanger every child in their community. And when a community has many unvaccinated children, even a single infected child can start an epidemic.

Like every medicine, vaccinations can have side effects. I am one of the few people who cannot receive certain vaccines: those cause an acute allergic reaction, to the extent of causing anaphylactic shock and subsequent death. That’s why children should receive vaccination only by the doctor’s direction. I have already said that vaccination presumes “infecting” the organism with dead of attenuated pathogens. The immune system reacts to the disease with symptoms resembling those of the real disease — temperature, bad mood, maybe slight rash. This is a natural reaction and poses no danger. Vaccines cause side effects among very few people, and the course and long-term effects of the diseases are much more dangerous.

The simple parental instinct should not be understated: the process of vaccination often causes discomfort for children. The child might cry and resist, have high temperature for a couple of days — all for a result that isn’t easily noticed. Many parents might think — maybe my child wouldn’t have measles at all, and they forced their child to go through all this for nothing. No caring parent likes seeing their child in pain and discomfort, especially when it is caused by other people.

I have already talked of smallpox. A disease that has been completely eradicated. But it took the lives of 300 to 500 million people only in the 20th century.

Back in 1700s people found out that when you cut a person’s skin and infect the wound with smallpox they have a lighter form of the disease and gain immunity for smallpox afterwards. Thus we might say that the vaccination method for smallpox was available since the 18th century.

Yet, only mass vaccination since childhood helped defeat smallpox. More than two centuries after discovering the vaccination method, smallpox would still kill millions. Let that sink in for a moment.

This is the reason why mass vaccinations among children are necessary.

Members of the anti-vaccination movement might give different responses to this claim.

German anti-vaccination activist and HIV denialist Stefan Lanka posted a challenge on his website back in 2011. He said he was ready to pay 100.000€ to any person who provided proof of measles being caused by a virus and showed the diameter of the virus. Lanka claimed measles was psychosomatic (a result of psychological processes, lifeslyle and other factors). Lanka also claimed there was no such thing as a measles virus.

When German doctor David Bardens produced the necessary proof, of course Lanka did not accept it. Bardens had to start a legal procedure. The court ruled in favor of Bardens, ordering Lanka to honor his end of the bargain.

Another claim of the anti-vaccination movement is the suspected connection between child vaccination and autism.

Autism is a condition not yet sufficiently understood by modern science, and while there are some known factors contributing to autism — like using alcohol and cocaine while pregnant — we know little to give a definitive answer — what exactly causes autism, and how autism works.

When a parent learns that their child has autism, it is only natural that an answer like “we don’t fully understand the cause of it” won’t satisfy them. These parents, not getting the answer from the doctors, often seek answers elsewhere — other parents, especially those with kids suffering from the same ailment, and the internet.

While there is no statistical evidence linking vaccination and autism, the source of this belief among anti-vaccination activists has its roots in a study published in The Lancet back in 1998. Here’s how it happened.

The Lancet is a peer-reviewed magazine publishing scientific articles. In 1998 it published a research by a certain gastroenterologist Andrew Wakefield and his co-authors. I have already mentioned Wakefield as “the father of modern anti-vaccination movement”, when talking about the measles outbreak among immigrants from Somalia.

Wakefield’s research claimed that 12 children in a northern London hospital received measles, mumps and rubella (MMR) vaccination, and after 14 days 8 of them developed symptoms of autism and digestive tract inflammation. The article caused an uproar, the press started interviewing Wakefield.

The study wasn’t published in a tabloid or a conspiracy theory website, but in a respected scientific magazine. It caused panic among parents and they started declining the mentioned vaccines for their children.

I understand these parents and do not blame them. Not being doctors themselves, they had heard of a shocking discovery finally explaining the cause of autism and showing how dangerous vaccines were — so they acted to protect their children.

Such a research could have scared me too.

Wakefield’s research resonated among the scientific circles too. Actually, peer-reviewed articles are mostly for scientists and not the parents. However, none of the subsequent studies could prove Wakefield’s claim or replicate its results.

The shocking discovery started to look like a dubious one.

Sunday Times journalist Brian Deer started his own investigation and found out that Andrew Wakefield had a conflict of interests of financial nature. In the light of these and other allegations, General Medical Council started an investigation into Wakefield’s research and on 28th January, 2010 ruled that he was guilty of more than 30 charges — including four counts of professional dishonesty and 12 counts involving the abuse of developmentally challenged children, like submitting them to invasive medical procedures without the necessity and the permission of the medical committee. GMC also found out that Wakefield had acted outside the bounds of professional ethic and falsified a lot of the data presented in the research.

The Lancet followed up on the Council’s decision by retracting Wakefield’s article and published a conclusion authored by 10 out of 13 co-authors denying the connection between autism and MMR vaccination.

Wakefield was struck off register by the GMC, thus barring him from practicing medicine in the UK. By 2001 or, according to other sources, 2004 Andrew Wakefield had moved to USA and continued his anti-vaccination activities — thus becoming the “father of modern anti-vaccination movement” and one of its leaders.

Wakefield’s activities led to a drop of MMR vaccination rates in UK, USA and Ireland. Outbreaks of those diseases followed.

I have studied and grouped most common arguments voiced by anti-vaccination activists:

  1. Vaccinations cause autism. Based upon Andrew Wakefield’s research. The research has been found false and retracted.
  2. Vaccines contain poisonous substances like formaldehyde and mercury. I have explained how trace amounts of these substances remain in the vaccines. While they sound scary, people come by this stuff in their everyday life, and the small amount received during vaccination cannot have a lasting effect on health.
  3. World Health Organization and Big Pharma use vaccination for monetary gain. Most vaccines, particularly — the MMR vaccines, are free. The technology of making them is freely available, and many different laboratories in different countries produce them.
  4. Hygiene is enough to avoid most diseases. If this statement was true, most of the people killed or crippled by polio would have avoided the ravages of the disease. And then, we have people like the South African president Hector Zuma advising people to take a shower to avoid AIDS.
  5. Living in harmony with nature is enough to have a healthy life. Living in harmony with nature can improve the health for many people. Urban life with its stress and dust and fast pace creates its own problems. Sadly, it is not enough to avoid infectious diseases. A native tribe of the Amazon jungles faced this truth the hard way: while living in an almost complete isolation from the civilization, they were unprepared for the tuberculosis virus, which almost eradicated the tribe. Only modern medicine helped — and in some cases, even medicine was powerless. Many members of the tribe still live with a chronic form of tuberculosis.
  6. Vaccines are used in a Mysterious Conspiracy by the Dark Forces (the Rich, the Masonic Orders, the Illuminati, the Zionists, the Reptiloids — take your pick) to control the world. This claim has no basis in the reality we are living in and arguing against it is as fruitless as banging your head against a brick wall.

Sometimes people believe in anti-vaccine ideas because they are not acquainted to the counter-arguments against them, and sometimes people just ignore the counter-arguments. It doesn’t matter how discredited Wakefield’s research is — there will always be people who make an honest mistake, and others who fight to spread Wakefield’s “good news” in combative ignorance. If Wakefield had claimed to have found a cure for HIV, and later it turned out to be based on a false research, some people would have concentrated on the falsification and scandal, and only a small amount of them would make up conspiracy theories about how the Dark Powers have engineered HIV to control the world and how they are attempting to silence anyone trying to cure it. Then desperate people with HIV would appear and ask Wakefield to save them. Desperate people often call for desperate means. This model of public behavior has been observed multiple times. And a scandal always gets more attention than a retraction. A scandal is an explosion, while a retraction is a slow, complicated process.

When materials like Wakefield’s research reach the internet, they seem to gain a life of their own. Tabloids love clickbait, trendy and scandalous topics, add their own juicy details, often exaggerated or fictionalized, add heart- and gut-wrenching titles to them. Then parents appear who claim that their children started exhibiting signs of autism after being vaccinated. And it is highly unlikely for a magazine (except for The Onion, of course) to interview parents whose children specifically did not develop signs of autism after being vaccinated.

Then the information keeps spreading in social networks. Fans of so-called “alternative medicine” embrace such ideas, and “alternative medicine” is often a commercial sphere which has a conflict of interest and financially competes with conventional medicine.

In most of the cases, the parents are not to blame. They worry about their children and attempt to find the best safest option for them. Of course, there are those who perceive anti-vaccination ideas as an ideology and are willfully ignorant. I have personally observed many cases when attempting to inform the parents ends in threats and insults by a vocal minority. How some people attempt to force their ignorance upon others simply by shouting louder. I see these people as a danger both for their own children, and other parents and their children. In most cases, parents are not doctors. And their children are their vulnerable spot. When a parent hears of something endangering their child’s health, they worry. It is a natural reaction. They search the internet, find the articles I spoke of earlier. Fear-mongering benefits on the naiveté of others.

Brian Deer — the investigative journalist who had a key role in the refutation of Wakefield’s research — does not often receive letters of gratitude from parents, while he protected their children from professional fraud.

Quite the opposite. His email inbox if full of hateful messages, claims of him being bribed by pharmaceutical companies and even threats.

People ask Brian — how do you sleep at night after what you have done.

“I was an anti-vaxxer”

The anti-vaccination movement has many faces ranging from naive and easily deceived parents to Islamist militants. Pakistan has an example of this last type. While Pakistan is one of the two countries where polio still poses a threat — with more than 300 cases of infection registered in 2014 — Islamist militants believe that polio vaccination is a Western plot to make their children sterile.

Doctors providing polio vaccine need police protection for their safety — which often is not enough. In December 2012 Islamist militants killed five vaccination specialists. Another four — in November 2014. In January 2015 a suicide bomber blew himself up near a vaccination center, killing fifteen. In February 2015 the corpses of four vaccination specialists were found. Eight armed militants attacked vaccination specialists and the police officers protecting them in April 2016. Seven people died.

While these terrorists do affect the face of the overall anti-vaccination movement, I’d refrain from associating them with your common run of the mill anti-vaxxer.

So let’s try to understand those who were members of the anti-vaccination movement and then left it, and maybe we’ll get a better understanding of the movement itself.

BBC did an article called “What’s behind the anti-vax movement?” in 2015, and I’ll quote a part of the interview with a former member of the anti-vaccination movement:

Juniper Russo is a single mother living in the city of Chattanooga in the southern US state of Tennessee, and used to be part of the anti-vax movement.

“Andrew Wakefield’s study was one of the things that had really scared me. People who are in the anti-vaccine movement largely believe that he was silenced and that he was actually a hero who was speaking up about something important.”

Juniper now writes a blog, Back From Nature, in which she advocates evidence-based healthcare. Like journalist Brian Deer, she’s faced a vicious backlash and even threats from anti-vaxxers for changing her views. But at one time there was no question in her mind: vaccinations were a conspiracy.

“I was only 20 when I got pregnant with my daughter and I was really young and really naive and I had gotten wrapped up in this world view that said that nature is just this wonderful thing and that everything about our big scary industrialised world was bad.

“I thought that the government wasn’t to be trusted and I very much believed in the idea that there was this big organisation called Big Pharma and I thought that people would be willing to make my child sick to make a dollar.

“All that I could think about was that I was doing what I needed to do to protect my children from this beast of modern medicine. I didn’t think about the possibility that I was putting anyone else in danger, but I now know that I was.”

But Juniper’s views changed after her daughter, who had never had a vaccination, was diagnosed with autism.

“That was the beginning of me starting to face that I had made a mistake in assuming that if I did everything in this perfect… way that nothing wrong would ever happen to my kids.

“I was seeing a lot of it on the news, and I now realise that it was actually very irresponsible of the media. They would have a physician who worked with the World Health Organization on TV, and then debating with him they would have a mum who said that her kid had autism from the vaccine.

“It was very easy for me to side with the person that I could relate to the most, instead of siding with the big scary doctor who was, I assumed, paid off by the government.”

Megan Sandlin is a 20 years old mother of two. She decided to give birth at home and be a more wholesome parent for her children. And, of course, she started having discussions with people who had the same approach towards parenthood. Megan noticed that many of her new acquaintances opposed vaccination, and asked a friend about it. Her friend offered her to read about the substances contained in vaccines, and on the possible side effects. Megan followed the advice and… was horrified, despite not understanding most of what she read. Then she checked how common the vaccinated diseases were. There hadn’t been a registered case of diphtheria in the US for years.

Megan’s story is a case of acquiring second-hand anti-vaccination information, when people already a part of the movement play on the fears of inexperienced parents and push them towards the movement.

Megan’s “friends” convinced her not to trust official websites and to google the information she needed, or find it on Facebook pages, told her that breastfeeding would protect her child from all diseases, supported her psychologically and represented her child as an example of a perfectly healthy unvaccinated child. It was a pleasant feeling, like being a part of a big friendly community.

However, being a skeptic, Megan started noticing that many members of the movement also believed in other conspiracy theories, which defy logic a lot more than anti-vaccination ideas. Like chemtrails.

Doubt lead her to do her own research, and the results of the official studies were scarier, than the ingredients of vaccines. No, hygiene did not reduce diseases — vaccines did. No, vaccines did not overload the immune system — improving over time, they covered more diseases using less antigens. No, autism had nothing to do with vaccines.

When Megan’s daughter was ten months old, she decided to resume vaccinating her. She posted it on Facebook, and lost around 50 friends immediately. People who welcomed her idea of giving birth at home, called her an amazing mother and an inspiring person, just unfriended her. Megan was removed from groups, people she never knew blocked her.

However, her children are now examples of a perfectly healthy vaccinated children. And I do believe her children being healthy is the only thing we should eventually care about.

Naomi Murray became a member of the anti-vaccination movement after reading Jenny McCarthy’s book — another example of how models aren’t better health advisors than doctors. Her husband convinced her to have their child vaccinated, and that just may have saved the child’s life.

At the age of four Naomi’s daughter was infected with whooping cough, for which she was vaccinated. Whooping cough is an airborne disease that causes people to cough so much that the air leaves their lungs. It is more dangerous for infants— 241 children younger than three died of whooping cough in between 2000 and 2014 in the US only.

Thanks to the vaccine, the disease had a mild course and there were no complications — whooping couch can lead to pneumonia or even brain damage because of oxygen starvation.

Now Naomi thinks it’s insulting when people knowingly refuse to vaccinate their children. The reaction of her friends who remained members of the anti-vax movement is predictably aggressive. But at least her children are healthy and safe.

I brought three examples of three different parents. All three had been members of the anti-vaccination movement for a period of time, all three consciously left it. All three faced a scorning reaction of almost religious nature — in different shapes and sizes.

This is where they lay

In 2015 Romania faced an outbreak of measles. It infected thousands of people and caused the deaths of 17 children.

As Romanian health minister Florian Bodog stated, none of these children were vaccinated against measles.

These children could have been saved.

Their parents likely weren’t even members of the anti-vaccination movement. It’s just that only 80% of Romanian population has access to medical services.

These parents could not afford the luxury of declining vaccination. The decision was made for them by circumstances.

Recently the anti-vax circles started passing around a news article on 130 families in North Italy ready to seek asylum in Austria if vaccination is made compulsory. Yet nobody talked about the events that started the debate on compulsory vaccination.

Six years old. The age of the Italian child that died of measles complications. He got measles from his brother, whom his parents had decided not to vaccinate.

The child’s immune system was weakened by leukemia.

He could have been infected by any unvaccinated child.

And this is what started the debates on compulsory vaccination in Italy.

The parents fighting for the right not to vaccinate their children believe they are making a decision on the health of their own children.

Now let’s think how such a decision can affect the health and lives of children living with cancer, HIV and other diseases weakening their immune systems.

The six years old child from Italy could have been saved too.

I hate writing about children who have died. Especially when they could have been saved.

But perhaps I must, if this can show people the possible repercussions of their decisions.
My heart aches for every child suffering from whooping cough because their parents decided not to vaccinate them. My heart breaks for every child who has died because they could not receive necessary medical help by the fault of their parents or the medical system.

Most of you have the choice of vaccinating or not vaccinating your children. That is a decision you shall make yourself, and you shall live with the results of this decision. We should make informed decisions — for we are responsible for those we have brought to life.

I will finish the article here; it wasn’t an easy job. I hope it will help someone.