Among HIV, climate change, and ebola, vaccine hesitancy has been named one of the world’s greatest health challenges by the World Health Organization. The World Health Organization began a five year plan, the 13th General Programme of Work, focusing on a triple billion target: ensuring 1 billion more people benefit from access to universal health coverage, 1 billion more people are protected from health emergencies, and 1 billion more people enjoy better health and well-being. Anti-vaccinators stand in the way of that goal.
In the spring of 2013, Canada’s vaccination rate was 84%, 11% lower than the global goal of 95%. However, the personal choice to not vaccinate isn’t that personal. Young babies, the elderly, and other individuals with compromised immune systems rely on ‘herd immunity’ to provide indirect protection from infectious disease. As well, statistics consistently show that vaccines work and claims of autism risk and dangerous chemicals are also unsupported by scientific evidence.
There have been many recent stories of children going against their parents and vaccinating themselves. An Ohio teen, Ethan Lindenberger, recently sought online help.
My parents think vaccines are some kind of government scheme,
he wrote in November.
But, because of their beliefs I’ve never been vaccinated for anything, god knows how I’m still alive.
As an eighteen year old, he wanted to get vaccinated, but he wasn’t sure how. Lindenberger has shared his story on the news and is attempting to inform people about the misinformation on the internet. With children at serious risk of essentially cured diseases, many are wondering what is the best way to deal with and convince anti-vaccinators of the benefits of vaccines.
The World Health Organization has recently addressed the six common misconceptions surrounding immunization. They are as follows:
- Diseases had already begun to disappear before vaccines were introduced because of better hygiene and sanitation.
- The majority of people who get disease have been vaccinated.
- There are ‘hot lots’ of vaccines that have been associated with more adverse events and deaths than others. Parents should find the numbers of these lots and not allow their children to receive vaccines from them.
- Vaccines cause many harmful side effects, illnesses, and even death, not to mention possible long-term effects (such as brain damage or autism).
- Vaccine-preventable diseases have been virtually eliminated from my country, so there is no need for my child to be vaccinated.
- 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.
These claims have been consistently disproven by scientific discovery and real life statistics around the world. However, the history of the anti-vaccination movement has allowed these claims to survive in today’s world. Even though vaccination has been described as one of the top ten achievements of public health in the 20th century, opposition has existed as long as vaccine shave themselves. In the mid to late 1800s, England and the United States opposed the smallpox vaccine with anti-vaccination leagues. Recently, there have been vaccination controversies surrounding the safety and efficacy of the diphtheria, tetanus, and pertussis (DTP) immunization, the measles, mumps, and rubella (MMR) vaccine, and the use of a mercury-containing preservative called thimerosal.
Widespread smallpox vaccination began in the early 1800s, following the experiments of Edward Jenner. Jenner’s cure was extremely novel for the time, and it was faced with immediate, public criticism. The criticism varied from sanitary, to religious, to scientific, and to political objections. Parents feared the vaccine because it involved scoring the flesh of the child and inserting lymph from the blister of a perviously vaccinated person. The local clergy believed it to be ‘unchristian’ because it came from an animal. Other anti-vaccinators at the time showed their distrust in medicine and issues regarding personal liberty, which worsened as the government developed mandatory vaccine policies. The Vaccination Act of 1853 required mandatory vaccination for infants up to three months old. The Vaccination Act of 1867 extended the age to 14 years old, adding penalties for refusal. The laws were met with resistance from citizens who demanded the right to control their bodies and those of their children. The Anti-Vaccination League and the Anti-Compulsory Vaccination League formed in response to the laws. Numerous anti-vaccination journals also were created.
An escort was formed, preceded by a banner, to escort a young mother and two men, all of whom had resolved to give themselves up to the police and undergo imprisonment in preference to having their children vaccinated…The three were attended by a numerous crowd…three hearty cheers were given for them, which were renewed with increased vigour as they entered the doors of the police cells.
The Leicester Demonstration March of 1885 was one of the most notorious anti-vaccination demonstrations. There, 80,000-100,000 anti-vaccinators led an elaborate march, complete with banners, a child’s coffin, and an effigy of Jenner. This opposition led to the development of a commission designed to study vaccination. In 1896 the commission ruled that vaccination protected against smallpox, but suggested removing penalties for failure to vaccinate. The Vaccination Act of 1898 removed penalties and included a “conscientious objector” clause, so that parents who did not believe in vaccination’s safety or efficacy could obtain an exemption certificate.
Toward the end of the 19th century, smallpox outbreaks in the United States led to vaccine campaigns and related anti-vaccine activity. The Anti Vaccination Society of America was founded in 1879, following a visit by leading British anti-vaccinator William Tebb. The New England Anti-Compulsory Vaccination League and the Anti-Vaccination League of New York City followed. The American anti-vaccinators waged court battles to repeal vaccination laws in several states including California, Illinois, and Wisconsin. In 1902, following a major smallpox outbreak. the board of health of the city of Cambridge mandated all city residents be vaccinated. Resident Henning Jacobson refused vaccination because he believed the law violated his right to care for his own body. The city filed criminal charges against him, and after her lost his local court battle, Jacobson appealed to the Supreme Court. In 1905, the Court ruled in the state’s favour, ruling that the state could enact compulsory laws to protect the public from disease. This was the first U.S. Supreme Court case concerning the power of states in public health.
In the mid 1970s, an international controversy over the safety of the diphtheria, pertussis (whooping cough), and tetanus (DTP) vaccine erupted. In the United Kingdom, a report from the Great Ormond Street Hospital for Sick Children in London, claimed that 36 children suffered neurological conditions following DTP immunization. Television and newspapers drew public attention to the controversy, leading to the creation of the advocacy group, The Association of Parents of Vaccine Damaged Children (APVDC). They gained public interest in reporting the potential risks and consequences of DTP. In response to a decreased vaccination rates and three major epidemics of whopping cough, an independent expert advisory committee in the United Kingdom, the Joint Commission on Vaccination and Immunization (JCVI) confirmed the safety of vaccination. However, the image was immunization was tainted and public confusion continued, in part due to diverse opinions within medical professionals. A survey in the late 1970s found that medical providers in the United Kingdom were reluctant to recommend immunization. An outspoken physician and anti-vaccinator, Gordon Stewart, published a series of case reports linking neurological disorders to DTP. In response, JCVI launched the National Childhood Encephalopathy Study, which identified every child between 2 and 36 months hospitalized in the United Kingdom for neurological illness, and assessed whether or not immunization was associated with increased risk. The study found that the risk was very low, lending support to a national pro-vaccination campaign. APVDC member continued to demand compensation, but were denied due to the lack of evidence linking DTP immunization with harm.
In the United States, a 1982 documentary, DPT: Vaccination Roulette, described alleged adverse effects of vaccination. In 1991, the book, A Shot in the Dark, further outlined potential risked. In parallel with the United Kingdom, advocacy groups began to form against vaccinations. However, response from medical organizations, like the Academy of Paediatrics and the Centres for Disease Control and Prevention, was stronger in the United States. There was a lower drop in immunization rates than in the United Kingdom, but there were several lawsuits, increased vaccines prices, and fewer manufacturers of DTP.
Almost 25 years after the DTP controversy, the United Kingdom was again a hotspot of anti-vaccination activity, regarding the measles, mumps, and rubella (MMR) Vaccine. In 1998, British doctor Andrew Wakefield recommended further investigation of a possible relationship between bowel disease and autism, and the MMR vaccine. Later, Wakefield alleged the vaccine was improperly tested before it was put into use. The media used these stories to ignite public fear. The Lancet, the journal that published wakefield’s work, admitted in 2004 that the journal should not have published the paper. The General Medical Council, found that Wakefield had a,
fatal conflict of interest.
He had been paid by a law board to uncover evidence to support a case made by parents who believed the vaccine has caused harm. The original journal formally retracted the paper in 2010, after the British General Medical Council ruled against Wakefield in several areas. Wakefield was struck from the medical register in Great Britain. In January of 2011, the BMJ published a series of reports outlining the evidence that Wakefield committed fraud. A large body of research has concluded that there is no link between the MMR vaccine and autism.
Even more recently, there has been a call to ‘green’ vaccines. Thimerosal, a mercury containing compound, has been used as a preservative in vaccines. It has also been the centre of the vaccination and autism controversy. Although there is no clear scientific evidence that small amounts of thimerosal in vaccines cause harm, in July 1999, leading U.S. public health and medical organizations agreed that thimerosal could be reduced or eliminated as a precautionary measure. In 2001, The Institute of Medicine’s Immunization and Safety Review Committee issued a report concluding that there was no evidence to prove or disprove the claims that thimerosal in childhood vaccines causes autism, attention deficit hypersensitivity disorder, or speech and language delay. Recently, a report by the committee,
favours rejection of a casual relationship between thimerosal-containing vaccines and autism.
Even with this conclusion, many researchers continue to study a possible link. Regardless, thimerosal is no longer used in most childhood vaccines, though some form of the influenza vaccine available in multi-dose vials may contain the preservative. Despite the fairly overwhelming evidence, concerns over thimerosal has led to a public ‘Green Our Vaccines’ campaign, which aims to remove ‘toxins’ from vaccines, in fear of their relationship to autism. Celebrity Jenny McCarthy’s advocacy group, Generation Rescue, and the organization, Talk About Curing Autism (TACA) have spearheaded these efforts.
Clearly, the emotions regarding vaccination, whether they are political, spiritual, or health related, has existed for a long time and remained relatively consistent. This leaves many to wonder what is the best way to dismantle vaccine fears.
The rise of social media in today’s world has created a completely new playing field for vaccine conspiracies to drive. Facebook groups and social media clubs has created deep echo chambers sharing misinformation that gets continually reaffirmed by individuals with parallel beliefs. A Facebook page, ‘Stop Mandatory Vaccination,’ created in 2015, has over 125,000 likes. Its incredibly active, private Facebook group counts nearly 160,000 members. The mission statement says,
Vaccines are dangerous and unnecessary for vibrant health. Unfortunately, we’ve been lied to. On this website you can find numerous videos of parents talking about vaccine injury or why they are vaccine free, read comments from over 180 parents who share why they stopped vaccinating, discover how to raise a healthy child without any vaccines, learn the many horrors of vaccines and how dangerous they actually are, and find out how we have been lied to about the need for vaccines for public health.
The United Kingdom’s Advertising Standards Authority (ASA) found that the founder was guilty of spreading false information through ads.
The internet is allowing false information to thrive, as it can be spread and multiplied so quickly. Fear of health and government institutions only elaborates on the vaccination hesitancy held by an increasing number of people across the world. Even with the internet providing information to children of anti-vaccination seeking vaccinations as adults, its clear that the internet has played a vital role in accumulating false information not only regarding vaccination, but the government institutions that provide them.
The World Health Organization has reported,
Measles, for example, has seen a 30% increase in cases globally. The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence.
Recently, it seems that anti-vaccinators have become the newest joke of the internet. A new wave of fear tactics and humour has been targeted towards anti-vaccinators in an attempt to decrease vaccination hesitancy. The New Brunswick Health Council reported that a media research company, Cormex Research, found that despite the recent messages in support of vaccination online, there has been no decrease in anti-vaccination chatter on social media. On Twitter, 75% of posts related to vaccination were pro-vaccination. However, tweets against vaccination only dropped from 17% to 14% from the summer of 2014 to the first two months of 2019. Cormex concluded that even with negative publicity, information about the benefits of vaccines, and the increased risk of disease contraction,
not only failed to change hearts and minds about vaccination, it may not even have been sufficient to diminish or further marginalize the visibility of anti-vaccination statements.
The negative media storm against anti-vaccinators and in support of vaccines and the institutions that provide them, seems to have had no effect on the rate or intensity of anti-vaccination talk. The echo chamber is strong, and the negative response is pushing anti-vaccinators deeper into their beliefs. The media has consistently and extremely bashed anti-vaccination, especially on social media. It’s true, anti-vaccinators are dangerous and the belief is unfounded, based on false claims that forever tarnished the reputation of vaccines, but the current attempt at change has been fruitless. It is necessary to rethink the conversation surrounding vaccines.
In the 1960s, 75% of Americans had trust in the government and medical industry. Today, that number is 25%. The attacks against anti-vaccinators have been unsuccessful because the attacks are coming from a source that is seen as untrustworthy by much of the public. Frankly, medical news is inconsistent. Constantly, new studies are proving and disproving the health of different foods and activities. It almost makes sense why people are becoming hesitant towards vaccines. Regardless is the hesitancy is feasible, it is still completely unfounded, so as a society, the attempt to dismantle the echo chamber of anti-vaccinators must account for the fears of inconsistency held by those who distrust government an medical institutions.
The 17th case of measles has occurred in Vancouver, and health officials are saying that there has been no shortage of vaccines for the disease. However, it seems that outbreaks, like the ones in Vancouver, Osaka, Minnesota, and New York, can prove helpful in diminishing vaccination hesitancy. Clark County, Washington, is home to one of the worst measles outbreaks in decades. In Clark Country, there are a plethora of anti-vaccination social media groups, and loose vaccine laws compared to the rest of the country. Going into the school year, 8% of parents declined vaccination for their children. The community immunity threshold is 5%. At the beginning of 2019, 64 people (62 of them being children) contracted measles. Almost all of them were unvaccinated.
However, once anti-vaccination parents saw the repercussions of diseases like measles, vaccination rates jumped 500% in one month. The same happened in Vancouver.
In the Fraser Health Authority, 1,103 doses of the MMR vaccine were given out in the week from February 25 to March 3, 2019. That’s more than two and a half times last year’s numbers. Over the same week last year, just 436 doses were administered. Similarly, Interior Health administered 3,220 doses of the MMR vaccine from January 1 to March 3, 2019, compared to 2,033 over the same period last year. Island Health more than tripled its vaccinations over a single week this year compared to last. From February 25 to March 4, 2019, it gave out 995 doses of the vaccine compared to 331 over the same period last year.
It seems that for now, attempting to convince anti-vaccinators to trust Big Pharma, the FDA, and major news networks, isn’t going to work. Instead, it is more effective to highlight the dangers of the diseases that are being brought back by anti-vaccinators. As well, it’s necessary to provide the opportunity for minors to get vaccines without parental consent, which is potentially happening in New York, Oregon, South Carolina and Pennsylvania, or at least, tighten vaccine laws. Truly, anti-vaccinators aren’t a group of evil cult members, instead they show how corruption and falsification can effect everyday people who just want whats best for their children. Vaccination hesitancy is a solvable problem, but it will never be solved with divisiveness.
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Vaccinated Disease Death Rates
A Note from the Author:
One more thing I would like to bring up that I feel may have otherwise taken away from the point of this piece, is the ableist implications regarding some anti-vaccination beliefs. Particularly, the issue that some people have with the MMR vaccine because they believe it may cause autism is shocking to me. Although unrelated to this overall piece, the fact that some members of society would rather have their child die from an ancient disease then have to care for their child with autism is deeply problematic. It shows truly how marginalized individuals with mental and physical disabilities truly are. The treatment of autism as a more dangerous and harmful issue than diseases like measles is concerning, and that attitude is what leads to gross abuse of individuals with mental disabilities like autism, even by primary carers. In the article, I’m Autistic, And Believe Me, It’s A Lot Better Than Measles, Sarah Kurchak breaks down the discriminatory implication of the anti-vaccination movement. Kurchak explains that those who refuse to vaccinate their children because they are afraid their child will be autistic have made the decision that people like Kurchak are the worst thing that could happen to their family.
I’m not about to take any solace in the idea that they’re willing to make exceptions for autistic people who can perform as neurotypical, or at least pose as little annoyance to neurotypical [people] as possible. That just means that I will cease to be of any value to these people if I am no longer able to pass as one of them, and that they see no value and no humanity in anyone who communicates or behaves differently from them. Tell me again who has the empathy problem?
When structuring conversation around vaccination hesitancy, it is important to realize and include the experiences of autistic people, whose identities have been ostracized in the broader context of an abstract justification for vaccination hesitancy. Autism is far from a death sentence, but lack of vaccinations can be, which is why enlightenment regarding not only the value of vaccinations is necessary, but also education dismantling the stigmatization and discrimination regarding neurodevelopmental disorders like autism must be instituted for concrete and quality improvement regarding the growing vaccination hesitancy in modern society.