Debate on Vaccination and Autism

Vaccines have been used to prevent diseases centuries, and have saved countless lives of children and adults. The smallpox vaccine was invented as early as 1796, and since then the use of vaccines has continued to protect us from countless life-threatening diseases such as polio, measles, and pertussis. The Center for Disease Control andPrevention (2010) assures that vaccines are extensively tested by scientist to make sure they are effective and safe and must receive the approval of the food and Drug Administration before being used. “Perhaps the greatest success story in public health is the reduction of infectious diseases due to the use of vaccines” (CDC, 2010). Routine immunization has eliminated smallpox from the globe and led to the near removal of wild poliovirus. Vaccines have reduced some preventable infectious diseases to an all-time low, and now few people experience the devastating effects of measles, pertussis, and other illnesses.

Despite all the testing and approval process of vaccines, many people still mistakenly believe that vaccines cause autism, even in light of research that has disproven the notion. This evidences the difficulty of dispelling false statements once someone has accepted falsehood, especially if it has scientific research backing the results. It also highlights the gullibility of the public at large to believe anything that medical research reports without questioning the findings. Unfortunately, the media attention such examples of junk science receive aids in convincing many of its truthfulness. The hype surrounding the belief that vaccines cause autism began in 1998 when Andrew Wakefield in the UK published an article in theLancet linking the measles, mumps, and rubella (MMR) vaccine to cases of autism in children. This claim gained a lot of momentum and quickly spread all over the world. This led to the support of various unproven vaccine-autism theories by parents in both the UK and America. After findings of intestinal disease in children with autism, Wakefield claimed that separating the MMR into three different vaccinations would be safer. Since then, Wakefield’s research has been discredited, he was charged with serious professional misconduct by the General Medical Council for violating several ethical practices, and he was investigated for failing to disclose a conflict of interest – a pending patent on a rival measles vaccine (Gross, 2009). Although false, many still believe wholeheartedly that vaccines are harmful.

In the 1998 article in the Lancet, Wakefield studied 12children “who, after a period of apparent normality, lost acquired skills, including communication” (Wakefield, Murch, Anthony, Linnell, Casson, Malik, Berelowitz, Dhillon, Thomson, Harvey, Valentine, Davies, &Walker-Smith,1998). All 12 children were reported to show behavioral symptoms after receiving the vaccination. After receiving the vaccination, the features associated with exposure collectively included fever/delirium, rash, self-injury, repetitive behavior, loss of self-help, convulsion, gaze avoidance, diarrhea, disinterest, lack of play, vomiting, and recurrent viral pneumonia. In 8 of the 12 children, the beginning of behavioral problems was linked to the measles, mumps, and rubella vaccination by either the parents or by the child’s physician. They performed extensive testing on the 12 children, which consisted of colonoscopies, cerebral magnetic-resonance imaging (MRI), electroencephalography (EEG) including visual, brainstem auditory, and sensory evoked potentials, and lumbar punctures. Urinary and stool samples were also assessed as part of the laboratory investigation. The MRI scans, EEGs, cerebrospinal fluid profiles were normal, and the clinical examination showed that none had neurological abnormalities. However, the colonoscopy results showed intestinal pathological changes in the children.

Based on these results, they state,“Intestinal and behavioural pathologies may have occurred together by chance, reflecting a selection bias in a self-referred group; however, the uniformity of the intestinal pathological changes and the fact that previous studies have found intestinal dysfunction in children with autistic-spectrum disorders, suggests that the connection is real and reflects a unique disease process”(Wakefield, et al., 1998). Although all 12 children show behavioral changes and some symptoms that are similar to autism, the study claimed that they did not prove an association between the measles, mumps, and rubella vaccination and autism. They also state that if there is a causal link between measles, mumps, and rubella vaccination and autism, a higher rate of autism could be expected since the introduction of the vaccine in the UK in 1988. However, they state that there isn’t enough data to prove that there was a rising incidence of autism. The paper concludes by stating that further investigation is needed to examine the syndrome and its possible relation to the vaccine.

Knowing that fears about the vaccine-autism claim would spread in the US, the CDC acted quickly and commissioned the Institute ofMedicine to convene a safety review panel in 2000. The panel was unable to find a causal relationship between the measles, mumps, and rubella vaccine and autism. They also carried out further research on the safety of the mercury-containing preservative thimerosal, which is used in the vaccine. Similarly, the Institute of Medicine couldn’t find enough evidence to accept or reject a relationship between thimerosal and autism (Gross, 2009). In 2003, TheCDC also released its findings on vaccine safety based on a study of 140,00children which concluded that there was no relationship between thimerosal and autism. By 2004, after reviewing hundreds of studies investigating a link between vaccines and autism, the Institute of Medicine unanimously announced init’s final report that there was no causal relationship between the measles, mumps, and rubella vaccines and thimerosal or autism.

Surprisingly, this evidence didn’t calm the tide of disbelief, but only gave rise to anti-vaccine activists who claimed that theInstitute of Medicine was riddled with conflict-of-interest agendas that brushed aside a generation of children. Notwithstanding all of the evidence, one in four Americans still believes that vaccines cause autism (Gross, 2009). Because of this lack of trust in vaccinations, the US saw the largest outbreak of measles in 2008, a disease that was declared eliminated in 2000, due to decreased rates of vaccinations (Ratzan, 2010). A mumps and whooping cough also made a comeback. By 2007, over 5,000 parents of children with autism had sued for compensation. One particular case in November of 2007 solidified the belief that vaccines cause autism. The Department of Health and Human Services acknowledged that vaccines had aggravated a preexisting disorder in a baby girl, which caused “regressive encephalopathy with features of autism spectrum disorder” (Gross, 2009, p. 4). Activists went on to report that this was a breakthrough in showing that vaccines cause autism and several media outlets gave the story unnecessary attention.

The impact of the vaccine-autism incidence has fueled anti-vaccine theories, and even today parents are afraid of vaccinating their children. In a letter to parents, Raff (2014) calls out anti-vaccine activists, “They say that vaccines aren't that effective at preventing disease. But 3 million children's lives are saved every year by vaccination, and 2 million die every year from vaccine-preventable illnesses”(Raff, 2014). Raff also addresses the fact that the MMR vaccine doesn’t cause autism, and that thimerosal doesn’t cause autism either, in fact, it hasn’t been used in most vaccines since 2001. Raff encourages parents to educate themselves on the issue and to read the scientific studies that have proved that vaccines don't cause autism. The letter also points to the fact that Wakefield’s paper that claimed a link between vaccines and autism has been withdrawn and his medical licenses revoked. It is clear that public health education campaigns have not been effective in dispelling parent’s concerns that vaccines cause autism.

The study that linked the MMR vaccine to autism received extensive coverage from the media. Due to such widespread coverage, the public concluded that there must be some truth to the claims that the vaccine caused autism. Parents became unsure if vaccines were safe and confusion on who to believe abounded. When the media tried to provide balanced coverage of the debate reported on both sides of the issue, it gives credibility to both positions. We learn quickly that once the public’s mind is made up, it’s hard to change it. Clements and Ratzan (2002) suggest that the blame does not necessarily lie with the press itself, but in the process by which it works by giving huge incentives to create scandals or scares. They also suggest that the media can be an extremely useful tool if used correctly for health education and promotion (Clements & Ratzan, 2002).

The World Health Organization (2008) lists several benefits of vaccinations. Firstly, eradication is a primary goal of all immunization programs; however, only smallpox has been eradicated to date. Eradication requires high levels of population immunity all over the world for a prolonged period of time. The World Health Organization reports that the next disease targeted for eradication is polio (Andre, Booy, Bock, Clemens, Datta, John, Lee& Lolekha, 2008). Secondly, elimination of a disease locally is possible without the eradication of a disease worldwide. In order for elimination to occur immunization of 95% of the population must occur through a two-dose vaccination program. The World Health Organization claims that mumps and measles can be eliminated by use of the MMR vaccine (Andre, et al., 2008). National programs help in the elimination and eradication of diseases. However, local elimination does not remove the possibility of reintroduction. Thirdly, vaccines protect individuals from mortality if administered before exposure to disease. The World Health Organization states that vaccines prevent almost 6million deaths worldwide annually (Andre, et al., 2008). They also claim that the US, there has been a decrease in incidence by 99% for nine diseases which vaccines have been commonly recommended. Fourthly, another benefit of the use of vaccines is the protection of the unvaccinated population. A reduction in disease among unimmunized individuals in the community is called “herd protection”. This occurs when a large enough proportion of a group is immune, and it reduces the spread of the infectious agent. Furthermore, immunization also serves as cancer protection. For example, chronic hepatitis B leads to liver cancer, and immunization against such illnesses can prevent associated cancer. Additionally, immunization provides health-care and other savings for society. Preventing mortality and morbidity increases long-term cost savings and potential growth. The World Health Organization states that the savings from vaccines in 2003 were estimated to be around tens of billions of dollars in savings. They also report that Malaria costs Africa about $100 billion worth of lost annual gross domestic product. Added savings are seen when combination vaccines are used. Finally, vaccines can increase life expectancy by protecting against diseases. “Elderly individuals given influenza vaccine in the USA had approximately 20% less chance of suffering cardiovascular and cerebrovascular disease and 50% lower risk of mortality from all causes compared to their unvaccinated counterparts” (Andre, et al., 2008).

Based on all the above-stated benefits of vaccination, along with the scientific research that demonstrated the health and safety of immunizations, one would seem silly not to choose to vaccinate themselves and their children. If there is so much concern about the unproven harm of vaccinations and their alleged link to autism, there should be much more hype surrounding the proven benefits of vaccinations. Unfortunately, a majority of the public is not educated on the topic of vaccinations, and consequently, they listen and believe what the media covers and what vocal, anti-vaccine activists profess to know. When unproven studies are publicized, such as Wakefield’svaccine-autism research, many use this as an opportunity to file lawsuits and displace their frustration. Regrettably, when further research proves the error in the initial findings, the media pays no attention to evidence that discredits false reports, and consequently, the majority of individuals continue believing that there is truth to myths such as the link between autism and vaccines.

There are enough problems and diseases in the world today to further these problems and illnesses because of ignorance. The eradication of common diseases depends on a majority, if not all, of the population to vaccinate and protect against disease. We must learn from history and trust scientific research in order to benefit as a global community.