Responding to the Anti-Vaccine Crowd
A pediatric attending recently provided a great way to respond to the anti-vaccine folks, as she responded to an ad claiming a link between rates of vaccination and and rates of autism:
Just because 2 rates have risen in the same 25 year span does not mean that either causes the other. It also doesn’t imply directionality – so one could actually argue that we give more vaccines because rates of autism are rising, if you’re going to argue by this groundless line of reasoning. Please note that there are MANY other exposures that impact children that have had equally large rises in the last 25 years:
1. Mention of sex on TV
2. Computer screen exposure
3. Mean environmental temperature
4. Number of both contraceptive and fertility methods used by parents
5. Celebrity DUIs
6. Airbrushing techniques in ads
7. Obesity rates
8. Number of websites on the internet
9. Decrease in funding for PE, music, and extracurriculars in schools
10. Decrease in legwarmers sold per capitaThere are many intelligent people really trying to learn the cause of autism as well as mechanisms of preventing this devastating disease, and there have been some promising developments. We don’t know the cause yet – that may be hard, but it is true, and also true of many phenomenon and diseases that we encounter. It is so important not to hamper these efforts by forcing their focus only in one area. We have to trust in the process of true, grounded,inquiry – making a hypothesis based on some substantive reasoning, and then working hard to test that hypothesis, and if one line of inquiry does not pan out, moving on to other possibilities. Please don’t fall prey to this line of reasoning.
I like the way she makes the point that by focusing on vaccines — something that science has really done its best to rule-out with multiple good studies — it’s preventing research and funding from going toward finding out the true cause of the rise of autism.
At the same time that the anti-vaccine crusaders focus all their might on vaccines, they ignore the reasons that we have vaccines in the first place. They have not seen (and neither have I) the scourge of widespread polio, measles, congenital rubella, or even neonatal meningitis that used to kill or maim tens of thousands of American children. Diseases that still take the lives of children in the third world — that mothers in the third world would give anything to be free of — now make a comeback because of misguided care and misguided suspicion.
The whole thing reminds me of the increased rates of HIV in the gay population, as my generation doesn’t see friends dying left and right of AIDS anymore.
What this boils down to is that autism is a subjective diagnosis based on behavior, and the “spectrum” has been widened to include stuff that would be considered mildly bizarre/inconvenient/behavioral (eg. hitting other kids for no reason) and/or in line with mild mental retardation in previous generations.
Yawn.
Of course, there are other issues, such as parental preference that their child be autistic vs. MR due to the services available for autism and the relative social acceptability of an autism diagnosis. “He’s smart, just autistic.”
My dad came out with the vaccine stuff once, and he was quickly convinced just by me saying pretty much that.
My family doctor has old quarantine cards posted in his office. I had my grandfather’s as well, which read “NO admittance, except by public health nurse, doctor or in case of death, coroner.” A little reminder of the horrors of childhood illnesses help.
In our micro class, they played a video of a baby with whooping cough, fighting to breathe. It was just AWFUL! I almost cried in class (I’m also a sucker for babies). I feel like people who think vaccines aren’t needed need to see something like that and think, what if that were my kid? Hearing it just breaks my heart.
Not only does the anti-vaccine crowd divert a lot of time, energy, and money from the search for the real cause, it’s been my experience after 12 years with 3 autistic kids that they spend SO much time on this one issue that they’re diverting resources away from actually helping to make their kids’ lives better. It’s frustrating, to say the least.
I agree that the anti-vaccine crowd peddles a lot of BS, and they are certainly wrong about the alleged connection to autism.
However, this cheesy list of straw men and the insufferably smug tone of the post does nothing to enhance the pro-science argument.
The tone of the post demonstrates the frustration at how the most inane of conspiracy theories gains wide media access at the expense of hard-working researchers. These Luddites are entitled to their own opinions, but not entitled to their own facts.
http://ap.google.com/article/ALeqM5jPIMulfcbi1seZqbdrRmkoVP20IgD8V7I5FO0
I think many people who are against giving vaccines to their children do not just blindly point at the rising rates of autism and the rising rates of vaccines and say “There!” I agree that was a straw man argument.
Many parents, like me, weigh the risks and benefits of health treatments of their children. I would assume that is the truth for most parents, actually. Yes, whooping cough and polio are awful diseases. So are autism and vaccine related deaths. What are the risks of our children in the United States acquiring such diseases? The last cases of polio in the United States were actually CAUSED by vaccines. If there are more outbreaks of measles and some end up closer to where I live, I may choose to vaccinate my children against it.
There is some evidence that it is the measles vaccine, not the thimerosal preservative, that may be linked to some types of autism.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11950955
I know this is hardly uncontroversial, but it is not Luddites, it is “hard working researchers” conducting this research. I rarely see this aspect of the discussion argued, and it is usually, again, made into a straw man argument. One in which the researchers are attacked personally, and not the science.
If my child lived in a third world country, I would want them to have the vaccines to any diseases they would be exposed to there. I am not going to give my child anti malarial medicine where I live, I am not going to vaccinate them against polio right now, and I am certainly not going to give them a chicken pox vaccine.
Here is a great analysis of the deaths (by a doctor, not a Luddite!) due to varicella before and after the vaccine, including the 10 deaths per year that are positively linked to the vaccine:
http://www.icpa4kids.org/research/articles/childhood/Chicken_Pox_Vaccine.htm
Considering less than 10% of adverse effects of vaccines are published, some parents find this information informative, also, in their risk benefit analysis:
http://www.cdc.gov/mmwr/PDF/ss/ss5201.pdf
We’re not all alarmist Luddites. Please keep the conversation more civil and give parents the benefit of the doubt. Some of us are even future doctors.
Oh, and
the incidence of shingles is definitely on the rise since the chicken pox vaccine has been introduced(edit by Graham, as the incidence of shingles is lower with the vaccine than with chicken pox infection), and herd immunity to chicken pox is actually decreased. Some of us see this argument in shades of gray, not black and white. The 2 dozen or so vaccines we are asked to give our child by the age of two should not be a sacred subject that is not open to argument.Whoops! One small correction. I had a lot of links open, and the person I linked to above is a Doctor of chiropractic, not a medical doctor, but the numbers he quotes are valid and available at the link from the VAERS I posted.
We’re all exposed to thousands of antigens by the time we’re born, and thousands more in the first month after that. 2 dozen is not a large number, and it always makes me smile, I hope not too rudely, when people bring that out as though I’m supposed to be impressed. If we were conceived in sterile tanks and brought up in bubbles, it would be different, of course.
They are two dozen medications with risks associated with their benefits and with an effect on the immune system. Some start at birth. I think it is insulting to chuckle at parents who want a part in the decision making process and see the number of vaccines to research as daunting and possibly excessive.
It sure is daunting to research the vaccines–that’s why doctors do it, and that’s why the Institute of Medicine did a review of the studies, too. I’m not chuckling. I’m pulling my hair out in frustration.