VACCINES, AMONG URBAN LEGENDS AND COLLECTIVE PSYCHOSIS
by Alessandro Zancla, MD
An anti-vaccination philosophy has spread for long among people, supported by blogs and websites that have taken advantage of people’s fears and susceptibility. As a consequence of this, we may risk destroying the progress reached in more than two hundred years of scientific research.
This anti-vaccination attitude thrives thanks to general disinformation, a false sense of safety against infectious diseases and lack of historical memory, and it is starting to produce its results: in some areas of developed countries vaccine coverage levels risk being insufficient to guarantee adequate protection.
Maybe we forgot too quickly that not many years ago diseases such as Diphtheria, Poliomyelitis, Pertussis and Rubella were a daily hazard, and so were the deaths they would cause and the serious consequences they would leave in the survivors (mainly children).
Perhaps we physicians have some responsibility in this too. We evidently failed to reassure and inform the public proficiently, but believe me when I say it is terribly hard to speak convincingly against fears and persuasions that are stuck in the deepest irrational psychological sphere of mankind, especially when people are not willing to get informed.
Sometimes a doctor proposing a vaccination is treated like a salesman you quickly want to get rid of.
Trust me, it is not nice at all.
When a doctor proposes a vaccine to a patient he only does so because he believes that it is useful and that the risks-to-benefits ratio is favorable to the vaccination, otherwise he would not.
I think it is time to clear a few main points.
I want to deal with the main issues of this sort of “religious war” that is raging against vaccines, in the attempt to shed some light and help people think and reason things out, because it is not just the raped dignity of Medical knowledge that is at stake but also and most of all the health of our children.
Let’s start by debunking a myth: one of the antivaccinists’ points is the belief that “vaccines are only useful to Pharma Companies’ incomes”.
I am far from willing to defend Multinational Drug companies and their interests, but it is right to state things as they truly are. Undoubtedly vaccines have a cost and undoubtedly drug companies make a profit out of them. However, we must keep in mind that researching, testing and producing safe vaccines is exorbitantly expensive, so it is only fair for the companies that do this work to cover expenses and yes, earn from it, since they are not charities and they pay tens of thousands of salaries.
Moreover, these “evil” pharma companies are the same ones that produce the drugs necessary to treat non-vaccinated children when they get sick from a disease they should have been protected from. So from a merely profit-making point of view, it is very likely that drug companies earn more from selling drugs to treat 10 children who get sick and have complications, than from 1000 vaccines.
One more thought on this: what about companies that produce all sorts of baby products from diapers to powder milk or baby food? They clearly make profits out of it, but this does not seem to shock antivaccinists.
One of the worst paradoxes in this debate is the anxiety and suspiciousness some parents have about the safety of vaccines.
Vaccines are very safe drugs, at least as safe as many other drugs we use and give to our children everyday. However, they are still drugs. This means they have precise indications, administration means and, as all medicines do, contraindications and side effects.
Antivaccinists say they want 100% safe vaccines, but this is simply impossible and quite provocative to ask.
Of course, it would be nice to have perfect drugs with no side effects or risk of adverse reactions, as it would be nice to be totally sure that a surgical operation will save a patient’s life or that an antibiotic drug will manage to cure an otherwise deadly infection.
Maybe one day we will get to that, but at the moment, we have to work with what we have. This obviously does not mean we should throw all our medical knowledge in the bin just because it is not perfect.
By the way, in case it was not clear yet, Biology and Medicine are not exact sciences. They are not like Maths; they are complex and very variable worlds where lots of different parameters contribute to determining the final result. Physicians trust the science behind their procedures, the latest studies and guidelines as well as their experience, but at the end of the day there will always be a margin of uncertainty, however small.
Vaccines and Autism
A lot has been said about the presumed (or better, legendary) link between vaccines in early age and some developmental and neuropsychiatric disorders. In particular, the debate about the link between vaccines and autism arose years ago, suggested by an English physician in a scientific paper. His research was later dismissed as false and based on altered data; later it also emerged that the doctor had received money from lawyers involved in lawsuits on presumed vaccine adverse reactions. After the “researcher” confessed having published misleading information, the paper was retracted and he was disbarred from the medical registry, but the damage was already done.
From then on it was like fighting an unstoppable flow of rumors and legends.
The international scientific community responded with great effort: a large number of studies and publications worldwide repeatedly reached the following conclusion:
TO DATE THERE IS NO SCIENTIFIC EVIDENCE THAT MAY INDICATE ANY VACCINE AS THE CAUSE FOR AUTISM
Years of research carried out in various institutes worldwide have compared the incidence of autism among vaccinated children with the one among non-vaccinated children, and absolutely no difference emerged.
However, antivaccinists promptly responded to this by asking: why don’t scientists demonstrate that vaccines do not cause autism?
The answer is simple: because it does not work that way.
First of all, we must confess we know little about autism, we still do not understand what mechanisms are at the source of this disease; though we know for sure that genetics plays an important role in the predisposition for and/or in the onset of it.
Then we should specify that this type of correlation studies must be carried out following a rigorous logic based on a comparison between two groups, which have to be homogeneous for any other variable that is not tested. If the two groups do not show any difference in the investigated factor, you cannot go further with your study: it would be like trying to demonstrate that drinking water does not cause multiple sclerosis, or hair loss, or aging, for that matter.
If we start overturning scientific evidence and methods we enter a loop of pure madness.
No research has ever been conducted to demonstrate that oxygen does not cause STDs, so would it be reasonable to think that breathing is the cause?
All men with prostate cancer have a nose, and since no paper was ever published demonstrating that having a nose is not the cause of prostate cancer, would it be conceivable to start a study to demonstrate it?
I hope these analogies make my point.
In my opinion of Medical Doctor, I believe that not getting your child vaccinated because you fear it could cause autism would have the same rational scientific sense of going to a shaman to cure cancer.
One last thing to say on the vaccine-autism topic: most of the times the “indicted” vaccine is the MMR (Measles – Mumps – Rubella).
Antivaccinists claim that this vaccine is the cause of autism since many cases have been diagnosed shortly after the administration of the MMR dose.
Autism is a disease that affects the psycho-emotional and relational abilities of the subject; there are not any specific organ dysfunctions. Thus the disease may only manifest itself when the child reaches the period of development in which he starts to relate and interact with others and the world in a more conscious and autonomous way. This process begins roughly after the first year of age and may casually overlap with the recommended administering period of MMR (between 12 and 15 months).
Another big point of the antivaccinists’ case is based on the fact that vaccines are not natural products and that it would be wrong to interfere with the body through artificial means.
However, this “naturalistic” philosophy is applied in a rather incoherent way: also TV, defibrillators, cars, life-saving drugs and ambulances are artificial and “non-natural”, but antivaccinists do not seem to be against being rescued and resuscitated if their heart should “naturally” go into arrest.
Some parents believe vaccines simply are not useful because they think children should make up their own antibodies by “playing on the floor”. No one ever denied the importance of immune autonomy in children; we do not want them to develop all antibodies through vaccines, only those which natural production involves high risks of death and/or complications and/or permanent damage.
It takes a very high percentage of vaccine coverage in a population (95%), in order for it to be protected from an infectious disease: only this way the pathogen cannot circulate. There may be some sporadic cases of infection, but epidemics will be avoided.
Importantly the immunity of this population can also protect those who cannot be vaccinated (because of health issues), those that still haven’t taken the dose and those that have been vaccinated but haven’t produced antibodies (so-called “non-responders”).
This is why this issue involves us all, even those that receive vaccinations.
“Many” means right, or not?
Antivaccinists often say: “if so many people believe vaccines are harmful, it must be true!”
Although luckily, at present, people against vaccines are a minority, they are already causing serious concerns and actual damage. The principle “we’re more, so we’re right” makes no sense.
Judging the worthiness of an idea based on how many people believe it to be right is not simply wrong; it is actually dangerous in this case.
I believe we should consider the training and professional background of those that speak out on a subject, like scientists or Medical Doctors, while the majority of those against vaccines does not have a medical or scientific education whatsoever.
Often times when a general practitioner attempts to explain something about a vaccine he gets dismissed with the following sentence: “It is my child and I do as I like!”
Obviously, the final decision is up to the parents and that is how it should be, but don’t forget that this does not mean you can do whatever you want with your child just because you think you have an idea of what you are doing: children are not property, they are a responsibility.
Being a parent is complicated and sometimes choosing what is best for your child is a very hard task, especially when it comes to such a delicate matter as health. But that is what doctors, hospitals and healthcare systems are for.
Media and public information
Mass and social media tend to highlight the opinions of antivaccinists probably because this makes more share and resonance.
Modern medicine is based on data, experimental method, and scientific evidence, but it gets abused on a daily basis when it is compared to legends, personal opinions and gossip. All of this is dangerous and has to stop now.
People who graduated from “the College of Life”, who got their residency at the “Club Bar” or their PhD at the “Facebook Institute”, feel they can go on TV, or on social media and spread falsehood of all kind, without being competent in that matter.
If you go on TV you must be aware of the tremendous responsibility you have. If you talk about something more serious than what your favorite color is, you must say a little more than your simple opinion (which anyway as such should be presented), especially if you are speaking about complex issues regarding scientific, medical or engineering topics.
Although freedom of expression is a very important right, we should have clear in mind that having the right to express yourself does not mean having the right to give lessons on topics you are not qualified on.
It would be like inviting David Copperfield at an astrophysics congress in which Stephen Hawking is the wallflower while the magician explains his “theories” on black holes.
In conclusion, I am disappointed to realize that we live in a society characterized by exaggerated sensationalism and emotivism at the expenses of honest reason.
I am not angry at those who have doubts or are worried, but at those who lead an a priori, deaf, blind and narrow-minded battle.
Anti-medicine has been fighting fiercely while official medicine has not understood the problem in time and failed to put in place adequate countermeasures.
And every so often a child dies from a disease he should have been vaccinated for.
The topics described here have been simplified both because some are too complex for a blog article and also because I believe that Web in healthcare should be more of an extra than a substitute for the trusty relationship with your doctor.
Besides, if it takes a degree to be a physician, maybe there is a reason after all.
Alessandro Zancla graduated from Medical School at the University of Rome “Tor Vergta” and is now a Public Health Residency Trainee at the University of L’Aquila – Italy