The Vexatious Anti-Vaxxers
Updated: Jun 6, 2020
“Misinformation or distrust of vaccines can be like a contagion that can spread as fast as measles.” Dr. Theresa Tam, Chief Public Health Officer of Canada
Why, you may ask, after a Germ Gem blog on the dangers of vaccine hesitancy only seven months ago does the topic need to be revisited so soon? The short answer is a vaccine against the coronavirus that causes COVID-19 is on the horizon, and it’s imperative that activists who oppose vaccines (aka anti-vaxxers) aren’t successful in impeding a key goal of the vaccine—helping the world achieve herd immunity.
The promise of a vaccine against SARS-CoV-2 being developed by late 2020 or early 2021 is good news. It is no surprise, however, that the anti-vaxxers are already geared up for a campaign against it. These anti-vaxxers have played a key role in the resurgence of measles not only in the United States but also in a number of European countries. The problem has become so serious that the World Health Organization (WHO) for the first time ever added vaccine hesitancy to the list of “Ten Threats to Global Health in 2019.” The WHO identified social media platforms as a highly effective tool whereby anti-vaxxers were spreading misinformation about vaccines. But, misinformation about vaccines is not new; it has always abounded.
Other anti-vaccination movements and vaccine hesitancy. Criticism of vaccines is as old as the founding of vaccination itself by Edward Jenner and the smallpox vaccine in 1798. Jenner’s earliest and most vocal opponents were men of the church, who believed that smallpox was a God-given fact of life and death. Any attempt to subvert the Almighty’s divine intention was blasphemy.
Vaccination was also considered bestial, because humans were being poisoned with disgusting material from an animal. Lurid reports of the dangers of vaccination appeared in medical journals and the popular press of the time. One physician claimed that vaccination could transmit bovine traits, and as shown in a copy of a print from the Anti-Vaccine Society that hangs in my home office titled The Cow Pock_ or_ the Wonderful Effects of the New Inoculation, where vaccinees are shown to have cow-like facial features.
Modern day anti-vaxxers, led by devotees of the discredited British physician, Andrew Wakefield, continue to do untold harm by their false message that measles vaccine causes autism. As was mentioned earlier, this movement has led to the disease called vaccine hesitancy. On the surface of it, the fear of side effects of any vaccine or medicine isn’t unreasonable. No vaccine or medicine is completely safe or effective. But the risk benefit analysis of measles vaccine, which has been examined carefully in numerous studies, overwhelmingly demonstrates that the benefit far outweighs its risks (and for that matter this is the case for all vaccines recommended by the WHO and the CDC). And quite simply there isn’t a shred of credible evidence that there is a risk of autism from the vaccine.
The underlying basis for the disease called vaccine hesitancy is complex. It appears that anti-vaxxers share a terrified certainty that someday the government will find a convenient excuse to enforce Orwellian degrees of control. Evidently, such fear and distrust of government isn’t uncommon, and when combined with the potency of social media in spreading misinformation, many public health experts realize they need strategies to combat what they call an infodemic. In one of many excellent articles on this topic, “Get Ready for a Vaccine Information War,” published on May 13 in the New York Times, Kevin Roose raised this troubling question: “The other night, midway through watching a clip from “Plandemic”—a documentary that went viral on social media last week, spreading baseless lies and debunked nonsense about the coronavirus to millions of Americans overnight—I had a terrifying thought: What if we get a Covid-19 vaccine and half the country refuses to take it?” This is a serious concern not only for all individuals but to entire communities that depend on herd immunity for protection of the most vulnerable.
Vaccines save lives. Unquestionably, the single most important achievement in all of medical history is the development of vaccines. Small pox, a disease that has killed more people in the world than all wars combined, was eradicated from our planet as the result of an intensive world-wide vaccination campaign.
The Center for Disease Control and Prevention (CDC) estimates that vaccines given to infants and young children over the past two decades will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths over the course of those people’s lifetimes. And the WHO estimates that vaccination against measles alone has saved 17.1 million lives since the year 2000.
Measles, the most contagious virus of all, is a prime example of why herd immunity (also called community immunity) is so important in stopping the spread of an infection. Experts suggest that at least 95% of people in a given community need to be immune to measles for protection of those who aren’t immune. As the measles vaccine is a live attenuated (weakened) virus, however, people with an immune deficiency shouldn’t be vaccinated. Instead, they are dependent for protection by a high rate of vaccination of those around them.
The precise herd immunity threshold for SARS-CoV-2 is not yet clear, but several experts suggest it would be higher than 60%. We are very far from that level of immunity that follows natural infections. Hence, we are in urgent need of an effective COVID-19 vaccine. And, anything that would discourage people from getting vaccinated once the vaccine is developed would be highly detrimental. Yet, several recent polls suggest that at least a quarter of Americans are already hesitant about getting vaccinated with such a vaccine.
Sadly, the lockdown due to COVID-19 has already negatively impacted the number of children receiving routine vaccinations due to difficulties posed by social distancing, economic hardships, etc. According to a May 22, 2020 article in Newsweek by Meghan Roos, 80 million young children are at higher risk because of missed vaccinations during coronavirus lockdowns. While this alarming development may make anti-vaxxers happy, it is disastrous for the children who need protection against the 14 pathogens that are covered by routine vaccines.
Optimistic outlook for a COVID-19 vaccine. In my May 13 Germ Gem post, “COVID-19: Where’s the Silver Lining?” highlighted an exciting National Institutes of Health (NIH)-led project, “Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV).” This unprecedented public-private partnership to develop a vaccine, announced subsequently by NIH Director Francis Collins and Paul Stoffel in the Journal of the American Medical Association on May 18, is likely to come good on its promise—to have a vaccine available if not in late 2020 then in early 2021.
Seven candidate vaccines are already in clinical trials. Results of one of the most promising and interesting vaccine candidates passed its initial safety checks last week. If successful, it would be the first vaccine that uses genetic material (mRNA) of a microbe to elicit immunity. Many other options for a vaccine are in early stages of development. At a media briefing on May 31, organized by the International Federation of Pharmaceutical Manufacturers (IFPMA), executives from AstraZeneca, GlaxoSmithKline, Johnson & Johnson, and Pfizer said they were committed to making coronavirus vaccines safe and ensuring equitable distribution. As IFPMA Director General Thomas Cueni affirmed: “The industry is all in.”
Presumably in sync with these scientific developments, on May 15 President Donald Trump announced “Operation Warp Speed” to have a vaccine available in the United States by the beginning of 2021. But for physicians and scientists the term “warp speed” triggers concern. Any medical therapy approved for public use in the absence of extensive safeguards (witness the hydrochloroquine treatment debacle promoted by President Trump in April) has the potential to cause harm not only for measures to prevent COVID-19, but also for public trust in vaccination efforts globally.
Good science requires rigor, discipline, and deliberate caution. Bad science plays right into the hands of the anti-vaxxers.
While writing this post over the past week, the city where I live and that I love, Minneapolis, Minnesota, has been suffering the worst period of turmoil and sorrow in its 143-year history. I stand with the African American community and with all of those in Minneapolis and beyond who are outraged by the senseless and brutal murder of George Floyd by a policeman. All week I’ve been thinking about the convergence of two evil forces that we are facing and that we must work together to defeat: one we can see, albeit you need an electron microscope—SARS-Co-V-2; and the other, which often goes unseen has been with us far longer, is insidious, and has killed many more people—racism.
In a May 11, 2020 article In the Journal of the American Medical Association, “COVID-19 and Racial/Ethnic Disparities,” Monica Hooper and her colleagues point out that while much attention is given to the medical and biological risk factors for more severe disease, such as, older age, cardiovascular disease, diabetes, obesity, and male sex, less attention is given to equally important risk factors called the social determinants of health. Among these factors are socioeconomic conditions (e.g., access to health care, quality of education, poverty, residential segregation, discrimination, and racism).
African Americans comprise 13% of the American population, but they account for 23% of COVID-19-related deaths. Similarly, African Americans are two-and-a-half times as likely as white Americans to be killed by police. Both SARS-CoV-2 and hate crimes target vulnerable individuals. As stated in the article by Hooper, et al, “The pandemic has shone a spotlight on health disparities and created an opportunity to address the causes underlying these inequities.” The senseless murder of George Floyd last week led to protests that continue worldwide. These protests shine a spotlight on racism and should lead to measures to prevent such senseless killings in the future. But, we must all work together if we are ever to change the system and eradicate racism.